In this blog I want to discuss the role of the mental health patient, their carer and any staff of Nottinghamshire Healthcare Foundation Trust.
They will be called:
The patient. The carer. The clinician.
Please note that the term clinician may be a different person each time. The patient is taken care of at various times and places by the carer and the clinician.
Who should the patient care for?
They should take care of themselves as the first option. Often of course, they do not take care of themselves. It would solve many problems if they did especially for the carer and also the clinician and of course for themselves.
The patient should also take care of the carer.
This is part of the very emotional relationship between carer and patient. The carer/patient relationship can be challenging and this situation would be described and understood better by a patient and their carer. However I will have a try!
The patient is often dependent on the carer but sometimes finds that very irksome and restrictive. The patient also can feel guilty about the physical and emotional strain they put on the carer. They do not want to be a burden. The patient is often more distressed by making the carer suffer.
Whilst the carer though loving the patient can feel anger at having their lives taken up by caring, this gives guilty feelings too. Often carers are angry with the illness and also with the clinicians for failing to find a cure.
Question: Should the patient help the clinician? (Discuss). I feel they should. When someone offers help either in friendship, physical care, advice or medication they should be helped and respected. However, the patient does not always want to be helped and may believe the treatment they are being offered is unhelpful. This can create conflict and distress to both.
But what happens when the carer joins this pairing? Do they side with patient or the clinician?
The Carer frequently lacks information from either person to decide. They end up with a double conflict of duty to the patient or their faith in the skills of the clinician.
All parties end up distressed and frustrated.
My proposal to improve the problems discussed in this blog is to increase communication and to encourage more of it; actually lots of it!
Communication between patient and carer I see as being very important with the same emphasis on carer and clinician whilst balancing this with the vital communication between patient and clinician.
The clinician may believe that the carer knows how to treat and take care of the patient. The clinician may believe that the patient knows how to treat and take care of the carer.
This is often not the case.
I believe a clinician should help and advise the carer in how to care for the patient.
I also believe a clinician should offer support and advise the patient how to care for the carer. (Discuss)
So often, the patient and carer don’t know whether to have faith in the clinician. Sometimes they get different perspectives from different clinicians.
Friendly, informal meetings should be the norm between patient, carer and clinician. They should all agree to discuss how to treat each other, how to care for each other and of course discuss the medical care together. Friendly communication can resolve a lot of problems.
Do not underestimate the power of the spoken word. Use it frequently and well.
Michael Osborne is a service user and volunteer with years of experience as a well respected member and champion of involvement within our NHS Trust. Michael is generous with his time and always listens to others who may need support, often putting others needs before his own.
Michael is a passionate and keen advocate of open dialogue and invites you to a discussion. Please share and comment on his blog article.
Hi Michael,
Welcome to the Blogosphere.
I enjoyed reading your blog…. a very thoughtful study of the relationships between the various people & roles involved in care.
There’s one word I want to throw into the mix: Mutuality. This concept is strongly embedded in the principles of Peer Support, but in practice seems very hard to achieve.
I don’t know if it’s organisational culture or human nature, but there always seems to be a tendency towards imbalance in therapeutic relationships.
The imbalances can be about who has power and who doesn’t, or about one person being more recovered than another, or about who gets paid for their contribution and who has to freely give.
We need more progress in this area, and for this to happen I think we need a greater spread of the genuine principles of Peer Support.
Nice to read your Voice !
Paul.
Paul. You are right and I agree. I did overlook mutuality and also the power balance and inequality in roles. It may have been a subconscious act as it would have taken me into deeper realms and made a longer blog. Perhaps something for you or others to take further.
I did also overlook the Peer Support workers which was serious and I should have brought them into play.
I would like to hear some thoughts on power of all parties because all have some power but the Clinicians have got the power base and deemed authority perhaps also an educational authority. It would be interesting thoughts on the power of the patient (which may be the power of getting well we hope at some stage) and the power of the Carer which is always being discussed (often in groups) in with the Clinical power. Also the power structure between patient and carers. Also if we introduce Peer Support workers and their power into the equation for all parties a whole new field for discussion opens. Whole areas for further blogs. Thank you Paul for introducing these thoughts. Michael.
Comment posted on behalf of Gladys Bombek.
Hi Michael,
You are a lot better (I can tell).
I agree with your blog, as I feel as though I should be helping my carer, who works full time and suffers with Rheumatoid Arthritis. I’m always worried about her being out of action.
Gladys.