Not doing enough

 

It can be very difficult especially in the early days of being a Social Worker to realise that no matter what you offer or do for someone it may still not be enough. The longer you are in the role the more you learn ways to come to terms with it or manage your own feelings on the subject. It is definitely still not easy.

We come into Social Work initially to help people or when we very first apply we think we are coming in to save them. We are coming to make everything better, to swoop in and fix everything. This is definitely not the case. I have sat on panels interviewing for Social Work students to get on the course at my local higher education university and these are the types of things that you hear people say. That and the word vulnerable quite a lot which is an entirely other topic that I have also written a blog about.

As I mentioned in a previous blog I am now classed as an experienced Social Worker so that has meant that I get allocated more complex cases including safeguarding ones. This has meant this feeling is coming up more often now and that is something that encourages me to think back to early days and what coping strategies I used to get through. I need to remember that I have a right to switch off at the end of the day or for the weekend and not feel guilty that I am not available. I find that when I am working on something I find particularly difficult it can impact my sleep and I have to work out how to mitigate this.

We have a few different types of cases come up where I know I have felt this way. It can either be some of the higher levels cases such as safeguarding ones where you can offer someone all the support that is available to them but if they do not want to accept it then you cannot force them. It comes down to whether they have capacity and if they do then it is their choice to make, whether I agree or not.

Other cases such as severe carer strain, when someone needs a lot of support but the people who are providing it are really struggling but they do not want to have other people or carers coming into their house and helping them. In some instances it is because they do not believe they have care and support needs. In most cases like this they are deemed to lack capacity around their care and support needs so options can be explored in their best interests. It becomes much trickier when the person you are supporting has capacity and refuses all support because although I am allocated to them and will offer them everything that could potentially improve the situation they do not necessarily see what is wrong because all their needs are being met by those closest to them. They may know that those people are struggling but feel so uncomfortable with the idea of having someone else take over that they just cannot accept that support. This can cause a lot of tension especially if more than one person is providing the day to day support.

The third scenario I have come across is where someone would probably benefit from social opportunities such as day centres or groups but are so reluctant to go to them. From my experience in this type of situation the carer could usually do with a break too. So although this would help all parties involved it is not necessarily something that the person who is being supported would want to engage with and this can make the situation harder.

I think the thing that can be difficult is that we support so many people with Dementia so we see the deterioration and the strain it puts on both the person and the carers. Although we work with a lot of people with Dementia everyone is so different and the way it impacts them is different too. There are also so many different levels to it that although people can make assumptions a lot of the time about the ability levels of someone with Dementia it does not always match up with where they are currently at. Thinking back to other blogs I have written regarding the assumption that can be made or comments that are said by families who do not have an understanding of the Mental Capacity Act and that people who have a specific diagnosis do not just automatically lack capacity. I was in training recently regarding Young Onset Dementia where there was a discussion with a person living with it who talked about how difficult it can be when you first get diagnosed and potentially referred into Social Services because in the early days you can still do all the practical tasks for yourself, get out and about, potentially work and manage a household but you have just been told something that is a major change in your life and there is not really anyone to speak to about it.

People do not know as much about Young Onset Dementia or necessarily realise this is something that exists and how it impacts those with it. When speaking with none-social workers about Dementia the automatic assumption is that it is a disease for Older People as that is what people are aware of. Same as most other diseases there are levels to it and it does not discriminate based on age. It impacts people differently when they are younger, both in the way it presents but also in the impact it has on their lives. A lot of people are retiring older now so it could be highly likely that someone getting a diagnosis of not just Young Onset Dementia but also any other form could still be working, could potentially be the breadwinner for the family or contribute equally. This then creates a situation where someone needs support but not for what we would usually provide and that leaves a gap in terms of what is available.

I have worked with people with other degenerative diseases previously such as Motor Neurone Disease and that was a situation where the person was not very old as this was before we were an older people's team and I could see this person deteriorating every time I visited. I could see them losing abilities but also grieving for what was lost. They would become quite upset when talking about what support they needed next because they could no longer do something for themselves. It is very similar in a way to the people we work with who have Dementia because it is a terminal diagnosis. It takes away abilities, just in a different way to Dementia. Dementia takes it away by changes in the brain and loss of abilities that way whereas for something like Motor Neurone the physical abilities disappear but the brain still knows what is happening and what they want to say long after the ability to speak has gone.