Understanding Powerlessness
As we navigate through our daily care routines we sometimes experience residents reacting in unexpected ways that can be confusing. That confusion calls for curiosity on our part. We can ask ourselves, and them, what could be the underlying reason for declining care — “No, I don’t need a shower!”
The Emotional Impact of Needing Care
A loved one who needs assistance for daily activities may feel helpless, anxious, and/or depressed. These feelings of powerlessness can be profound and create barriers to many aspects of care. This can include medication assistance, bathing and grooming, and participation in social activities. How can we help reduce these feelings of powerlessness and create a sense of strength and belonging?
Building Confidence Through Tools and Preparation
Our approach means so much! And developing a variety of tools in our caregiver tool kit can give us the confidence we need to create a positive experience with care. When I say “tools” I mean several things. Of course this includes the right equipment: an over tub shower bench with a grab bar in the correct spot and a fluffy towel to sit on. OR if safety is the priority— bed bath supplies and techniques that clean and moisturize beautifully without the need for a trip to the shower.
The right equipment and tools can be determined by better minds than mine like Occupational Therapists. It can’t hurt to ask the primary care doc for a visiting home health team to step in when needed. Also — Check out Bathing Without a Battle for effective ways to approach baths/showers: Bathing without a Battle
Caregiving Skills That Make a Difference
The most important tools are the essential caregiving skills that help us meet whatever challenges come our way. These skills require some finesse of sorts. A gentle but firm touch to the hip can give the right cue to move when necessary for care to be comfortable and successful. Or staging for a successful shower by preheating the bathroom, testing the water temperature, setting up fluffy towels, and applying aromatherapy soaps and lotions for a spa day experience. Add some music by playing a favorite song on your phone. (I tell “Alexa” to play Spa music and have been known to sing You Are My Sunshine on the walk over to the bathroom.)
From “Doing To” to “Partnering With”
But how can we help with feelings of powerlessness? Answer: Change our own perspective from “doing to” the person in need of care to “partnering” with them. Teepa Snow OT is the mastermind behind this approach. We have been putting her techniques into practice for over 10 years — because they work.
A Real-Life Example: Allie’s Story
Here is an example (with names and details altered): Mrs. A likes to be called by her nickname Allie. She has arthritis and wakes up with pain and severe stiffness all over. She remembers living in her town and is familiar with the faces of her family and caregivers but is not able to recall their names. Each morning comes with some anxiety of what is happening next and it takes at least an hour to feel alert after breakfast and coffee. Her eyes look wide and bewildered and she has difficulty finding her words. Each time her bi-weekly morning shower is scheduled she “refuses.” I put quotes around “refuses” because that is what we as caregivers say in our reports. Is it really a refusal? As her care partners we asked what she doesn’t like about showers and then adjusted our schedule and approach, with her input.
What We Discovered Through Listening
Here is what we discovered.
Number 1: the early morning time is the worst for her. She needs time to wake up and for the prescribed acetaminophen to take effect for her arthritis pain. And so we adjusted her shower time to late morning after breakfast and 30 minutes to an hour after taking acetaminophen for pain. Number 2: it’s cold in the morning so she doesn’t like getting undressed for the shower. She is also confused because she thought she just had a shower yesterday. We started preheating the bathroom and using a large towel heated in the dryer for a few minutes for her to use as a wrap around her upper body while we start the shower at her feet. By printing her “shampoo and hair styling” schedule she can keep it with her bedside calendar to lessen her confusion. Number 3: We call her by her preferred nickname “Allie” and introduce ourselves with our names as a friendly reminder of who we are and that we are happy to assist her with her shampoo and spa time.
Partnering to meet care needs is empowering for both parties. We can ease feelings of powerlessness by listening to concerns and respecting those concerns with flexibility in our caregiving schedules and attitudes.
The Power of Gratitude and Positive Reinforcement
Making positive statements during care also increases feelings of wellbeing. Sometimes I give a “high five” after care and say “thank you for working with me, I really appreciated your help during the shower.” Communicating sincere gratitude creates an overall feeling of satisfaction for both the loved one and caregiver.
When Things Don’t Go as Planned
All of this said still may not make it any easier. Sometimes we fail. And that is OK. Maybe the shower didn’t happen in time for a special outing or visitor, and so we dig into our tool kit a little deeper. We pull out all the stops on a head to toe sponge bath with no-rinse shampoo, luxurious body lotion, a quick blow dry, then put on a colorful scarf and her favorite lipstick. We may not have accomplished a shower but she is glowing and feeling great about herself. High five!
Related articles about powerlessness:
Feeling Powerless? Here’s How To Take Action