Thursday 14 January 2016

What's in a word - personal care

Yesterday I shared examples of miscommunication that arise when making assumptions that people have a common understanding about the words we use - in the example yesterday the words were supplier management, and in workshops I often use the word chocolate! (Follow the links for more explanation).

Over Christmas and the New Year whilst my dad was in hospital in England for 2 weeks I had reason to observe the opportunity for miscommunication that hides in the language of the NHS.

Sick vs vomit
It started fairly innocently with my dad describing that he'd 'been sick'. The Dr then seemed to spend an inordinate amount of time trying to get my dad to say 'vomit'. It may be he was testing my dad's mental faculties, but it did seem to me to be a test of whether my dad could use the correct medical term for what he was experiencing!

Bad hip vs bad back 
Again an innocent difference of opinion on whether dad's pain was coming from his back or his hip. The more the Dr used the word 'back' the more agitated my dad got - how simple for someone to explain to dad that sciatic pain starts in the back and passes over the hip and that they weren't in fact talking about a different pain, and had listened to what we was saying the first time!

Social services vs the individual services provided
Then it got a little more difficult. My dad was told that after discharge 'Social Services' were coming to visit, and took that to mean they were coming to undertake an assessment of what help he might need to support his personal care. In fact they meant they were sending out an occupational therapist just to see if he needed any aides to support him.

A number of us are old enough to remember when the use of Social Services did mean a whole raft of services. Today they offer a fraction of those services. More clarity at the hospital about the services being offered would have significantly reduced the angst for us all when he got home!

Personal care - washing vs washing the essentials  
and then it gets really difficult! Personal care is a term used to describe a number of services available via Social Services that help people live independently at home here in the UK. Services might include:
  • Washing
  • Dressing
  • Preparation of meals
  • Getting up in a morning
  • Going to bed at night
  • Going to the toilet etc
Which on the face of it are seemingly useful activities - until you scratch bellow the surface.

What would you think the minimum requirement would be for someone to be able to wash themselves? That is what's the minimum cleanliness you'd think was acceptable. Last week I got a shock to realise 'washing' in the context of a Social Services assessment meant:    
  • Can they stand or sit in-front of the wash basin, and clean the essentials themselves
What personal care doesn't mean is - can they:
  • Wash their hair 
  • Wash their back
  • Get into a shower
  • Wash the non essentials
Which puts a whole different spin on 'personal care' in the community. I understand in many care homes 'washing' means 'having a shower once a week', but that's better than it being OK that someone can wash the essentials only, and it being acceptable that they do not require any help to do otherwise! (Postscript - from twitter exchanges on publication of this post it would seem that many in care homes do not have showers or baths and do in fact wash or are washed in-front of the washbasin. 11 months without a shower was one quote given :-( )

Which reminds me too much of my many rants about the inhumane way we treat each other.

Next time you make an assumption about what a word means - do check you have common understanding with others who are using it.

Alison Smith
Inspiring Change Inside and Out (more here on why that's important)

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