Caregiving for Adults with Mental Illness: How to Diffuse Tension
Working with people who have intellectual disabilities or behavioral issues can be challenging, Daisy Williams takes steps to minimize stressors in the lives of those she cares for. She has been a direct care professional who provides care for individuals who live in Casmir Care’s Community Residential homes for eight years and counting.
Her work involves direct caregiving. The individuals she works with have cerebral palsy, intellectual disabilities, schizophrenia and/or bipolar disorder. She helps them with activities of daily living such as eating, bathing, dressing, continence and instrumental activities of daily living such as cooking, caring for pets, completing housework, and using the phone.
When caring for individuals in Casmir Care Services’ Community Residential Homes, she has noticed that sometimes what people watch on television can set them off. Someone who is fully bipolar, schizophrenic, or both, may think everything happening on “Jerry Springer” is about them. They may react to what they see by saying, “I don’t have no gun,” Daisy said.
(Residential Associate Daisy Williams demonstrates the “soft face” she uses to calm residents down.)
“So, you have to be really careful about what you put on the television,” she said, so that they don’t get all worked up. Sometimes something said on TV triggers something in their memory. Then they will react to it by becoming sad or violent or having an outburst. “And you have to know them to be able to understand what just happened to them, so you can diffuse it,” she said.
She recommends not letting these people watch “Criminal Minds,” some news programs, talk shows, or “Court TV,” because it can set off the voices they hear inside their heads. Shows with built-in conflict don’t help, because it can get them worked up.
When individuals in care are accidentally exposed to things that trigger them, Daisy’s standard procedure is to proceed with caution. “The most important thing I do is stay calm and do not speak until I’m sure that they’re ready to be approached,” she said.
If you come close to them, but don’t understand where they’re at in their head, she said, the individual might act out. And you might be attacked.
Instead, it’s safer to not move and carefully assess the situation.
“And you try to look in their eyes softly,” she said. Make your eyes soft so that you can melt their heart, she advised. “Then they’ll open back up to you,” she said. “But you have to be able to do that.”
When pressed for more details, she said to put on a soft face with puppy dog eyes. You might say something like: “I feel your pain. Tell me what you need. I wish I could make it go away.” Watch the person’s body language. Once they relax, perhaps unballing fists and you see the tension drop away from the person’s body, it will be easier to approach the individual. Then you can rub an arm or shoulder and say, “That was then. We’re here for you.”
If a resident is having problems that day, Daisy tries to ease them into working toward having a better day tomorrow. The idea is to keep them focused on what’s ahead and the good things in their life as opposed to whatever they were complaining about. She might bring up something fun they did in the past, like going to Dave & Buster’s, and suggest doing it again. The mental redirect gives them something else to think about, she explained.
Those under care trust Daisy to understand their needs, she said. “I’m not a disciplinarian caretaker,” she said. “I’m more of a mom caretaker.”
As director of operations here at Casmir Care Services, I know that Daisy has a great sense of intuition that helps her manage our individuals’ needs with ease. Her antennae are always out, trying to a get a read on how they are feeling. She has the patience, flexibility, compassion, and empathy required to deal with the individuals we support. She has demonstrated this consistently over the years and with a cross-section of the individuals we support. Our individuals are lucky to have her help them through their days.
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