Does abuse towards Support Workers really exist?

Miryam Clough documents her experiences of dealing with aggressive residents, and how more support would benefit the problem.

It's 8.30am.

Only an hour into my shift, and already I’ve been hit, kicked, spat at and had a glass of juice thrown over me.

What have I done to deserve this?

Attempted to encourage a lady with dementia, currently wearing nothing but a vest, to return to her room from a busy corridor and put some clothes on.

Although it is not often described in these terms, managing abuse and aggression is part and parcel of working in dementia care.

Along with the kicking, hitting and spitting, over the years I’ve been bitten, scratched, pinched, nearly had my fingers broken, hit repeatedly round the head with a large book, threatened with a heavy wooden chair, chased, and had some very scary altercations with more than one angry naked man who was covered in poo.

Compared to staff working in acute mental health wards, and with some of my immediate colleagues who have sustained injuries, I’ve come off lightly.

Mostly, the ‘challenging behaviour’ I’ve encountered has been from frail elderly women, who can certainly hurt and insult, but are generally not frightening. At times, I’ve had to deal with men who are bigger and physically stronger than me, and whose aggressive behaviour and unpredictability has been scary and challenging.

As care-workers, we put ourselves in the way of aggression to protect other vulnerable clients.

At times, we could deal with situations more effectively and perhaps pre-empt aggressive behaviour. Often, our ability to do this depends on experience, on our relationship with the client, on our energy levels, our stress levels, on how many shifts we have just worked, whether everything is alright at home, on how supported we feel by our colleagues and managers.

Quite often, aggression accompanies much needed personal care when we are making decisions that we hope are in the best interests of our clients; to keep them clean, comfortable and safe.

Additional support would benefit carers

Abuse of care-workers is not, to my knowledge, given much attention. Certainly, it was not discussed in the training I've received, or by managers.

My experience is that, while emphasis is placed on documenting such behaviours, support for care-workers who have been injured, or to deal with violent and abusive clients is sadly lacking, to the detriment of support-workers and the clients themselves.

Additionally, there is often reluctance, on the part of staff at all levels, to acknowledge that aggressive behaviour from clients is abuse or assault because we attribute it to the dementia rather than to the individual.

Although compassionate, it allows staff to burn out and situations to escalate, resulting at times, in the need for more drastic intervention.

An open discussion about the realities of care-worker abuse and support for care-workers who deal with clients who assault them is overdue, and would arguably, benefit both care-workers and their clients.

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