Caring Skills and Techniques

Observation

Involves collecting information about clients by taking measurements such as temperature and blood pressure, or by weighing them

Also refers to noticing how a person is behaving – for example, whether they are eating or sleeping as usual or whether something has changed

In everyday life, observation tends to be selective. This means we tend to focus on things that interest us.

As a care worker we have focus on all aspects of the client’s measurements and behaviours in order to understand their needs

Social Perception

This means being aware of a person’s likely feelings, needs and intentions.

These factors can be shown by facial expression, posture and tone of voice as well as by what is said

Perceptions can accurate and inaccurate and we must be aware of making assumptions that are wrong

Working Alongside

This means working in contact with a client either by doing what they are doing or by working on an activity in order to encourage them to join in

This is useful in situations in which clients might not like to be approached directly, e.g. clients in a residential home who suffer from dementia may not recognise a carer and may respond better if they can see the carer doing the same thing rather than the carer telling them what to do

It is also useful when carers need to be seen more as equals and less of a threat, e.g. a parent may not like to get advice directly from a nursery teacher but sitting in with a teacher playing with the child will help them to see how they themselves may play with their children

Modelling

This means observing and imitating the behaviour of another person.

Practitioners can help clients to learn new, more effective ways of behaving by acting as models

Rather than telling someone how to behave, the practitioner demonstrates appropriate behaviour and encourages the client to copy this

An example of modelling may be to greet clients with a warm smile and a cheerful ‘good morning’ when entering a room. Clients may eventually greet you in the same way

Setting Challenges

This means suggesting tasks or activities to clients that will stimulate them and perhaps help them to improve their abilities, skills or confidence

People recovering from disabling illness and injuries can progress if they are set a sequence of achievable physical challenges that gradually become more demanding

Children can also benefit from challenges, e.g. a child who can easily complete a jigsaw puzzle could be asked to complete it without looking at the picture on the box or with the pieces picture side down

Communication

Communication does not just mean talking to someone

It includes:- Good listening- Allowing people to ask questions and giving

answers- Using writing and reading- Non-verbal communication

As a skill used by a care worker, communication means more than typical everyday conversation

Communicating with clients is how care workers can assess the needs of the clients and provide life quality factors

Encouraging adaptive behaviours

Adaptive behaviour is behaviour that tends to increase the well being of a client

Encouraging adaptive behaviour means reinforcing behaviour that increases health and well-being

Maladaptive behaviour tends to harm a client, either directly or by making other people become hostile to the client

Examples of maladaptive behaviour include:- Aggression- Dishonesty- Self-harm- Excessive use of drugs (including alcohol

and smoking)- Care workers should try to avoid rewarding

maladaptive behaviours and concentrate on encouraging more adaptive ones

Showing approval

This means giving positive responses to the behaviour of a client, e.g. smiling or praise or even a cuddle if appropriate

Physical contact

Physical contact can be used to comfort a client who is anxious or upset, as well as to show approval

Touching a client’s hand or arm, or putting an arm around someone’s back can be very reassuring and provides emotional security

A direct look with a smile and a touch will also show that you approve of a situation

Touching someone with whom you are unfamiliar is inappropriate, e.g. someone from a different culture or a person who might consider a touch as a sexual advance

A care worker learns when to resist using touch until he or she is sure that it will not be misinterpreted

Creating Trust

This means acting in such a way that a client is likely to judge the care to be reliable

In order to be reliable behaviour needs to be consistent, i.e. behave in a similar way in similar situations

Reliable behaviour also involves following correct procedures and keeping promises

Gaining compliance

This means getting the client to do what is required and is an important skill in a care setting

Examples of situations where care workers need to gain compliance include:

- A GP trying to get a patient to stop smoking- A nursery worker trying to get children to wash their

hands- A radiographer trying to get a patient to keep still for

an X-Ray

A care worker should not use an authoritarian approach to order a client to do or not do something, nor should a practitioner coerce or threaten a client

Remember that choice is an essential life quality factor and client should be allowed to choose whether to comply or not

If a practitioner has created a trusting relationship with the client then it is usual for the client to comply

Clients’ will be more willing to comply if they understand why the practitioner wants them to behave in a certain way, so using good communication skills is important, e.g. ‘I would like to take a blood sample from you to test for infection (or diabetes etc.)’

Distraction

This technique is most often applied to help the management of temporary pain and/or anxiety

Distraction is a way of making people focus on something other than the pain or anxiety, e.g. waving a cuddly toy at an infant who is receiving an injection

Clients can be taught self-distraction techniques to help them cope with pain, e.g. women in antenatal classes are told to say a nursery rhyme to themselves when the pain begins. Having to concentrate on remembering the words lessons the concentration on the pain

Reducing negative feelings and beliefs

Negative feelings include anxiety, sadness and anger and can result in the client behaving in negative ways, such as being apathetic, self-harming, destructive or hostile

These feelings and behaviours might be the result of ill health, difficult circumstances or the personality of the client

Care workers may be able to help reduce negative feelings and behaviours by the way they respond to the client

Care workers should not respond negatively to a client. If a client becomes hostile, responding aggressively by shouting back is unlikely to diffuse the situation

In conflict situations, it is sometimes a good idea to withdraw from the client temporarily

A care worker should remain calm which will help to calm a panicking client

Showing a client respect and approval can also increase the client’s self esteem which in turn will allow him or her to feel or behave in a less negative way

Never promise action you cannot fulfil in order to reduce tension in a situation as this will lead to a lack of trust and an increase in negative feelings or behaviour

As a care worker you need to try and reduce the ‘emotional temperature’ of a situation

Disengagement

This means temporarily withdrawing from contact with a client

As described earlier this can be useful when a client is displaying negative behaviours such as hostility or aggression

Disengagement does not mean withdrawing in a hostile way, e.g. walking out slamming the door behind you. It is more sensible to withdraw calmly perhaps explaining why you are withdrawing

Eye contact and facial expression

Eye contact is an important part of using effective communication skills

Eye contact can help to establish trust between care workers and clients

Facial expressions are also important in communication. A smile tends to produce a positive response from clients

Using positive eye contact and facial expressions can also help gain compliance from a client

The use of eye contact is not always appropriate. If a client feels threatened, e.g. if they are feeling angry or guilty about something they may interpret eye contact as being accusatory and/or hostile

15 caring skills & techniques

Observation Social perception Working alongside Modelling Setting challenges Communication Encouraging adaptive

behaviours Physical contact

Showing approval Creating trust Gaining compliance Distraction Reducing negative

feelings and behaviours Disengagement Using eye contact and

facial expressions