Identifying your limits

The is the second extract from Starting Social Work: Reflections of a Newly Qualified Social Worker by Rebecca Joy Novell. Here she reflects upon a day she spent shadowing a mental health social worker early in her course.

My final visit was to Bernard, a 70-year-old man living in his own home. Bernard had been diagnosed with Parkinson’s Disease Dementia a few months previous. Bernard was an inspiration. In his youth he had travelled the world. He’d lived in India, Australia and Paris. He’d fallen in love with the girl of his dreams, married her and lived happily ever after until her death ten years earlier. While he had never had children, he had worked as a professor of philosophy and his intelligence shone through. Everything he said was worth saying and worth hearing.

Bernard was at a heart-breaking stage of life where he had all his faculties, and was astute and alert enough to be fully aware that all of that was going to fade away as the years progressed. For me, the cruellest aspect of dementia is when you are aware that you are ill and aware that it will get worse. I find some peace in those dementia sufferers who are so badly affected that they don’t know that they are not experiencing reality. Watching Bernard and listening to everything he had done and everything he knew, I felt as if I was talking to a dying man. Even though his physical health could remain excellent for the next 30 years, his mental ability would be gone long before then.

Liz’s job was to make sure that the support would already be in place for Bernard when things started to get really bad. As Bernard was a widower he had selected two younger friends to be his carers. Bernard received a personalised budget and was using that to pay his friends to check on him twice a day, do his shopping and other basic tasks. It was a great comfort to Bernard to have people he knew caring for him, rather than a stranger. Pride is a common feature among people I have met from the war generation. Bernard wanted his carers to know him as the fiercely intelligent and independent man he was, and to act accordingly and appropriately when his capability decreased.

It was comforting to know that Bernard was able to avoid a care home, which, in his own words, he described as being completely unsuitable for someone as intolerant of others as me. He was visibly content with the support he was receiving from Liz. He had few queries for her and instead spent half an hour showing a genuine interest in me and my social work journey. Liz and Bernard clearly had a great professional relationship, and as we vacated Bernard’s house I was left with an incredibly positive feeling. My day may have had a rocky start, but it had a great finish.

My day in Mental Health Services was definitely a memorable one. It taught me a lot of lessons about the importance of early intervention to prevent crises and to prevent people from being placed in residential care settings. It also showed me the value of personalisation. Liz knew each one of her service users as an individual and treated them as such. As a result they felt listened to and important.

I learned just how little I knew about mental health, particularly dementia. Until I met Liz, Bernard and Elsie, I had no idea that dementia was an umbrella term for a wide range of diseases which affect the brain. I realised how little I knew about the law concerning mental health, and how important it is to ensure that people’s legal rights are maintained when they become incapable of defending themselves. Overall, I learned that mental health is nothing to be scared of. My previous associations with mental health were of depressing, chaotic lives with unhappy endings. My day with Liz had shown me that does not have to be the case. Did it make me want to be a mental health social worker? No. But it has made me a better children’s social worker. Mental ill-health is unavoidable in social work, regardless of your specialism. I dread to think what an awful practitioner I would be today if I still held the negative perception that I had started with. By pushing myself to the limits I was able to firmly identify what my limits were. Identifying your limits is, as I would continue to learn, a key skill to becoming a successful social worker.

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