Differences between family and professional carers

The majority of research about violent and abusive behaviour towards carers investigates the experiences of professional carers working in nursing homes and psychiatric secure services.  These studies tend to explore how and why violent and aggressive behaviour is more common amongst people with a diagnosis of mental health and cognitive impairment problems. It also looks at what the impact of ‘challenging behaviour’ has on staff members and what can be done to reduce the likelihood and frequency of it occurring.  This research has helped develop understanding about how to communicate better with people in times of distress and how to anticipate and recognise signs of potential aggression and violence.

 

We suggest that this research is useful in some ways in developing understanding about harmful behaviour towards family carers.  We also think that it is reasonable to suggest that there are important differences between situations of professional and family caring.  In families, it may be important to think about more significant and more complicated types of psychological and emotional harm.  Communication and trust are important aspects of family and intimate relationships.  When they are absent or unpredictable, this can have a significant impact on how family members respond to one another and how they feel about themselves. In this way, the threat or memory of violence or abuse can have a long-term and damaging effect in a way that is unlikely to occur in hospital and nursing homes.  In these environments, caring is shared between different people and there is no long-term or emotional relationship between carers and people with health needs.  The intimacy and intensity of the caring and family relationship changes what it means to hurt or to harm someone.  More subtle and ‘hard-to-see’ types of harm can have just as significant an impact as verbal and physical aggression.  In the context of family care, it may be useful to consider harm in a broad way and not focus too specifically on acts of observable violence and abuse.  It may also be useful to consider the immediate and the long-term impact of harmful patterns of behaviour on people needing and providing care.

 

Taken together, these issues raise questions about the limitations of transferring lessons from research about professional caring to understand the particular experiences and needs of family carers.  Until we know more about harmful behaviour in family situations it is difficult to compare and to contrast it with situations of professional caring.  We hope that this project will contribute towards this aim.