The Psychological and Spiritual Needs of the Care Provider
The 'Carer Care' or ABC Model
The two of us (9,10) advocate a 'carer care' or 'A x B x C' model of care in which the emotional and spiritual needs of the carer for support (C) must be factored in to the caring process to energise the primary relationship between the carer (A) and the recipient of care (B). In common sense terms this means that care can only be as good as the mental state of the carer and the mental state of the carer depends in turn on the support and nutrition of the working environment.
All of us when in need of care have the right to encounter a care provider whose mind is in a receptive and energised state to attend to our needs. However, these emotional resources for care are not usually prioritised in any traditional list of health care competencies. Whilst there are stringent codes of conduct for care professionals set both by their professional and employing organisations, there are no similarly enshrined written codes relating to the quality of support that care providers themselves are entitled to if they are to avoid losing the energy to care through overwhelming stress, compassion fatigue and burn-out. This is in some ways strange given the unarguably high levels of stress, burn-out, sickness and absence that we find in the public care sector. For example, staff ill health costs ?45m per annum in the social care sector alone (10).
Health care is seen primarily as a fixed skill or competence rather than as a dynamic process that requires emotional and spiritual nutrition and there is a mind-blindness to the needs of the caring mind. Indeed, whenever the well-being of care providers is written about, it is usually only in terms of self-care, indicating a belief that professional care workers are expected to dig deep within and find yet more energy to self-care on top of caring for their clients and patients.
We argue that emphasising only self-care in those who are already caring for others is missing the point in terms of generating the mental and spiritual energy that is required for care and compassion. Human beings cannot simply create their own spiritual energy from a vacuum. They need nurturing relationships with other people and outside sources so that their own energy can be constantly replenished. For this to happen, the needs of care-givers have to be recognised and the working environment has to be designed to meet those needs.