Linda and Greg Crowhurst March 2018

If you are care for someone, who is at high risk of deterioration in any moment from the slightest wrong intervention, for example someone with Severe/Very Severe Myalgic Encephalomyelitis, the MOMENT APPROACH is a structured way to:


It is key to providing high quality care:


This means creating a physical environment where there is maximum possibility for a positive and helpful interaction, Ease of access and comfort for the person are paramount. Anything practical that is required for care, needs to be in the best place to help the person.

The caring environment, however, is something additional, it brings a wider perspective, in that it is about the approach of the Carer. It is not necessarily concerned with doing things, though this may be required. It is more about knowledge and presence, awareness, attitude and intention.

The Carer is required to know what needs doing and how to best approach and help the person. Any preparation for this needs attention.

Your presence is of the utmost importance:

  • all you say and do
  • how you are feeling in yourself
  • your energy level
  • what you are conveying through your posture toward the other person
  • your values and attitudes

These are all key to interacting well with anyone, but especially so, with someone who is in high physical pain and may have a range of tormenting, unremitting and very severe symptoms.

It is important you know that the slightest wrong movement, noise or action, on your part, may lead to even worsening levels of symptom experience and physical distress. It is a very skilled approach.

Every nuance, every breath, every movement counts and can bring relief or negatively impact the person.


When you consider caring as an opportunity to engage with and make a difference in the person’s life, it is an exciting opportunity:

  • Every single MOMENT can be a moment of possibility and hope.
  • Each MOMENT can be experienced positively or negatively.
  •  Each MOMENT can flow with the next one or change direction, good or bad.

A good thing to remember, is that even if you cannot help the person, in one moment, there is always the OPPORTUNITY in the very next one or in another one, later on, when things may be a bit easier for the person to tolerate your presence, get their need met or interact, have a moment of connection that brings meaning and comfort, an easement or a success.

Even if you get something wrong in one moment, there is still an opportunity for getting it right, even getting it better than before.

Even if the person is in utter agony and unable to tolerate your help or presence in the room, still, there may be an opportunity in a future moment when pain may be coped with better, when reaching out beyond the experience to feel your presence positively, just may be an option. Or simply a moment where the person feels stronger to bear the interaction.

Or you may, incredibly, be able to help the person do something that they have had to wait for months, even years, to achieve.

Opportunity is a wonderful word to hold on to. Always remember opportunity, especially if you are not feeling so good, if you got something wrong or just not good enough or if the way is just incredibly tortuous and hard for the person and every interaction is always agony beyond imagining.

You are the opportunity for change, for goodness, for tenderness, for care of the highest standard. This is to be celebrated!


Every act of caring is a meeting.

You interact with the person, even if you do not notice this so much. You may be preoccupied with the task or simply unaware of yourself or on automatic pilot.

To care for someone in extreme need means that you need to develop an awareness of this meeting point and how you meet the need required in any MOMENT. Every MOMENT counts!

How you meet the MOMENT makes all the difference!

You need to learn to notice whether you are meeting need well or not. With someone in an acutely hypersensitive state, in intractable pain, at risk of instant deterioration, you need to learn to focus on meeting the need to the best of your ability, every time!

 It may sound a tough demand, yet that really is required, because if you do not manage to see the person and meet the person, to see their need, to see them as a person, not a task in themselves, you will miss a great opportunity to meet the need beautifully, tenderly, kindly, well; to make such a difference in the quality of the person’s life.

This means becoming aware:

  • of your voice
  • your conversation
  • your practical skills
  • how the person is receiving your help
  • whether you have to be even quieter, gentler, more careful or simply try again later.

Non-verbal communication says much more than words and needs noticing. How you communicate with the person, what signals you give out, are incredibly important , you are to MEET together and flow in the MOMENT.


This may seem like a tiny word, but EACH action and interaction is important, relevant, of value, significant. Every single action needs to be noticed, focussed upon, attended to. It is no good getting just one thing right, if everything else is not attended to equally. EACH THING IS EQUALLY IMPORTANT!

Remember this and make a commitment to notice EACH thing that you do and consider it as equally important even if it seems mundane and boring to you.

 The life of the person that you are helping is not like your own. The simplest action, performed well, can make an unimaginable difference if you focus on the quality of care you provide EACH moment, EACH Day, EACH year.....


The need of anyone with highly complex care needs is massive. Every single thing matters to them. They are totally relying on you to meet their need. It may feel like at tall order, a hard path, but when you give high quality care and you actually meet the need gently, tenderly, kindly, compassionately, sensitively, you cannot imagine the impact or the gratitude.

NEED exists on multiple levels. Meeting NEED is no easy task. The slightest wrong thing can ruin the whole day for the person or increase the burden of suffering intensely.

So make sure you absolutely focus on the person, not just yourself and that you understand the need and what is required of you to meet it, practically as well as emotionally and mentally.


THIS IS THE MOST IMPORTANT REQUIREMENT OF THE MOMENT APPROACH. Tenderness is the way that you approach caring. It is the way that you see each need. It is the way that you realise that you have a profound opportunity to make a major difference in the person’s life - for the better.

Aim to approach both yourself and the person you are helping with the same tenderness. If you get it wrong, remember you can do it better in the next moment and do not be overly harsh on yourself. It is not easy, it is emotionally and physically demanding, but it is important!

Always approach caring tenderly, with tenderness of attitude and action, tenderness of thought and approach. It is what makes the difference between an average interaction that will be unlikely to barely meet the need adequately and a deep connection and sense of connection and achievement.

MOMENTS of tenderly meeting need flexibly, with awareness and sensitivity is your aim; then you will understand how important the MOMENT APPROACH is to caring.


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