Understanding the Moment Approach
Linda and Greg Crowhurst
My wife, Linda, is unimaginably ill; I mean that. After all these years I just cannot imagine the agony she is in, when a thing like moving my thumb, or moving, speaking without thinking, is enough to utterly destroy her.
The Moment Approach is not just some theory to me. Worked out over twenty five years of caring, it is a framework that I hold onto every day, literally like a drowning man - especially, when things are beyond tough.
Without it I might despair.
I tell you, brothers and sisters, by now the Moment Approach is deeply ingrained into my very soul; this is NOT head stuff!
Consciously reminding myself of it, I find I am able to find a way through the most complicated and demanding situations, incredibly, in a gentle, kind, aware, loving, focused way.
That may not sound that much on paper, but an approach like this, rooted in deep, life-bringing values, is profoundly healing, uplifting and liberating!
So yes, the Moment Approach is vital in our life.
I have never read anything else comparable to it. The literature is full of advice on Pacing etc, but you only need to spend a split nano-second or so in our environment, to know how inappropriate and useless, techniques like Pacing are for someone with Severe/Very Severe ME.
Here you need to know how to :
NEED of the person
The first consideration is the environment - and especially the role of you, the carer, in it:
Means creating a physical environment where there is the maximum possibility for a positive and helpful interaction. The worse mistakes I make are not thinking the basics through- safety and security. Don't go rattling cups, for example.
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 wider, caring, environment is about the approach of the Carer, this is about knowledge and presence, awareness, attitude and intention. If I am not focused, if I am distracted, impatient, I am going to mess up; that's a just a fact- and make a nightmare situation much, much worse.
Your presence is of the utmost importance:
1.All you say and do
2.How you are feeling in yourself
3.Your energy level
4.What you are conveying through your posture toward the other person
5.Your values and attitudes
These are all key to interacting well with anyone, but especially so with someone who is in high physical pain with a range of tormenting, unremitting, very severe symptoms.
It is important that you know how the slightest wrong movement, noise or action, on your part, may lead to even worsening levels of symptom experience and physical distress. You cannot afford to not be ultra aware of the potential to do harm..
Every nuance, every breath, every movement counts and can bring relief or negatively impact the person.
Sometimes there is very little or nothing you can do, in the moment, to help, things are that bad. You don't give up, though, for in Severe/Very Severe ME opportunity is an ongoing, not a static process.
When you consider caring as an opportunity to engage with and make a difference in the person’s life, it is an exciting opportunity:
1.Every single MOMENT can be a moment of possibility and hope.
2.Each MOMENT can be experienced positively or negatively.
3.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:
a/. tolerate your presence
b/.get their need met or interact
c/.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 is 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 there may be 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 get something wrong or just not good enough or if the way is 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.
Caring for someone this ill, however, all the time you need be noticing if you are helping or hindering.
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:
1.Of your voice
2.Your conversation
3.Your practical skills
4.How the person is receiving your help
5.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, if you are to MEET together and flow in the MOMENT.
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.....
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, focused upon, attended to. It is no good getting just one thing right, if everything else is not attended to equally.
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, as it may do.
It may feel like at tall order, a hard path, but when you give high quality care and you actually meet the person's need gently, tenderly, kindly, compassionately, sensitively, you cannot imagine the impact or the gratitude.
The need of anyone with hugely 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.
Aim to approach both yourself and the person you are helping with 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!
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.
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.
And that is everything!
Stonebird 2018


Popular posts from this blog

Linda's response to the BMJ

The psychiatric abuse of Children with ME

We Remember: A poem for 8th August, Severe ME Understanding and Remembrance Day