2.1 What kinds of relationships are involved in the practice of relational care?
Relational care involves multiple interconnected relationships. Click on the hotspots in the interactive below to see how each type of relationship interacts with and supports another.
Very broadly the practice of relational care prioritises building and sustaining an environment comprising at least three different kinds of multidirectional, interconnected relationships, namely:
- relationships within the care setting: between staff and residents, between staff, and between residents. When reference is made to ‘staff’ this includes all staff involved, i.e. not only those who are in caring roles but also, for example, cleaners and maintenance staff (denoted by circle A)
- between the care setting and the wider community and locality, including families, volunteers and other organisations (denoted by circle B)
- between everyone living, working in, and visiting the care setting and the physical and natural environment within and around the setting (denoted by circle C).
Where these three kinds of interrelationships are attended to, people, spaces and objects dynamically come together and interact, facilitating multidirectional relationships and flows of care (Gopinath et al., 2023a).
Reflecting on the care setting you work in, you will explore the presence and relevance of the interrelationships identified above in the following activity.
Activity 4 Thinking about where you work
Spend a few minutes thinking about the following questions and make a note of your thoughts in the text boxes below.
- a.Which of the relationships described in Interactive 1 can you identify in the care setting you work in?
Discussion
You may have recognised the presence of several of the important relationships as outlined in Interactive 1 in the care setting where you work, including relationships between the physical environment and people.
- b.Why might these relationships be important and for whom?
Discussion
- Positive staff–resident relationships are critical to everyone’s quality of life, shaping how comfortably residents and staff can settle into a new environment; increasing opportunities to experience good care; and allowing residents to participate and contribute flexibly to their own care and the daily life of the community.
- Staff-care manager relationships and relationships between staff members matter for the wellbeing of staff and managers, and by extension, for the delivery of good care. Working conditions not only affect recruitment, retention and continuity of staff but also influence whether staff are encouraged and supported to spend time building and maintaining relationships with residents.
- Relationships between the care home and the wider community enable residents and relatives to maintain continuity in their relationships and family life, and in daily activities (e.g. going shopping, visiting the local pub, or going to clubs where they may have been members). These relationships also support socialising where families cannot visit often (e.g. with volunteers). Furthermore, welcoming the wider community into the care setting (e.g. in form of interactions with school children, organising sales and open garden events, inviting gardening or crafting help) helps to break down stereotypes, change perceptions about people living and working in care settings, and encourages learning about them to help reduce anxiety and smooth transitions when moves to day or residential care are needed.
- In addition to residents’ relationships with significant others, acknowledging and supporting their relationships with other residents, and valued objects is seen as vital to upholding a sense of autonomy, as an expression of a valued identity, and to participating in meaningful activities.
- An accessible and welcoming physical and natural environment can play a huge role in facilitating these different kinds of relationships. This can be through private spaces to which staff can retreat during breaks; overnight accommodation for relatives; room layouts which encourage communal interaction as well as allow residents to enjoy peace and quiet, and access to outdoor spaces. An overall atmosphere of ‘home’ rather than a clinical or ‘hotel’ vibe is very important.
- c.Who do you think should be responsible for initiating and maintaining these relationships?
Discussion
On a day-to-day basis, the responsibility for initiating and maintaining relationships with older people and their families may lie primarily with the care staff and possibly volunteers. However, creating an environment and culture that encourages staff to foreground and centre relationships in their day-to-day work requires active support from managers and from care providers.
A care setting that nurtures relationships (as identified in Interactive 1) can favour and sustain human flourishing and build resilience. In the next section you will explore how these core relationships can be developed and sustained in practice.