Supporting a Vulnerable Client as an SEN Nanny

2 June 2020

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Supporting a vulnerable parent as an SEN Nanny

A mainstream nanny will often have sole charge of the child or children and will provide all aspects of childcare, acting in loco parentis in the parents’ absence.

In other roles, a nanny may work alongside a parent, sharing the childcare. Within this role, the nanny may have periods of sole charge, for example while a parent works elsewhere in the house.

The role of an SEN or SEND nanny, where the child has a disability or additional needs, will fall into one of these two categories, but they have additional responsibilities to carry out therapies, rehabilitation and/or attend to more complex medical needs such as tube feeding or medication administration.

Within these two roles, the parents will pass a level of responsibility for their child’s well-being to the nanny. The nanny will be expected to care for the child under their guidelines and standards but will use their initiative and creativity which adds their own influence.

There is however another role which can also be defined as an SEN nanny, where the nanny supports a vulnerable client to parent a mainstream child, or children. Such clients include those with a brain injury or learning disability.

The emphasis in this role is completely different, it is not just looking after the child, but enabling and empowering the parent to do so, whilst ensuring the safety, well-being, and happiness of the child.

Supporting a vulnerable parent goes beyond simply teaching parent skills. It is understanding how to weave in good childcare practices into the daily routine, explaining why one approach might be more practical or the better option, in a way that is neither patronising nor ‘point scoring’. It is about knowing when to step back and enable the parent to take control and when to intervene; and the best way to do that.

Each vulnerable client will have their own learning style and ability to process and retain information. The SEN nanny needs to clearly understand these complexities to work with the client and help them be the best parent they can be.

Personal preferences of the nanny should play no part in the client’s decision making unless the client’s choices are going to negatively impact on the child.

 

Case Study: “Getting Sarah Dressed”

‘Julie’ is 30 years old. She has an acquired brain injury following a road traffic accident 4 years ago. Her brain injury has left her with impaired executive function, chronic fatigue, and epilepsy, which is only partially controlled with medication. Julie has a 6-year-old daughter ‘Sarah’ who was 2 at the time of her mother’s accident. Sarah spent a great deal of time away from Julie while she was in hospital and then a rehabilitation facility.

Julie has now been home full-time for 8 months and wishes to look after Sarah. Her daughter has been cared for by her paternal grandparents during the week while her husband, ‘Thomas’, works full-time. An SEN nanny, ‘Carla’ is recruited to support Julie to look after her daughter.

Each morning Julie is keen to choose her daughter’s clothes for the day, she loves to dress her in pretty dresses or brightly coloured jumpers or tops. Sarah is happy for her mum to do this and enjoys this time together.

It seems a relatively simple task, but Carla worked for several weeks with Julie to prepare and agree the best way to approach the task. Julie can overestimate her ability to retain information and misjudge her energy levels. This can lead Julie to become frustrated, upset and angry if she is unable to do the task.

Carla and Julie worked to producing a written checklist, which looked like this:

  • Select Sarah’s clothes the day before, with Carla’s help
    (Carla organised a small selection of appropriate clothes for Julie to choose from, Julie found it difficult to make a choice if there were too many options)
  • Have own breakfast before starting to help Sarah get dressed, Carla to help Sarah with her breakfast.
    (Julie suffers from chronic fatigue, just getting herself up, having breakfast and getting dressed can be exhausting. Julie can be very impulsive and would want to rush to do the activity straight away).  
  • Ask Carla to check the clothes are suitable before putting on
    (If the weather or planned activity unexpectedly changed, Julie found it confusing to re-think which set of clothes were now suitable).
  • Put nightdress under Sarah’s pillow
  • Watch Sarah brush her hair and put in a ponytail (Julie found it difficult to let Sarah do things herself, she still thought of her as a much younger child)


Sarah enjoyed spending the time with her mum, but also wanted Carla nearby. Julie did not always find it easy to relate to Sarah whose mood could change unexpectedly. She had been apart from her mum for extended periods after the accident and needed to rebuild their mother-daughter relationship. Sarah was also fearful of Julie’s seizures which could be severe and look distressing.

One day, Julie selected clothes that did not go together, clashing colours and styles. Julie and Sarah loved the outfit. Carla said nothing, the clothes were appropriate for the weather and the planned activity, and this was Julie’s choice to make.

The above is a short example of the requirements required for just one task. Throughout the day, Carla had to take into consideration many needs, some very subtle to ensure she always enabled Sarah to be as much of a parent as possible.

Goals were discussed, broken down into manageable tasks. These tasks often had to be adapted to suit Sarah’s health, energy levels, or mood on any given day.

The role of an SEN nanny supporting a vulnerable client to parent is complex and requires sensitivity, empathy and the ability to understand how the parent’s brain injury or disability affects their ability to parent, and creatively work together to get the best outcome while ensuring the child’s safety and well-being.

When these considerations are taken into account, it is one of the most rewarding jobs you can do. 

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