Why are angry customers on the rise?

To begin, social stress has increased over the last two to three years due to the pandemic and the general life upheaval we’ve all experienced as a result. Many of us carry a hidden or underlying ticking stress bomb. When we reach a certain point of pressure, we could go off at the slightest provocation. I’m sure we can relate to those seasons in our life where we’ve had to be strong and resilient. Perhaps we didn’t even realise how much we had bottled up, until a situation or person inadvertently flicked a switch and we exploded. It can be just as much a shock to us as it is to those around us when this happens.

It’s obvious that this social stress increase is correlated with the dramatic spike in customer abuse in recent years. In particular, the increase in angry customers seems to belong to an aggressive behaviour category we call the expressive. 

The expressive aggressive is an emotional outburst. Think of it like a volcanic eruption, or a phrase we sometimes use, ‘they’ve gone nuclear’. So it’s always overt. It’s an outward aggression with outbursts and rants that seek to attack and shoot down its targets. It can be quite intimidating when someone launches at you in this way; it’s very dramatic and theatrical.

This hasn’t been isolated to a particular industry, but instead has been experienced across the entire service sector, from retail and health to corporate products and services. It’s caused enormous amounts of stress for frontline staff who’ve been inundated with these behaviours as people attempt to access services. None of this reasoning excuses aggression, of course. However, it can certainly help us understand why there’s been such a spike.

How to respond to the expressive aggressive customer type

The good news is the expressive aggressor is an easier customer aggression type to address. Let’s have a look at how we do that.

1. The expressive needs to be heard. As this type is primarily triggered by stress and pent-up emotion, the emotion needs to be released. Trying to redirect the behaviour too early will only end up creating further blow-ups. Instead, focus on helping them feel heard and validated. Listening is like releasing the pressure valve on their anger.
2. Use the Ferber method. This is a popular method for sleep training with children, famously used for comedic purpose in the ‘Meet The Fockers’ movie. It’s essentially based around letting the child cry for permitted amounts of time before giving them reassurance. This is designed to teach them to calm themselves down and fall asleep, or as this method calls it, ‘self-soothe’. Applied to an angry customer, you allow space for them to rant. Then, rather than attempting to control their emotion, seek to understand and ask questions to direct the conversation. This helps them to vent and start to self-soothe. You’re supporting their need to release emotions and get them away from that heightened state and into a calm state.
3. Acknowledge their issue. It’s only when customers move into a calm state that we can direct them positively. Acknowledge their issue and emotion before providing direction or a solution. This communicates to them that they’ve been heard, and they’re more likely to listen to you as a result. Once they’ve reached this state, it’s not uncommon for the expressive to apologise or say something like, “Look, I’m really sorry. I know it’s not your fault. You’re just doing your job.” 

Throughout this process, it’s important to remember they’re not usually aggressive people. It’s a stress response and they are simply having an emotional reaction to a situation.

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So, if it’s widely accepted that customer service can make or break a brand, that also explains how company behaviour when dealing with complaints and angry customers has got a massive impact on how that brand is perceived.

Why do customers get angry, and why is this an issue?

Despite millions of dollars being spent on customer service, a good deal of interactions with customer support still leave people feeling angry, frustrated, and dissatisfied. Particularly now, with the explosive nature and impact of social media, it’s never been easier for customers to share their experiences and reviews with a large audience. A recent example of this was a customer who spent $1,000 on X (formerly known as Twitter) advertising to express his anger over his father’s lost luggage with British Airways after the company didn’t respond to his original complaint after two days. This generated thousands of impressions on X alone, then went viral on other social media platforms, and was even picked up by the traditional media. Even then, it took the airline another 24 hours to respond. Pretty terrible.

You may be wondering, why do customers get so angry? Well, it’s not always the issue that drives the anger, but the perception of the issue. Most of us would agree that managing customer anger is about managing the perception of the issue, which helps diffuse the customer’s emotions and behaviour, particularly if you’re face to face. Easier said than done, right? But at the core of perception is always the belief of how we are being treated and respected through the process.

How companies inadvertently create angry customers 

Many companies have rigid policies that inadvertently create disrespect. For example, consider the disrespect for customers’ time through being put on hold. They’re manoeuvred through multiple customer support departments, trying desperately to get to someone who can actually help you get a solution, only to find that they get put on hold again. It’s all very frustrating. This loss of power and dignity is doubly insulting when our public message is that our customers are the priority, but our actions transmit the message that we couldn’t care less. There are countless examples of poorly managed and avoidable incidents where companies come across as impolite, sarcastic, rude, and dismissive.

Another common issue we see in some organisations we serve is customer’s beginning- and end-state experience being very different. When the customer is looking into a product or service, sales coaxes them in with social proof of a customer-centric culture where the customer is valued. They set the bar high and create high expectations. This is a great example of sales doing their job well, and there’s nothing inherently wrong with this. The problem arises if the product, service, or support available (i.e. the back-end) doesn’t meet these sold expectations. 

We all know what it’s like to buy into a product or service, only to have an issue crop up that requires resolution by a support team member. What should be a straightforward process becomes a nightmare as you’re put on hold for elongated periods of time. Or the modern equivalent, get stuck chatting to an automated bot or virtual assistant trying to get through to a real person. This leaves you feeling disempowered, unheard, unseen, and angry.

We want to avoid this type of situation at all costs.

How to defuse and respond to angry customers

Respect is the cornerstone of building trust. To be received as genuine, this respect needs to be driven and represented through the organisation at all levels. Less than 4% of customers will actually let you know they’re angry, and 91% will never return. So it’s critical that organisations work to understand the source of angry customers’ frustration and use those insights as opportunities for improvement. To that end, here are five fast and focused tips to deal with angry customers.

1. Empathy before direction. Establish your customer’s value and importance. Then listen to their needs before you give them directions. Even though your priority is to fix and solve, their priority is to feel that you care and respect them first.
2. Ask before telling. One way to do this is to respond by asking questions, versus trying to explain and defend against your customer’s attacks and accusations.
3. Positive acknowledgement. Always respond using positive acknowledgement phrases. For example, “I appreciate it’s frustrating” or “I understand it can be very confusing when you get conflicting messages on how to resolve this.” Well-placed apologies can be useful too. Your customer just wants to feel validated.
4. Establish a calm state before attempting to solve the issue. Wait until the customer displays signs that they’re starting to calm down and come off the ledge before you start working on the resolution.
5. Ask for feedback. Get an update on your customer’s status, how they’re tracking, and express gratitude and appreciation to them. You never know what you’ll learn when you take the time to listen. Their piece of feedback may lead you to revolutionise your product or take your service to new heights. 

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Of course, the two can work together. Bad service can lead to bad experience, and service is about the logistics of how a product is provided. But experience needs some thought and design to get right, because it’s all about customer impact.

So what are the hidden costs to an organisation when they don’t get that experience strategy right? In this article, we’ll list the seven deadly hidden costs of poor customer experience, alongside a five point checklist of simple things you can do to improve customer experience.

1. Poor experience leads to brand damage

Cost number one: poor experience leads to brand damage. This is about the hidden cost of damage to your brand when there is a poor or ineffective customer experience strategy in place. Approximately 87% of customers rely on Google reviews, with a four-star review being the minimum rating for most people to engage with a product or service. Did you know that it takes approximately 40 good reviews to remove one bad one? Forrester reporting surveyed over 200 enterprise brands and more than 1,000 customers recently and found that businesses underestimate how often customers have poor experiences by an average of 38%.

So this really begs the question: do you have a customer service strategy or do you have a customer experience strategy?

The increase of angry customers recently has also become problematic, with many organisations overwhelmed with complaints and frustrated customers, which affects these ratings dramatically. Did you know that 73% of customers point to experience as an important factor in their purchasing decisions, whereas companies that prioritise better customer experiences has dropped to just 10%?

Prioritising experience sets you apart from the competition and sets you up for success with your customers.

2. Poor experience impacts staff retention

Increased stress on the staff creates retention risk, and you can lose your talent very quickly when that happens. Recent research points to service businesses experiencing increased staff quitting due to the hostility of angry customers. This links staff retention and poor customer experience and reveals the negative and personal impact to people serving on the frontline.

Attrition rates, high customer service roles, and losing experienced staff is costly. It’s also not that easy to find skilled customer service staff who can represent your brand and organisation in a way that becomes an integral part of creating that positive experience for customers. Creating better working conditions and prioritising customer experience may help counteract this risk.

3. Poor experience increases costs of retraining staff

This follows on from the previous point. If staff turnover is high, and you’re constantly recruiting and training, it becomes a large expense. This cost would be better redirected into an effective retention and nurturing strategy for existing staff.

We can all think of at least one company with an incredibly bad staff support culture that’s created a revolving door of staff joining and then leaving soon after. Not investing and nurturing your staff is a false economy, which affects your bottom line and immediately impacts customer experience when there is low morale amongst employees.

4. Misunderstanding customer impact touchpoints can create poor experience

Not understanding or empathising with customer touchpoints can lead to blind siding or poor customer experiences.

A classic example of this is when you’re put on hold for a long time, trying to get through to customer service on the phone. Some organisations work really hard at reducing this timeframe and may use positive acknowledgement messages, or offer a ‘hold your place in the queue, and we’ll call you back’ strategy, to create customer empathy. However, other organisations seem completely insensitive to wait times, and this is a major frustration for their customers. This is a classic result of focusing on a convenient, effective delivery mechanism (read: service), versus designing a better customer experience strategy.

How many customers does an organisation lose through frustrating access times with a lack of care attitude? How many people can they impress or relieve through offering a callback or similar? This is becoming more crucial to consider as technology and the ability to talk to a real human gets overtaken by cost-effective tech.

5. Poor customer experience can lead to a competitor sale

If you don’t have a good customer experience strategy, it can create easy sales for your competitors. The comparison sale happens when your client has had a bad experience with you. By default, you’ve made the competition look good. The customer will use their bad experience as a reference point, and anything that is slightly better will look amazing. This means that not only have you lost a customer, but your competitor doesn’t have to work as hard to gain their business. You’ve made them look really good.

6. Lack of attention to customer experience leads to increased marketing costs

If you haven’t paid enough attention to creating a customer experience strategy, you’ll have to work harder on the front-end to continually attract new business. It’s a well known fact that it costs far less to invest in existing customers who love you rather than the cost of buying a new one. If you don’t have an experience strategy, however, you’ll need to invest more in marketing and advertising to make up for this.

7. Underestimating your brand’s potential can cost you

Finally, underestimating brand potential and market penetration by not focusing on customer experience strategy can hurt your business. Many customers cite that positive customer experience is their most important criteria. So if that’s the case, how far could your organisation’s brand go with a well thought through customer experience strategy?

Five things you can do right now to improve customer experience

We’ve gone through what can happen when you ignore customer experience or prioritise service over experience. Now it’s down to what you can do. Here are a few suggestions to get you started.

1. Create a customer impact blueprint. Identify touchpoints, gain impact data, and review how you can improve upon that data. What can you do better?
2. Develop a service charter to create better practice standards for your frontline team, so everyone is on the same page.
3. Identify how you measure the success of that blueprint. Then, charter and monitor the performance of it.
4. Train your staff with professional skills and proactive customer service strategies.
5. Lastly, employ an effective support framework strategy to sort to nurture the resilience levels of the team.

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So why is ‘the customer is always right’ such a strong sentiment? The message in this phrase is not in its words, but in its inferred meaning and understanding. What we’re trying to convey is that the customer is important. They are the lifeblood of any business or organisation that provides a service or product, so they need to be treated with a high level of respect and value. So perhaps a better reengineering of that statement is: the customer’s not always right, but must always be managed right.

An excellent customer service organisation understands that great customer service is just as much about the wellbeing of the employees as it is about the customer’s needs and demands. Sometimes, in the desire to meet customers’ needs, the care of the staff may be overlooked or perhaps even ignored. When employees do not feel like they’re getting the correct support and care, particularly over time, it can quickly accelerate to retention risk. So what can we do when the customer’s not right and can even be mistreating or abusing frontline staff? Here’s a simple three-point staff care strategy.

Protect

An effective customer service charter helps everyone’s confidence, sets expectations, and clarifies the dos and don’t. This should include an easy-to-apply escalation policy that is behaviourally-focused (versus some difficult-to-apply policy mumbo jumbo). Display elements of this policy publicly for customers, so they know what behaviour is expected of them. Where applicable, these signs can also flag the consequence for non-compliance.

You’ve probably seen examples of this in bars and restaurants, where a sign near the bar lets you know that abuse of staff is not tolerated. Staff have the right to refuse service or ask you to leave if they feel unsafe.

Define the lines of safety and boundaries (both emotional and physical) for the team. This helps identify the points of breach. For example, abusive yelling and ranting at a staff member. In this case, you’d develop a framework for the team on how to implement boundaries in this situation, whether it’s face-to-face, over the phone, or via email or live chat. Explore what safe boundaries look like for these different mediums or environments of communication. Then give your team clear empowerment and actions they can take around that.

Train

One of the big gaps in customer service teams is when the skill level is quite variable. This means that some people have a better ability to manage a difficult customer than someone else in the same time. Training helps bridge that gap and creates a team with a common language and skill set. This, in turn, benefits the team with higher levels of confidence and ability when facing these issues.

The benefits of customer service training become particularly apparent to customers who try to push the team’s buttons by playing one off against another, for example. Because when a team’s received consistent training, a customer will find that the ‘response shield walls’ are the same for each member of staff. This ensures consistent boundaries for the customer and consistent protection for staff.

Additionally, conducting regular training – whether in-house or via an experienced external facilitator – can be a powerful way to accelerate a team’s skills and knowledge. Good training will equip them with tools, practical applications, and real-world scenarios, so they can move their learning to that experiential level.

Support

Implement an effective and well-thought-out back-end support. This makes the biggest difference to staff retention and job satisfaction. Not surprising, given that customer service teams face the bullets on the front line like soldiers. If they feel they are in this together, there’s a sense of camaraderie. Everyone feels they’ve got each other’s back. Where this is done well, there’s often a high degree of job satisfaction, engagement, and motivation – even when they’re having bad days. This also feeds everyone’s basic needs for that sense of belonging.

So there you have it, a simple three-point staff care strategy.

1. Protect.
2. Train.
3. Support.

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The nature of how customer services are offered can make this more challenging for certain sectors or organisations. Services which have a greater degree of public access or offer public support services, can be particularly affected by customers who use substances or struggle with mental health issues. Of course, this doesn’t exempt normal goods and services from this type of behaviour.

Do angry customers respond to certain strategies?

Often, when we’re running a skill session for angry customers, people will ask, “Well, what about those who have mental illness or substance issues. Will they respond to these strategies?” The answer to that is generally yes and no, depending on the issue, and where the team’s current ability is when working together as a collective to display a unified and consistent strategic approach.

One thing is for certain –this can be a real challenge in creating a skill strategy for teams, because the issue is complex and may require a customised approach. For example, with the type of service that’s being offered, the demographic being served, or the location, may have a certain concentration of this customer type and a unique approach should be developed taking into account those community considerations.

So, how do we deal with this effectively? Let’s explore some key strategies that may help.

Focus on developing a team strategy

Focus on creating a team strategy rather than focusing on individual skills’ competency. Although individual skills are important, responding to angry or unpredictable customers requires a holistic team approach. Everyone needs to work together to provide the consistency and skill application to display a united front. That’s key. This also creates a greater degree of team confidence, which goes a long way to reducing the fear and intimidation that can occur with this type of incident.

Gauge which strategies are working for you already

Adopt a consultation approach to identify answers and strategies that already exist in the skill base of your team. Gaining behavioural examples from your team members and collating them into groups of common issues, is a good place to start to determine where you need to focus.

To make this work effectively, collaborate as much as you can. Work together to find out what the most common and successful ways of mitigating and dealing with those behaviours have been previously.

Create a best-practice approach moving forward

Once we understand which strategies are working, we can make a list of best practices or benchmarks to guide the standard practice response for those particular issues. So, once you’ve consulted the team and collaborated for optimal success, you can come up with a blueprint which essentially maps this all out. You can make it specific to your organisation and focus in on things like demographics or concentration of particular issues.

It’s important to note here we’re not talking about building a policy document. We’re talking about a behavioural document that empowers team members with more tactical strategies to develop behavioural changes and understanding of how to apply their skills in response to mentally unwell or substance-using customers.

Training your team on responding to angry customers

Finally, create a team-based training strategy to help support the gaps in the team as they transition to your best practice response model. In practice, this may look like hosting team-wide training to ensure consistent comprehension and understanding, creating print-outs, or displaying reminder infographics in key locations to reinforce this training.

What this gives you is a comprehensive, individualised, and solutions-based strategy to bring your team more success and less stress when responding to mentally unwell, angry, and substance-using customers in the future.

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An equilateral pyramid is one where all sides are equal and there is a solid base. If one side begins to dominate, or drops the ball, then the whole structure changes and collapses.

In direct care, the three sides to the pyramid:

1. The client.
2. The staff.
3. The organisation.

The base is solidly made up of the desired end result for all three pyramid members – improved quality of life, job satisfaction, and a thriving business. Each side of the pyramid is full of drivers, variables, purpose, and personality. In an exemplary direct care service, each member understands, accepts, and works together.

The variables

Variables are many and differing. They’re often shared between two or three members.

Achieving the desired end result for each member – improved quality of life, job satisfaction, thriving business – is obtained through eight key things.

1. Achieving balance and clear timely communication. An equilateral pyramid has all sides supporting each other. If the organisation didn’t have the business, the service wouldn’t be available. If the staff didn’t do the job well, the clients wouldn’t return. If the client doesn’t choose the organisation, the business closes.
2. Each member knowing who they are and how they react. Individual personality traits and communication styles are not always easily understood or accepted. In direct care, we work with people. Our business is about people, and our role assists people. Being aware of ourselves, how we communicate, what pushes our buttons, and how we handle stress allows us to handle and minimise conflict.
3. Recognising the importance of self-esteem and valuing each individual. It is a basic human need to be valued. How we feel valued can be different and varied. But in essence, it is appreciation. Self-esteem is how much we value ourselves. If you are dealing with very ill or difficult clients, and are isolated from your team and management, value may not be forthcoming. Therefore, having a strong self-esteem is important. We show value to clients in the first place by seeing them first, and their condition or illness second.
4. Accepting and using verbal, non-verbal, written and visual communication in a professional, empathic, and timely manner.
5. Finding clarity around ‘musts’ versus ‘wants’. This has a huge impact on time.
6. Being aware that perception, expectations, and understanding have a complex relationship. Often, our history and background have us perceiving something one way, when the intent or expectation was the opposite.
7. Recognising that actions are multidimensional and need to be considered in the wider picture.
8. Finding the technology that helps.

As equilateral pyramid is a wonderful construction, and when working well, looks magnificent. To be working well, all sides must be considered equal and individually valued. In addition, the foundation or base must be understood and agreed upon.

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A friend has been having in-home nursing, every day, for the last four months. One day, a new nurse arrived. They introduced themselves and entered my friend’s home. Sessions went for 30 to 45 minutes and the nurse left their coat on the whole time. The nurse was cold and found it difficult to work. My friend felt that the nurse didn’t want to be there and wasn’t staying. She became very uncomfortable and ended up making a complaint about the nurse. The nurse’s intent was to stay warm so they could work to the best of their ability – the impact was a ‘please explain’ session between the nurse and their supervisor and an upset client.

This could have been avoided if:

• My friend had turned the heater on.
• The nurse had explained they were cold and asked permission to wear the coat.
• The nurse took the coat off despite feeling cold.

Identify issues and difficulties

The nurse and my friend had two issues:

1. They didn’t communicate and speak to one another about what was happening.
2. The impact did not reflect the intent.

It is often difficult to explain your intent (what you think you are doing), and difficult to know how someone is going to perceive your actions. Some difficulty arises due to:

• Time pressure. Explaining everything takes time, and direct care staff are often time poor. However, thought needs to be given to the time that would be required to resolve a negative impact.  In the example above, time had to be found to talk to the supervisor about the complaint and then meet with the client.
• Different cultural understandings or standards. The client in this situation had been raised with the firm belief that it is disrespectful to wear a coat inside the home.
• The context of the situation wasn’t agreed on. The client saw the session foremost as the nurse coming into her home. The nurse was viewing the session as a job first.

How to resolve the matter

How often do you find yourself saying, “but I didn’t mean that”? Or wondering why the person got angry or didn’t smile at your joke?  When this happens, and it looks like there is going to be conflict or the loss of a relationship, there are a few things you can do:

What you don’t do is say:

• “I’m sorry but…”,
• “If you only…”
• “I’m sorry if…”

These types of phrases are looking to lay blame and usually make things worse. Instead, focus on resolving the matter, not pushing the other person to accept responsibility. This can be done by:

1. Genuinely apologising or acknowledging the impact that your words or actions had.
2. Focusing on the feelings of the ‘hurt’ person. Even though you might feel bad when you are told you have done something wrong, particularly if you don’t agree, moving forward in the relationship requires acknowledgement and a demonstration of learning.
3. Having a discussion where you agree with a goal of understanding one another.  This is achieved through active listening and repeating back what you have heard.
4. Be aware of the context. In someone’s home, their standards and practices come first –  you may never agree with them, but you follow them.

Intent versus impact is complex and present in everyday life. Be prepared to listen, be aware of the context and focus on the impact as a hurt needs to be addressed first before a conflict can be resolved.

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But what if an irrevocable life-changing event is so profound that it is not possible to reach a new normal that remotely resembles our life before? Are we profoundly changed as a person, or is it the way that other people see and respond to us that is profoundly different? That is when our internal bias can shift how we treat the person.

How our experiences shape our lives

Profound changes to our physical capabilities and cognitive capacity may occur due to critical or chronic illness, disability, even old age, but our desires, our likes and dislikes, our ambitions, religion, politics – our worldview often remain unchanged.

If you ask residents in aged care, most will tell you that what they see when they look in the mirror does not match the person that lives inside their head; our bodies may deteriorate, our cognition may decline, but the same person still lives within us.

A person, as written by B.J Neblett (2009), is:

“…the sum total of our experiences.  Those experiences – be they positive or negative – make us the person we are, at any given point in our lives. And, like a flowing river, those same experiences, and those yet to come, continue to influence and reshape the person we are, and the person we become. None of us are the same as we were yesterday, nor will be tomorrow.”

The development of “self”, as influenced by our life experiences, is a slow-burning process over a lifetime – life’s ups and downs may sharpen our edges or round off our corners, but our core identity remains.

When a sudden incident or illness means that life will never be close to the way it was before, it may seem to others that a person’s core identity has suffered the same unrecognisable change, but this is rarely the case.

Such unrecognisable change shaped the life of theoretical physicist, cosmologist and author Stephen Hawking. When he died in 2018, Hawking had lived with Motor Neurone Disease for more than 50 years.  This debilitating illness slowly eroded Hawking’s physical capabilities and changed his physical appearance, but his vision and his intellectual curiosity remained unchanged.  Despite losing all mobility and the ability to speak, Hawking continued his ground-breaking scientific research, writing papers, theorems and books, which won him prestigious awards for his work until a couple of years before his death. Hawking said he preferred to be regarded as:

“…a scientist first, popular science writer second, and in all the ways that matter, a normal human being with the same desires, drives, dreams and ambitions as the next person.” – (Stephen Hawking, 2015)

When a disability, illness or condition is seen before the person, the identity of that person becomes overshadowed and undermined.  I have some personal authority in making this claim: at 19 years of age, I was struck down by an auto-immune disease that was to devastate my life as I knew it:

My Story

I had gone to bed unaware that I was anything but healthy, but when I put my feet on the ground the following morning, I was unable to bear my own weight.  What followed was decades of pain, immobility, confusion, frustration, drugs and their side-effects until finally, I was lucky enough to be accepted onto a course of treatment that put my disease into remission.  What hurt, almost as much as the physical pain, was the change in the way people behaved towards and around me.

The same friends I had been nightclubbing with only weeks before, now spoke to me in hushed tones, as you would to a small child; with a slight tilt of the head, they would ask, sympathetically, about how I was feeling. Conversations would stop when I entered a room – my friends were afraid to talk about normal life around me, because my life was anything but normal. They assumed that I would not want to hear of nights out, new loves, that fabulous pair of shoes. They saw my illness and disability before they saw me, their friend; to them I was altered and our relationship was different. Not being included in their conversations about “normal life” made me feel abnormal, isolated and devalued. These were good people, caring and considerate friends, but the hurtful impact of their changed behaviour towards me did not match their intention of protecting my feelings.

It is easy to forget that our intentions, however well-meant, can be unsolicited, unwelcome and unhelpful. If we launch our arrows of good intentions without first understanding their impact on our target audience, we risk missing the mark or worse, causing harm.

J’s Story

A young family friend of mine suffered a catastrophic accident at the home of his pal one sunny summer afternoon – a momentary lapse, that left him an incomplete quadriplegic.

Prior to his accident, this fit young man was a gifted footballer, a strong and active teenager with every opportunity in front of him. It was a devastating time for him and for all who cared about him.  In dark times like this, it is common for friends and loved ones to experience feelings of helplessness; we scratch around, desperately searching for something positive to say that might improve the outlook of the situation.

I remember going to see our friend in the earliest days of his rehabilitation; to soothe my own feelings of helplessness, I trawled through medical research, searching for innovative treatments for spinal cord injuries.  Having learned of successful trials using electrical implants, I was excited to offer my friend the hope of being able to walk again – his response was not what I expected:  he told me how frustrating it was that everyone thought his main goal in life would be to be regain the ability to walk; in actual fact, his main goal was to be able to manage his personal care without assistance, which would restore some of his privacy and dignity and allow him to spend time with his friends, without embarrassment or the guilt of feeling like a burden on them.

His second priority was to be able to improve his hand function, so that he could hold and let go of a bottle, enabling him to “crack open a frothy”.  The realisation of my mistake hit me like a road-train: this was still the same person, albeit in very different circumstances.  His interests, his likes, his dislikes, his love of football, of having a beer with his mates remained unchanged.  I had been clumsy; I had seen the outward signs of my friend’s disability before I saw the person I knew him to be; I had made assumptions when I had little idea of how much the accident had impacted on every aspect of his life and no understanding at all of how he felt about his new situation – because I hadn’t asked him.   The next time I visited, I took him the latest footy magazine, something I had previously thought would be an unthinkable gaffe – he was delighted with it!

Theoretically, a life-changing event could happen, or start to happen, to any one of us by the time we have finished reading this blog. We all know of people in the public eye for whom this theory has become a reality:

• Athlete and mining engineer, Turia Pitt, whose life and appearance were irrevocably changed when she was trapped in a bush fire during a marathon.
• Christopher Reeve, known to us all for his super-hero action movies, lost much of his mobility following a riding accident.
• AFL star Adam Goodes suffered life-changing mental health issues following an unexpected life event.

All of these people have continued to pursue the things that were and still are important to them despite their dramatic change in circumstances. The courage and generosity of these celebrities and others, who are sharing their experience of life-changing health issues via the media, are helping to shine a light on the issues and challenges that frustrate millions of people every day.

Personal insights, from people in the public eye, eloquently demonstrate that though life may change how we are, it doesn’t necessarily change who we are.

Despite high-profile advocates, progress on accessibility is slow.  Having experienced mobility issues myself, I have a heightened awareness of the accessibility fails in so many places:  from cafes with disabled toilets but a corridor leading to them which is too narrow for a standard wheelchair, to venues with steps and no ramp.

People with mobility issues are like the rest of the population; maybe we love to drink coffee, go to the beach, the movies or shop at the market – maybe we don’t; but we do want the choice and the  ability to make that decision for ourselves.

At some point during the pandemic, all of us experienced being denied access to things that we want or need.   Whether it was not being able to leave our homes, not being able to access the gym, or the library or not being able to shop for whatever we needed whenever we wanted to – we have all experienced barriers to doing or getting what we want.

Were we altered by this dramatic and unexpected change to our lives? Possibly. Maybe we are a little more appreciative of family and friends, maybe we make fewer excuses for not going to the gym, but most of us were the same person in new and very different circumstances.

My years working in the aged care and disability sectors offered me the great privilege of really getting to know our clients beyond their care needs.  Time spent talking and listening to your clients and what makes them who they are, who they have always been, is a wise investment in avoiding conflict and behaviours of concern that would require far longer to manage:  Below are two examples of how knowing your client better can avoid a difficult and distressing situation or even a crisis:

The Supermodel

“S”, a client in an aged care facility, had been a supermodel. For most of her life, she had dressed in beautiful clothes from the most exclusive fashion houses in the world; her family often brought her high-value clothes of the quality she was used to.  Inevitably, the high-volume laundry processes of an aged care facility could not provide the delicate care that these items required and many of them were ruined.  When the client’s daughter informed the management that her mother’s expensive clothing had been incorrectly laundered, she was asked to provide cheaper clothing for her mother, as a remedy for the problem.  The daughter was affronted by this suggestion and lodged an official complaint to head office about the facility and the care being provided to her mother.

The intention of the manager was to remove the distress being caused by the client’s expensive clothing being ruined in the facility’s laundry; The impact of his suggestion however, was that the daughter took offense on behalf of her mother and made an unjust association between the lack of care for the clothing and the standard of personal care her mother was receiving.

A great deal of time was spent by staff and management, both locally and at head office, in investigating and resolving the complaint.

The vital triangle of trust between client, family and service provider was compromised.

Had the manager understood who the client was beyond her immediate care needs, he would have understood that what made her feel whole and secure had little to do with the quality of her clothing but everything to do with maintaining her identity – for this client, the way she dressed was an important part of “self”.

The War Veteran 

“L” was a war veteran who suffered from Post-Traumatic Stress Syndrome; he also had dementia, but his long-term memory was excellent. A sensitive conversation with him was all it took to unlock a invaluable insight into his behaviours of concern:  Understanding that our monthly fire alarm tests triggered this gentleman’s anxiety, by evoking traumatic memories, was a breakthrough in managing his wellbeing and the safety of our other clients and staff; though we were unable to avoid the mandatory tests, we were able to schedule a coinciding activity into L’s care plan that meant that he would not be triggered by the sound of the alarms.

It is vital, when caring for someone of any age, with any type of challenge, that we see the person first and foremost, putting them at the centre of everything we do and say. A simple “memory board” at the entrance to a client’s room can offer opportunities for staff and clients to connect, providing clues as to how we might tailor a person’s care in accordance with their individuality and avoid harmful insensitivities.

It is well documented that a person who appears to be wholly changed by the ravages of late stage dementia, can still be reached with a familiar song; the person will often “come to life” singing along, word perfect, whilst visibly experiencing comfort and enjoyment from their positive reminiscences and there is evidence that these periods of clarity last for some time after the music stops.

I have had the privilege of witnessing this wonderful phenomenon and need no further proof that, though we may be shaped by everything that happens to us, at our core, we remain true to our “self”.

I would encourage anyone who works in the caregiving profession to view the following video, which perfectly illustrates the benefits of person centred care for both client and staff.

References

• George (Part One) by BJ Neblett © 2009
• Physics Daily, Stephen Hawking, 2015

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In an aged care facility when a resident dies the staff become crazy happy. They start singing and dancing with the other residents so they don’t see the body leaving the facility. The driving thought is that seeing the body leaving is upsetting and the other residents shouldn’t have to see this. This is ‘Jollying’.

However, the impact is:

• Staff feel silly and have to hide their own sadness.
• Fellow residents don’t know what happened to the person – they just aren’t there anymore.
• Grieving is not seen as important.
• Residents begin to know that the ‘crazy’ act means bad news.
• Residents are not given a choice, such as they would have in a family home.
• Truth and trust have taken a beating.

In direct care the way staff reacts or handle potentially traumatic events is often not in their control. The service they work for may have a clear policy, such as in the aged care facility example above. The family may also express their wishes on how they want things handled. The individual/s involved may also express certain expectations.

Why emotional validation is important

It is critical that we don’t lose touch with our own emotions and feelings. Or indeed be made to feel the emotions aren’t valid. Emotional validation is important.

This doesn’t mean that you have to agree with the emotion being expressed, it means you acknowledge that their emotional response is warranted.

Validation is not only acknowledgement of one’s feelings, but an understanding that allows a person to feel heard and valued. Individuals can provide their own emotional validation or can receive it from others. In the workplace, it is often colleagues and clients who provide this. In some emotionally charged workplaces, such as palliative care, some disability services, nursing homes, some aged care facilities, counselling, and support is provided by the organisation. This act is validation of the workforce, and individual validation occurs in counselling.

Take this example: In a disability residential service a child has died. The child had lived in the home and been cared for by the same staff for over 5 years. The supervisor was rung and came to the home. On arrival, it was clear that the other four residents were upset and agitated – one in particular had begun to self-harm. The supervisor told the staff members to calm down, stop crying and focus on the other children.

The result was that staff experienced a range of feelings:

• Rejected.
• Embarrassed.
• Blamed.
• Judged.
• Invalidated.

The supervisor’s intent was to calm the other children; the impact was to upset the staff in different ways. Within five months 50% of the staff in this home left the job.

It is not just staff who require emotional validation but also other residents/clients and families.

Why is empathy so important?

Maya Angelou, African-American poet and author (1928-2014), said: “I think we all have empathy. We may not have the courage to display it”

It is felt that nearly all people have empathy, the exceptions being psychopaths, sociopaths and narcissists, but many of us don’t use this cognitive process. There are ways we can learn empathy, or enhance our ability.

In essence, empathy is about understanding things from another person’s perspective – the key word here, understands. You don’t have to agree or believe the same thing, you just have to show that you understand and accept the validity of emotions or feelings. Relationships thrive with nurturing, care and understanding.

In the disability services example above the supervisor showed no understanding of, or care for, the staff’s feelings. They only focussed on the job to be done.

Showing and building empathy can be reflected in:

• Listening: this means not interrupting but focusing on the person you are talking to; putting aside your own thoughts, opinions, and phone and really hearing what the other person is saying.
• Tuning into nonverbal communication, including tone of voice.
• Using the other person’s name and showing them you are engaged through your own body language.
• Not allowing the person’s beliefs to colour your understanding: if you judge a person and allow your findings to colour your interactions, then practicing empathy is both difficult and uncomfortable.
• Start giving genuine recognition: move beyond “wow, you’ve had a great life” to “I admire your skill in rock climbing and the way you approached the challenges”. Instead of writing “LOL” write “you have a great sense of humour” or “I love sharing your humour”.
• Broaden your horizons: read fiction.

A study in the Netherlands shows that when a story transports you emotionally to a new world you are likely to increase your empathy. The study showed that fiction influences empathy of the reader, higher immersion meant higher empathy in fiction readers. These effects were not found for the group that read non-fiction. (Bal, 2013)

In direct care, empathy is an important response and can be linked to compassion.

Jess recently experienced daily in-home nursing care for 4 months. The nurses had a heavy work schedule and did not have a lot of spare time. However, when they talked to her, they continued laying out supplies for reading or writing notes. Jess was going through something new and traumatic and needed to understand what was happening. Jess asked lots of questions, but her need was not being met. Only one nurse picked up on this need: this nurse stopped and looked at her when they talked, explaining when she needed to write or read and why. She picked up the clues. In answer to the question “why was this infusion necessary?” most would reply “your doctors have ordered it and must think it will help.”

The truly empathic nurse would explain how the medication was used and the conditions it treated; in addition, she would talk about potential side effects and things to watch out for.

How does sympathy impact direct care?

Sympathy is about sharing the feelings of the other person, and is often related to compassion, pity, or sorrow. It is a valid reaction and response. However, sympathy doesn’t have the same strength as empathy, because you are sharing a feeling rather than understanding the cause.

Sympathy states “I know how you feel”, whilst empathy states “I understand what you feel”. Whilst the difference is subtle, it is worth noting as ‘knowing’ something is based on judgement and your own perspective. Understanding is accepting, thoughtful, and empathetic.

Sympathy is often our first reaction when we hear disturbing news. It is a valid and meaningful response. The challenge is to stop at the expression of sympathy and not sharing your own story but keeping the emphasis on the individual.

One of the issues direct care workers need to be aware of when feeling and expressing sympathy: There might be a natural tendency to feel sympathy for someone who developed leukaemia, but less sympathy may be shown to someone with an opioid addiction. When the problems are perceived to be generated by lifestyle, the judgement component can come into play. In direct care, this can be dangerous to wellbeing and the environment in which a client is living.

In 2020 Susan Silk, a clinical psychologist, and mediator Barry Goldman developed the “Ring Theory”. The theory recognises that everyone surrounding an event will have negative feelings and emotions but because those most closely affected by the event need comfort not someone else’s grief, they proposed that the venting and sharing of opinions moved outwards.

“When Susan had breast cancer, we heard a lot of lame remarks, but our favourite came from one of Susan’s colleagues. She wanted, she needed, to visit Susan after the surgery, but Susan didn’t feel like having visitors, and she said so. Her colleague’s response? “This isn’t just about you.” (Silk 2013)

In Ring Theory, the colleague who needed to talk would do so with someone in a more outlining circle and only pass comfort inwards. Susan as the person at the centre can say whatever she wants. Everyone else can complain, bemoan, and curse life to people in a more outer circle to theirs. You wouldn’t say Susan looks awful, and you hate it to her husband, but you may say it to someone on an outer ring, such as a colleague.

This is a good easy to remember phrase: Comfort in, Dump Out.

It is also worth thinking about timing. When supporting someone after an event happens, lots of people rally and offer support, compassion and sympathy. They can become inundated with flowers in the first few weeks. Grief lasts beyond these first few weeks, however, and offering support a month or longer down the track is worth thinking about. A month after my grandmother died, a close friend sent me some flowers, and it made me feel warm and supported still.

What does this mean for direct care?

There are many options open to us and the path we follow has impacts both on ourselves and others. In a direct care role we have three drivers:

1. The client or person we are dealing with.
2. The policy and procedures of the employing organisation.
3. Our own personal believes feelings and skills.

Direct care workers are working with people in less-than-ideal situations that they have not chosen. They deal with death, debilitating illness, pending death or disability, loss of capacity and change of personality more often than the general public. Empathy is a highly utilised skill in this type of work.

References
The Netherlands Study: Bal PM, Veltkamp M (2013) How does fictional Reading Influence Empathy. 

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