GUIDELINES FOR CARETAKERS

It is important for caretakers to be oriented towards the mental, emotional and physical well-being of the children that they are caring for. It is as important that the caretakers are in a good place as far as their own well-being is concerned and that they take care of themselves too.

GENERAL GUIDELINES

1. Caretaker must be equipped to handle the emotional demands of the child with sensitivity and empathy.[1]
2. The children must have been through difficult circumstances and hence it is important to be non-judgmental.[2] Try to understand where they are coming from.
3. Allocating duties is good for the child’s overall development and makes for a smooth functioning home.
4. Basic requirements like a balanced diet, health care, medical examinations, sanitary napkins, education, self-development and recreation facilities must be ensured.
5. Non-offending attitude and empathetic support is most desired.
6. Talking negatively, labeling children and giving corporal punishments can impact a child’s confidence and well-being, and hence, should be avoided.
7. Discussions or sarcastic remarks about the child’s personal/family issues must be prevented/avoided. Such insults cause permanent emotional wounds in them.
8. Effective punishment can be in the form of withdrawal of privileges, like television time.
9. Children are entitled to a certain degree of privacy within permissible limits and the limits are be decided by the home, keeping in mind the rules of the shelter home.
10. As the caretaker is the parent figure in his/her life now, it is good to maintain a rapport with the child so that the child feels confident enough to approach the caretaker if he/she is in need of support or guidance.
11. Maintain appropriate physical boundaries with the child to avoid attachment and transference[3].
12. Children must be provided with relevant news and reading materials that is good for improving their knowledge and reading skills.
13. Visitors should not be allowed to take photographs of the children.
14. Caretakers must be vigilant towards the use of bad language, bullying and conflicts among the children. Problem should be dealt with without being partial.
15. Some children might not know how to behave with outsiders; so, guiding them in this respect would be helpful.
16. On reaching adolescence, children start going through psycho-sexual developments. At this time, it is important that caretakers show care and understanding to them, while also being non-judgmental.
17. Negative or critical reactions to a child’s body, gender expression or sexual orientation can have long-lasting effects on their mental health. Hence such reactions must be avoided.
18. Childhood trauma can have implications beyond what is normally seen on the outside. For some, it could manifest as anger issues or withdrawal from others. Others might exhibit sexual behaviours that do not conform to the societal moral standards. Please take some time to understand their mindset and try to be non-judgmental. They might have been through circumstances that may be unimaginable to us. So it is important to make an effort to understand them empathetically.

ADMINISTRATIVE GUIDELINES

1. Start a file/documentation on the child.
2. At the time of admission of the child, the caretaker is to attain all important and relevant documents like birth certificate, school certificates, marksheets, Aadhar card, etc. so that these are available to use whenever necessary. Copies of these documents are also to be maintained.
3. Collect all important information regarding parents, family and medical history, etc. while maintaining strict confidentiality[4].
4. It would be good to make an evaluation of interests and an assessment on them, which can be recorded and kept on file.

MEDICAL GUIDELINES

The caretaker must collect all relevant medical details of the child. This includes: –

1. Any on-going treatment.
2. Information on medication, if the child is taking any.

• Should not delay any consultation with the doctor in case it is required.
• Should not start or stop medication on their own. It should be done only after consultation with the doctor.
• Follow up with doctor must be done regularly as advised by the doctor.
• Medication should be administered by the caretaker herself/himself.
• Medication should be kept with the caretaker.

3. Caretakers must be able to recognize some signs of mental health problems like that of depression, manic symptoms, psychosomatic issues, psychotic indications and must report it immediately, if required (some symptoms listed at the end for ready reference).
4. Ensure the children are deloused[5] and dewormed thrice a year. If there are new children, they should be dewormed and deloused to avoid infestations to other children.
5. Classes or presentation on hygiene and importance of the same to be done.

SIGNS AND SYMPTOMS OF MENTAL HEALTH ISSUES TO LOOK OUT FOR

1. Depression –

Look out for signs of depression such as: –

• Physical- chronic fatigue, sleeping too much or too little, overeating or under eating, weight loss or gain, irregular menstrual cycle, difficulties in concentration/attention.
• Behavioural- excessive fear/ worry, withdrawal from others, frequent crying spells, neglect of responsibilities, being suspicious without any apparent reason, self-blame, loss of interest in personal appearance, lack of self-care, flat (blank expression) or inappropriate emotion, poor academic performance, low self-esteem, self-criticism, loss of interest in pleasurable activities, feeling of worthlessness, drop in school grades.
• Thoughts of death, suicidal wishes/ attempts, tendency to harm self/others.

2. Manic symptoms – such as restlessness, irritability, impatience, overactivity, needing less sleep than usual, rapid speech, lack of inhibitions (promiscuous tendencies), grandiose ideas (unrealistic, exaggerated thoughts).
3. Psychotic indications – such as a sense of alteration of self/others (e.g. feeling that self or others have changed or are acting differently), strange ideas, firm beliefs, unusual perceptual experiences such as a reduction or greater intensity of smell, sound or colour.
4. Psychosomatic symptoms – such as unexplained aches and pains (headaches, abdominal pains, vomiting, muscle pains, tremors/shaking, dizziness, tingling sensation, numbness), pain while urinating, bed wetting, etc.
5. PTSD symptoms – such as recurrent and intrusive distressing memories of the traumatic event through nightmares, flashbacks, or distressing thoughts. Avoiding situations, people, or places that remind them of the trauma. They may be hypervigilant, constantly scanning their environment for potential threats. Persistent negative emotions and changes in cognition and mood may be observed.
6. Please note that these signs and symptoms are merely indicative and not proof of any mental illness or abuse per se. Please contact a mental health professional if symptoms persist.
7. Caretakers should be aware of the importance of medication in children, and about the consequences that could occur due to irregularity or difference in prescribed dosage.

HELPING THEIR WAY FORWARD

1. Help them in their healing journey.
2. Give them a routine. Try and include sports and meditation into their schedule.
3. Make them feel secure and balanced.
4. Education and career guidance.
5. Help them to adjust to society.
6. Let them know whom to connect to when they need support.
7. Help them with tips on anger management, dealing with loneliness, etc.

SELF-CARE TIPS FOR CARETAKERS

1. Training on handling and understanding children.
2. For the caretakers to be able to look after the physical and mental well-being of the children properly, it is extremely important that the caretakers look after their own well-being.
3. Looking after children can be stressful at times; reach out for professional help if needed.
4. Caretakers must take some time out every day for themselves.
5. Eat a balanced diet.
6. Try to fit in some light exercise into the schedule.
7. Meditation is known to have a positive effect on general well-being.
8. Get regular checkups done by a doctor.
9. Indulge in a hobby that is calming and enjoyable.

For more information, please refer to the blog articles at www.bodhini.in on self-care tips like sleep, mindfulness, etc., which will be beneficial for the children and for caretakers.

[1] Empathy: Empathy is the ability to understand and feel the same emotions as someone else. It is like putting yourself in their shoes and caring about how they feel.

[2] Non-judgmental: Non-judgmental means not criticizing or forming harsh opinions about others, being accepting and understanding instead. It involves being open-minded and treating others with respect, regardless of personal beliefs or biases.

[3] Transference: Transference is when a person projects the feelings or emotions that they used to have towards a person from their past onto an entirely new person.

[4] Confidentiality : Keeping information shared by an individual private and not sharing it with others without permission.

[5] Deloused: Process of removal of lice from hair.