Words of comfort

I came into my local favorite coffee shop to work on blog posts and do some research for other projects.  I often do this as there are (actually) fewer distractions than at home.  I’m sitting near the self-serve station for sugar and creamer and getting into my writer’s brain when an older gentleman approaches to doctor his coffee.  He greets me and we exchange pleasantries.

When I speak with seniors who make negative comments about how their day is I often say “Well you’re out and about under your own steam, you must be doing pretty well.”  This often gets a smile and change of attitude.  It did for this gentleman.

He came in for some coffee while his wife was getting a massage next door.  We chatted a little more about nothing special but he started struggling for a word and got frustrated. He explained to me that his doctor had put him on a medication that has messed with his short term memory and then said if it became the real thing then he wanted to just die.  He said that he didn’t want to live when he couldn’t remember who he was.

I looked at him and explained that I care for seniors as my profession and specialize in dementia care.  I told him that while it is true you may forget about some of the people in your life that you never completely forget who you are.  It’s always there, at least some of who you are.

I told him about my dad.  Dad was bed bound and completely non-verbal, non-responsive to anything other than stimulus-response.  Still, when I walked into his room and called out his name he would grunt and move his head in the direction of the sound of my voice (the grunt was a typical guy-type grunt of acknowledgement).

I also told this gentleman that Dad had been in the Marine Corps and when I would play a CD with marching cadences Dad’s feet would tap like he was marching.  The gentleman perked up when he heard my dad had been a Marine, he too had been in the Corps.

We joked about the fact that Dad would “march” and how if you’re a Marine you’ll always be a Marine.

I brought up the fact that sometimes I would say something funny and he would giggle.  One time in particular his hospice nurse had brought more bandages for the pressure sore he had on his tailbone.  I told him that I was going to change his butt band-aid – and he giggled.

I told the gentleman that although the disease took much from him and us, it never fully robbed him of the essence of his humanity.  He knew his name, he recognized his service in the Marine Corps and he could still laugh at something funny.

He looked at me with relief on his face and just said “I’m glad I spoke with you.”

I’m glad he did too.

Advertisements

24/7/365

When caring for someone with dementia or any other illness that robs a person of being able to do for themselves you really sign on for a job that’s 24/7/365.

You help with bathing, dressing, grooming as needed.  You make sure meals are prepared and hope they’re well received.  You make sure doctor’s appointments are made and gotten to on time.  You make sure that doctor’s orders for treatments and medications are followed.  You keep your loved one safe from others and often themselves.  You are their protector, shoulder to lean on, and champion.  You give wholly of yourself for their welfare.  Your entire focus is on their needs.  You are their hero.

This is the life of a caregiver.  This is part of the reason I love what I do.  I get to be the hero to the caregiver.  I come along side them and offer them a chance to recharge their batteries.  I step in for a few hours to take some of the burden from their shoulders.  I look them in the eye and say, “I’ve got this, go take some time to be good to yourself.”

For a caregiver to have a few precious hours to take care of themselves is huge.  It is a chance to breathe.  It is a chance to connect with the outside world.  It is an opportunity to decompress from the stresses of life.

So, dear caregiver, here’s hoping you have someone in your life who can say “I’ve got this for a while, go take some time to be good to yourself.”

For those of you who know a caregiver, could you think about coming alongside them?  Even a few hours can make a huge impact on the caregiver’s ability to continue.

Home safety

I have spoken about home safety in the past, but I’d like to bring up a couple of specific things today.

Today more and more seniors choose to remain in their own homes for as long as possible.  There are many good reasons for this, first it can be less expensive than moving into retirement or nursing facilities.  Second, when they are in a familiar environment they are able to feel more comfortable and are less likely to become depressed.

The most important thing to remember when making the decision to age in place is whether the home is physically safe to be in.  I’m not referring to structural issues, although that is also a consideration.  I’m talking about fall risks.

Any items piled around on the floors can cause an elderly person to potentially trip and fall.  Even if they’ve always had that pile of stuff there as we age our depth perception and balance start to fade.  So the pile they’ve always stepped over will one day trip them up.

Making sure that all walk ways are free and clear of all debris and clutter is one step to making the home safer.

Another important potential trip hazard to clear away are throw rugs or area rugs.  Your elderly loved one may not be able to lift their feet properly when walking and get tripped up by the rug.

If there are tears or rips in carpeting or if the transition area between tile or laminate and carpeting isn’t secured down, these need to be repaired or the whole carpet replaced.  Once again, these are tripping points.

A large number of falls in the home happen in the bathroom.  Look into installing grab bars near the toilet and in the shower.  These should be properly mounted in order to safely take the weight of your loved one.

Transfer poles are also helpful.  These floor to ceiling poles offer support for standing.  They are helpful next to the bed and/or next to a favorite chair.

Electric lift chairs are very handy in getting a senior citizen to the point of standing.  They also recline via the electric motor.  There are many different styles both on the decor side of things and how many bells and whistles come with it, many even include heat and massage.

If there are any steps or stairs in the house it is important to make sure there are secure handrails to use.  At no point in time should anything be left on a step, they should always be clear of any clutter.

If climbing a flight of stairs is physically too taxing it may become necessary to convert a room on the main level into a bedroom or invest in one of the stair chair lifts.

In the kitchen, make sure that plates, cups, bowls and other such eating implements are within easy reach.  As we age we loose muscle tone and reaching above our head becomes more difficult.  At the same time our knees and circulatory system won’t accept bending over for more than at most a few moments.

Once everything is as safe as possible in the physical home, it may be helpful to hire a service to come to provide companionship, housekeeping help, meal preparation and assistance running errands.  Depending on the level of independence of your loved one this may only need to be once or twice a week for a couple of hours.   By starting this kind of light assistance early it may help them accept more help if they need additional help with activities of daily living (aka: ADL’s) in the future.

Another good investment of money is for a emergency call button service.  This way if your love one is alone in their home they will have a reliable method to reach out for assistance, especially if they’re unable to reach a phone.

Scary!

Each state has an agency that is responsible for investigating reports of abuse or neglect of seniors by care facilities and their staff.  These findings are supposed to be available for the general public to help inform them of which facility may be the safest for their loved ones.

Recently the main newspaper of my neighboring state did an audit of actual complaints vs what is available on the agency’s website for public reference and they found a huge discrepancy.  It makes me wonder if Oregon is unique in this or if a similar audit for other states will show the same results.

Oregonian’s Audit of Nursing Care Facility Complaints

Why I pretend that I’ve never heard that story before

I work with seniors, most of them have some level of dementia.  I care for their most personal needs.  I help them eat.  I help them with bathing and toileting.  I wipe their hands and faces.  I dress them and change their Depends.  I put bibs on them.

For all of this, they tell me their stories – often and repeatedly.  Every time I react as if I was hearing their story for the first time.

Why do I do that?  Because it is what they have left of their dignity.  It makes them feel important.  It lets them remember with pride their younger life while they have to live with the humiliation of needing assistance with the most basic of daily activities.

It is important to them to have their stories heard, acknowledged by another human being.

They need to know their stories hold value.

They also have a disease that means they cannot remember telling me their stories.

So, each time they tell me their story it is, to them, the first time.  This means that if I’m dismissive to their story because I’ve already heard it, to them I’m being dismissive to their pride, their humanity, their value as a person.

So, I listen to their stories with the same rapt attention each time.  I rejoice in their achievements and successes.  I laugh at their humorous anecdotes.  I sympathize with them over their losses.

As I bathe them, I laugh at cute stories of their children.

As I clean them up after using the toilet, I smile as they tell me about their school day hi-jinks.

As I get them  dressed, I cheer for their personal and professional successes.

I acknowledge their value as everything is being stripped away from them by a horrible disease, this is why I listen to the same stories over and over again responding as if it was the first telling.  I am giving them something back.

Dignity.  Honor.  Pride.  Humanity.