October 1, 2009 by David Gillaspie
WHO WILL TAKE CARE OF US
The speaker was a married woman in great health. She didn’t need anyone taking care of her, but the question is on everyone’s mind. This isn’t to say everyone needs taking care of. You’ve seen eighty year olds having the time of their lives; you’ve seen twenty year olds who will never leave their bed unassisted.
Some time between twenty and eighty a caregiver may come into the picture, but who will it be? Here are some of the choices:
Carla is in her mid-twenties. She’s a CNA, a certified nursing assistant. She’s done the class and earned the paper. When she comes to your house she is all business. She understands what needs doing because her boss, one of the owners of a home care company, came for a ‘needs’ interview.
During the interview you stated that your loved one can stand and walk with assistance, hits the can with assistance, does everything with assistance. You’ve been assisting for years and need a break, which is why Carla is in the picture.
Except you’ve never met Carla. Her boss picked her from a list of available caregivers who can handle the tasks at hand. She parks her truck at the sidewalk and takes a finishing puff on a cigarette before stepping out. You see a truck rebound after three hundred pounds leaves the cab.
Before Carla knocks on the door you consider how she will navigate your loved one into the bathroom, into the hallway, into the bedroom. You know it won’t work out, but you still need a caregiving break.
Carla comes into the house trailing wisps of Marlboro Red. You remember how the administrator said none of their workers were smokers, but keep quiet. You need a break and she is here to provide one. At least that’s how it’s supposed to work.
The first thing Carla does is decide your loved one is beyond the scope of the services she provides.
“He must be able to stand on his own. We cannot pull them out of their chair or bed. That is reserved for specialized nursing,” she says.
Since you’ve got an automated lift chair all she needs to do is push a button and hold it, but she wants to see if he can stand from a sitting position.
He can’t, so Carla calls her office and reports that this patient has needs she cannot fulfill. You’ve been rejected by someone who didn’t even try to work with your loved one. You thank her and watch from the window as she flips the lid on her hard pack for another cigarette before climbing back into her truck and driving off.
You had plans, but change them. You felt light and free, but now choke down resentment. Your loved one dozes in his chair. Fifteen minutes later you tap out their pill regime, grind them up in your mortar and pestle, mix them into apple sauce and spoon it into your loved one’s mouth. Carla is a plan killer, but she does it by the book; she’s a professional who knows all about limitations. You didn’t want her to begin with, you tell yourself.
The caregiver stress you felt is still there; you still want a break but not leaving your loved one with the likes of Carla offers a small moment of relief. You dodged that bullet.
The next candidate is a nursing student, a young man with a can-do attitude. Sure he’s only about a buck forty but he’s a gamer. He’ll get your loved one out of his chair one way or another. The chair controls confuse him so he uses all the brute force he can muster, which isn’t much.
It doesn’t help that your loved one is uncooperative. You’ve seen it before. If he doesn’t trust someone, he won’t try to help. He obviously doesn’t trust this skinny kid and the results are dismal. You do the work as usual and the nursing student stays the evening for bedside company at twenty bucks an hour. He’s a one-time hire.
Meet enough professional caregivers and you come to realize there is only one answer to the question of “Who will take care of us?” We will take care of us. It might seem an obvious choice. It might seem the only conclusion for responsible people. And it’s still too much to ask. You’ll need to figure it out sooner than later.
Look in your family, in your tribe. Does anyone have someone they care for? Trade caregiver duties. Recruit early so your loved one will grow accustomed to a new face. Build trust. Make a plan, but know it won’t work the way you planned. Settle with the idea that you are your loved ones last, best, hope for anything resembling normalcy.
Your loved one may not be the cowboy riding the range like he used to, but you can still paint that picture and put him in it. Ask him to pick a pair of boots for the ride while you choose a new Zane Grey novel.