Wrestling With Care

7

From http://www.caregiver.com/channels/stories/articles/wrestling_with_care.htm

Caregiving in America is in great demand, from adult foster home owners offering familiar surroundings, to assisted living center staff patrolling hallways to answer assist request buzzers and lights.  Rehabilitation centers employ physical therapists, speech therapists, occupational therapists, and the caregivers on site. 

Some nursing homes have as many as twelve “patients” for each worker.  They are all on the job and working hard. 

They all knew men like Grandpa Ken, men who needed to stay on their feet.  Some staff could assist him with a walker; some couldn’t, but tried anyway.  It takes acute balance and lightning quick anticipation to keep someone like Ken on his feet. 

My name is Dave and I met them all when my father-in- law got Parkinson’s disease.  

From one unfortunate experience after another, Ken entered the hospital for the last time.  His room had the whole end–of–life package, his legs wrapped in circulation pumps, IV and oxygen tubes taped in place.  I was with the gathered family when I noticed Ken’s doctor pass the door. 

“Excuse me, Doctor,” I said.

He looked up from his charts and focused his attention right on me.  He knew Ken’s situation better than anyone and gave his sympathy.

“Hello, David.  How’s he doing?” he said.

“Comfortable.  He’s comfortable.” 

Being comfortable was the main goal at this point.

“I’m glad.  He seems like a nice man.”

“He is.  Doctor, how long does he have, if you took a guess.”

“I can’t say, it would be…”

“I’m a former Army medic; you can tell me.” 

I was a staff tech in a civil service clinic, not a  battlefield doc, but he didn’t need to know that.

“Two days.  Maybe.”

Two days?  Maybe?  Two days?  One?  It dawned on me to make the only gesture that mattered.  For two days, I could earn a lifetime of good merit points in heaven.  Not that I need them; but if the entrance requirements change, I’d like some extra credit points.  So I did it.  I said it.

“What about taking him home for his last days? We can do that, can’t we?  I’d do it.”

The doctor bowed his head in a solemn nod.

“That is always the best.” 

I don’t know if he said it as part of the insurance script to get patients out of the financial stream, or a hospital policy to open up another bed, or the heart-felt words of a compassionate fellow human being, or a little of all.  What matters is I volunteered for the second time in my life. 

The first time was the Army for two years; this time as a caregiver for two days.  Death with dignity.  I went in to talk to my wife, mother-in-law, and two teenaged sons. 

Four years later, after a series of fortunate caregiving experiences, Grandpa Ken has slowed down a bit.  From his death bed in the hospital where he could barely move one finger, he climbed stairs with assistance a month later. 

Instead of an IV tube, he took his meals at the dining room table.  Keeping him moving was the key. 

Today, he moves around in a wheelchair instead of a walker, and I feed him in his recliner, but he is still on his feet.  He stretches out and makes the moves needed to get from his recliner to his wheelchair and back. 

These are moves the professional in-home caregivers cannot perform due to licensing and insurance considerations.  In their view, Ken would be best treated if he were bed bound.   

Over the years, we’ve interviewed agencies, as well as private caregivers, to come in for a few hours.  Some came ready to keep him moving, realized the challenge, and quit after the first day.  One quit on the first chair- to-chair transfer attempt.  One agency sent a man in his seventies as a caregiver. 

It continues to be an interesting adventure, and now I’m the only person in the world who can move Grandpa Ken; the world champion of Grandpa Ken moving.

What is the difference between me and the rest of the world?  The first is that Ken and I talked about what worked best with him before he went silent.  No one else knows his likes better than me, and no one ever will.  Second, I have an acute sense of balance and anticipating movement. 

It’s the sort of training you can only find in one place, a wrestling practice room. 

I am a former Army medic, but I’m also a former high school wrestling all-American.  As a one-time Greco-Roman champion, I studied balance and footwork to avoid being tossed on my head.  Literally.  Footwork is something you don’t forget, like riding a bike.  Applying the same skill set to caregiving makes for an ideal caregiver move.

A formally-trained wrestler has better caregiving transfer instincts than any other athlete.  In no other sport do participants regularly hook their arms under their opponent’s arms and lift them up.  In what sport do they recognize the steps that lead to tripping, or not tripping? 

On a wrestling mat, you look to trip, watching the other guy’s feet shifting weight, then sweeping their lightened foot with yours.  Getting a guy with Parkinson’s to back up is impossible unless you shift their weight and move their light foot back with yours.  Only a wrestler knows how to do it safely.  A soccer player might give it a try, but only if Grandpa Ken wears shin guards.

The characteristics former wrestlers bring to caregiving are determination, compassion, and competitiveness.  The statistics on Parkinson’s guys say they will die from either pneumonia or falling.  Grandpa Ken had pneumonia after eating an ill-prepared meal at one facility.  He’s fallen at others. 

My goal is to provide him, and my mother-in-law who shares in his care, the best environment possible, one absent the fears of growing old and vulnerable.  Keeping him on his feet is the best way to accomplish that.  I share my goals with Grandpa Ken, treating him more like a training partner than a geriatric patient. 

When he came home from the hospital, I wanted to reach him where all others’ had failed.  When a man’s time comes up, so it seemed, they turn off the senses.  I knew Ken had been in the Marines, and I knew how Army Drill Sergeants spoke, so I had first-hand experience when I pulled a chair up and gave him his first Parkinson’s Boot Camp pep talk.  It went like this:

“You and I will work together.  We can do everything we need to do if we cooperate with each other.  The only thing that will try and ruin our work is Parkinson’s.  Parkinson’s wants you to curl up in a ball.  It wants you to sit, leaned over in your wheelchair with your chest on your thighs.  It wants you to fall.  Parkinson’s wants to choke you.  But we’re going to fight Parkinson’s every day, every minute. 

“We’re going to bring our A-game and we’re going to compete.  Parkinson’s is tough.  It’s challenging you.  I can help you give it a fair fight.  It’s taken its share of opponents, won it’s share of matches, but we will fight it together.  If it’s only you fighting, Parkinson’s wins easily.  If it’s just me, and you don’t help, Parkinson’s has already won.  But if we hit it together, if we surprise it and hit it where it doesn’t expect, then we have a chance.  That will give us a chance every day and the first thing in the fight is getting out of bed.  Let’s go.”

With an old wrestler’s sense of body leverage and balance, I helped Grandpa Ken out of bed.  He took a few steps.  The next day, he took a few more, until he was taking laps around the center staircase, moving from hardwood floors, to carpet, to brick.  He wasn’t wearing his Nikes, but he should have been.  It’s never a fair fight, but as long as you move with it, you get a shot in now and then.