Once again I find myself dealing with the same issues with my own parents as I do with people calling the assisted living. What is it about caregivers and especially male caregivers that tells them they have failed if they ask for help.
We have an on-going struggle with my dad to try to get him to see that the children want to be of help and he doesn't need to do everything on his own. It seems to be shouting into the wind for all of his response. His theory is he should be able to do it all and he doesn't want to impose. If your family is not there to pull together to help in a situation, that what kind of family are you?
Likewise I had a call yesterday from a man I've spoken with before, but he has called in the past about his elderly mother. Yesterday he called about his sister who was diagnosed about 4 years ago with early onset Alzheimer's. Four years ago, she would have been my age. Since that time, her husband has been taking care of her. Naturally, things have gotten more difficult with her care over the years. The call yesterday was from the long distance brother who wants to get help for his sister and her husband. The prevailing wisdom is that people are always better off at home (a topic I intend to talk about in a later post). So the husband spends thousands of dollars every month with sitter service, buying meals because his wife's care is all consuming and still he finds himself on the brink of exhaustion as her care needs increase.
My phone call with the brother consisted of talking about possible respite placement for the sister not only so we could meet her care needs, but to prevent the husband from literally wearing himself out. I see the same thing with my dad and my fear for him is that he will literally kill himself trying to take care of my mom without help from the kids or others. My conversation yesterday involved a lot of discussion about how to phrase the discussion so the husband will not feel like he is failing if he gets help.
I feel like that is a big reason there is not a better turn out for the Caregiver Support Group. For some reason people feel like it is better to suffer in silence, more virtuous or something, than to accept help. As the number of people diagnosed with dementia increases, this is going to become an even more serious problem. When the caregivers exhaust themselves, then who will care for the individuals with dementia. We will end up with both husband and wife needing long term care, which a huge percentage of the population has not prepared financially. So many questions and not many answers.
On the other hand, I look back over my career and I'm amazed at my experiences and how God has prepared me just for this particular role, both personally and professionally. What is most needed in the assisted living setting is not someone who is a nurse, although the nurse is invaluable. But as the administrator, what I find myself doing more and more is counseling people. I did enjoy my 7 years working for the mental health center. At the time, I thought of it more as the job that was available at the time. But now I see how those 7 years honing my counseling skills has better prepared me to be of serious help, not only to the residents and families I serve, but to the community. Once again, I see how God really does have a plan and really does know best.
Saturday, July 12, 2014
Saturday, July 5, 2014
Change in Focus
I have loved working with seniors since I was a volunteer at 12 years old. I have tried to work in other aspects of health care over the years, but it never feels right when I'm not working with seniors. Obviously in assisted living our focus is providing the highest quality of life possible for our residents.
When I first started at the assisted living, my philosophy about families was that we should do as much as possible because that is what they were paying us to do. I think my perspective was similar to others in health care, we were the experts, we knew what was best. Through the years I have matured to realize that families have to be included to the extent they choose. There are those families that certainly love their mother or father, but really feel under-equipped to handle the life decisions facing them now. So while we don't make decisions without talking to the family, we are fairly certain they will agree with whatever we recommend. While it may seem this makes things easier, to have that kind of responsibility is pretty stressful. We better be sure we are looking at every possible option and the consequences and letting the family know what we have found before we make any kind of recommendation. Then there are families who have their own ideas about what needs to happen regardless of what the consequences might be. And as long as the resident would not be in danger from their ideas, it becomes our role to support the values of that family and keep our own judgements out of it. I had an experience about 6 months ago which really brought home how important it is for some families to be involved in every tiny detail. It is my job to assess where the family is coming from and to involve them to the extent they choose. So the last few years, my professional growth has centered around supporting the family as well as providing care to the resident.
The last couple months, I see my focus changing again. I am finding myself doing a lot more counseling with families on how to cope with the aging of their parents and especially coping with the symptoms of dementia. I remember years ago when I worked in mental health and the requirement if you were going to work with substance abuse counseling that you had substance abuse in your own past. I thought at the time how unfair it was to prevent me from promotions just because I had not had that experience in my past. However, I can see now how my experience with my own mother makes a huge difference in how I relate to families at assisted living. Not only when families are looking at coming to assisted living, but I get a lot of phone calls just trying to find resources. I am certainly not thrilled to be facing my own mother's dementia, yet I can see that my own experience makes me much more empathetic when talking to families.
I had a new resident to move in this week. She has come to assisted living after a psychiatric placement. She had been experiencing more and more short term memory loss and it led to paranoid ideation. I know there is this perception out there that kids just want to "put their parents" in assisted living or the nursing home to be rid of the responsibility. But that is not the reality that I see in my day to day work. What I face are children who are very concerned about their parents, really want them to be happy, yet also safe and who are overwhelmed by the changes they see when there is a diagnosis of dementia or the symptoms of dementia. I feel when I can say to a family, "my mother had dementia and I have experienced many of these same things," there is a kind of relief with the children, they know I am not judging them or being patronizing, but that I can really relate and we can work together to provide the best quality of life possible for their parents.
I made kind of a flip remark to one of my employees the other day that "God really does know what He is doing", and I am finding that to be true in this situation. I look back on my attitudes and approach when I was a young activity staff person in the nursing home. I loved the residents and did my best to make their lives the best I could. But I did not have the kind of approach to help families. To be truly helpful to families, it does really take knowing their experience from the inside. And I really know that God does know what he is doing.
When I first started at the assisted living, my philosophy about families was that we should do as much as possible because that is what they were paying us to do. I think my perspective was similar to others in health care, we were the experts, we knew what was best. Through the years I have matured to realize that families have to be included to the extent they choose. There are those families that certainly love their mother or father, but really feel under-equipped to handle the life decisions facing them now. So while we don't make decisions without talking to the family, we are fairly certain they will agree with whatever we recommend. While it may seem this makes things easier, to have that kind of responsibility is pretty stressful. We better be sure we are looking at every possible option and the consequences and letting the family know what we have found before we make any kind of recommendation. Then there are families who have their own ideas about what needs to happen regardless of what the consequences might be. And as long as the resident would not be in danger from their ideas, it becomes our role to support the values of that family and keep our own judgements out of it. I had an experience about 6 months ago which really brought home how important it is for some families to be involved in every tiny detail. It is my job to assess where the family is coming from and to involve them to the extent they choose. So the last few years, my professional growth has centered around supporting the family as well as providing care to the resident.
The last couple months, I see my focus changing again. I am finding myself doing a lot more counseling with families on how to cope with the aging of their parents and especially coping with the symptoms of dementia. I remember years ago when I worked in mental health and the requirement if you were going to work with substance abuse counseling that you had substance abuse in your own past. I thought at the time how unfair it was to prevent me from promotions just because I had not had that experience in my past. However, I can see now how my experience with my own mother makes a huge difference in how I relate to families at assisted living. Not only when families are looking at coming to assisted living, but I get a lot of phone calls just trying to find resources. I am certainly not thrilled to be facing my own mother's dementia, yet I can see that my own experience makes me much more empathetic when talking to families.
I had a new resident to move in this week. She has come to assisted living after a psychiatric placement. She had been experiencing more and more short term memory loss and it led to paranoid ideation. I know there is this perception out there that kids just want to "put their parents" in assisted living or the nursing home to be rid of the responsibility. But that is not the reality that I see in my day to day work. What I face are children who are very concerned about their parents, really want them to be happy, yet also safe and who are overwhelmed by the changes they see when there is a diagnosis of dementia or the symptoms of dementia. I feel when I can say to a family, "my mother had dementia and I have experienced many of these same things," there is a kind of relief with the children, they know I am not judging them or being patronizing, but that I can really relate and we can work together to provide the best quality of life possible for their parents.
I made kind of a flip remark to one of my employees the other day that "God really does know what He is doing", and I am finding that to be true in this situation. I look back on my attitudes and approach when I was a young activity staff person in the nursing home. I loved the residents and did my best to make their lives the best I could. But I did not have the kind of approach to help families. To be truly helpful to families, it does really take knowing their experience from the inside. And I really know that God does know what he is doing.
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