Tag Archives: caregiving

Dealing with Difficult cases

Being a caregiver can be both draining and uplifting. The people I work with are often fragile. They have damaged bodies and/ or minds. Some have broken psyches. Yet it is a precious thing when you know you have made a difference one day at a time.

Working with the family can be challenging. They have expectations and different perspectives than you. This creates confusion and frustration at times. As an example, yesterday was my last day on a difficult case. The man had PTSD from his time in Vietnam. He had also lived alone for many years and had developed some antisocial habits.

This man was noncomplant with his medications and virtually every other activity of daily living. He had mannerisms that were offensive. He repeatedly spoke about wanting to die. Depression was evident. He is a heavy smoker. His mind couldn’t get past his difficulty walking due to a stroke. Not only that but he had Obsessive Compulsive behaviors. He was reactionary to most situations. His mind would get caught in a loop, circling around his mobility problems, focusing on the negatives, unable to see solutions, only concerned with his leg and his inability to walk independently.

As a caregiver, this case demanded fortitude and endurance. His Power of Attorney loved this man but didn’t see some of his more offensive behaviors. The chain of information was sketchy. For instance, she was upset because she thought I was complaining about the fact that that he hadn’t taken his medications and thought it was me who complained. She was told it was my last day and was upset. She reacted to the continuing medication issue. I hadn’t raised the issue that day but the physical challenges of not taking his medications was evident.

She was also upset that I didn’t make food for him, bring it to work and go food shopping for him on my own time the way another aide did. Mainly she was upset I was leaving when the client was happy with me. She was also upset I charged mileage even though it was stated in the contract.

It is rare that I give up on a case. I tend to like the people I work with. But I am learning it is okay to occasionally be selective. I need to do what is necessary for myself. And I have learned my needs have to come first because at the end of the day, I need to feel I have been a force for good.

I am not a quitter as a rule. I was on one case for 3 1/2 years where the Alzheimer’s affected woman would become violent when she didn’t want to do something like taking a shower. I loved this woman and was with her until her death.

However, I have learned there are always other caregivers to take over. I am not the only person who is competent. And I am more effective if I am happy in the case. I am less likely to suffer burnout if I feel like I am making a positive change. I always give my best, but life is a lot easier when you want to be where you are. Knowing your limits is essential. It is something I had to learn the hard way.

Care Receiver

I have been a caregiver for many years now.  Taking care of the elderly has been a privilege and hard work.  So now it is a humbling experience to be the recipient of care.  I had surgery on my foot and have to keep it elevated for a couple of weeks.  The past several days I have had a caregiver coming to care for me.  I feel all my secrets have been exposed . . . that extra roll around my middle, my fastidiousness, etc.

As I gain a little more mobility, I feel I am regaining myself.  To turn over my care to another is disconcerting, to say the least.  Being helpless is not a comfortable feeling.  It is giving me a sense of how it feels when I am caring for someone else.  You need to make allowances for the caregiver’s way of doing things – your way is not the only way.  Still, it can drive you a little crazy to see someone else’s handiwork where things are not exactly the way you do them.

There are clients I’ve had that instructed me step-by-oh-so-minute-step how to do every task, telling myself this person thinks through these things day-in, day-out, with little else to think about as the days wear on.  I understand a little of that now.

I am more than grateful to have a wonderful aide who has stood by me this week as I transition back to a somewhat more active life. Knowing the recovery is going to be 6 – 8 weeks long, I better learn how to be fully independent again.  Home care is not cheap.  But I have to admit, I like my knee scooter.  It’s like having a skateboard and I can move much quicker than otherwise, especially as I’m supposed to be off my foot (do they really think that’s entirely possible?)

It’s good to be back.

Caregiving challenges

His face a maze of rivulets and ravines, crutches help bear the weight he carries,
his feet heavy, movements ponderous. Yes, age has wormed its way into his bones
but more, he carries the years upon years of caring for a willful, capricious wife –
most times removed, caught up in her own world, with people and presences
no one else can share or know, leaving him alone with the battle of care.

Caregivers have a heavy burden even with the easiest people those with minds still clear, bodies more or less functional. Whose age or disease make the need for care, daily or occasionally, a burden, willing or not.

But for others, caregiving  carries a much different burden. When they must manage a violent or mentally challenged person, a person with bipolar or schizophrenic
episodes, one whose body has worn out, needing total care, it can make the caregiver
sicker than the person cared for.

That old man has cared for his wife since she had nervous breakdowns forty years prior, sitting by her bed every minute, ignoring all else, including his only son, alone, left to fend for himself, do the shopping, laundry, cleaning.

He has abided her demands, given into whims, defended her right to choose not to medicate. In so doing, she has chosen a tangled trail leaving her family to carry a hard burden of care allowing the right of self-choice to medicate and feel largely better or be “in control” of herself as she berates, hits, babbles, ignores him or
or talks gibberish. BUT always remains the center of attention.

The burden of caregivers is their lives aren’t their own, at the least for sizable chunks of time.  From bill paying and shopping, to bathing, feeding and all facets of self care,
they spend from Sunday visits to constant care for family or hired professionals.

When it comes to Alzheimer’s, all bets are off. You are not often recognized for yourself. Hitting, endless paranoid pacing, constant distraction, inability to  voice thoughts coherently . . .it is exhausting. But it is also a means to give back, to make amends, to relish the moments you have because they may not be long.

That old man now must also contend with a son who believes his mother has every right to choose not to medicate, even though all who are part of her life are negatively affected by that choice. The son refuses to listen to his own children who have enough detachment to see the situation more clearly.

When the Father is overwhelmed, the son brings her, 600 miles away, to his home
where she sits alone, hour after hour, or wanders off with the dog, lost, unaware of where she is or why others are yelling at her to get off the street. It’s not care, not a solution, it’s an ill-chosen stop-gap measure that could hurt or kill her.

We need to be aware of the long-term effects of the decisions we make for our loved ones or those under our care. Sometimes the right solution is personal care by the family, sometimes it’s professional care within the home, but assisted living or skilled nursing homes may be the best options too.  Money is, of course, a vital component in decision-making, as is insurance coverage, and what the impact will mentally have for the person being cared for.