Mark Harvey – "Peninsula Daily News"

There are steps to make in-home care work well

January 6, 2019

 

By: Mark Harvey

Email: harvemb@dshs.wa.gov

 

Let’s begin today by making what may or may not be an obvious observation: The vast majority of us will never see the inside of a nursing home, unless we (a) work there, (b) are visiting somebody there, or (c) are in for short-term rehab, so if that’s something that you’re walking around being afraid of, rest assured that it’s statistically unlikely.

Given that, let’s move on to overstating the staggeringly obvious: The vast majority of us would prefer to live out our days at home; granted, “home” might be a retirement community, an assisted living facility, a stick-built house, a mobile home, a yurt or an igloo, but home is home, and that’s where we’d rather be. Period.

So what? Well, I spend a lot of time talking to families about how to help Mom or Dad or both or whomever do exactly that, because (a) it keeps me off the streets, irresponsibly consuming precious parking spaces, and (b) those families want to help Mom or Dad or both or whomever do what they want to do, so do you know what we often talk about? Right: Getting help into that home.

And “help” usually will take the form of another human being, whether that human is called a “caregiver” or an “aide” or a “nurse” or a “housekeeper” or a “companion” or a “live-in”…Live-in?? Yeah, we’ll come back to that, but first, consider this: Do you know what all those names and titles have in common? Right: Stranger.

Oh, sure, sometimes you can find somebody you know or have met or comes highly recommended by a friend, or maybe a friend or family member leaps into the breach, but often, “help” = “stranger.”

The first miracle was probably getting Mom or Dad or both or whomever to even accept the idea of “help” coming in, because you know what message that sends? Right: You can’t do it alone. Would you want to hear that? Neither would I.

And now I’m being told that I have to accept help in MY home from a STRANGER? That’s going to go down sideways; in fact, I’ve seen “care receivers” torment (and, sometimes, inadvertently kill) people they purport to love because they insist that they will only accept help from her or him, but that’s a tragedy for another day; for today, let’s just stay with the idea of a stranger.

Think about it: If it were you, what comes to mind? Oh sure, we’ll assume that you (or someone) has done all the obligatory background checks and double-checked references and blah blah, so the possibility of paying (yes, PAYING – Remember, this is a business relationship) a predator has been minimized, but still, what comes to mind?

Someone who cleans differently, cooks differently (never mind probably eats different foods), cleans up differently, goes about things in a different order, probably has different preferences about temperature or light or noise or pets. Someone who will have to park somewhere. Someone who will have to put their stuff somewhere. Someone who may want to take a break or get a phone call.

Or eat. Or sleep. Or have things come up in their lives that they have to go deal with.

Depending upon what kind of help we’re talking about, like the very personal side of “personal care,” people who might bathe differently, or even (yes) toilet differently. Wow.

And if this person is going to live-in, everything we just mentioned plus about a million other little day-to-day realities will be magnified magnificently – It will change your life. Are you ready for that? No? Then why, pray tell, would you expect Mom to be?

It’s absolutely true that we all hear wonderful stories of paid caregivers and care receivers who have bonded and become “family” – It happens, and it’s lovely. We also hear stories about predators that can even sink to abuse and financial exploitation – It happens, and it’s horrible. But the vast majority of these situations are somewhere in-between, and in spite of everything I just said (barring the occasional personality conflict), they work surprisingly well most of the time. Here’s what makes them work:

  • Good, decent people, on both sides of this business relationship, genuinely trying to make it work;
  • Everybody remembering that, underneath it all, it is a “business relationship;”
  • Patience;
  • Honesty;
  • Flexibility;
  • Everybody genuinely trying their best to listen, to hear and to be fair, and finally, above all else…
  • …negotiation.

Right: Negotiation. Ongoing negotiation.

Start slow, if you can – An hour or two, here and there, doing easy stuff – Has anybody killed anybody yet? No? Good! Then, maybe a few more hours, here and there, maybe some harder or more “personal” things, step-by-step, day-by-day – Be honest, listen, negotiate.

Tell the truth: This is an “invasion.” It is an “intrusion.” There have to be…adjustments.

And remember that caregivers have lives, too – Again, this is a business relationship, not indentured servitude. You want to be treated well? Or have your loved one treated well? Then, treat the people who are helping you or them, well. The Golden Rule isn’t rocket science. And here’s one more thing that most of us need to remember:

Respect, like contempt, is earned.