It Takes a Village to Preserve the Dignity of our Elders

I was involved in home care with a couple of different agencies for two and a half years. It can be a real eye-opener seeing how people cope, or don't, with their limitations and limited resources.

I was sent in to evaluate and draw blood work on a gentleman who was was very frail and malnourished. He was absolutely selfless in his care of his wife who had suffered a stroke. He lifted her in and out of bed into her wheelchair, did the cooking and his home was filled to excess with piles of clean laundry and bags of trash. He really needed help but he did have some interesting ways of getting things done. I enjoyed how he used his pliers and other handyman tools to cut up medication for his wife. It was not so amusing to see what kinds of food they were eating and it was a struggle to get him to accept care for himself. He constantly tried to get me to do things for his wife instead of him.

Families can be the reason the sick, disabled or elderly person lives well or struggles. I took care of a gentleman who was unable to go up and down stairs without a valiant effort and a lot of help from his sons. He was "trapped" in an apartment over a garage. In the winter ice would freeze up the stairs and it was a dangerous climb to get to him. His family was slowly remodeling the "basement" area of this structure so he could live down there and be a little more able to get out and do for himself. They were good kids! Unfortunately he died before the work was done. :^(

In the same neighborhood I had another patient who was very very fragile. He was a 92 year old widower living alone. Every day I would go into his home and find him with new skin tears, bumps and bruises. He got meals on wheels and split the food between lunch and dinner and that was about the only part of his situation that "worked." He had four grown children, some of whom lived in the same town, and they did not visit or help out. The furnishings and decor were from the seventies. Even the dust was from the seventies.

I found him one day making out his bills and discovered that it took him hours to write a couple of checks to pay bills. He had trouble seeing and holding a pen but somehow managed. He struggled to read the small print on his bills and it was just such a sad thing. I wondered why someone didn't come by and do this chore for him once a month. There were doorstops on the floor to trip over, too heavy for me to lift and I finally picked up on the fact that when he sat on the side of his bed in the morning he slid right out onto the floor.

Every time I visited him I had to call his doctor, write orders for antibiotics and bandages and call his family. There was never a visit that didn't include a patch up job. Eventually we had to discharge him from home care, with the cooperation of his doctor, because his children had decided they didn't need to help out because "he has a nurse." These home visits are typically from half an hour to an hour, more in an emergency but certainly not a substitute for a caregiver. Sometimes, much as you hate it, you have to discharge a patient from home care because you are "perpetuating an unsafe situation."

Much of our society has become very independent and interdependence is eschewed as being too much trouble, not any fun or interfering with the privacy of the more able bodied people in the extended family. I have heard people say "I have my own family to take care of," and not think another word about it. I fume because I imagine that these parents did selfless things for their children like keep them alive until they could care for themselves....... that's a rant for another time.

Cliche, maybe but it does take a village....... to preserve the dignity of our elders.