When I first started writing about caregiving, I had worked with family caregivers in home health care settings (linking family caregivers to respite services) and in nursing homes (helping them admit their care recipient to the facility). But, I had never provided direct hands-on care.
When the opportunity to work as a private-duty caregiver for Evie, 88-years-old and failing from a series of small strokes, presented itself, I jumped at the chance. I decided if I was to provide quality information to family caregivers, I needed to walk in their shoes, albeit for only a short time. I thought it important to better understand their day. A friend, her sister and another friend already worked for Evie; I filled a shift (Tuesdays and Fridays, 9 a.m. until 3 p.m.) that was open.
I was familiar with assisting with ADLs because of training programs I had previously sponsored for family caregivers and through osmosis in the nursing home. I worked as an admissions director, but I also interacted regularly with CNAs, charge nurses, therapists.
But that doesn’t mean I didn’t find providing personal care very hard, especially when I would second-guess myself. And, Evie, just as is anyone with frailties, chronic illness and memory loss, was often cranky and uncooperative. I quickly learned if I let her intimidate me, if I let her call the shots, then she wouldn’t wear her adult briefs, she wouldn’t bathe, she just wouldn’t.
After a few initial struggles, I learned that our personal care regime worked best when it honored her preferences. Evie was a late sleeper, often waking at 11 a.m. And, by the time she awoke, she was hungry and cranky. With the other caregivers, Evie began her personal care routine as soon as she got of bed: A trip to the bathroom, a sponge bath at the sink, assistance with dressing, then to her chair in the family room to needlepoint while breakfast was prepared.
But, I found this schedule often let Evie’s hunger and crankiness negatively impact the routine. Incontinent, but disgusted by the thought of wearing an adult brief, Evie often began the battle as soon as she got out of bed. She often threw the adult brief against the wall (“I don’t need that,” she would yell) and would rail against the clothes chosen, particular her Orthopedic shoes (“I hate those shoes. I want another pair.”).
I found, though, if I adjusted her schedule, we would have a much easier time with the brief and the clothes. So, our routine became: When Evie awoke, I assisted her to the toilet, (I would make her bed and lay out her clothes at this time); then we walked, Evie still in pajamas and robe, straight to her chair in the family room; she needlepointed as I prepared breakfast. I didn’t worry about her incontinence for the short period during breakfast.
After breakfast, as I helped her out of her kitchen chair, I would say: Let’s go brush your teeth. And, then on the way to the sink, we made a quick stop at the toilet again, to the sink for a sponge bath (except on Tuesdays, the dreaded bath day), and oral care. Then, to the bed, which displayed her clothes neatly laid out. I handed her fresh underwear and her adult brief. She usually told me that she hated the brief (to which I always replied sympathetically: I know) but in a quieter manner. And, she always put it on. And, she made comments about her shoes, but she always put them on as well. I was always amazed at what a good breakfast could do for Evie’s disposition.
If you and your care recipient struggle during the personal care regime, try some adjustments in timing, demeanor, even the environment. And, try to add some fun to the routine: Singing songs and listening to music your care recipient enjoys can make a huge difference. A personal care regime can turn into a terrible power struggle. You want your care recipient to do this–he or she wants you do that. Give in–your care recipient will always win. Which is why making some adjustments can make you both winners.
