Who Speaks for the Speechless?

sue-whospeaksforthespeechless(Originally published on Voice Space.)

That was my dad only two short years ago. Today, he lies in a hospital bed in a room outside of my parents’ home, unable to communicate, enjoy life or the company of his granddaughter, unable to walk around or sit in “his spot” on the couch. These two years have brought many changes, but the most difficult has been his inability to tell us what is going on. It is nearly impossible to figure out his needs and wants.

It is so disappointing to see the way my dad is treated because of this inability to communicate. He is frustrated and he lashes out. People, especially caregivers, seem to think that he is able to control this behavior and that we, as his family, are able to influence this behavior in some way. My mom has been told numerous times about his “bad behavior” or his being “uncooperative.” Caregivers have told her to “talk to him.” That they “will try” to do things like give him a bath or feed him or shave him, but that they “can’t make any promises.” I am confused by this, as I am not a caregiving professional, but I am aware of the symptoms of dementia that include angry outbursts, uncooperative behavior, etc. So, why are these supposed “professionals” confused or surprised by this behavior?

I question the training that is received by these individuals who often become the primary caregivers for these individuals who can no longer speak or advocate for themselves. We have a relatively strong family unit and my mom has an additional caregiver for herself (she is suffering from long-term cancer) who goes with her twice a day to visit my dad. Without these visits, I am unsure of what care he would receive. My sister and I are well-educated and financially secure. We can take the time necessary to come down and deal with paperwork and medical appointments and medicine needs. I often think of what my mom would do without this support network. But, there must be many out there who do not have these support networks. And even with this support network, my mom is often a nervous wreck, worrying about how to do better by my dad, worried about what her medical results will show, worrying about what will be done with my dad if her cancer takes her before his dementia takes him.  And there is no comforting her out of this. Her concerns are all valid. Her life has become one of a depressing wait for death to take one or both of them. And I can speak for and advocate for them, but I cannot take that end point away.

So, why am I saying all this? What is the point? What do I want done? The answers are not as easy to find as the questions/frustrations. I think the reasons I’m saying all this is to consider how we, as advocates, caregivers, citizens who will probably be part of this aging community (or maybe already are) can make this place a bit better. I know I’m not the only one who wonders about these things and some have already taken action – my new favorite place is Caregiving.com - part resources, part therapy, part support! I know there are many blogs out there. I know that there are great movements in creating better education, better advocates, better speakers for those who can no longer speak. I hope to join those movements and make some changes, if not for my own parents, then for parents of others, and myself, and my daughter.

It isn’t easy, though. But, nothing worth doing ever is.


5 thoughts on “Who Speaks for the Speechless?

  1. Petra Burdine

    When an elderly person “acts up” it is most often a form of communication. Especially in elderly persons with communication difficulties, “acting up” is a tip off that something is wrong. The person may be in pain but is unable to say so. Or the Caregiver, nurse, etc. are trying to rush them, are not gentle enough or may not be as nice when nobody is watching as they want family to believe. The way a caregiver or nurse talks to an elderly person may also effect the “acting up”. When I visit my clients I always pay attention to the client’s behavior and what is not said and then find the reason for the potential problem.

  2. Avatar of lisa_renea

    In Virginia, where I live 40 hrs. is the minimum training Medicaid requires for a personal care aide. And a lot of that training does cover how to properly care for the patient. I know it’s a non-medical position but when you go into homes you have to deal with different crises, various health problems, and in the majority of cases these individuals have either problems with depression or anxiety, or both. Aides have people’s lives in their hands, 40 hours isn’t enough training.

    • Avatar of SueSue Post author

      Lisa – I agree that 40 hours is not enough training. And I think at these board and care facilities, there may not even be a requirement for that. I am unsure. I know that to become a CNA (Cert. Nursing Asst.) in Ca takes six weeks of classes, much of that is training done in nursing homes, etc. I think that is helpful. But, I don’t think the people working in the Board and Care are actually CNAs. So, I’m not sure if there is that same requirement for Medical (California) or Medicare…

      Either way, I think that there is definitely a lack of training that is specific to dealing with these particular patients – non-communicative patients – which seems important. A communicative patient can tell you when they are in pain or when they are thirsty or when they are hungry, etc. But, these patients can’t and it seems like a lot of the people working with my dad take that silence as “not wanting anything”…

  3. Avatar of DeniseDenise

    Hi Sue–This is just a terrific post. I think a big problem is that many facilities (and home care agencies) don’t offer attractive salaries and benefits which makes attracting qualified individuals really difficult. I guess I wonder: If this is how the CNAs treat residents, who treats the CNAs like this? I wonder if they pass along the frustrations they feel in their job and in their lives.

    It’s such a huge problem and only going to get worse. I love how you ask us all to work together to make it better.

    I love the picture of your daughter and your dad. Your daughter is soooo cute. :)


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