Living in an aged care residence at this time of year brings home the realities of life. Too many of our residents do not have any visitors and the aloneness they feel can be crushing. Many feel abandoned by their families. Many have unhappy visits from family members that they find difficult to transact pleasantly despite their hopes for a “happy family” experience. And it should be said, some of our residents do indeed have pleasant and fulfilling experiences of being with family who come and take them home for a day or two to share in their lives and celebrations.
This time of year brings home the stark reality of the lack of satisfying and nourishing attachments for many of our elders who have been dislocated and isolated from their families, some for years. This creates a deadening effect for some as they defend against the pain of not being loved in their old age. For others they rail against it and become angry and upset with those nearest to them – the care staff and fellow residents, pushing away the very people who are there to care for them.
We need infinite patience and a caring mind to see the opportunity in this period of the year. This is an opportunity to see the aloneness and isolation and break it down with a quiet (perhaps brief but regular) warm visit and friendly conversation that establishes or sustains the rapport you have with the elder.
If the person has cognitive impairment they will likely be living with a constant threat of isolation and aloneness and a sense of struggling to make good sense of what is happening and feel competent to handle it. We can step in and provide a support to their desire for competence by helping them finish the sentence, patiently listening, or even just sitting quietly for a few moments and smiling and not blaming them for their angry outburst but trying to find an explanation. Its not complex but it seems to be difficult to do these simple things consistently.
So there it is. My wish for 2012 is that you find at least one moment this year to give another person comfort in their isolation and aloneness and support in their desire to feel competent once again.
We had 32 very motivated people participate in a great day of ideas and problem solving around Working with Families in Aged Care today. They will put into practice such ideas as being proactive in working with families, using email to build trust and rapport from the waiting list time, being aware of the previous roles of family members in helping them to remain in a good emotional space and not invalidated by our taking over.
Families affect the wellbeing of the people you care for. Some are easy to have involved and others are difficult. Every one of them is doing the very best they can and in the only way they know how, to be involved in the care of their older relative.
Think about your family for a moment. It is the place where you attached to your mother and father and learned the ways of relationship and behaviour in society. How to function and feel, how to solve problems and make your way in the world. You also probably learned how to avoid some feelings. Its all part of your own attachment history with your caregivers.
Now come back to the families you have in your work. The older person is the attachment figure or caregiver for the younger people who visit them, their adult children. And you are now an attachment figure for the older person. How the wheel turns.
Some families do not cope well with being replaced by professional caregivers. They feel angry and guilty at the same time. They think they should still be the primary person to provide care for their mother or father. Some parents have instilled this guilty thinking into their children so they are caught. Others find themselves doing it naturally.
Caring for an elderly parent is not easy so we should be patient and understanding but also careful to maintain healthy boundaries for ourselves and them.
Next Thursday you may wish to come along to the latest public training day we are holding on “Working with families in aged care” at the Assisi Centre, Rosanna, Victoria on Thursday August 5th from 9.30am to 4pm.
Bookings limited by space so book soon on 03 9431 0311
Caregivers of people living with dementia at home are often bundled into the one box of “caregivers”. However, research shared at the ICAD 2010 in Hawaii today has shown the importance of treating the adult children carers differently from the spousal carers.
Adult children who care for their parents with dementia have higher levels of burden than spouse caregivers. Their lives have been interrupted by dementia and felt bound by duty to endure the burden of caring. They can fearful of the future and and the likelihood of increasing burden as the disease progresses to its natural conclusion in death of their loved one.
Spouse caregivers expressed more intense grief than the adult child caregivers. This makes sense when we consider the lifetime of commitment in a relationship that is usually on an equal footing and now they find it has changed irrevocably. They have lost companionship, roles, freedom hopes for the future and the intimacy that can be so satisfying in later life. They are robbed by the disease and now find themselves in a carer-dependent relationship.
It raises issues for us in terms of how we support these carers. Other presenters today showed how vulnerable caregivers are to depression and other forms of stress and illness. Support programs are effective in reducing the burden caregivers feel and the depression they experience, and can have a good effect of reducing the disturbing behaviour that can cause such distress for caregivers.