I met “C” about a decade ago. He came to the office I was working in at the time with a charming lady for whom he was caregiving. There are a few things I recall from our meeting. The first is I was struck by a male working in a field usually thought of as intended for women. C was a man providing caregiving for a woman. The dynamic almost invites challenges, questions, and obstacles. It is one of the horrible myths of our culture that men are not thought of as caring.
My initial surprise, however, was quickly overcome as I observed C interact with his employer. He was so gentle. His tone when he spoke with her was, well, dulcet is the word that comes to mind. His voice reflected his gentle manner and I saw the effect on C’s employer. She was reassured and felt safe in his care. It was clear to me that this was a relationship based on a firm foundation of trust and compassion. It was kind of beautiful to observe.
The other thing I noticed is that C presented handsomely and spoke with ease and intelligence. It dawned on me that C is the sort of person who would be easy to spend a day with either going to an appointment or visiting an art gallery. Even today I can effortlessly imagine that C provided his employer with the kind of companionship that brought happiness, dignity, and value to the autumn years of her life.
After 15-years together, C’s employer passed away in 2017. I cannot imagine what that must feel like for a Caregiver like C. Caregiving is unlike other positions in the Private Service field. Where blurring of professional boundaries are forbidden in most roles, Caregivers are a little different. In many ways their role necessitates a degree of boundary blurring since the core of what they are offer is care and companionship. With the loss of his employer, C experienced both the loss of his job and the loss of a companion. I think it is worth taking a moment to consider this.
I have wanted to write on Elder Caregiving for some time now. My motivation is both personal and stems from an agonizing sense that, as a society, we are shamefully unprepared to care for our aging population. In Canada there are social services and income support programs, but there is no government ministry dedicated to formulate forward-thinking policy on the demographic tsunami that is here. This, in my opinion, is a dereliction of social duty.
I also know that there is a lack of popular understanding about the kind of support that does exist. This includes the profession of Caregiving. As I thought about the article, I understood that I should start by interviewing a professional in the field. C immediately came to mind. What better person to particularize the fundamentals of the role and the challenges people face who have the heart, soul and skills to seek.
I spoke with C recently and this is what we discussed:
Tell me how you got into this field. It almost occurred by accident. At the time I had a sportswear, surf-wear clothing company. I was a young man and my father approached me and told me about a colleague’s father who had been in a car accident, experienced cognitive impairment, and needed an “assistant.” I wasn’t sure what the role would entail, but I recall initially thinking that I would be a glorified baby-sitter. At the time I had no experience working with seniors, but that’s kind of how things started. In the beginning I didn’t get into the field by trade. Things just evolved from that point and I was eventually able to achieve my Personal Support Worker (PSW) certification through George Brown College in Toronto.
As I look back, I understand that the role became a fit because I never had a grandfather. Both my grandfathers passed away before I was born. So I never shared time with an elderly gentleman before.
Tell me about your first week on the job with your most recent employer. Well at first I worked for both husband and wife. When Mr. passed away after 4 years, the family decided to keep me on to look after Mrs. since the relationship was established. For 11 years I worked with her.
At first it was uncomfortable for all parties. My employers knew why I was there but they didn’t necessarily know what I could do for them. So at first I would establish what they needed and after doing A, B, and C, I would start to do things that weren’t necessarily asked of me like fixing a leaky faucet. These things would come as little surprises to my employers and it made their lives flow that much easier. Once they knew what I could do, then they could just ask as opposed to being immobilized by not knowing. That was the avenue towards establishing a comfort level and trust.
What does a Caregiver do? I guess the simple answer is as much or as little as the employer needs. Caregivers do a little at first and then they do more. They need to adapt to the demands of the situation and hopefully grow in the role.
I recall a situation when Mr. was choking and then, coincidentally, Mrs.’ blood sugar levels dropped and she was about to pass out. Both things were occurring at the same time. When things like that happen, you have to act fast and once handled be prepared to go off and polish silverware.
Often clients don’t know what they need. In time and through observation you almost become them, which helps to determine what those needs are. It’s not really a case of crossing of boundaries. It’s really just part of the job. Basically you pay attention to the mental and physical needs of the employer, which can change very quickly.
What were the most difficult aspects of your job? The most difficult? I think I’d say flexibility. There’s also the risk of taking on too much at one time and spreading yourself too thin. You need to know your limits. Caregivers offer care up to a point. They need to know their limits and work at a level just below those limits so that they know when to call the doctor and/or the Power of Attorney (POA). At some point Caregivers will encounter life or death situations and they need to react within their limits and reach out to the right people. There can be serious consequences if they make the wrong decision.
In researching this article, there is a lot of data about depression and clinical anxiety among caregivers. Did you ever experience this? If so how did you manage it?
I did not. I was able to creatively diversify my interests and hobbies to give me the release I needed when I needed it. It was a very important thing. Just as a student at university cannot work 24/7, Caregivers need to give themselves breaks. Some employers may try to own you and your time and there will definitely be problems that arise in situations like this. You cannot lock yourself into those kinds of relationships.
How do you emotionally handle the suffering of the person you care for?
You become so tied in and in tune with your employer that you feel their hurt. You see it, even if they might not as with dementia cases. I guess the best way to respond is with compassion and endeavour to provide them with as much normality in their life as you can give. You cope by helping. You can’t just run away into a closet and cry for them.
What are some of the pitfalls of managing relatives? How do you avoid these?
There are definitely pitfalls. Every family member often has their own agenda and very often they feel that they know better than me or other members of the family. I always handled situations like this respectfully. I would then go to the POA to find out more, verify facts and receive direction. Caregivers MUST have a point person.
As your client’s health declined, how did you manage that?
I took the approach that my employer was the same lady I’ve always known and I adapted. From walking, the person will go to a walker, and I would respond by gently placing my hand on theirs to help guide them. Wheelchairs often follow walkers and so you push the wheelchair with care. From that point the person might become bedridden and so I would spend time keeping them company, holding their hand,
speaking with them and watching television together. It just changes as things evolve and with each change you adapt. Adaptability is so important in Caregiving. Changes with the elderly happen slowly and then suddenly and you need to be prepared.
Were there ever times when you thought that the job was beyond your coping and/or skill level? Yes, only once. Towards the end with my employer I experienced a feeling of really not knowing what to do. It was the first time in 15 years I experienced a feeling like that. I responded by calling the doctor, getting direction and clarification. I also made sure to get those instructions in writing so that the protocol that was verbally explained is outlined on paper. It’s at these kind of moments when the risk of legal ramifications are highest.
What advice do you have for families with aging parents? Dementia is a huge concern and the rate of diagnoses is increasing. Get affairs in order sooner rather than later. No one wants to do it, but it is so important. Get wills done. Get Living Wills completed. Name a POA so that they can act when the time comes. There will come a point when all of the above is too late and that presents big problems for all involved. Think of it this way... You can’t predict a fall but you can take steps to prevent one.
If you were elected Prime Minister tomorrow, what would you do to improve the current system? I could be wrong about this, but I don’t believe there is a Government Minister or advocate dedicated to the elderly. If I’m right about this, I can’t believe that nothing has been done. The demographic changes are happening and as a society in 2017 we need to come to terms with the implications. Where I live, over 50% of residents are 65-years of age or older. That’s a huge number.
How were you generally treated by extended family? Did they seek your advice? Because I was with my employer for so long, family almost always conferred with me for advice. It was only in the final month when this changed. At that point the family took over and I faded into the background.
Can you describe the ideal Caregiver for me? A caregiver has a singular desire to help. If they are in it for the pay cheque, they will likely never do well in the profession.
Before anyone considers a career in Caregiving, what advice would you give people? What kind of personality traits should they have before they start developing the skills? I would say that, most importantly, an individual must want to help the elderly. They need to recognize the need to care for the elderly. Who the person requiring care happens to be should not matter. Caregivers should see a person who should be protected and have their dignity preserved.
The second thing is that the person must be flexible. There is no script for this job. Finally, they must be compassionate and be contented with the fact that they have made a difference in another person’s life.
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With those thoughtful and compassionate words I recognized that the interview had come to a natural close. I know there is much more I could learn from C, but sometimes in an interview things flow towards a natural conclusion and I try to respect that. These days C is spending time at his beloved cottage with his family. He’s keeping busy and I can’t help but believe that there is a kind of healing process taking place. C would likely never admit to this, though. Like his employer, he’s too dignified and professional to make such an admission. For my part, however, I can’t imagine how it could be any different.
C’s employer was fortunate to have him in her life. I know that C would add that he was fortunate to have her in his life. And in those two sentences is a beautiful balance. There should be more of these balances in our world. To give is a kind of gift to yourself. To accept kindnesses is one thing. To offer them, consistently and passionately, is something else. I think C would agree with this statement.
AN UPDATE: I was delighted to learn that C and his wife have purchased a Seniors’ Retirement Facility in Canada’s beautiful Muskoka region. C is also putting his years of experience to good use by offering consulting services to families who require assistance with needs assessments and forward planning. Families are in good hands with C at their side. To learn more, feel free to contact me.
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