Must-Read Caregiving Advice: How the Elderly WANT to be Treated
By Guest Blogger Martin Rice of Fifty2NinetyOnline.com
Caring for the elderly, whether paid or unpaid, is certainly one of the most difficult jobs out there today. The problems involved in taking care of people who, like most of us, have been independent their entire adult lives can be overwhelming. Many of these problems are due to the health difficulties of the elderly and the frailties that make them unable to care for themselves in the first place.
But caregivers’ problems also stem from the difficult behavior shown by the elderly, which makes caregiving an additionally trying and highly stressful job. The elderly in our charge can be abusive, psychologically and sometimes even physically, they can seem to be stubborn, unreasonable, and outright mean.
Fortunately, there are many places to which caregivers can turn to find support, places where they can discuss their problems, find suggestions for coping, learn about resources for assistance in all aspects of caregiving, and, no less important, find sympathy.
One of my favorite places for this kind of support is www.agingcare.com/Caregiver-Forum. This is a place where you can find hundreds and hundreds of questions posed by caregivers who are desperate for help, and which detail the most vexing and stressing problems. And you’ll also find hundreds of sympathetic and helpful answers provided by the experienced caregiving members of the forum.
What I find missing from the extensive network of help and support sites for caregivers, however, are discussions about how our elderly charges want to be treated; how to avoid being impatient and condescending with them; how to take their emotional and psychological needs into account every bit as much as we take their physical needs into consideration; and how to ensure that their self-respect, dignity, and quality of life have not been significantly diminished by a caregiver who only sees his or her responsibility to the elderly person in terms of giving physical care and.
It has also occurred to me that much of the seemingly abusive, stubborn, and unreasonable behavior on the part of the elderly, which I referred to above, is most likely the patently human, psychological defense reaction of people who feel they have lost so much of what they had enjoyed during their long lives, namely: their independence, their dignity, the means to express and exercise their will, the respect they were accustomed to simply by virtue of being an equal among equals.
Caregivers, often with the best of intentions, do not treat their charges as equals among equals but much like children among adults.
My wife and I came across a vivid example of this just the other day while we were visiting my 92-year-old father-in-law at a large, highly respected, residential complex for independent-, assisted-, and nursing-care residents.
A woman, whom we know, is an independent-living resident at the Village. Her daughter visits her everyday and helps her out with things she needs help with. Because of a large building project at the Village, some residents had to move from one apartment to another. The mother wanted one of the available apartments that had a beautiful view of the surrounding mountains. Her daughter, however, decided that this apartment wouldn’t do because another one was much closer to the elevator, much closer to the entrance, and much closer to the dining room, thereby requiring her mother to do considerably less walking and providing more convenience. As the daughter was telling us about this, the mother said in a quiet and rather small voice, “but I’d rather have had the view.”
To my way of thinking, this is a perfect example of the way older adults are unfairly treated by the people who care for them and even love them. The fact that the mother is an adult in decent health and can live independently to a great degree, and who is a person capable of making her own decisions based on her wants and needs, seemingly was not considered by the daughter who felt that her reasoning far outweighed that of her mother, and that because her mother was elderly and did need some help, her wants and choices could essentially be disregarded “for her own good.”
I think it’s rather obvious what will happen to the mother now. She’ll spend years in an apartment she’s not happy with, she’ll feel hurt or resentful or both because she wasn’t able to make her own decision about where to live, her sense of self-worth will be reduced because she’ll have come to feel less independent and able. In general, her happiness will be diminished and, consequently, so will her quality of life. And, as an ironic aside, the fact that she would have had to walk more every day, had she got the apartment she wanted, would have most likely been better for her health.
The daughter in this case is not an unkind or uncaring woman. She believes that she has her mother’s best interests at heart and only wants to do what’s good for her. We can see in this incident, however, that simply feeling this way does not guarantee that the mother’s best interests are served. Her mother is in a much better position of knowing what’s good for her than her daughter is.
The reason this happened, and the reason that this type of incident is repeated uncounted times every day by caregivers who do care, is because the caregivers are not thinking matters through, they are only seeing things from their own viewpoints and disregarding the fact that their charges are thinking adults whose expressed wishes must be respected.
So what can caregivers do in order to help reinforce and preserve older people’s sense of dignity and self-worth; to minimize their feeling marginalized, infantilized, ignored, invisible; to enhance the their sense of well-being, happiness, and contentment?
Here are some tips to help caregivers achieve these goals for the people they help. These tips are not all new by any means, but they bear repeating and reviewing both to enable the caregiver to be more successful at his or her job and to improve the elderly person’s quality of life.
Be A Person-Centered Caregiver
Elder care must be person-centered, not patient- or object-centered, in order to maintain the elderly person’s dignity and self-worth. Always remember that you’re not dealing with a child but with an adult who has much greater experience and capabilities than a child and in many cases, greater than you, the caregiver. Ask yourself, “If this were a person I worked with in an office, would I treat or talk to him or her the way I’m treating and talking to this person in my care?”
You know that the person you work for (that’s another thing to remember, you’re working for this person; he or she is your boss, even if you were hired by someone else) has certain physical limitations. You must take these into account in your dealings and behavior with your elderly charge. For example, one of the most common limitations among the elderly is difficulty in hearing (and I’m one of them with this limitation). So don’t forget to always position yourself so that when you speak you can be seen. Be in front of the person. Don’t talk to them from another room or with your back to them. The benefits from this accrue to both the elderly person and the caregiver. For the elderly person there is no need to constantly say, “What did you say,” “I didn’t hear you,” “beg your pardon,” etc. And he or she is not constantly reminded of the hearing limitation they suffer with. For the caregiver, there is no need to constantly repeat yourself and eventually to have feelings of irritation because of it.
Talk, And Do It As An Adult Talking to An Adult
Converse with those you care for about more than just what you’re helping with. Talk to them about national, international, and local news, for example. Tell them funny stories about your family or your experiences. Make them feel as though they’re spending time with another adult who perceives them as adults, too.
No Baby Talk
Do not engage in Elderspeak with them. Don’t call them “honey,” or “sweetie,” or “dearie,” or “young lady,” or “good-looking.” It’s demeaning to be spoken to like this when you’re an adult of advanced age. You don’t speak like that to the UPS delivery person, the supermarket clerk, or the salesperson at a big-box store. You might feel that you’re being affectionate and showing it, but in most cases that’s not the way it’s taken. Once again, this type of speaking is something that contributes to the older person’s sense that he or she is not being treated as a serious adult. The best thing to do is make a point of asking the person how he or she prefers to be addressed.
My father-in law, a 92-year-old retired Colonel, wouldn’t mind if his two caregivers addressed him by his first name. But both of them call him “Colonel” and “sir.” I know that this is what he really prefers after 40 years of being shown respect though his career as an officer in the army. This shows me that these caregivers are thinking about the way he feels in regard to things like respect and self-image.
Don’t Do Things For Them That They Can Do For Themselves
It seems obvious that the more things an older person can continue to do for him- or herself the more independent and self-reliant they’ll feel. Many caregivers seem to feel that their job is to do everything for those they care for. Additionally, there are those who get impatient with how long it might take an elderly person to do something that the caregiver can do in a fraction of the time.
In the first case, the caregiver should observe carefully whether there are things he or she is doing that the older people could do for themselves – taking into account, of course, the real limitations that might exist and helping them to avoid any activities that might result in injury. But in the absence of such limitations, gently encouraging the elderly to do as much for themselves as they are able will more often that not result in an increased feeling of self-reliance and independence for the older person, which in turn will help enhance his or her feelings of well being.
In the second case, even though you, the caregiver, can do something much more quickly and efficiently that the person you’re caring for, the benefits of allowing the person to do things by themselves, as stated in the above paragraph, are much more important than any feelings of impatience you might experience. Remember, your job is not just to get things done but also to enhance your charges’ sense of physical and emotional well-being.
Be Highly Solicitous Of Their Privacy And State of Undress
In many cases, the caregiver’s job includes helping the older person dress and undress, bathe or shower, and go to the bathroom. In these situations, you, the caregiver, must be extremely careful not to make these situations any more embarrassing than they are. After all, just imagine how you would feel if you had to be unclothed and doing these highly personal things in front of your employee. Be sure to avert your eyes as much as possible and be ready to cover the older person as quickly as the situation allows.
Don’t Get Insulted Or Angry
The people we care for, as stated earlier in this post, can be abusive, grouchy, finicky, unpleasant, mean, and insulting. Being exposed to that kind of behavior can easily result in our feeing hurt and getting angry. It’s difficult, if not downright impossible, for most of us to hide our anger. If the situation is difficult, our anger is only going to make it worse. It will heighten tensions, anxieties, and stress. We must learn to understand the mechanisms in play that cause us to be angry and realize that no matter how personally directed at us the older person’s behavior appears, it would be directed at anyone else who was there doing the same things we were doing. It might seem personal, but in a strict sense it’s not. More often than not, the older person’s behavior is the result of the great frustration they feel at having to be cared for. You must constantly bear in mind the first tip in this list: be a person-centered caregiver. The person you’re caring for is, at this point in his or her life, most likely at the lowest point ever physically and mentally. What is called for here is empathy, not anger. And you’ll only feel empathy if you constantly bear in mind that the person in your care is a feeling – and to some degree – helpless human being. Try to see yourself in that older person’s situation. If you were living like this, would you be pleasant and easy to get along with? I don’t think so.
Don’t Spend Time Talking To Your Family and Friends On The Phone When You’re Not Occupied
I mention this because I’ve seen it happen more than once. The older person is sitting in a chair, watching TV, or dozing, or even just lost in thought. He or she is not talking to you and not responding to your attempts at conversation. The apartment or room is overheated and you’re getting drowsy yourself. And you’re bored. So you want to pull out your cell phone and call someone you can chat with and pass the time. Don’t do it. The older person is going to resent it when he or she notices. The person will feel that you don’t want to be there with them. It makes no difference that thinking like that really seems irrational. That’s the way it is. From the other person’s point of view, you’d rather be talking to someone else (yes, I know the person won’t talk to you) and that will be hurtful. There are other things you can do in this situation. You can knit or crochet or read a book or write in your journal. And these activities, besides helping you to pass the downtime and avoid boredom, can also result in some additional things to talk about with the older person when he or she is ready to engage again.
Listen To Them
Of the eight tips I’m suggesting here, I believe this is the most important. When I say “listen” I mean “LISTEN,” not just hear. I mean listen with your ears, your eyes, your mind, your empathy, your understanding.
The daughter I told you about who kept her mother from the apartment with the view of the mountains she wanted, certainly heard her mother say she wanted the apartment with the view. But she didn’t listen to her, she didn’t think about the outcome I described, which is sure to happen. She didn’t see her mother as a person at that point. She had no true understanding of or, perhaps, didn’t even try to understand what the request meant to her mother. She just wanted to do what she thought best for her mother.
I think we have to be constantly aware of what the people we’re caring for are truly saying. And sometimes in order to listen to them, you also have to be sensitive to everything about them, things such as facial expressions, what’s most likely going on in their minds, what their voices sound like, their body language. There are all sorts of subtle signals we humans give off to communicate. We have to be aware of these signals in order to listen with the understanding that must accompany listening. Without the understanding, we’re just hearing. And if we only hear, we’ll never be able to do our best for the people in our care who depend on us for so much.
About the Author:
Dr. Martin Rice is a retired university professor and software and Internet entrepreneur who lives in Signal Mountain, TN.
He founded and currently edits a blog for Boomers and Post-Boomers at http://www.Fifty2NinetyOnline.com