Many Strokes for Different Folks

 

A few years ago I consulted with a family in California.  The son’s 90 year old mother was at the end of her life with heart failure, but she didn’t want to go to assisted living.  His wife was willing to help care for her husband’s mother within their home, but the unemotional accountant son wondered if he could do such a thing. The relationship between mother and son had been challenging.

The son drove to his office, listening to music and thinking about it, when Schubert’s “Death and the Maiden” came onto the radio.  For a moment, his heart stopped.  It was the same music played when his grandmother lay dying.   At a family meeting he told us, “I believe in auspicious coincidence.  I want to bring my mother here to live.” To him, it felt as if he had received a message from the cosmos.

So the family got some caregiving support from an agency along with a walker, wheelchair and hospital bed.The old woman came to live with her son and his wife. As her care progressed, the doctor suggested that the mother should have a catheter. She was so weak.  It was hard to get her out of bed at night for frequent urination.  A nurse came to put in the catheter.  She was a little frazzled.  Perhaps she misspoke, but she told me that her office had told her, “Don’t put in the catheter if it is to help the family. We only practice person centered care.”  Perhaps the office was being overly zealous in their understanding of person centered care. Is the person some skin encapsulated ego separate from her family and helpers and home? When the phrase, person centered care was first used, it was an attempt to stay with a person’s goals and sense of living within the institution.  It was  meant to counter the over efficiency and materialism of the dark age.

Nowadays, we realize that  a person is part of a whole stream of being. If we don’t care for the caregivers, we end up not with just one person dying, but a whole society acting like the walking dead. What support does the family need to bring comfort to a loved one without damaging the whole family’s state of mind and pocket book?  We need more articles like the one in the AARP Bulletin in April, 2013, by Sally Abrahms called “Saving Money by Living Together: Three Generations Are Making it Work.” She dwells on the practical aspects of the arrangement which creates a situation that is more than saving money, but also the basic goodness of healing lives.

Many strokes for different folks.  Each person is unique.  Once you look at the whole person in the whole setting, you start to see what could make life easier for older people, for the family caregivers, for the professional helpers and neighborhoods and cities and a whole wide world.

The day before I left this consultation, I remember a goodbye party.  Sitting at the table, with the sun shining in were the older woman with a wheelchair and a caregiver, and a grandson who was going to coordinate his grandmother’s care.  They were laughing and eating chicken sandwiches. A coconut layer cake was waiting to be served.  Later when I went into her room to say good-bye, the older woman thanked me and said, “Don’t worry about me, this is what happens, it can’t be helped.”

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Ann Cason

Ann Cason,
Geriatric Consultant

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