Caregiver's Day
    Ever wonder why there's a National Secretary's Day but not a National CEO's Day? Of course you haven't. CEOs are well enough compensated, not only for their position but for their years of what may have been undercompensated apprenticeship.
    Every wonder why there's a Mother's and Father's Day, even a Grandparent's Day, but not a Kid's Day? Of course not. Every day's a kid's day, some days, such as religious celebrations involving gifts and birthdays, more so than others.
    The people who have "Days of Appreciation" scheduled for them are exactly the people who don't receive nearly enough compensation for or help with what they do. Their "Days of Appreciation" are an attempt, I think, to mollify them so that they don't, during a particularly stressful stretch of service, go off the deep end and suddenly refuse to serve in the undercompensated capacity to which society has assigned them. It's a shallow and not wholely successful attempt, to be sure. Despite a glut of "Days of Appreciation", our society continues to foster droves of parents (primarily fathers, interestingly, considering that men are more used to the idea that service demands adequate compensation) and service workers who "inexplicably" abandon their duties and leave those depending on them in the lurch.
    It wouldn't surprise me if, as I write, someone, somewhere, noticing the ever increasing number of what could be considered avocational caregivers being pressed into service and the ever decreasing number of inadequately compensated, thus, unreliable professional caregivers, is trying hard to establish a "Caregiver's Day", under the assumption that it might help ease our increasingly tense national caregiving situation and allow some breathing room for people (on their own, of course, and, primarily already involved caregivers) to figure out how to modify this situation to everyone's benefit.
    No one likes to squarely face the state of service work in the type of economy in which we live. Having to do so appears, initially, to undermine all our hopeful "positive thinking" philosophies and starkly keep-the-money-flowing "Thank You, I Appreciate You" holidays. Such considerations also appear to threaten the possibility that people, primarily women, will continue to devote themselves "naturally and selflessly" to the care of our children, our elderly and our infirm. I think, though, that the difficulties have to be faced, squarely and uncomfortably, in order for the current caregiving situation to change. Let me tell you, from the front, without delicacy or apology, how it feels to be "appreciated" for my caregiving.
    Curiously, the only "thank you's" I receive that don't, in some way, irritate me are those from strangers who notice my mother and me and in public, approach me and thank me for taking care of her. Sometimes these are people who have taken care of parents. Sometimes they are people who are related to a dedicated caregiver of one of their parents. Although I'm open to the unabashed goodwill of such thank yous, it has puzzled me why strangers would thank me for taking care of my mother. The opportunity recently arose for me to question a stranger who was so moved. The blogger brainhell's reply was as follows:

I guess I thanked you for taking care of your mom because we all like to do good things for other people, and like people who do good, even though the actual doing is so hard. And I guess maybe it's some form of wanting to receive mercy if or when we ourselves are in straits. You could call it selfish but it's probably agape.

    The honesty of his response brought another consideration to mind: Often it is awkward and difficult to thank a family member for taking care of another family member because there is an unspoken undercurrent of, well, something unpleasant detected in the caregiver. I am no exception. My mother and I enjoy cut flowers so much we often buy them for ourselves. We love cards, especially those with newsy letters attached. Although it's neither fun for me to admit this nor pretty for anyone to hear, the truth is, with every bouquet of flowers, card, or verbal thank you I receive from my relatives, underneath my sincere delight and appreciation is an ashamed, internal, automatic reaction: "Well, there's another day someone won't be available to take over for me; there's another care-free vacation from caregiving I won't be able to take; there's another inadequate attempt I'll have to make to partially refresh myself in the midst of my constantly intensifying responsibilities; there's another doubt that, if something should happen to me, no one I trust will be prepared to adequately pick up the slack in my mother's life."
    I try very hard to hide the force of this undercurrent. I don't want to lead people, especially those I love and who I know love me, to believe that I don't revel in the few but magnanimous times when a relative has covered for me; when one of them has performed indirect but complimentary chores for my mother and me; the flowers and cards and profuse thank yous and notes of appreciation my mother and I have received (pretty regularly around recognized holidays, birthdays and during very occasional visits); the extraordinary sounding board I have in one of my medically trained sisters who has been invaluable in helping me gain the knowledge and confidence to defy the medical establishment when necessary; the thoughtful, much appreciated gifts. In fact, I am full of inadequately expressed gratitude for all these, especially considering that I almost never have the mental or emotional space to acknowledge their birthdays, holidays, etc. My life's history is not that of an ungrateful, unperforming wretch. If it had been, I wouldn't be here with my mother, I wouldn't have spent the last 10+ years taking care of her, and I wouldn't experience the many periods of exhilaration, gratitude and reverie afforded me by not only doing this for and with my mother, but being available (through situation, character, and the peculiar way I've lived my life) to do it. Yet, the gods forgive me, I remain so completely overwhelmed by the task of taking care of my mother alone that I periodically have to fight both anger and depression and am not always and completely successful. I know that, either by social sense or reading my "therapeutic outbursts" in my journal, all my relatives are a little afraid of extending themselves in whatever ways they are able, simply because they might risk a face-to-face outburst. In addition, the matter is complicated by knowing that all of them are independent, underappreciated (if not by their families then by their society), unpaid primary family caregivers who are trying desperately, as all caregivers do, to seek their compensation in the only ways this culture makes available: The twin practices of positive self-talk/taking themselves to task for feeling unrewarded; the sentimental published homilies provided by those who have never given intense care or are master self-illusionists; and, not only cherishing but worshiping the times when they hit their stride and are experiencing, unadulterated, the inspiration and exhilaration inherent in caregiving.
    I have the support of a family of friends who have been extremely helpful, in a variety of ways, to me as I give care to my mother. The primary caregiver of this family took care of her elderly father in home for several years. During some of those years I was able to help her out. When they visit, their eyes are as trained on my mother as mine are. Never does an extended visit go by but what they don't tell me to "go take a nap" while they "keep an eye on Mom", of which I gratefully take advantage. When the primary caregiver of this family detects that I'm going through a caregiver funk she blatantly tells me she's worried and immediately responds with ways to try to ease my burden or my feelings. I perennially forget to expect their concern and their help and yet, there it is, regularly, touching me on the shoulder or, sometimes, grabbing me by the scruff of the neck when I get in so deep I am foolishly refusing contact and help. Interestingly, they have never thanked me for taking care of my mother. In fact, the thank yous, generously, rightfully and sometimes, I regret to say, not often enough, flow the other way.
    By now, everyone is tired of hearing, "It takes a village to raise a child." Why? Because no such village exists in our culture and our cultural propaganda is that it is "natural" that mothers be the almost exclusive primary caregivers to children, that children be the almost exclusive primary caregivers to elderly parents and that any relative who's available be the almost exclusive primary caregiver to those with "special needs", and, as well, that professionals not only can but should be relied upon for help above and beyond family and are a concern free resource; if the caregiver can't let go of her concerns, that's her problem. If our cultural caregiver set-up is so natural, how is it that, in other parts of the world, exactly the opposite is considered "natural"?
    The resistance to our cultural recognition of caregiving as a community affair that can and should be compensated with elevated survival status to everyone who gives care doesn't only come from those who have never practiced primary caregiving. Just as there is an undercurrent of resentment in every informal (and, many undercompensated formal) primary caregiver(s) who ever accepted a "thank you" from a family member who is unable, for whatever reason, to participate in caring for a shared relative, there is a social undercurrent of resentment among all types of caregivers in this nation toward any caregiver who complains about the lot of caregivers, in particular or in general. The consensus is that millions of people (primarily women) throughout the ages have met these challenges "adequately", often without complaint, "I'm" doing it, too, so why can't "you" just shut up, buck up and get back to "your" job? Millennia of the neglect and abuse of caregiving due to staunch individualism, though, is not a reason for the situation to continue. This is no way to honor the memories of our past primary caregivers, let alone the reality of our present primary caregivers. If our culture is so damned good at producing and supporting primary caregivers, why is our international status as a nation who cares about its children so low?
    If I was to design a Caregiver's "Day" that was truly useful to me, here's how it would play out:

    One day every month someone who knows my mother or is interested in getting to know my mother, perhaps a relative, perhaps not, would show up. This person would follow me around from an hour or so before I awaken my mother until after she retires and I have performed the last chore directly related to taking care of her. This person would take notes (both of her/his own accord and at my direction) on every item and issue involved in my mother's care, observe what I do, how I do it and how I interact with my mother under all circumstances.
    On a second day every month this person would appear at the same time as previously. She/he would give care to my mother under my supervision while I observed, suggested, reminded and corrected him/her. This second monthly day would allow my mother and the substitute caregiver to become familiar with one another, adjust to each other's personalities and methods and design a relationship which both my mother and I could trust would be in her best interests when I need a vacation from caregiving.
    Both of these days would happen once a month because my mother's care changes, either in intensity or by method, at least once a month. Having these two days a month under her/his belt would allow the substitute caregiver to observe these changes so she/he wouldn't be thrown by new routines or conditions that need to be addressed on a daily basis. As well, some of these months would no doubt happen during periods of time when my mother was enduring short term out-patient treatment for some medically related condition, or hospitalization. Thus, the substitute caregiver would be exposed to the oversight caregiving necessary when medical providers come into play.
    Then, during predetermined times throughout the year, my mother would experience periods when this well prepared, very familiar substitute caregiver was her only caregiver. Because the caregiver would be so familiar with my mother and her care and have a working relationship with her, I'd be able to refresh myself without concern about whether my mother was being accidentally or purposefully mistreated, whether she was safe and receiving every aspect of care that is and might be needed and I'd know that, if urgent medical conditions arose while I was vacationing, they'd be taken care of adequately and with only as much of a possibility that my mother would be medically mistreated as exists when I am overseeing her medical care. I would also be sure that, in the event of a personal emergency that took me out of the primary caregiver racket, my mother's care would continue satisfactorily without reason for me to worry.
    I'd also have a type of partner in my mother's care who would automatically provide me with a specifically knowledgeable sounding board, would be motivated to think about my mother's care both "on and off duty" and offer meaningful suggestions and feedback. My mother would benefit from the stimulation of having at least one other person provide, in her/his eccentric style, the type of interaction that is autonomic assurance that she exists within a community of people who not only appreciate that she is alive but consider her life a resource worth many continued visits and interactions.

    So, whatever you, as a nation, do, for or to the growing ranks of caregivers to the elderly and infirm, give us some days to prepare you then give us some days when you are the caregiver, but, please, don't give us a "Caregiver's Day".
- posted by Gail Rae @ 17:00  2 comments   email...this post

 
Love and All that Shit
    Today my mother had A Mother of All Bowel Movements. I have an idea how she and I managed to work up to it. She hasn't had popcorn for the last several days and apparently not enough fiber to make up for that lack. The other problem is that for the last 3 days at least she's been persnickety about fluids, we've had more than a few pitched battles about this and I gave up during a little over half those battles.
    When she headed into the bathroom to move her bowels neither of us had a clue that a little over an hour later she'd still be in there, would have eliminated very little, would have strained quite a bit despite my advice not to strain, would have read through an entire spice catalog, drunk a cup of hot herb tea and still be very uncomfortably clogged. She didn't want to remove herself from the toilet and walk around a little, which I thought might help. She was afraid she'd have an accident. I was hoping this, which I would not have minded cleaning. Anything to end her misery.
    A couple of times throughout the ordeal I offered to clean her. When she's a little constipated cleaning her mid-movement helps. She refused. After a bit over an hour I told her I was going to clean her anyway. She was so uncomfortable she decided to allow me this. I discovered that she was trying to expel rock shit. Jesus Christ Almighty, it was bad. I was able to trim the shit extending just beyond her anus. She returned to the toilet. I left her alone for about 10 minutes. She wasn't able to expel any more. I told her I was going to clean her again in case a bit more had managed to bulge out. Again she refused and I ordered her up. She complied. I knelt beneath her ass, separated her cheeks, looked up and, well, what a sight it was. Her sphincter was locked open almost two inches by a block of rock shit that appeared as though it had no interest in going anywhere.
    I told her it was enema time. She roared her disapproval but I told her the situation was beyond choice. She was so uncomfortable that she didn't think she'd be able to arrange herself into a reclining position to take the enema. I agreed. I decided I'd better give it to her standing up at the toilet, which is not recommended and carries some danger but, well, what are you going to do when comfortable reclining is impossible? I removed all rugs and plastic from the linoleum floor, brought in a huge towel expecting that the enema might work on her before she'd be able to reseat herself since it was obvious she wasn't going to be able to hold the liquid in. I very carefully inserted the tip of the enema bottle between the shit block and the wall of her colon. Before I'd gotten the tip in a half inch, before I was able to discharge the liquid, apparently the agitation of inserting the tip caused her colon to spasm just enough to catalyze a downward expelling contraction, she turned toward the toilet, which movement dislodged the tip of the enema bottle, sat down, strained mightily and immediately released two very thick, very hard blocks of shit, one of which was about 6 inches long. The ordeal was over.
    I ordered her not to flush and immediately taped the flush handle to the side of the toilet. She remained sitting until her colon relaxed a bit then stood while I cleaned her. Cleaning was easy. The olive oil she receives every day keeps her iron laden shit from soiling her entire uro-genital-eliminatory tract.
    Once I'd cleaned and redressed Mom, instead of letting that shit sit in the toilet and soften (which I wasn't sure was going to happen) I decided to glove myself and go after it. It's a good thing I did. She'd expelled quite a bit and all of it was either like slabs of granite or river rocks. I dug down into the pipe and extracted as much as I could before I finally had the confidence to flush the toilet. It probably sounds like this operation was disgustingly messy but it was the opposite. I only had a toilet to clean, not an entire half of a bathroom. Fishing her shit out of the toilet worked so well that it occurred to me perhaps this is the way I should handle all her bowel movements. That would certainly take care of the toilet clogging problem and after today I have no problem handling her shit.
    What does all this have to do with love? My maternal grandmother was in a nursing home during the last months of her life suffering from what was labeled as advanced Alzheimer's. When she became colonically impacted the staff cleaned her out with a spoon. I recalled this throughout my mother's ordeal today and realized that if she'd been in a nursing home spooning is one of two very uncomfortable, potentially dangerous ways this situation would have been handled. The other was the way the skilled nursing facility perpetuated on my mother last August: Load her up with laxatives and let her rip. If you read about it you'll know that from the nurses' point of view I was amused because I warned that if they used a typical laxative dose on her they'd have a mess on their hands. They ignored me and they had a 36 hour continual mess on their hands, and the bed, and the floor, and the bathroom. This situation was not at all healthy for my mother since her urethra had just begun to work off the challenge of the hospital's 6 day catheterization. Luckily, she was still on antibiotics for a UTI but continued having UTI problems after this, no doubt from the contamination of having diarrhea for 36 hours. As you'll recall as well, after this incident I instructed the staff to make sure she drank at least one 11.5 ounce can of V-8 juice a day (which I provided) and ate a bag of popcorn (which I provided). As you also know, I visited every other day and noticed that the staff never did this. Thus, when she left the facility she was shit impacted, although only slightly. Today was the first time her impaction has been this bad since the laxative incident at the nursing home.
    The love part is that my mother is not in a nursing home, is not being regularly subjected to spoons and lethal doses of laxatives in order to clear up impacted fecal problems which she'd probably be suffering on a regular basis if she was in a nursing home. She is on an extremely high fiber, high olive oil diet (which she wouldn't be enjoying in a nursing home) in order to keep incidents such as the one today as infrequent as possible. I also monitor her liquid intake much more closely and successfully (even when I lose pitched battles) than the hospital or nursing home did (and I kept after both places, explaining more than once to each that telling her to drink and leaving the vicinity would not work...she has to be coaxed to drink and monitored while she's drinking).
    After today's shit fest I gave her a modified and expanded lecture on refusing liquids which I think probably made an impact (forgive the pun, I couldn't resist). I expect we'll continue to have occasional problems. Although I'm being careful not to overdose her on liquids (expect today), she still has flashes of remembering a couple of doctors saying, "Have her drink only when she's thirsty." When these memories return she becomes so inordinately obstinate that, well, this time, I gave in. I obviously shouldn't have. Now I have an argument that, I hope, will trump her next "I don't need to drink anything if I'm not thirsty, that's what the doctors said" episode.
    I'd like to say that I can't imagine how a hospital or nursing home would have treated her today. Unfortunately, I know exactly how they would have treated her. This is one of the many reasons she's not in a nursing home. I love her enough to willingly maneuver through days such as today rather than have her in a nursing home. Someday, the gods please forbid, I may have to put her in a nursing home. But not today. Today, once again, I pulled myself up to her needs and discovered I am able to meet those needs in a way that preserved her safety, her dignity and her sense of community. I'm now even more determined to keep her at home as long as I possibly can. If I can plow through her shit I'm willing to bet I can plow through anything on her behalf.

9/15/11
Hmmm. It seems that Blogger has put a limit on the number of characters that can be entered into a comment. I discovered this when I attempted to respond to the comment below, left half a month ago. Since I don't want to shorten my response, here is my response:

Gary,
Sorry it took me awhile to get around to responding to your comment. Thank you for noticing my post and commenting, even though my mother died in December of 2008.
In response to your question: During the last year of my mother's life she was in a skilled nursing facility for short term physical therapy after a difficult bout with pneumonia drained her strength but, other than that, no, I didn't consider looking around for other nursing homes for long term care, for a variety of reasons, not the least of which was the extraordinary relationship my mother and I developed during the years in which we were companions and my ability to rise to ever occasion of care that our companionship demanded. I not only have never regretted that decision, I have been constantly extraordinarily grateful that mutual companionship worked out for my mother and I through the last several years of her life. I wouldn't trade it for anything. I wouldn't even trade the intense-need care circumstances for anything else.
Despite the tone of my post, I completely understand when people find the need for nursing home care for their infirm relatives. There are so many reasons why nursing homes, assisted living facilities and skilled care facilities work well for families. Each care profile for each family, while having similarities with others, also contains striking differences. I do wish that our society was at least as supportive of in home care for the needful elderly and infirm as it is for parents with children. The government is beginning to realize that supporting in-home care is much less expensive than facility care, but there are still many problems with government intervention. Of course, our society has problems in supporting parents, as well, but that's another subject for another day and, at least, it's not nearly as bad as it was in the later 1800s and the early 1900s when children whose in home care support fell through the floor and lots of children were warehoused in orphanages or left to fend for themselves. I have a great grandfather and two great uncles who became orphaned in that time and were orphan-trained from New York to the Midwest. Their lives turned out well, thank the gods, but I know this was not the outcome for many, many children.
I often think of that time when I consider the booming industry in long term care facilities. Children, at least, sometimes have the opportunity and the time to rise above their circumstances. Elders do not. Although I personally know cases that have great outcomes, I also personally know of cases that have been less than optimal; some of these cases include families moving relatives from one facility to another in order to attempt to find better care.
In the case of my mother and her first period of short term facility care (two weeks) of which I spoke in this essay, we were given a short list of facilities that were available for care, had a social worker in the family who used his contacts to narrow the list to the best facility not only on the list (which was compiled by Medicare) but among any other facilities which might have fallen under the auspices of my mother's short and long term care policies, and the care was scheduled, ahead of time, for two weeks and no more, to start on a particular day, so a move would not only not have been a good idea, it would not have been supported by the institutions funding her Skilled Facility Care (we checked into this). We handled monitoring of her time there in family, kept ourselves well informed and operated on a meticulous schedule of oversight.
One of the problems, of course, inherent in selecting a facility under these circumstances is that facility care cannot wait, so if a particular facility doesn't have an opening, one must go to "the next one on the list". This didn't happen to us at this time; the facility we determined to be the best also had an opening.
During a later short term stay (four years later) in a much smaller community, two institutions were recommended above the one that took on my mother's care, but both had no openings, so our hands were tied; she needed therapy immediately.
I'm sure that the situation is different when families are looking for long term care options, when time can be taken to research and choose an appropriate facility. The conundrum of the need for short term skilled nursing care is quite a bit different than seeking long term facility care.
Thank you again, Gary, for your comment and your link. Although my blogs are rarely visited, anymore, I suspect that the link may prove valuable to an occasional visitor.
Gail
- posted by Gail Rae @ 01:19  2 comments   email...this post

 
Song of the Washer-ing Women
    My mother and I sing the following song every morning for anywhere from 25 to 45 minutes, depending on how slow she and I are moving. Every morning it includes improvisations that may or may not have previously included. I've written in as many improvisations as I can remember of the hundreds that have been created since we began sink bathing her on October 26, 2003. The basic structure of the song, though, is always the same, every day, usually once a day, very occasionally twice.
    Every day, for a couple of months, now, I've realized that this song should be recorded here as a dedication to all caregivers who bathe their Ancient and/or Infirm and/or Just Beginning Ones. This is the most important song we sing with those for whom we care. It is always the first song of the day (even if it is repeated throughout the day), it allows us to draw a bead on each others' moods, sets the tone for the day and the accompanying dance, through a smoothly accelerating idle, revs our Beloved Care Recipients for the rest of the day.
    Feel free to sing along and add your own verses.

First Verse

Mom:  [sitting on the edge of her bed] My, did I sweat, last night! I'm soaked with it!
Me:  That's not sweat, Mom, that's urine.
Mom:  [glaring at me suspiciously] I don't think so. I think you're wrong.
Me:  Mom, your bladder has been leaking profusely at night for over a year. Beleive me, that's urine. If it isn't, there's definitely something wrong because, I can tell you, you're sweat smells exactly like urine! [she comically mugs her displeasure with what I've said] Take off night shirt, put on bed, not over the edge...good. Thank you. Arise! Let's get you bathed.
Mom:  And shine! I don't think I'll bathe today. [Mom rises from the edge of the bed and stretches.] Ohh, that felt good!
Me:  It looked like it felt good. You don't have a choice about bathing. I'm not going to let you marinate in your urine all day. Okay, you know the drill. Into the bathroom, sit down on open toilet, take off underwear, throw it away in garbage, not on floor, not in bathtub.
Mom:  Throw it away?!? Why?!?
Me:  Because it's paper, and it's soaked.
Mom:  Well, I hope we have more, then!
Me:  We've got lots. Now, go, now that you're practically naked, the only warm place is in the bathroom. Go! I'm going to strip your bed, spray it and I'll be right in.
Mom:  Spray it!?! With What?!?
Me:  Vinegar water. Go, before you freeze!
Mom:  Why are you spraying my bed with vinegar water?!?
Me:  The party line is that it's to clean your urine off your bed, but the real reason is to kill your kooties! Now go!

Second Verse

[Accompaniment for the following verse: A constantly running sink.]
Me:  Okay, last pill, open up...nope, nope, nope, don't touch it, your hands are covered with urine...good girl...okay, water...
[Mom raises her hand, waves away the water]
Me:  You don't have a choice, you're dehydrated, drink up, you may not be thirsty, but your body is...good, one more gulp...
Mom:  That's enough.
Me:  Okay, give me your left foot.
[I wash her left foot]
Let me know if the water temperature is uncomfortable.
Mom:  If it is, I'll kick you!
Me:  Whoa! You're in rare form today! Okay, right foot.
[I wash her right foot.]
Okay, lift left foot only.
[I lift the left half of the towel on which her left foot has been resting, throw it over the right foot, while holding her left foot.]
No, No, leave your right foot down, keep it under the towel. Thank you.
[I position a clean towel beneath her raised left foot, then support her left foot and rinse it.]
Okay, you may now raise your right foot.
[I pull the wet towel out from underneath her right foot, throw it behind me into the bathtub, pull the clean towel underneath her right foot, support this foot and rinse it.]
Mom:  [wriggling her toes] That feels good. You can keep doing that.
Me:  [soaping up the blue washcloth] I'll do it again, tonight, when I rub lotion on your legs. Now, you get to wash your face while I wash your left leg. Here.
Mom:  [snuggling her hands and face in the wash cloth] Mmmm, warm.
Me:  [while I'm soaping up the green washcloth] Wash all over face, both sides and forehead, to the hairline, wash ridges around nose, behind ears, front and back of neck, scrub, scrub, scrub, do everything twice, avoid eye area so you don't...dut, dut, dut...[a little louder] avoid eye area so you don't get soap in your eyes, we'll get that during rinses...
[I wash her left leg, keeping my eye on her face and neck progress]
Me:  Don't forget neck, scrub, scrub, scrub...
Mom:  I did my neck...
Me:  No you didn't, I was watching...
Mom:  How can you watch from down there?!?
Me:  I have eyes on the top of my head...come on...get that urine off your neck, behind ears...good girl...
Mom:  [picking through the hair on the top of my head with her free hand while I squat at her feet] My goodness, girl, one, two, three, four, you've got more than one pair of eyes, up there...
Me:  I don't recall that I specified how many eyes I have up there...
Mom:  Well, you didn't get those from me, you must have gotten them from your father.
Me:  Really?!? I got the eyes in the back of my head from you, I know that from when I was little, you always used to talk about the eyes in the back of your head. I assumed I got the others from you, too.
Mom:  Nope, not from me.
[I'm on my feet now, at the sink, wetting the rinse cloths, so I reach over and teasingly sort through her hair]
Me:  No, I guess you're right. My mistake.
Mom:  Let that be a lesson.
[I hand her a wet rinse washcloth, wet my own]
First rinse, face. You can do your eye area, now, first, before rinsing anything else, so you don't get soap in your eyes. Pretend you have soap on that washcloth, scrub, scrub, scrub...
[while I direct her I'm rinsing her left leg]
...no, you're not done yet, get all your face, up to the hairline, behind your ears, scrub, scrub, scrub, ah, ah, ah, you didn't get your neck...
Mom:  Yes, I did!
Me:  That was while you were washing. You need to rinse it now, scrub, scrub scrub...
...excellent, third rinse, scrub, scrub, scrub...get the last of the soap off...
Mom:  You forgot to rinse my leg a second time.
Me:  I already did. I'm faster than you. Wanna race?
Mom:  No, you get up earlier than me.
Me:  Okay, left arm only, start with fingers, scrub, scrub, scrub, between fingers...
Mom:  [holding up left index finger, she asks with exaggerated innocence] How do I wash between this finger?
Me:  Touche. Wash between all fingers, individually, all the way down to the knuckles, scrub, scrub...
Mom:  scrub...
Me:  [smiling] Very good, Missus Hudson, you may advance to the next step, top and bottom of hand...
Mom:  scrub, scrub, scrub...
Me:  [while I'm stopped, soaping her right leg]...all the way around forearm...
Mom:  I only have two arms...
Me:  No you don't, you have four arms on each side.
Mom:  You don't have four arms.
Me:  That's because I take after my father.
[we both laugh]
All the way around the upper arm, under the arm, scrub the armpit, don't swab it, get this area right here [running my finger along the bottom of her upper arm] there you go, top of shoulder...
Mom:  I already did that!
Me:  No you didn't, I was watching, I have eyes on the sides of my head...
Mom:  Now, those you got from me.
Me:  Ah, ah, ah, left arm only, no cross contamination here...
[handing her a rinse cloth] Okay, first rinse, left arm only, start with fingers, in between all fingers individually, all the way down to the knuckles...
Mom:  You learn quickly.
Me:  I got that from my Mom...top and bottom of hand, scrub, scrub, scrub...all the way around the first of your four arms on your left side...
Mom:  Smarty!
Me:  You know what I think is funny...scrub that armpit, don't swab it, get all that urine contaminated soap off, come on, top of the shoulder, back of the shoulder...
Mom:  No telling.
Me:  Now that we know that people inherit their intelligence from their mother's side...get that area under your upper arm that you always miss...there you go, here, second rinse, left arm only...
Mom:  [primps with her free hand] Naturally.
Me:  That kind of shoots men marrying for beauty all to hell, doesn't it. And, what's the point, then, of women marrying for brains?!? We may as well marry for brawn.
Mom:  That's a good idea. Maybe I'll do that, next time.
Me:  Come on, Mom, rinse the entire arm...top of the shoulder, too...okay, here you go, wash right arm only, starting with fingers...I think you did. Dad was incredibly strong, besides being smart.
Mom:  He was, wasn't he.
Me:  [I notice Mom examining something on the side of her forearm] What's that? Looks like another bruise. What do you do in bed at night, woman?!?
Mom:  I don't know. I wish I could remember. It sure looks like I'm having fun.
Me:  It sure does...start with fingers...I mean, I wonder, what was Nature thinking, letting us slip into attraction patterns that would seem to be exactly the opposite of what 'survival of the fittest' would demand, anyway...between all fingers, Mom, come on, all the way down to the knuckles, top and bottom of hand...
Mom:  Maybe Nature doesn't care whether we survive...
Me:  I know, maybe all Nature cares about is interesting stories that don't necessarily go anyplace...all around all four of your arms, over there, don't forget your elbow, inner and outer...
Mom:  Sounds reasonable to me.
Me:  Ah, ah, ah, get your upper arm, Mom, top of shoulder, armpit...
Mom:  I did!
Me:  You got three of them, but not the fourth.
Mom:  Like I said. Smarty!
Me:  Here, first rinse, right arm. Get all that soap off, all the way down to the knuckles, all your fingers, Mom...anyway, regarding Nature...
Mom:  What's the point of a plan if you can't have a little fun along the way?
Me:  Good point. Excellent, you did that without prompting! Here, second rinse, right arm...
Mom:  I think tomorrow I'll take a bath.
Me:  Don't forget the top of your shoulder, Mom, you did good on the armpit and underarm...you know, I know you long to take a bath, I wish you could, really I do, but, you know, I think [MCS] had a good point, since you're prone to urinary tract infections, now, you shouldn't be taking baths anymore. I don't suppose you'd consider sitting on a stool and taking a shower, would you? Okay, good. Arise and face me.
Mom:  Absolutely not! No showers!
Me:  I didn't think so. Step forward a little, don't stand on your hands, Mom, stand on your feet...don't hang from the bars, it's not good for your back. Well, then, I guess we'll be doing this for the rest of your life...
Mom:  I suppose so. Well, it's better than taking a shower.
Me:  Okay, well, that's good. [stooping to see how the creases at the tops of her thighs look] Well, this looks much better, Mom. That anti-itch cream does the trick. I think we'll keep using it. It looks like you never had a problem.
Mom:  Do you realize you have four washcloths in there? Why do you need four washcloths?!?
Me:  [washing her thigh creases and pubic area with one washcloth, then switching cloths and soap and washing her front torso] Two for washing, one for you and one for me, two for drying, one for you and one for me, then, when I'm the only one washing you I trade off. It's to avoid cross contamination. It's worth it, Mom. If they every have a "Cleanest Elderly Person" contest, you'd win hands down.
Mom:  Watch your language, girl! [she's referring to my use of the word "elderly"]
Me:  Okay. Cleanest person who's been around for at least 87 years. Hows that?!?
Mom:  Better. Not much. You already did that. [referring to me rinsing her again]
Me:  One good wash, two good rinses. That's my motto, Mom. Okay, let's dry you and put on the itch cream.
Mom:  You're motto lacks something in imagination. You need a new one. Don't you mean "anti-itch"?
Me:  [laughing] Oh, yeah, wouldn't that be funny, applying itch cream to that area!?!
Mom:  Not to me!
Me:  Okay, I won't use the itch cream, then, I'll use the anti-itch cream. Turn around so I can do your back. Center yourself over your legs. Don't hang on the bars. Looks good. No interesting things back here. We're doing good.
Mom:  I prefer to be interesting.
Me:  Trust me, Mom. You don't want your back ever to be as interesting as it was before I started washing it!
Mom:  Mmmmm, that feels good. Right there. Rub right there.
Me:  Hold on, I'll rub you better during the rinse. I don't want to rub soap into your skin. Okay, there. How's that?
Mom:  Good. Good. Scratch right there. Ohhh, good. Thank you.
Me:  We aim to please, Missus Hudson. Okay, here comes the part that both you and I hate.
[I take down the baby wipes, open the box and pull one out, preparing to wipe her backside and her uro-genitary area.]
Mom:  Is that really necessary?
Me:  Well, it's working to keep your urinary tract infections down. You haven't had one in three months, now. I'm sure your urethra has snapped back from all those catheters, but I don't want to tempt fate. Believe me, Mom, I don't do this for pleasure. If someone asked me to list my hobbies, I wouldn't put, "Cleaning my mother's ass" down as one of them.
Mom:  [she snickers, then mocks offense] Gail! Shame on you! You didn't learn to talk that way from me!?!
Me:  [snickering] Nope, you're right. I learned it from Dad. Thanks, Dad! Okay, I'm going to dry you off and put lotion on your back...Okay, turn around, let's finish you off. Cornstarch first...[reaching into the box of cornstarch, bringing out a handful]...yeah, I definitely like this cream stuff better, the cornstarch doesn't become glue up there. Okay, let me get your underwear, hold on...[I leave the bathroom, get two pairs of paper underwear from the closet, one small, one large, and return]...My goodness! There's a naked old lady in the bathroom!
Mom:  [laughing] A cute naked old lady!
Me:  And her cute, clothed daughter! [stooping with underwear] Okay, lift foot, from the thigh. Okay, lift other foot, from the thigh. Okay, lift other foot, from the thigh...
[my mother snickers]
Me:  Okay, let's put pants on...
Mom:  You only need to put them on two of my legs.
Me:  So, you want to be daring today, eh? Okay, your choice. You may sit down, now...nope, don't put your watch on yet, here, put out your hand for lotion...okay...do this...[I slap my hands together a couple of times, demonstrating how she needs to distribute the lotion between her hands]...that's right...distribute it evenly, okay, take one hand like this...[I place one of my hands palm down on the top of the other]...okay, take that stuff all the way up the arm, no, no, don't rub it in yet, distribute it all the way up, that's right, okay, do this with the other arm...[I demonstrate, again, with opposite hand and arm]...good, okay, rub that stuff in, up and down your arm, all around...[I mime rubbing lotion into my arms]...come on, rub that lotion glaze into your arms, that's right, take it all the way up to your shoulder, get the back of your arm, that's good...Okay. Good. Now you may put on your watch and glasses...[I retrieve her shirt and bra from the floor at the opposite end of the bathroom and drape them over the edge of the tub]...okay, here's your shirt and your bra...remember to latch your bra in front, swing it around and stuff your things into your thing holders...
Mom:  [directing a comic smirk my way] I thought I taught you better than that!
Me:  Okay, Mom, put your breasts in your thing holders, but explain this to me, if this is a thing holder, why aren't breasts called "things"?!?
Mom:  I'm going to have to sit you down and have a talk with you, child!
Me:  Let's do that over breakfast. Okay, [as I collect towels, cloths and soiled clothes] your house coat's hanging right here, when you're done and dressed meet me out in the dinette.
Mom:  I suppose when I get out there you're going to check to see that my "things" are in my "thing holders".
[She hates that I do this but, if I don't, she ends up wearing her bra around her neck before breakfast is over.]
Me:  Only if you don't want to make a little money on the side. Want me to get the change box out this morning?
Mom:  No, not this morning. Maybe tomorrow.
Me:  Okay. I'll see you in the dinette.

- posted by Gail Rae @ 00:09  1 comments   email...this post

 
"You've Got to Give a Little..." More
    Ever notice that during The Season of Giving it's mostly the year round primary caregivers who shift into Hyper-give Drive?
    Even if the primary caregiver in a family isn't the only caregiver, the secondary caregiver relies on the primary caregiver to perform most of his hyper-giving errands. I witness this every year in the families of friends and relatives.

First Scenario: The secondary caregiver and/or those for whom the primary caregiver cares are all enlisted in holiday decorating. It becomes a family or community affair, usually involving group selection of the main decoration, lots of help sorting through and putting up companion decorations, everyone has a great time and even the primary caregiver doesn't mind providing and directing the atmosphere and food for this event. When the holiday is over the primary caregiver takes down and stows all the decorations without the morale booster or help of a family/community celebration except, maybe, for the dragging of the tree to the curb and the removal of outdoor decorations.

Second Scenario: The secondary caregiver plans one, maybe two weekend days during the season in which he 'goes holiday shopping' with a list carefully composed, usually with the help of the primary caregiver. Inevitably, the crowds and the confusion get in the way of completion of the list, the balance of which is relegated to the primary caregiver along with the dregs of the lists of all the care recipients in the family. If anyone in the family decides to make gifts or 'give of one's time', the primary caregiver is automatically enlisted to make sure raw material is scavenged and assembled and/or the Giver of One's Time is directed in order to make sure the Gift of Time is performed.

Third Scenario: A day or two is set aside for Holiday Baking. Everyone's excitement is stirred and all (except the secondary caregiver) volunteer to help. Since the primary caregiver is the most experienced baker, all prep and clean-up and direction of the helpers (in order to make sure resources aren't wasted by mistake) are performed by the primary caregiver. Most the dispersal of Holiday Treats to family, friends and neighbors, as well as the monitoring of snacking on such treats within the primary caregiver's home, is performed by the primary caregiver.

Fourth Scenario: The secondary caregiver graces the primary caregiver with the 'gift' of preparing the main dish for the holiday meal to help ease the burden of holiday preparation. The primary caregiver, of course, does most, if not all, the shopping for this course, but, "she's doing it anyway", so, the secondary caregiver assumes, it's not an added burden for the primary caregiver to perform this tiny chore in order to make it easier for the secondary caregiver to 'help' the primary caregiver. The secondary caregiver's main course is usually one that requires slight preparation (such as marinating, maybe preparing a simple sauce, certainly not stuffing) and involves cooking in a salutary atmosphere such as on the outside grill. The primary caregiver spends the entire day (and much of the previous day) in the kitchen preparing the companion courses and condiments from start to finish, setting up the eating area and performing after dinner clean-up. During dinner the efforts of the helper(s) are lavishly extolled, often most lavishly by the primary caregiver in a usually unsuccessful effort to encourage daily participation through holiday compliments. The efforts of the primary caregiver are given a habitual, taken for granted nod. While it's true that after dinner clean-up often solicits offers of help, usually, since the primary caregiver is the only one who is expert at the myriad small tasks involved in household clean-up and put away, the offered help is refused because the job is more quickly done without help which inevitably needs to be directed or has to be repeated, later, when the primary caregiver takes some time to set up her kitchen in the manner most efficient for her continued use.
    Meanwhile, the secondary caregiver directs all the fun activities, like group gift opening and/or picture taking and/or family games while nudging the primary caregiver's involvement with gentle reminders directed to the kitchen/dining room, "Honey, we're ready, we're just waiting for you."

Fifth Scenario: The primary caregiver, sometime in the weeks before the holiday celebration, experiences an "ah hah" moment, usually through reading a column in the daily newspaper or monthly magazine that exhorts weary Holiday Event Directors to drop some of their plans (including meal courses) and delegate holiday chores in order to allow for time to 'enjoy the holiday yourself' (which usually translates as more time to do other people's holiday chores). On the holiday someone inevitably and poignantly expresses that the skipped or delegated event or course is 'missed' or 'just not the same'. The primary caregiver makes either a silent or vocal promise not to drop or delegate these events and chores the following year.

    Question: What makes us, as a society, think that an intensely involved primary caregiver wants to strip her gears into Hyper-give Drive for almost two months at the end of the year? Answer: The societal propaganda that the holidays are 'for the children'; the celebration of the minute category of monster caregivers who have a talent for overextending themselves and making it 'look easy'; and, the insistence that if primary caregivers dread the holiday season it's because they don't know how to handle it, thus, it's the primary caregiver who's at fault.
    We can no longer use the blighted excuse that hyper-giving should be the province of the stay-at-home parent. There aren't that many stay at home parents, anymore. Few families can afford the luxury of a stay at home parent, a phenomenon evidenced by the fact that such families are celebrated in human interest stories only because they are rare. In addition, childhood being what it is in this day and age, the stay-at-home parent is probably, most of the time, in the family car shuffling the away-from-home family members to and from their destinations and running everyone's errands. She may also be home schooling her children, thus performing yet another societal task with little support, unpaid and unsung.
    As well, our holiday season is drowning in the twin commercial concepts of hyper-giving and hyper-getting. Even those of us who swear we know what the holidays 'are about' have forgotten that the traditional winter celebration was a time of community involvement in winding down to the seasonal rest that we used to believe was the providence of winter.
    What if we decided to change the current emphasis of the holiday season in order to suit our relentlessly every-activity-in-every-season society? What if we instituted the holidays, from Thanksgiving through the New Year, as the season for minimal caregivers to concentrate on thanking, in tangible ways, our maximum caregivers? What if The Season of Thanking and Giving became The Season of Thanking and Giving To Primary Caregivers? What if children were expected to get into the act? What if the holidays became The Season of Everyone Else Besides the Primary Caregiver Making and Executing Holiday Plans; Planning and Preparing Gift Giving; Baking the Holiday Foods; Decorating for the Holidays; Making Sure Everything Is Perfect Just the Way the Primary Caregiver Likes It; Passing the Infants and Young Children, the Infirm and the Elderly Around so the Head Caregiver Has an Extended Chance, Once a Year, to Clear Her Head?
    What do you suppose would happen? Is it possible that, after almost two months of Spreading the Caregiving Around and Making Sure the Primary Caregiver Receives as Much Support as She Has Given Throughout the Year that, within a couple of years, we'd transform ourselves into a society in which everyone learned not only how to give care in every season but to notice and participate, all the time, in the tasks of caregiving? Then what? Then, maybe everyone would look forward to the holidays, enjoy them, and be refreshed and ready for every New Year.
- posted by Gail Rae @ 13:00  1 comments   email...this post