By Glyndora Condon MS MFT LPC
Fourteen years were invested in working with this population as a certified nurse assistant. Two of those years were at a nursing home; and 12 were in private duty. Four years I invested as an Activity Director in an effort to provide a ray of sunshine to a forgotten people. They had invested their time raising their families (if they had children during their younger adult years) and yet I often did not see any family to enter the doors to visit them. Birthdays and other major holidays often came and passed without a present or a card. While the elderly remained in our care; they lost friend after friend, spouses, and wished that they could be with their children and grandchildren-at least for a little while. Some were more fortunate and did have family to come and to spend precious time with them. They were provided gifts and taken to shop or church. Those were the more fortunate. Some had no children to long for or hope for. They were truly alone when they were either single or widowed. From this crowd then some were independent and seemed to accept their aloneness-taking part of the activities that I offered each day. A few of the remaining seemed to prefer isolation.
C.N.A.'s worked to ensure their patients/residents (I had the skilled floor with seriously ill or disabled patients) were fed (feeding them each bite and making sure they did not aspirate); cleaned from evacuating bowels or urine (most were incontinent), and bathed; with oral care and skin care administered. My floor also included turning the residents every hour to two hours depending upon the condition of their skin and health. Often we were short handed and had to lift people almost double our weight; and often we had entire floors of residents to care for when their CNA's did not report to work. Just the basic care for each human being was almost impossible many days as I would find myself drenched in sweat, my feet soaked due to taking people into the showers and washing them-and even though I knew that I gave it my best-I did not feel as if they received what they deserved. The best I could do was to chat with them as I gave them baths or checked in to turn them. This I cherished.
The Activity Director position was a more fun position since now I could round them up and visit, sing, play, dance, act, do art, or go shopping! Although most were able to report to these activities; some were not-and it was important to go to them so as to read to them; or chat, or sing a hymn. I was given a blessing to honor these people. No less should every occur. They had such interesting lives that were not much different than our own other than the hardships of more difficult physical labor (building the railroad tracks, gardening for a family of 15; servicing in WWI and WW2); and they were there to provide wisdom to peers, staff, and me when we were having a bad day. I began noticing how this opportunity brightened their days and made them feel worthy. It was interesting that some of them were frisky, and it was obvious that they were young in heart.
The most prevalent emotional disorder was clinical depression for many of them. After all, their health was often struggling with chronic pain, arthritis, sugar diabetes, weakness of muscle and degenerating bone. Some were trying to recover from broken hips due to frequent falls, and others were in rehabilitation to learn how to eat again due to a stroke. Some had Parkinson's Disease, and several also had Alzheimer's. Many did not have their own teeth and many had failing eyesight and hearing. Appetites tended to wane since the taste buds were not as sensitive. Each day they did not know if they or their neighbor would wake and often would hear of a loved one who just passed while they see that empty spot in their dining area. Depression seemed inevitable even for the most vital and active.
The first thing that begins to chip away at them is the loss of independence. Driving is such a freeing skill and when the keys must be taken; they are angry although they understand. Being in their own homes for as long as it is possible is another huge desire. As home care nurses and family invest more and more time and money to allow as much time as possible; provided by the family if the individual has nothing of retirement substantial enough to pay this expense; then it becomes more clear that mom or dad needs to be in a residential home-if the children must work and have families of their own. which are being sacrificed. Both children and their parents experience anxiety and stress over this decision and will attempt to forgo this decision as long as possible. Normally, a serious fall, stroke, heart attacks, or high risk behaviors then force the decision.
In a circular culture as extended family often reside together-then also are the elderly more honored and taken care of but in our culture then the elderly are often a nuisance and burden. As the elderly finds their needs increasing-then so does their stress and depression. They find themselves in a conflict vs conflict situation where either decision will bring hurt to someone. Children also find themselves with this issue as their family, their funds, their jobs, and their needs conflict with their want to give their parent(s) their wishes and independence. For those who have no children-then this decision is often made earlier in fear of being unable to think rationally later by some; or not done at all as they are sometimes discovered by a neighbor.
Sometimes our elderly takes their prescriptions responsibly yet are told that the mix of prescriptions that they are taking are toxic-rendering them weak and close to death. Sometimes the caregivers are cruel, neglectful, and abusive. At times when reported, then people ignore these since they think that elderly people are all senile. This is false. Most elderly people are cognitive able to express and receive information, have good judgment, and good insight.
Deaths are more common during the holidays for the elderly. Sometimes these shortly follow the death of a family member or close friend. Full moons also provide an increase of suicides, deaths, negative moods, and combative behaviors.
The biggest gift anyone can give to an elderly person is a visit. To listen to their story and to ask for their wisdom. They are a vital people with plenty to give. They will need to speak about their past, their sorrow, their achievements, and their hope. We need to listen. They need to be stimulated with good conversation, music, crafts, reading, and exercise. Our treatment of them at all times will need to display dignity regardless of our function. They are our senior. They are to be respected. They should not be put out to pasture or treated as if they are without reason or worth.