Caregiving 101 — Caregivers need to balance the care with independence
11/12/2013 2:15 PM
11/12/2013 2:15 PM
“You can lead a horse to water, but you can’t make it drink.”
There’s a reason that the old English proverb has endured through the ages —because it’s true! A caregiver can provide good and reasonable care, but cannot make the caregivee accept it.
My father-in-law (I’ll refer to him as FIL) moved in with us last spring after a bout with pneumonia. He needed our help on many fronts, and we made all the decisions for him for a few weeks. But as he regained his health and mobility, he also wanted his independence back.
While FIL was bedridden, I made the food selections and monitored the amounts. He wanted pizza and cheese puffs almost exclusively, but I tried to serve him a well-balanced diet with consideration to his diabetes, hypertension and diverticulosis.
As he regained mobility, FIL began foraging. He cruised through the kitchen in his wheelchair when he thought we weren’t looking, searching out snacks and goodies.
First horse-to-water lesson: A caregiver can place a variety of healthy snacks — fresh fruit, Jell-o, applesauce, peanuts, crackers, veggies and dip, cheese cubes, granola bars — on the counter each morning, and kindly include an individual-size zipper bag of cheese puffs, BUT the caregivee can ignore the healthy choices day after day after day, sniff out the full bag of cheese puffs on the highest shelf of a cabinet, miraculously stand up to retrieve it and consume the entire bag in one sitting.
FIL spent a few weeks in a rehab center and progressed to walking independently again. I worked with the staff and insurance company to verify home health benefits, and FIL returned to our house. I juggled our schedules to arrange appointments for one nurse, two physical therapy and two occupational therapy visits each week. I met with each of them with FIL at our home for their introductory sessions, and listened in awe as FIL lied through his teeth, saying “yes” to all their queries about his safety practices and exercise routine.
Second horse-to-water lesson: A caregiver can endeavor to decipher insurance benefits and secure therapy, BUT the caregivee can decide they aren’t helpful (even though they’ve brought him from bedridden to walking in less than a month) and terminate their services.
FIL has several health issues and consequently many pills to take. He is prone to complain about his symptoms, visit doctors for advice and get new prescriptions. He searches the Internet for information on each of his maladies, and we help him discern the ads from the reputable sources. He became very enamored of his digital blood pressure cuff for awhile, monitoring his BP several times throughout the day. I made him a chart, which revealed his high BP in the morning and its sharp decline after he took his daily meds.
Third horse-to-water lesson: A caregiver can lay out the medications each morning, naming each one and explaining what each is for, BUT the caregivee (who is “tired of taking so many pills”) can choose to take only his favorite three (“that’s all I’ve taken for years and years and I’ve been just fine!”) regardless of the effect on his blood pressure (and that of his caregivers!) and his overall health.
We’re into our seventh month of caregiving for FIL. It’s hard. We make a lot of mistakes. We push too hard. He pushes back. We let up. He falls down. What works well one week fails the next. We make changes.
FIL reminds us frequently that he’s been taking care of himself since he was 13 years old. When people call him stubborn, he corrects them. “I’m not stubborn. I’m independent.” When a guy is 97, it’s tough to convince him that he’s not doing it right.
There are some areas where we cannot compromise — driving, for example. But there are many others — from hygiene issues like bathing and teeth brushing to business dealings like correspondence and paying bills — that just aren’t worth the battle.
So if you visit our home, you may encounter a smelly old guy in a soiled shirt (and FIL disagrees with the word “soiled,” by the way, because he looked it up in the dictionary and “soil” means “dirt” and this is not dirt on his clothes) with orange stuff all over his 12 remaining teeth. But he’ll be smiling.
For now our job is to provide what he needs, but still allow him to make his own decisions.
Bottom line: the caregiver is only that — a care giver, not a care forcer.