Caregiving 101 — It takes more effort to let the patient have control
01/07/2014 4:38 PM
01/07/2014 4:38 PM
My father-in-law (FIL), at age 96, was active — even driving — until last April.
At his own home in St. Louis, FIL had his own routine. He kept up his household, in his own way and to his own standards. He ate what he wanted, when he wanted.
Then he succumbed to pneumonia, was hospitalized for a week and released — physically weak and unable to care for himself — to our care.
Now he was living 250 miles from his house, yard, car, truck, farm, tractor, friends and favorite dining and recreational venues.
His old routine was gone, and his new routine was ... boring.
For my husband and me, meeting FIL’s physical requirements was manageable, but alleviating his mental and social predicament was daunting. We searched for things to entertain and occupy him.
We supplied the newspaper sections and puzzles he enjoyed. We tutored him daily in operating our different-from-his remote control and navigating through the different-from-his TV channels. We established shortcut buttons on the desktop computer so that he could get to Spider Solitaire and Internet Checkers by himself. We encouraged friends and family to write, call or visit, and they did.
Still FIL seemed malcontent.
It took a heartrending drama, unfolded laboriously before me, to reveal the actual problem.
FIL loves to be outdoors. One mild June day, I settled him into a chair outside with his water jug, dog and walker. I had stuff to do inside, but could monitor him through a window.
I glanced out once to see him pushing his walker down the driveway, a flat of petunias on its seat/shelf. I figured he was taking them to the spot where he wanted my husband to plant them.
The next time I looked out, I saw FIL lying in the grass, with the tipped-over walker nearby. I went outside to investigate.
FIL assured me that he was fine, “just resting and enjoying the sky.” I righted the walker, brought the chair over and went back inside.
The next time I checked, FIL was crawling towards the street, dragging the flat of flowers. As I watched, he pulled a little gardening spade from his pocket and started digging. One by one, over the course of at least an hour, FIL planted the petunias. When he finished, he crawled back to the chair and pulled himself into it. He sat there for another hour or so, then used his walker to return to the house.
FIL was happier that evening than he’d been in days.
And I finally realized something. It wasn’t the lack of things to do. It was the lack of value in the things he was doing and the lack of control in everyday decision making. It was FIL’s role in our household. He had no responsibilities and not a lot of say in what happened day to day.
It was a matter of pride.
I made some changes after that. Instead of giving FIL busywork, we assigned him meaningful tasks.
We cut some of the red zinnias he likes so he could harvest the seeds for next year’s garden. When we carved our Halloween jack-o’-lanterns, FIL — who in former years grew hundreds of pumpkins and gourds for his children and grandchildren — salvaged the pumpkin seeds.
We left things out where he could find and use them: a pan and spatula so he could fry his own eggs; his mug, spoon and instant coffee so he could microwave his preferred style of morning brew.
Instead of us doing everything for FIL, we accepted his help with everyday tasks — bringing his sheets, towels and clothes to the laundry room, rinsing his dishes, fetching the newspaper from the driveway.
There were some messes and spills and delays, but really — so what? FIL was cheerful.
I swallowed my own pride, and asked for FIL’s assistance, opinions and (choke!) even his advice on issues ranging from meal preparation to politics to relationships. And guess what? A 97-year-old guy knows lots of stuff. Go figure.
Caregiving 101 lesson learned: It often seems easier to do everything for your patient. It takes extra thought and time to let them contribute. But there are dividends in contentment for all parties involved if you will squelch your own control and esteem issues, and elevate theirs.