Monday, November 22, 2010

Case study #12 control issues

She walked into a client's home. Uncomfortable, irritable, uncomfortable, sliding around in his chair.
He didn't want her there. You could tell. 
Complaining about her being his babysitter.  Come on, she tells him, "I'm going to help you have a shower."

This man hadn't had a shower... let me think. I don't ever remember Dad having a shower! He always had a bath. Every night, after working in his garden, he had a hot bath while mom cooked supper. He'd wash the precious garden soil off of his dirty hands. Revelling in a day in which much was accomplished. 

Now, ravaged by arthritis in his knees, a hot bath always made him feel good. Now, unable to balance in the shower due to the brain tumour, his dementia or delirium (who knew which, he had both) this stranger marched into his bedroom and told him what was up. Well, needless to say the shower didn't happen. Despite new handrails in the shower, a bath seat, furnished by CCAC, he wasn't up for this. 

Dad's response? "The hell you are!" I still laugh as I recall him hanging on to his privacy and dignity. I didn't have the heart to tell him this was going to get worse. When we put dad into the retirement residence, he refused a bath or shower for two weeks. 

My favourite time was getting that phone call from Gay, his nurse manager, telling me he wouldn't take his pills, have his breakfast, put on his glasses, put his pants on. "They're not mine. Nothing to do with me!" he told us. Yikes. I now understand that this is a sign of dementia. Agnosia. Inability to recognize objects. You can be unable to recognize faces, or things.

When Dad then had to be transferred into a long-term care home he refused food for another two weeks. That's another story, but I know it was anorexia. It was the last control. It is a familiar story for many.

Long-term care: not quite 'home'
Seniors ill at home, whether they be relatively frail, or not, are reluctant to accept help. Whether it is paid help, or not, a sign of increasing health issues and the progress of old age, is not being able to control one's life. 

Your daughter might have sent someone in to help out with vacuuming. 
Hospice sends someone in while a spouse gets a respite break.
The PSW is there to change your bedding, help you bathe.

My story, as a Hospice Volunteer, is that I am there for their loved one. I am there to give them a break, to feel more relaxed going out for a change. Many understand this. Many clients can take a moment and appreciate that their loved one has been working hard. 

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