Caregiving Lessons: Distinguishing Between Inconveniences and Crises
In late August 2005, a torrential downpour that lasted for well over an hour seemed to stall over my house. I watched as the water started rising in my courtyard; a little bit later, it was starting to inch over the cement porch. Twenty minutes passed and the water was approaching the foundation of the house. And soon I had what a friend later called “an indoor swimming pool” that spanned several rooms in my house.
The next day I relayed the story around my “indoor swimming pool” to my work colleagues. Amazed at my calmness after having my home inundated, my coworkers asked how I was handling this situation. I replied, “This is an inconvenience, not a crisis.” Less than two weeks later, the horrific events of September 11 happened, which reinforced to me what truly qualified as a “crisis."
Why am I sharing this story? Perhaps because I’ve had to learn the difference between what’s an inconvenience, what’s a crisis, and what can develop into a crisis in relation to caregiving. And in learning the difference among these three situations, I’ve been able to tailor my response so that I handle each situation appropriately in order to support Mom and also to ensure that I don’t burn myself out as a caregiver.
For instance, Mom has a tendency to have horrific emotional outbursts in which she demands immediate action from nursing home staff or from family members (such as getting her out of the nursing home). When I first was exposed to these emotional onslaughts, I took them as “crisis events” since these reactions were so uncharacteristic of what I experienced from Mom throughout my life.
But, I soon learned that however disturbing, these outbursts should be classified as “inconveniences.” Yes, Mom was irate about an issue, but her irritation was most often caused by Alzheimer’s or paranoia, instead of issues that truly would pose a threat to her health. I learned to handle these issues in a logical, caring manner which helped Mom calm down. And I learned by taking this route, I could maintain my own composure and sanity (and, thus, lower my own stress level).
Then there are the true crisis moments. Fortunately, these situations in care-giving have been few and far between since Mom came to live near me in September 2005. However, when Mom has experienced a health crisis, my response has been much more directive during the crisis and confrontational afterwards. For instance, one day in January 2006 I went to visit Mom at an earlier time than normal and was stopped by two nurse’s aides who told me Mom was having health issues. Upon entering Mom’s room, I found her slumped in bed and non-responsive. After trying to get her to respond (during which she would groggily say, “I’m fine”), I called the nurse into Mom’s room and pointedly said that something obviously was wrong with Mom.
Fortunately, another nurse was coming on duty at that point and she quickly sprung into action. After getting Mom’s vital signs, she called the doctor to get an OK to send Mom to the hospital’s emergency room. While awaiting the return call from the doctor, I told the nurse that we needed to have some sort of emergency transport to the hospital. She agreed and within 15 minutes, the paramedics were putting Mom gingerly into a gurney and transporting her to the emergency room. Mom spent five days in the hospital fighting off bronchitis. Once Mom’s health crisis was averted, I expressed my extreme displeasure to the nursing home administration and staff about the earlier nurse’s inattention to my mom’s mounting health issues (even though the nurse’s aides had tried to tell that nurse that Mom was having problems).
Finally, I find that I also have to be vigilant in confronting some caregiving issues that can lead to a crisis; these situations need to be addressed quickly so they don’t escalate. For instance, when Mom got back from that five-day hospital stay, she was extremely weak. However, a nursing home aide assigned to work with Mom insisted that Mom was able to walk by herself to the bathroom. Upon hearing this response, I immediately went to the nurse on duty and asked why Mom was being told to walk by herself when she was so weak. It turns out that the signage that indicated the amount of assistance the patient needed had not been changed during Mom’s absence. If I hadn’t been there at that time to see the aide’s response, I’m afraid Mom would have been back in the hospital with a broken bone.
I’ve learned that caregiving requires different responses from the caregiver. Not every situation is a crisis; however, if not addressed, the seemingly little situations can build and become a crisis. And when a health crisis does happen, I’ve learned to take the lead to demand the proper care that Mom needs (and deserves). Learning how to handle each of these scenarios effectively is important not only in helping Mom, but also in maintaining my own emotional reserves during the rollercoaster ride that is caregiving.