The list
By MP on Friday 1 September 2006, 13:43 - Background - Permalink
Here is the list of problems that Rachel and I drew up. I thought that
when I presented this to our case manager she would simply offer a solution for
every item. Instead, most of the problems have been pushed back on us, the
family. Most workers who made an effort to help on certain items gave up as
soon as they experienced some resistance from our parents. One of them refused
to attend because dad twice told her there was nothing to do and wouldn't let
her into the house. The agency once sent a man when we were hoping to have
someone help my mother to shower.
It has come to the point where simply having mum and dad accept a worker in the
house seems like a major step forward. Getting any further than that is
increasingly difficult. The notes in parenthesis show where solutions have been
provided by the social services. Out of sixteen problems, we are getting help
on only four of them. I'm not really satisfied with how things
stand now, but I've run out of the effort required to keep pushing.
When I bring other items up with the case manager, she has sympathised,
explained that change is very difficult for our parents, and asked me what we
are doing about longer term care.
Food
- eating cat food
- feeding human food to cats
- not finishing Meals on Wheels meals
- not eating fresh food
- eating food past its use-by date
Medical
- not taking medicine (the nurses administer medicine every day)
- missing doctors' appointments
Cleaning
- not cleaning cutlery and crockery
- not dusting
- not washing clothes, bedding, or towels
- not cleaning the floors or the toilet
Psychological
- boredom (dad goes to the Day Care centre once a week, and Pauline takes mum out)
Hygiene
- not showering or bathing (dad showers before going to Day Care, mum showers while he is there)
Safety
- vulnerability to robbery
- uncertainty on the outside steps (white lines have been painted on them)
- mum's attacks on dad
Comments
"...I've run out of the effort required to keep pushing."
"...and asked me what we are doing about longer term care."
Your list of problems is horrifying only in that it is met with passive resistance by case managers.
I more than sympathize, Mike, I empathize. I long ago passed the point of no return with social services which are supposed to be available to my mother but aren't. As well, I find it both astonishing and typical that your case manager responds to your requests for help by gently encouraging long term care. Not that long term care would be inappropriate, but, certainly, in many cases, long term care would not be necessary if appropriate, professional, here-and-there short term care were made available to families who need it.
I can't help but consider that social service agencies (and, of course, nursing homes) experience financial drain from providing in home services but lose very little and, finally, gain enormously financially when families are pushed, due to lack of available services, to liquidate their parents' financial assets and turn them over to long term care. This consideration reminds me that elder care is a service INDUSTRY, not a service provider.
In response to an earlier comment of mine you mentioned "bean counters (too many, you said) at the helm". This is a problem of economics, not of compassion. As well, since globalization is promoting a specific type of economic system which has faith in paying attention to the bottom line, I fear that all answers to the delivery of compassion at every level, including the personal level, rest with global economic overhaul. It's funny, because, lately, I've considered that, when my mother dies, perhaps I will hit the books, once again, become an economic expert, and see what I can do by approaching society's care problems from this end. It has been clear to me, for some years now as I've taken care of my mother, that the problem isn't that humans are a species of too many with too little compassion, but that we have inadvertently invented an economic model that cannot possibly reward compassion, can only, in fact, suffer compassion, and thus cannot truly promote compassionate care given by anyone, including family members.
Mike--First of all I say "Hear hear!" to Gail's comment.
I'm in the same place as you with my mother. I've compromised on so many daily hygienic habits that I cringe to think of them. But if I don't do her laundry, food preparation and housecleaning it won't get done unless I pay someone to do it, and I'm now too financially strapped, paying for the homemaker to come by during the day just to provide some company for her.
Clearly, few policymakers in your country or mine are thinking of the "collateral" cost of relying so heavily on family for caregiving. Here it is, only the beginning of September and I have already taken 20 sick days from my job. That's almost an entire month! (Actually, it IS an entire month of weekdays...) Not to mention the time I spend while at work, having to field and make phone calls that can't be made outside of business hours. I work at a university so the pressure isn't as bad as a business atmosphere, but if you multiply my story by whatever, you get some idea of the cost.