Names have been changed and details of accounts included here have been altered to protect privacy, pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). All quotes are from real Benton County caregivers.
Teresa never planned to be a caregiver. Her mother was a nurse, her childhood filled with memories of mom refusing hugs after work, exasperatedly exclaiming, “I’m covered in poop!” Nowadays, it’s Teresa who lumbers through her apartment door after a brutal shift as a memory care caregiver, bagging up soiled scrubs and trudging towards the shower.
While at her previous job as a waitress, Teresa made minimum wage, plus hefty tips… now, she does pretty much everything she did as a server, but then, after dinner, she cleans up her customers, changes their adult diapers, toilets them, brushes their teeth, and gets them ready for bed, often with quite a bit of resistance and wacky, demented tomfoolery.
Wanting to improve herself, Teresa took a training course through a local school and became a CNA (Certified Nursing Assistant). This new job pays just above minimum wage, yet it encompasses a vast panoply of specialties that seem to be better suited for someone who has undergone years of training.
“I feel like a waitress, a busser, bathroom attendant, personal handmaid, hairdresser, foot care person, counselor,” she sighs, “and it seems like every other week they’re closing another department and tacking on more duties for us. It can be heartbreaking, because I already feel like we’re stretched as far as we can go, and that affects the level of care being given.” It’s a dirty, tough job. But it can be immensely rewarding.
In moments of clarity, residents are wizened elders—sometimes hilarious, sometimes poignantly reminding their caregivers of the rich, fathomless fabric of the human soul. That couples with the pure, Zen unselfishness of the act of service itself. “I love being able to be there to support people on an emotional and spiritual level,” Teresa says. “When you see pure gratitude in somebody’s eyes, there’s no feeling more rewarding than knowing I put somebody’s needs before my own, and they’re truly thankful for it. It’s done heaps for my ability to empathize with others.”
A typical shift begins with a group meeting between incoming and outgoing caregivers to discuss residents’ health and behavior problems, and, occasionally, a resident’s passing. Yesterday, Bill died. Despite having roving hands—often goosing or grabbing male and female caregivers alike—he was the sweetest of guys. His rapidly declining health be damned, he was always smiling or cracking a joke— his beaming grin was contagious, and will be sorely missed. Two caregivers cleaned him up, folded his arms across his chest in preparation for rigor mortis, and tidied up his room awaiting a hospice nurse’s arrival. Superstitious caregivers will open a window.
“And then it’s time to move on, you know? You have to. Back to work, there are others still to care for. It almost feels weird and melodramatic to say it out loud, but it can be really tough when you’ve taken care of someone for years and you don’t really get to take a huge time out,” Teresa comments.
At 102, Gerty is the oldest of the bunch. She has to be hand fed, and is usually ravenously hungry and quite intolerant of delays forking morsels of food into her waiting mouth. “Help, help,” she’ll yell when not getting full attention, which is quite often, since whomever is working her section has to hand feed both her and her neighbor Linda, while being responsible for another 10 residents as well. Every single person staying there has individual, special needs. Andy has Parkinson’s and while he is clear in his mind, his body is out of control. Jenevieve spends the day asking for her vodka, waving around antique pearls, and singing. Frank was in a terrible accident and must be reminded daily what happened to him, often resulting in fits of rage. The other week he tried to strangle a caregiver, and how any given facility chooses to handle that sort of thing seems to be more of a crap shoot than policy.
Most facilities have helped improve employee to patient care by splitting the facility into “neighborhoods” and attempting to schedule the same workers to those same areas. The personality quirks and needs become familiar, and those that spend a lot of time together can almost become like family. Other concepts, such as a Life Enrichment Department (referred to by myriad other names) that dedicates time and space towards fostering hobbies, game playing, and social time between residents are out there, but not everywhere. There’s no lack of trying on any end to improve the quality of life for residents and caregivers alike, but all sides are victim to the same cost-cutting and bureaucracy.
Teresa had some last words at the end of our discussion that people would do well to take to heart: “I love what I do, despite how hard it is. But I think that’s what makes myself and some others good at it. The position is rife with negative aspects, and can be pretty thankless, but I’m not here for thanks. I’m here to care.”
While the problems inherent with this kind of work tend to create a hostile environment to drive up turnover numbers for employees, there aren’t many of us out there that aren’t thankful for those like Teresa that have stuck it out.
By Tom Baker