I have yet to meet an elderly person who has stated that they want to be lonely and poor. My job requires that I complete home visits to assess senior citizens' (age 60 plus) health, living conditions and needs. Most of us envision retirement as a time in life filled with family, travel and doing those things you've always wanted to do. Maybe it's just my line of work, but there are a lot (A LOT) of people who aren't "living the dream." My husband says, "Remember, you're seeing worst case scenario." Maybe. But, I live in a town where poverty really isn't in the forefront. We're a resort town...people come here to vacation. We're fine. Buy some t-shirts. Retire here. Raise your cute family here. We're good at that.
We have a little work to do when it comes to aging and poverty.
Most of my people (my elderly clients) fall in that awful gray area. They don't qualify for Medicaid, they can't perform what is known as "activities of daily living" (bathing, dressing, toileting) on their own and their money is disappearing for various reasons. They want to live independently in their home. A few, however, would really like to live in assisted living, but they certainly couldn't afford it.
Truly, I wonder how many did not consider conserving finances in their youth. I have no idea. As a nurse, my job is not to judge my patients (that's not my job as a human), so I have to put that aside. I wonder how many have alienated family members. It's not that I can only see their loneliness, I can feel it. Sometimes it comes out as endless tears and other times it comes out as a fist banging on the table while shouting,"I hate being so alone!" For others, it is evident through the cookies and tea they've set out prior to my arrival. The table is set for a complete stranger. All I have to go on is what they tell me, what they show me. I can't dig into the past and decide whether or not they are worthy of love or finances. My goal is solely to help them, but truthfully, I end up loving them, too.
I lost one of my favorites in August. This person was a giant in their younger years. They were an athlete and caught they eye of others based on charm and good looks. Their blue eyes twinkled as if they were the only thing left over from a youth. In those eyes I saw an energy enslaved by a deteriorating body that just was not worthy of that spirit inside. I met them early in the year and as the months progressed, so did their maladies. Soon their happiness and joking, became buried under anger and frustration that is all related to the ability to observe one's own physicl aging. I had to dig and dig to find the person that I met. They were still there, I just had to work more to unleash the humor and lightheartedness. This person told me, "Ivonne, I think I'm going to stop taking my medications. I can't live like this anymore. I've had friends with illnesses like the ones I have and once they were diagnosed, they didn't last long." My friend was right about this. The illnesses were terminal, though you won't necessarily hear a physician say that. Docs will medicate you because, naturally, that is our instinct: to live. At some point, however, we know that we can't win this one. No one comes out alive. Yes, I encouraged them for a moment to take their medications as prescribed and then I caught myself. I was not going to say anymore about it. It's their choice. It truly is. How can I tell my friend to prolong their pain and suffering after having lived a long, fulfilling 80-some-years on this planet? I can't because I loved them too much. So, I gave one sentence of "nurse-speak", "You SHOULD blah blah blah" and that was enough bullshit for the both of us. Whenever I left, I felt it was the last time I would see them. We never left without mutual "thank yous" and I was the grateful recipient of weak, but heartfelt hugs and a kisses on the cheek. I drive by their home often (not because I'm a stalker), but because my daily life takes me by. The home has it's blinds drawn and life has continued it's usual hum, but their home doesn't have a heart. It's more like a dark cave now - no charm, no personality - just an empty space.
In a geriatric assessment, two things are very important: Maslow's hierarchy of needs and identifying if a person can perform their activities of daily living or ADLs. In Maslow's hierarchy, which you probably studied in school, the foundation of a person's motivation and ability to fulfill other needs is based upon their ability to fulfill basic needs. Basic needs are food, water, breathing (physiological needs to ensure life). From their, you move on to shelter, resources, employment. And just above that is when things fall apart for my patients: love and belonging. Interacting, socialization, intimacy, family, friendship...they don't have these. Some have absolutely none of these. Then again, going back to ADLs (which include: bathing, toileting, self care), some can't perform these either and these functions fall into Maslow's basic needs category, the foundation. These people, generally, have to employ someone to come into their home to assist them with self care. It's not cheap. This service will generally cost you anywhere from $15 to $25 per hour and most services require a minimum number of hours to be met. Hopefully, these seniors find a caregiver who truly loves their job and cares about those they help. Wiping bottoms, bathing, changing linens...sounds like motherhood: it's not glamorous, but the reward can be enormous. Imagine doing all this for someone unrelated to you. It's a sad and beautiful interaction all at once. These basic needs can be addressed and believe it or not, it might be the easiest part of this puzzle.
The more difficult need, to me, to fulfill is that of belonging, socialization, friendship. To feel that you are loved and important doesn't happen easily. All of us have felt this need unfulfilled in our lives. As a senior citizen, it's very easy to remain isolated with minimal interaction with another human since many feel they are a burden. I have met people who haven't been anywhere except to their physician's office in years. I've met someone who has not been outside in a year. I met someone too embarrassed to go out because they can not put on nice clothes, only clothes pants with elastic and maybe a t-shirt. Another recently told me that if she did not talk aloud to the picture of her deceased husband, she would lose her mind (this is an intelligent, educated woman who is absolutely aware of national and world events and who has an opinion). How fortunate I am to have met each and every one of them. Each has a unique story that I'm afraid will vanish. But the thing is, they want to share their life, their stories - with people like you and me. We are utter strangers and they WANT us and maybe even NEED us.
So, what do we do, my little town? How do we change this? We do what hundreds of other communities are doing: we include them in our daily life. We build places where young and old can coexist safely. We plan residential areas where it's easier for us to keep an eye on each other. We transform existing structures into affordable, safe housing and gathering places. Even easier, you develop programs that connect young and old. We create an daily routine of checking on our elderly neighbors. You open your mind and your heart and you fill them both with the friendship from a source you may consider unlikely.
*If you live near me, I would encourage to research Williamsburg Faith in Action (http://wfia.org/). It's the best thing going. Volunteers fulfill the needs of our local senior citizens. This is not rocket brain surgery. No one is inventing something new here - kindness, generosity, community - existed long before you and I did. Faith in Action "simply" does all the organization and planning that you and I try to avoid.
http://www.greatbigstory.com/stories/a-retirement-home-for-young-and-old/?xrs=CNNAPP#
https://www.facebook.com/aimediaAUS/videos/10153953588224220/
http://www.nytimes.com/2016/09/06/health/lonliness-aging-health-effects.html?_r=0
http://blog.csa.us/2016/05/green-houses-alternative-to-nursing.html
Truthfully, we are all headed in the same direction as the people I mentioned. My wish for you and for me is that we find ourselves in a different situation. Maybe we should get to work..
No comments:
Post a Comment