It was five am the day before Christmas Eve. I was on my way to work, driving bleary-eyed through the crisp darkness, the fields beside me a white frosted blur, signs of the sun’s arrival appearing dimly and distantly on the horizon, distinct and noticeable only by the shades of pink that shot through the sky above the hills surrounding the valley I had made my life in.
I gripped the steering wheel with my black mittens, cranked up the heater, and zipped up my two winter coats as high up around my neck as they possibly could. I turned on the music, hoping it would wake me, and I sang along.
After about thirty minutes zooming across the abandoned roads, I arrived at my destination, awake, ready for whatever lay before me, but paused just outside the assisted living facility entrance and sat in my car, staring at it, lost in a moment of thought.
I considered who I might meet inside, what my client would be like, tried to remember her name and apartment number, wondered how I would find her suite, pondered about whom I might ask, and more. But most importantly, I took a moment to center myself, to calm my nerves (the nerves that inevitably arise when I find myself in a foreign situation, which is basically every time I take on shifts with a new client), and to think about how I was there to serve her and to meet her needs.
The woman at the front desk brought me to my client’s apartment, and I stood outside the door after she rounded the corner to return to her post by the front door, a post she’d probably faithfully guarded throughout her entire night shift there.
I removed my mitten to knock, shifting my medical bag on my shoulder. It wasn’t that heavy, thankfully. I had some gloves, a blood pressure cuff, a stethoscope, two one way CPR masks for adults and infants, a small first aid kit, etc. inside. It isn’t required of us to carry one, but I figure, better to be safe than sorry. The nurses who work with my company each have one.
Knock, knock, knock.
The woman opened the door, frail, disheveled, confused. She’d been in the ER the night before, she informed me, bypassing my handshake and brief introduction as she spun on her heel and shuffled over to her chair where she collapsed.
I stood outside the doorway still in the drafty hallway and I looked at her, sitting in her chair, so small and weak.
And when I looked at her, something strange happened, something magical, something that happens every time I go to work and meet my clients: I saw myself.
It’s how I get through my job every day. It’s the only way to do this job, and to do it well.
Every single elderly person I encounter, I think to myself, “This is me, 70 years from now. This is me after living a life.”
My first task that I’ve assigned to myself every time I meet with a new person is to sit down with him or her in whatever home I’m in and begin asking questions.
“What’s your name?” “Do you have family close by?” “How long have you lived here?” “Who is in that photograph on the wall?” “Do you have holiday plans?”
After this, I open up the folder with my company’s name and logo on it, located in a center location in the home, generally a TV stand, coffee table, or dining room table, and I quietly review the care plan the nurse created.
Then, I go over it with my client, formulating a plan for how we will accomplish these tasks, allowing them to retain a sense of independence as we plan our morning, evening, or afternoon together.
Sometimes, I am supposed to make a meal, give the meds (already proportioned by the nurse and placed into med boxes), and help with a shower. Other times, I am supposed to help the client exercise or to take him or her out to run errands. And finally, I might simply be there to relieve the caregiver, be it a spouse, a mother or father (rarely-this is only with younger clients), or maybe a son or a daughter by being a calm and reassuring presence in the house while they step out to get some fresh air or have an evening out to themselves. During this time, I might straighten the kitchen, prep some dinner, or watch a TV show with my client. We might make small talk or occupy ourselves with a task like folding clothes or filling out the crossword puzzle from that morning’s newspaper. Most importantly, every single one of my clients has a story to tell.
It’s generally a very pleasant job.
It may even look quite easy on the surface.
But there is an fine art to this job. Some of my clients have dementia, Parkinson’s, MS, injuries, are fall-risks, stroke victims, and more. Many of them are lonely, having lost friends and spouses over the years as they aged. Some are isolated due to lack of transportation or finances. Many of them struggle with grief and some are mal-nourished, living alone, failing to prepare healthy meals. On any given day with any given client, I can expect to encounter one of these several common emotions found in the senior age group: Anger, frustration, grief (over a loved one or loss of independence), confusion (“dementia,”), distrust, guardedness, anxiety, fear, joy, pleasure, or laughter. Sometimes, in a given appointment, I may watch the person experience all of these emotions at once.
While this occurs, it is my job to complete the tasks written into the care plan despite the fact that my client may be on a totally different page than I am. It is then when I learn to listen while I work. I attentively tune into their expressions, body posture, tone of voice, words, keeping all of this while I work.
For example, sometimes, when I’m helping a client get dressed, they may grunt. Grunting, of course, can mean discomfort or pain. Other times, I’ve discovered, it may simply be what I like to call, “The grunt of old age” because when asked why they groaned, sometimes the client has nothing to say about it other than, “I don’t know why I was doing that. I’m fine.”
There is nothing more personal than my job, and very few things in my life can measure up to the sense of honor I feel when I step into this person’s home.
You see, I don’t just step into this person’s home. I skip past all of those niceties and go straight into their kitchens, their bathrooms, their showers, their lives, and their hearts.
I don’t see how it could get more personal than washing somebody’s back, breasts, or butt in the shower while they tell me about their life from the day they were born until how they got here to where they are at. It may sound totally weird, but that’s something really special. It’s something not everyone can say they have done (or may ever want to do).
It isn’t always rewarding. Sometimes I get brushed off or overlooked. Sometimes I don’t get a thank you. Sometimes, I’m even unwelcomed into the home itself and have to coax my way in.
But when I am thanked, in the moments where I know beyond a shadow of a doubt that I’ve made a difference for the better, that warms my heart and encourages me to stick with it.
So I looked at that woman in the chair, and I saw myself.
“What do I need?” I asked myself, and the first thing I did was listen.
Days later when I was finished with my assigned shifts with her for that week, I stepped out the door, not knowing if I’d ever see her again, and just before I shut it, she called out to me, “I love you! I love you, Dear.”
That was the thank you I received after three days of helping her recover from food poisoning, panic attacks, hospital visits, washing her in the shower while trying to preserve her honor and dignity, folding clothes, helping her settle in her new apartment, taking her to hair appointments to get her hair piece styled (because not everybody keeps their hair in their old age), laughing with her about the ailments of being newly diagnosed with dementia and turning 91 years old, putting up signs around the house for her to remember things she needed to remember, listening to her grief over the loss of her husband and the meaninglessness that Christmastime now has as a result, encouraging her to eat a bland diet for her stomach, and comforting her when she felt scared or confused.
I offered her friendship, listening ears, a compassionate heart, a heart that became so invested in her that when I lay in my bed that night, I wondered to myself, “If I knew I had dementia, if I was living alone in a new place feeling scared, what would I need?” I thought about if I had a caregiver like myself coming to see me, would my needs have been met? When I fell asleep each night, I fell asleep at peace, because I knew that I had done absolutely everything I could to make her comfortable and happy.
So when she told me she loved me, my heart melted. Tears welled up in my eyes as I felt my heart tug at me. The “professional” thing to do would be to say, “Thank you, have a nice day,” but can that be said when you’ve helped somebody shower, dress, eat, walk, etc?
Screw professionality. When I am 91 years old, I want to know that I’m loved. I bet her sons and daughters want her to know she is loved.
“I love you too,” I replied before shutting the door with a soft “click.”
And it was true. I did love her. I love every single one of my patients as though it they are some future form of myself, or another manifestation of my own grandmother. It sounds selfish, that imagination game I play in order to get my job done, but it is the best way for me to do everything with 100% effort, 100% investment.
Every day I work, I am reminded that my cells divide a bazillion times in my lifetime. My telomeres are shrinking with each cell division, oxygen is having a negative effect on my mitochondria, all of my innate genetic weakness or abnormalities are being replicated upon each cell division, and every day, I am marching one step closer to my inevitable demise. I am aging. One day, I will die.
It is a curse we all have hanging over our heads; it’s one long march on death row, and our mortality stares us right in the face every time we wake up in the morning.
Believe it or not, I’ve grown accustomed to this fact, grown a friendship with it, and I have accepted it, at least on some sort of surface level.
Jesus lived life to the fullest. I think that is one of His great accomplishments about His time here on this earth. I’d like to follow in his footsteps in many ways, that being one of them. My life here on this earth is brief, but a blip in the scope of all of eternity, past, present, future. It is so small and insignificant, it’s not even funny. My existence is both significant and insignificant all at once.
I hope that each person whose home I walk feels cared for, even if they never know that I think about them when I go to sleep at night, when I drive to work, when I wait in line, or when I sit in school.
Each person whose life I walk into, whose hearts meld with mine becomes a part of me. I carry their stories with me, I cherish my memories with them, I pray for them, and I hope that one day, when my hair is silvered and I am frail (if I have the privilege of living that long), that somebody will love me like I have loved them. I hope that somebody will take my hand and help me in the shower and make sure that I am clean and warm and dry, that that person won’t strip me of my dignity when they dress me, and that that person won’t take advantage of my financial and emotional vulnerability. I hope that person will be sensitive to my needs if I am grieving, and that that person will help me to eat healthy if I am not.
I hope, I hope, that one day, I can tell the girl softly clicking my door shut, “I love you,” and that she’ll quietly and honestly say back, “I love you too.”