It’s About Who They Are

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Yang

The third and final Green House Project core value I’ll be dealing with is meaningful life.  I think this is really the essence of the Green House movement. It says that “good care” isn’t enough and that we can’t truly address the humanity and dignity of those who reside in LTC without awareness of what it is that makes their lives worth living – to them, as individuals. It’s not just about what they need, it’s about who they are.

The basic premise behind meaningful life is that in some respects the last stages of life are really no different than any other stage. We don’t stop growing and developing just because we hit a certain age or suffer from some debilitating physical or mental condition. Whatever our life circumstances, stagnation is unnatural and harmful to both body and spirit.  People in their 70’s, 80’s and 90’s can still have their dreams. Sometimes we just have to work harder to see it. And harder still to facilitate it.

But what does this mean from a caregiver’s perspective? I often hear caregivers say that the hardest part of the job is losing residents to whom they’ve become attached. While I’ve also experienced that kind of loss, the most difficult part for me had more to do with what was going on with certain residents while they were still very much with us. It’s not easy to describe the blend of emotions I felt after providing routine care to a favorite resident – hygiene, dressing, transferring, grooming and finally wheeling him down to the day room – and then having to turn and step away, leaving him there in front of the TV, waiting for his next meal as if getting a few spoonful’s of pureed meat and vegetables was the point of all of this and the pinnacle of his daily existence could be found in his dessert pudding. And I had no choice but to leave him there and move on because there were nine other people waiting for me. We did this day in and day out.

In those moments when I had to turn and walk away, I experienced more than just that sense of emptiness. I also felt guilty and angry and frustrated because I wanted to do more. I really believed we could do better than this. Yes, the facility provided activities and encouraged him to participate and this was better than nothing. But none of it was really about him. It was more about meeting some requirement imposed from the outside or impressing the never-ending train of oh-so important visitors. It was really about what the institution needed – and quite honestly, in this regard, he was just part of the window dressing.

What a person finds meaningful – what to him makes his life worth living – is intensely individual. It varies widely from person to person and can significantly change with time and circumstance. And it is not something we can choose for another person.

What we can do is know that person so well that we are able to engage him and help him experience what he does find meaningful. And no one has more opportunity to know a resident on this level than his caregiver. This is even more so when dealing with people who suffer from some degree of cognitive impairment or inability to express themselves in the usual ways. The caregiver-resident relationship provides a context that allows communication that might otherwise be overlooked.

The genius of the Green House Model is that it recognizes the potential of this deeper awareness and enables caregivers to act on their profound desire “to do more.” 

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