Tag Archives: home care aide

Behind the Scenes

My eyes scanned the unfamiliar environment, quickly assessing potential pitfalls and hidden dangers. Carpet, possible fall risk. No hand rail in the bathroom. Air conditioning vent directly over the only place at the table my client’s wheel chair can fit. No other chair in which she can safely sit. Ok. A manageable if not ideal environment. I had prepared for those obstacles. Thankfully, I thought to put the commode chair in the trunk just in case. All the bases were covered and though I left exhausted at the end of the shift, my client was able to enjoy Thanksgiving at her daughter’s house surrounded by love and family.
When I was told that her daughter wanted to host Thanksgiving dinner at their house this year, I balked inside. It was a twenty mile drive into completely unknown territory and I had no idea what would be needed to keep my client as safe and comfortable as possible. People who aren’t living with or caring for those with disabilities tend to take for granted the amount of effort and time that goes on behind the scenes. This is a truth that transcends all avenues in this field. Get it done. Handle it. Make it happen.
And we do, don’t we? How often have I thought about the impossibility of a problem as I was in the middle of doing my best to solve it. Be it in homes or in facilities, uphill battles are what we do. It’s part of our job description and we don’t falter. Personal life in shambles? Worried about bills? Car troubles? We have to leave it at the door. We don’t get the luxury of falling apart. We have people who count on us.
Today, I was strongly reminded of how much that inability to fall apart has taught me. My dad had to have emergency surgery this afternoon. He is going to be okay, but he has quite the road to recovery ahead of him. I was blind-sided by this news. We all were. My dad, who is the picture of health and stands taller and stronger than most men, both physically and mentally, hit a bump and there is absolutely nothing that I can do about it. After a night of wrestling with powerlessness and fear, I woke up this morning, put on my scrubs and went to work. I don’t have the luxury to fall apart and because of that, by the simple effort of putting one foot in front of the other, I was able to regain perspective.
It isn’t a good situation but it could have been so much worse. I am powerless over his pain, but I am capable of being supportive to both him and those around him. I can offer information about self-care and I have insight that will benefit my family. All of this comes from lessons I’ve learned from the field and the unseen efforts that go on behind the scenes of what we do. Our job teaches us courage. At times, it outright demands it.
Management, regulatory agencies, even the families of those in our care are only interested in the end results; the appearance. If everything looks ok it is ok. If everything looks easy, it is easy. We caregivers know better. We are behind the scenes people, the muscle behind the movement and the heart behind the smile. What I have learned in the simple act of trying to do my best in this field has enriched my life in ways that defy reason. I didn’t want to go to work today. I wanted to hide from the world, but I went anyway. I didn’t want to write this post. I didn’t want to express my fear and vulnerability, but I wrote it anyway. That’s what we do. We tackle the task at hand and keep moving. We do not shrink from adversity and that is what makes all the difference in life.

A Day in the Life

Ughhhhh. Five more minutes. Five more minutes. FIVE MOOOORE MINNNUTES! I think to myself as my fifth and final alarm blares, jarring me from my sleep. I look at the clock. Sigh. No more minutes. I was pushing it as it was. Three minute shower time. I throw on clothes after kind of sort of drying off and simultaneously brush my teeth, hunt a missing shoe, and grab my keys. Catching a glimpse in the mirror, I smile wryly. Good enough, I guess. I kiss my love goodbye and off I go.
Thirteen miles to empty. It’s going to have to do. I’ll make it on time but only if the bridge isn’t up. Don’t be up. Don’t be up. Don’t be up! Traffic isn’t backed up. Always a good sign. Ahhh! I breathe a sigh of relief as I see the cars flowing smoothly over the bridge. I’m going to make it.
I pull into my client’s driveway with three minutes to spare.
“Help me have patience. Help me do some good. Help me maintain my sanity”. It is my little ritual. I send that prayer out to the universe at the beginning of every shift.
I let myself in the house and start the coffee. My client is still sleeping pretty soundly, so I put out some chicken to defrost for dinner, prepare her morning meds, set up her glucometer and put the gas fireplace on low to knock out the chill in the room.
“HEY GAL!”, her husband yells down from upstairs. I make sure she’s still asleep before I go to the staircase. He forgets sometimes that he hired me as his wife’s caregiver and often monopolizes my time. Still, he means well and I don’t have the heart to tell him. I think he sometimes just wants a captive audience.
After ten minutes of listening about his knee pain, bunions,”damned liberals”, and a list of chores he expects me to do (honestly, I’m not sure how cleaning HIS bathroom became part of my job duties), I am able to make a graceful (graceful-ish) exit.
My client and her husband live in a beautiful house on the beach. It’s huge, divided into two separate living quarters, almost like separate apartments. Most of the time, when he is home, he is downstairs with my client. The upstairs is mainly for when he goes to bed. He is active and loves to be out and about, so until one or so, my client and I have the house to ourselves.
I head into her room to start the day’s routine. First, I open the blinds. Then I check to see if she took any of the three pain pills that are left by her bedside. If all three are there, we’re in for a good day. If all three are gone, it’s going to be a rough one. There are two. Could go either way. I massage her legs to get the blood flowing, apply lotion and her leg brace. The transfer from bed to chair goes smoothly and we are off to the bathroom.
We call it the bat-cave. A good chunk of our time is spent in there. I think, in part, because it is a comfort zone for her. She has a routine and deviating from it causes her unease. In the mornings, we wash her face, she takes her AM meds. She says she keeps pharmacies in business. I check her blood sugar. She handles it like a champ. 137. Not too shabby.
Dark cherry Chobani yogurt, oatmeal, half a cup of coffee with one Splenda and a dash of cream, cranberry juice over crushed ice in a tall glass. NEVER a plastic cup, which would be easier for her to manage. I’m not sure the reasoning behind that but I aim to please. Breakfast is served. I pour myself a cup of coffee, sit down beside her and we do some morning readings from her daily meditation book.
She takes her time at breakfast. It can last anywhere from one-two hours, depending on how she feels. I don’t rush her. I’m grateful that I don’t have to hurry her along. It’s one of the job perks of private care and she told me once that she hated it when people put pressure on her to speed up.
Time is a funny thing in that house, simultaneously crawling and flying, depending on the moment. Take the shower transfer, for example. I am not one to throw the word hate around. Usually, I think it’s an embellishment of mild annoyance, so you can believe me when I say that I HATE that transfer. On the BEST of days, I feel it’s a risky maneuver. The handrails are all in weird places. It’s a tiny space. It requires my client to take a step that’s about three inches and then walk backwards. To get out, she has to let go of one rail, reach her arm out and grab one outside the shower, lean forward, and step down on her good leg as I assist her on her affected side. It is the stuff of nightmares for an over-protective caregiver.
As I am independently contracted, I don’t have an agency to set work boundaries and that is not a strength of mine. Still, after nearly a year with this family, I have learned to draw a few lines in the sand…not many, but a few. It’s all about progress, right? So, back to the shower. Now, that was a conundrum. My client loves the shower. It’s every bit as much of a joy for her as it is an anxiety attack for me. I actually get her much cleaner using a Sitz bath and scrubbing her down on the shower chair than I do in that tiny shower. Still, perception is fact in this gig and a shower feels better. What’s a girl to do? Finally, an opportunity arose to address it. My client was having a tough day. Her pain level was high and her mobility wasn’t good. Still, she insisted that she could handle the shower. She asks for so little that I didn’t have the heart to tell her my misgivings. She got into the shower fairly easily. Getting out was an entirely different beast. It took over an hour and a half. We tried a variety of ways to exit that tiny tiled tomb. By the time we got out out, I was sweaty and exhausted, she was sweaty and exhausted, we were both sore and completely out of breath. It was a dumb move on my part. Though it was well intentioned, she could easily have fallen and that would have been on me and my stupid Wonder Woman complex.
Still, it opened the door to solving that problem. From calamity came opportunity!
“You know, after all that effort, you ended up messier than you were before the shower! What do you think about doing a full shower every other day so it’s not quite as hard on you?” She looked dubious at first.
“I can do a more thorough job if we wash in the bigger space. Plus, it will give you the chance to soak your feet! And the time we would spend transferring out of the shower we can spend on hair and make up! Turn those days into in-home spa treatments!”…AH-HA! Those were the magic words! I saw her eyes light up and it has been far less of a problem ever since. She still gets the full showers on her good days and on her challenging days, she gets to be spoiled like a princess, complete with a foot massage.
Today is hair washing day, so that means a full shower. I push her into the bat cave and maneuver her as close as I can to the treacherous step. The transfer goes smoothly, much to our relief and I slowly release my breath as she settles onto her chair. Now, hair washing seems simple enough. It certainly was when I worked in the facility. It’s a little different here. There are steps. And timers. And products. And then hair appliances. My client and I move seamlessly through the process. Such a difference from when I first started! I got the products confused and had no idea what “confixer” was. I still don’t, really. I call it hair cement. And wasn’t adept at curling or teasing or spraying hair. Personally, a good day is when I can find my brush. I am much more concerned with my client’s hair and appearance than my own. See, it matters to her and she thought for many years that she had to let it go. That’s also one of my favorite perks in private care. I can help her hold onto who she is underneath her disability in ways that those who aren’t in the field often overlook. I have the time to make that a priority.
12:30. We successfully made it through the shower and hair. Nine hours left in my shift. Next is her beauty regimen. I set up a variety of lotions and powders and push her close enough to reach. This process takes around an hour and she likes to do it for herself. While she’s beautifying herself, I chop potatoes to boil and mash later. I marinate the chicken and wash up the breakfast dishes. I peek in the bat cave to make sure she’s doing all right. After getting the thumbs up, I load up the laundry, run it upstairs and toss it in the wash, collect the upstairs garbage ( and the man has like twenty five tiny waste baskets filled with nothing but tissues and scary political pamphlets) and it’s back downstairs just in time to hear his truck pull up into his garage.
“The Bear’s here!”, I call out to my client. It’s our nickname for him; a nickname he likes a little too much if you ask me. Goes straight to his head.
“Hey Gal! Make me a sandwich!”, he says before going on a long rant about whatever crap he heard on conservative talk radio. Ok. I’ll make you a sandwich. But ONLY because I’m not doing anything else right this second. Not because I suck at setting work boundaries!… I think that, but I don’t say it. Light mayo. Light mustard. Two slices of cheese. One piece of Carolina Pride boiled ham Nuke it for 15 seconds. That’s the only way he will eat it. The ratio of cheese to ham is of utmost importance. He’s like the picky eater, frustrating kid I never had. All that aside, I have a fondness for him. Almost a protectiveness. He is unaware how he comes off sometimes. Besides, I had to fix my client’s lunch too and when he’s happy, she’s happy.
As he is eating his sandwich, I dress her in her favorite purple shirt and black pants, she picks out her jewelry and I push her to the table for her lunch; turkey on rye. Every day. She doesn’t like to switch it up.
I set up her afternoon meds as her hubby continues to rant. Something about Obamacare and guns. I try to keep my face neutral and decide it’s a good time to switch the clothes to the drier. Or escape. It’s a matter of perspective.
After lunch, she brushes her teeth. This is also a very specific routine. I’ll spare you the details but it takes about forty minutes. By this time it’s 3:30. I settle her into her lounge chair and turn on the Waltons.
Then it’s back to the kitchen. Wash up the lunch dishes, put the potatoes on to boil, pre-heat the oven. Run upstairs and grab the clothes from the drier and drop them in her bedroom to be folded later. Pop the chicken in the oven, turn off the potatoes and take my client to the bathroom.
“You know, Alice, when my daughter was a teenager she wanted me to buy her a KISS album for her birthday. I didn’t mind it. I didn’t tell her but it was catchy.” …my client will surprise me on a regular basis, but this takes it to a new level. I can’t stop laughing as I transfer her back to her lounge chair. It’s 5:15. I have to turn on the porch lights. Her husband is very particular about what time they come on. OK! I’ll turn on the porch lights at exactly 5:15, even though you are perfectly capable of doing so. But ONLY because I’m not doing something this second and not because I’m lousy at setting work boundaries!…I think but don’t say.
Dinner, chocolate ice cream since her sugar was good, then back to the bat cave for her teeth brushing routine, PJ’s, night time meds. I transfer her into bed, massage lotion into her legs, put on her nighttime fuzzy socks, and arrange her pillows so she’s comfortable. It’s 8:30. I make certain she can reach her pain meds, water and tissues and then I collapse in the chair beside her bed and pull Little Women from her book shelf. We’re on page 284. This book is flying by! I read to her until she falls asleep and then quietly slip out of her room. I gather my purse and keys, grab the trash and call out good bye to her husband.
“Goodnight, Gal! Thanks for all you do. Don’t know what we’d do without ya!”
As I lock the door behind me and pull the trash bin to the curb, I realize that I am exhausted…but it’s a good kind of exhaustion. The kind that comes from feeling like a job is well done.

Beneath the Surface

The longer I am in this field the more I realize that in order to truly change the culture of Long Term Care, we must change the way those who are living within the system are viewed. Regulations can be changed. Environments can be improved upon. Staffing levels can be reasonable, but until society begins to see through the physical disabilities and age to the person underneath, such changes, though important and well meaning, is like treating the symptoms rather than curing the disease. This point has become so much clearer to me since I began working in private care.
As an independent caregiver, I have the freedom to do the job as I see fit within very wide margins. Being pretty terrible at setting work boundaries, I find myself in many roles throughout each shift; CNA, housekeeper, family confidant, driver, personal shopper, cook…the list goes on and on and each shift brings new surprises. There is only one client and yet for me it’s every bit as challenging as working in a facility. Working one on one with my client has opened my eyes to how people view those living with disabilities outside of the four walls of a facility. Sometimes, it’s not very pretty.
My client loves baubles. She loves bright colors, and make up and having her hair done professionally. Her appearance matters to her. It always has. Religiously, once a month she goes to a particular salon and has her hair washed, colored and styled. She has been doing this with the same stylist for five years. Now, this particular stylist knows that my client suffered an immediate and life altering change to her health sixteen years ago. She sees the effort it takes for her to transfer from her wheelchair to the shampoo chair and back again. She knows that on my clients tougher days, when it takes all she has to get dressed, it is the idea of her beauty days that pushes her through that pain. I’ve told her that myself.
It’s a splurge. It’s not a cheap salon and this hair stylist is always tipped well. Getting beautified is one of the few good things that has remained a constant from the time before my client fell ill. It takes her more effort, but it is well worth it. So you can imagine my fury when I received a call from my co-worker informing me that this hair stylist would no longer be taking appointments from my client because she was fifteen minutes late. This hair stylist to whom my client had formed an attachment, despite what I considered to be her snarky attitude, who had NO problem gushing over her tips and taking her money, was put out. She did not bother to tell this to my client. No. She told it to my co-worker who, like myself, does not have the heart to tell her.
Look. I understand that we all have lives and a client being late for an appointment can cause inconveniences to whomever is providing a service but if you are incapable of taking on those with physical challenges, then DON’T TAKE THEM ON. When my client is going to be late for appointments, we call. After so many years, the very least she could have done was have enough respect to have a conversation with her about it.
It was such a clear example of apathy. I realize that it’s not cruelty that causes such slights, but the damage done from it is the same. It’s an example of the self-centeredness that we all have within us in one form or another. Even those who are closest to my client are subconsciously guilty of this thinking. How much is my client going to slow them down if they take her with them? Is there room in the car to pack all of her necessities? Is it worth the effort when she will be so exhausted the next day?…they see all the obstacles and none of the opportunities and in so doing, they diminish her humanity and reduce her to little more than “person with disability”.
I look at people through the lens of a caregiver. There is not a single person on the face of this earth who doesn’t have obstacles or challenges. Most have the luxury of wearing them on the inside. The downside to that is that too often, they forget those wounds exist and begin to convince themselves that they are a part of a group lucky enough to be normal. Allow me to disabuse those of you in that category of that notion. There is no normal. It’s imaginary. The only thing that separates you from those in my care is circumstance or age.
If I had to pick one lesson that I would like people to learn from my posts, it would be this: We are all human. Separating yourself from the way you view those in our care may make you feel safer or more comfortable but you do yourselves a disservice. One day, you will age out too, if you’re lucky enough to maintain your health. Ask yourself this: How would you want to be seen? As an “invalid”? A burden? As someone who has “outlived usefulness? As a bed filled to keep census up? As a cause? As part of a group to be pitied?…I wouldn’t. I would want to be seen as a person first. As Alice. And I would hope that all of those who were fighting for my rights would take the time to actually ask me my opinion of the system and what I think would be an improvement. I would hope my loved ones would see me before my disability and I would hope that an overpaid hair stylist would have the decency to tell me to my face that she no longer wants to do my hair.

The Life Coach




“I wish I could run around with my grandkids,” my client said wistfully, “I feel like half a Grandma.” I sighed to myself. It isn’t the first time she’s mentioned such things. I wish I could help my husband clean out the store. I wish I wasn’t such an ordeal to everyone. I wish…I wish.  It made me so sad! What could I say to any of that? Sure, I could be a supportive listener. People say that’s helpful. I get that. I do!…but I’m wired to try and solve problems and I couldn’t shake the idea that I wasn’t quite as powerless to help as I thought I was.x

       So I went home and obsessed about it, as I am prone to do. After about an hour of over complicating a fairly simple problem, I had a EUREKA! moment. HAIR! I know absolutely nothing about hair. I’m lucky if mine meets a hairbrush every other day. I know nothing about a LOT of things! Fashion! Apparently my Blossom hat is no longer en vogue. Who knew?! I’ll tell you who knew! My client! She taught cosmetology! She raised two daughters and has an eye for fashion! My limited cooking abilities give me ample opportunity to ask for recipes! She loves to read and could quote Shakespeare. THIS was what I need to be focusing on! Instead of feeling sad for her, I needed to remind her of all the things she could still do, not with words but with action! 

     The next day, I pulled up a chair as she ate breakfast. I looked her straight in the eyes and said with complete honesty, “My life has gone nuts! I’m going to New Orleans for a once in a life time opportunity, I’m on a big writing kick, I’m learning water colors, my paintings are hanging in a coffee shop, I drove back and forth to Long Island twice this year, walls that I spent years building have melted in a matter of days by the person who motivated me to build them in the first place, and I don’t know how to cook a steak. Most of that is amazing but it’s all overwhelming. You are now officially my life coach.”

       She recognized the honesty and knew immediately that I wasn’t being condescending. I could see her eyes light up as we looked at pictures of dresses and discussed what would be appropriate for public speaking. I asked her for recipes. I sought her guidance. I watched and listened and learned. It was mutually beneficial. That shift, she wasn’t my client. She wasn’t her diagnosis. She was the teacher and I was the student. By stepping out of my comfort zone, embracing my own vulnerabilities, and expressing my flaws and fears, I gave her the opportunity to be genuinely helpful and I gave myself the opportunity to gain some clarity. Such a simple solution. Living with purpose and feeling useful are basic human needs. Sometimes we all need to be reminded that we are here for a reason.

A Teachable Moment





        Private Care is kind of like a weird Tim Burton version of Mary Poppins, except instead of love starved, dysfunctional children, I’ve got an elderly couple who have been married for nearly fifty years.
Technically, only one of them is my client but the fact is it’s a dance. As I am working independently, any work boundaries that need to be set have to come from me and setting and accepting my own limits in a work environment is an area in which I sorely lack.
I don’t like to rush my client. It is quite simply my favorite part of home care. If she wants to take an hour to brush her teeth, she can! The shifts are long and we have the time. I fail miserably at curling and teasing her hair and helping her with her make up, but the end result isn’t nearly as important to her as the fact that I’m willing to try. The trouble comes when her husband feels the need to rush. If I don’t act quickly, he’s a bundle of nerves and then she’s a bundle of nerves and then HELLLLOOOO ANXIETY, as I try desperately to keep everyone happy while maintaining an air of serenity.

I find myself tip toeing on that line of co-dependency far too often. Staying late and coming early, letting those little bits of time go without mentioning pay, cooking for their children and grandchildren on occasion, it does add up. I’m learning though, and not just how to be a better cook either. For one thing, I’m negotiating with myself. I like it when my client’s family comes to visit. It fills her with pure joy, like turning on an inner light switch. I am willing to cook for ten and clean up after for my client to have those moments. It gives me joy too. But then I have to put on my big girl pants and have that oh so scary conversation about being compensated for the hours that I stay late or come early. That’s the deal. Some things, I am learning to bend on and others I have to stand firm.

I’m learning how to teach someone who doesn’t even realize he’s a student. I love that!
“You have to speed her up. Sometimes she needs reminding that she’s handicap.” Her husband said to me one day. I explained to him that my job is to do all that I can to make it so she feels LESS powerless over her condition and owned by her limitations, not to remind her of them. He was quiet and for minute I thought I was in for it.

“You know, I never thought of it like that before.”  It was a teachable moment for both of us. I forget sometimes that not everyone can see what is obvious to me after working in this field for a few years.

Often I miss facility work. I felt more at home with the pace and home health can be very lonely. It’s long days with only the client and her husband to interact with. So much is dependent on moods. If her husband is in a bad mood, it throws my client off too and then I’m in for a long and uncomfortable fourteen hours. But it definitely isn’t boring, as I thought it would be. There is plenty to do and learn. I feel like I’m still exploring the parameters of my job in this area of the field.

Do I want to be in private care in a year? No. But for now that doesn’t matter. This is where I landed and this is where I’m needed. At least I’m not in Long Island!

The Belle of the Ball





I watched as my client carefully applied her lipstick, resisting the urge to offer to do it for her. It’s that familiar balancing act between my desire to help and the need to foster and maintain my client’s independence. She looked beautiful.
Tonight was the big event! Her birthday dinner! A night out on the town! All day, we prepared for it. We picked out her outfit and jewelry. I shampooed and deep conditioned her hair. A stylist came over and curled and styled it for her. She would be the belle of the ball!

As we headed to the restaurant to meet her daughters, it occurred to me that this was one of those rare days when the stars aligned and everything went smoothly and everyone was happy. We even made it on time for the reservation.

I watched as the family laughed and bonded over oysters Rockefeller and shared childhood memories. There was such warmth and connection that I had a sudden pang to be with my own family, scattered over so many miles. I was deeply moved to be a part of this celebration.

It was a long night and by the end of it everyone was exhausted, but in a good way. For an entire day, the fact that my client lives with a disability was on the back burner. It wasn’t about her struggles. It was about her beauty. It was about celebrating her as a fantastic mother and grandmother, a loving wife, a wonderful friend. It was a reminder that we are all so much more than the sum total of our difficulties; that life is so much bigger than the challenges that we face. In this field, I call that a victory.

The Roles We Play




       I started to write this post about more comprehensive training and higher standards for certification in this field. I stopped. Then I started writing about the need to constantly evolve and adapt as a caregiver. I stopped again. Both are topics I want to explore and on which I have many thoughts, but not this week. This week, I want to talk about the roles we play.     

         What defines us? I’m a caregiver. I’m also a writer, a starving artist, a scatterbrained and mildly neurotic advocate. I’m a sister and a daughter, a niece and a friend.

          I’m a caregiver but I’m also a granddaughter, two roles that do not go together as well as you might think. She has been a source of unconditional love for my entire life. How many people are blessed with that? No matter how lost, hurt, angry or sick I was, she was there with me.  She knows me better than anyone else in the world. She told me that I was beautiful; that life was beautiful during a period of my life when all I saw seemed so ugly. It wasn’t all sunshine and rainbows when we were living together. I know that. It was a very co-dependent relationship and there was no shortage of enabling. Still, I have never doubted for one second that she loves me and wants the best out of life for me. She has been in my corner from day one. She holds all of my fears and I carry all of her stories.

       I miss my grams. It’s hard to explain…it’s sort of like mourning a person while she’s still alive. I used to think that the families that would visit regularly in the facility were cold and removed. Working in private care and experiencing the impact of my own grandmother’s aging process has changed my point of view. It’s impossible to detach from a lifetime of memories and it’s close to impossible to step out of the role you’ve been in your entire life, be it daughter, granddaughter, son, or brother. It’s like simultaneously grieving the loss of the person you’ve known all your life and getting to know the person she’s become.

       Agitation, depression, slight paranoia, loss of appetite. Stubbornness. Desire to isolate.  The patterns are the same. Everybody loves her. Everybody wants her to live with them and the patterns are exactly the same as those who were in my care at the facility. No one said growing old is for the faint of heart.

     The caregiver in me wants to fix it. She’s physically in good shape and a daily consistent routine that includes activities with others would do wonders for her spirits. Or a trip to NJ to see her great grand kids. Or here to NC. I call her twice a week, fully intending to convince her of this and twice a week I fail. I crumble. I can’t change her mind, I can’t redirect well or set boundaries or negotiate effectively. The skills that have been so helpful in caring for my clients and residents are about as useful in this situation as calculus.

       Finally, I give up and listen as she curses the day she ever moved to be close to us when we were kids and I try not to take it personally. I listen as she lists her friends who have died. Sometimes I can redirect the conversation to her childhood or stories from when my dad and uncles were kids. I listen. I tell her I love her and just listen.

       She feels better after our conversations, wherever they may lead. I can hear it in her voice. I always feel keenly aware of my powerlessness afterward, but I try to keep my voice upbeat as I promise to call again in a day or two. It’s such a small thing, a phone call, a listening ear, but for now it’s the best that I can do.

It’s the Little things

photo ALICE

I can’t believe I’ve only been on this job for two weeks. I unlocked the door to my client’s house, turned on the three lamps in the living room and started the coffee. Already, parts of the routine are becoming muscle memory. Its funny how at home I feel.

Much to my surprise, I am thoroughly enjoying private care. I thought the pace would be too slow. I thought I would be bored. Instead, what I have found is a whole new dynamic to caregiving.

Working independently for families has its challenges. In a facility, it is all about the residents. Meal times were set, showers were assigned and family members were people to greet in passing as I rushed to complete my daily routine. With 32 residents needing care, my interactions with their families were limited by time constraints.

Its flip flopped in private care. The families are inviting me into their home. They are trusting me, not only with the care of their loved one, but also with their house. They are trusting that I will be able to implement a routine that will consistently run smoothly for all involved, that will encourage and stimulate the well-being and quality of life for my client and her family while maintaining professional safety standards. The high level of enthusiasm just comes with the package. That is the sum and substance of my job description. While my client will always be my primary focus, the family plays a much bigger role in accomplishing this in private care.

I plan and cook meals for her family, making certain that there are left overs in case her daughter comes over. It’s a simple task and in doing it my client gets the peace of mind in knowing her daughter will eat and she gets to eat dinner at the table with her husband just like she did when she was physically well.

It’s those moments that bring her the most peace. Mentally, she is sharp as a tack and she has adapted with courage to a life that was dramatically altered in an instant. Dinner with her husband, enjoying a big bowl of ice cream, getting her hair done; these simple tasks bring her such joy because they are the same things she did when she was well. They are about who she is as a PERSON not who she is as a stroke victim.

That is the one thing that is the same in a facility and out; people seem to see the age and disorder instead of the person. As caregivers, we are uniquely qualified to fight this. The very nature of our work is dependent on knowing those in our care. In private care, I am given the opportunity to gently remind those around us that their loved one is more than her doctors’ appointments and obligations. She is a person first and foremost. We do this not with words but with actions. Inside jokes, little compliments, asking cooking advice, simply listening; there are countless ways to let someone know that they matter. Imagine what it could be like if all the caregivers applied the lessons we learn on the job in our daily lives. There would be far less people who feel invisible in this world.


A Moment of Zen




  At peace. That is what I was feeling. It took me a minute to put my finger on it because serenity is often in short supply for me; a mirage just out of reach that fades as soon as I reach to grab it.

         I always thought it was sort of a tradeoff. I get passion instead of peace and I was more than ok with that. Still, as I breathed in and noticed how relaxed and comfortable I felt in that moment I realized that there is something to be said for inner peace.

        I have run my entire career in this field. Running to the news, running on the floor, running to Long Island and all the while my mind was running too, keeping track of my residents and learning, sometimes painfully, the inner workings of what makes a good caregiver. And make no mistake, that is very important to me. The idea that if we do this right, we are in a constant state of growing and learning.  Ask any seasoned caregiver if they viewed life the same after a year or two on the floor. This is a career that changes you, sometimes for the better sometimes not. The rules and the environment may change, but the very nature of what we do remains the same; we take care of those who cannot care for themselves. I’ve come to know that there is something sacred about that.

       In all of this running and thinking and day to day prioritizing, peace of mind got pushed further and further down on my list of necessities. I only noticed it was missing on the rare occasions when I stumbled onto moments of serenity, followed with fleeting thoughts of “oh! I don’t know what this is but its niiice. I should feel like this more often” and then it was right back to the running.

        Love, loss, frustration, humor, grief, anger, resentment, joy, heartbreak, exhaustion, powerless and empowered at various points, connected, and useful are only a few of the emotions involved in our work. Nowhere on the list is “calm.”  And yet, here I was after a twelve hour shift, perfectly at peace.

          I feel comfortable with my new client. I have slipped into the routine like a favorite pair of jeans. After my first day, I thought ok. This is going to work. It felt like coming home, though it’s private care instead of a facility. There was a familiarity about it and despite the new surroundings, I was in my comfort zone.

       I love that if she wants to take an hour to talk me through how to properly tease her hair because the bigger the hair the closer to God, we can do that. There is no need to rush. I can be on her time frame. I can read to her or just listen. This is a lady with stories and they are my favorite kind of people.

     “I used to be a worrier. Used fret this and that. Never slowed down. Then I had this stroke. That slowed me down. I don’t worry so much anymore.”

       She was only in her fifties when she had her stroke. It hit me like a ton of bricks when she told me that. I do not understand how I can forget so often to be present and embrace the moment I am in when I’m constantly surrounded by such courageous reminders, but I do. I forget all the time.

       I am taking my peace of mind back. Or at the very least I am going to make it a point to embrace the moments and not live so much in self-centered fear. It’s a journey and worrying has never solved a problem. The lives and experiences of every person for whom I’ve cared has taught me this lesson.

New Beginnings




This is going to be awesome. That’s the thought I kept repeating to myself as I walked up the drive way to the gigantic and imposing house of my new client. And I did believe that. At least the part of me that wasn’t filled with anxiety believed it.

       This is my second job as a home health caregiver. It comes at the heels of my first gig in home care which led to…well, it led to Long Island for God sakes. And to many many first time experiences, all of which were eye-opening and incredible, but none of which were easy.  So you can understand why my perception of home care was a little askew. I just had no idea what to expect.

         Mainly, I was incredibly grateful that this opportunity came about. I can’t be without work. I’m a CNA. We don’t have financial safety nets. We’re lucky to cover the electric bill. So, this is where I landed and I’m thankfully still on my feet.

        Still, even after all this time, I get nervous when meeting a new resident or client. It’s an awkward dance. There is no graceful way of saying “Hi! It’s nice to meet you! I will be with you in your most vulnerable moments. I hope you like me!” But that’s also my favorite part of the job; the building of a mutual trust and connecting deeply because of it. Some of my most valued moments have arisen due to the unique caregiver/client relationship. You have to learn each other.

       This is going to be awesome. I took a deep breath and knocked on the door. As my new client’s husband showed me around, I noticed a big magnet on the fridge. It read “Well behaved women rarely make history.” I smiled to myself. Oh we are going to get along just fine!