Every time I visit 82-year old Ruth Cuddlepot I read this poem.
She has it up on a wall of her home near the toaster, just above the kitchen bench. I know it by heart now because it’s so hard to miss and I stand there every Wednesday reading it (at least three times over) – while I’m waiting for her crumpets to pop!
It’s a short, but popular verse and most of us carers have encountered it on our travels in and around the Aged-Care industry. To be honest, I always feel annoyed whenever I read it because as far as describing the hopelessness and grim reality of Alzheimer’s disease – it’s pretty spot on.
It is also completely sad.
The story goes that back in her day, Ruth Cuddlepot had etched herself out and prospered, in an outstanding career as a principal in some posh private school for boys (at the time the youngest female to obtain such a role). She never married, didn’t have children and had no real family to speak of. Therefore, she had bucket-loads of money tucked away ready to spend totally on herself, whenever she might need it.
That day came a few years back when Ruth received the official crushing diagnosis of Alzheimer’s Disease. Being such an insightful person however, she decided early on that she would set herself up for when the time came, when she could no longer work or take care of herself.
Indeed, there would be NO nursing home for Ms Ruth Cuddlepot!
Instead, she arranged her affairs and teed-up the lawyers so she could be completely looked after and cared for IN HER OWN HOME. No matter what. She knew her condition would deteriorate; that her memory would crumble, and she would eventually “lose my marbles completely!”
Apparently, that’s how Ruth used to say it, although I didn’t know her then and have relied on verbal reports from other carers to fill me in on all the background reading.
Needless to say, she was a very clever lady. Although, by the time I had the pleasure of caring for Ruth Cuddlepot she was no longer the organised and efficient educator I had been told she once was.
Ruth had, instead, evolved into ‘Ruthie’.
And thanks to the personality-morphing Alzheimer’s, Ruthie had become a frail, yet openly happy and affectionate elderly woman…. WHO LOVED TO HUG!
Even when her speech faltered, Ruthie could at least continue to communicate with a nice big welcoming embrace whenever I arrived for my shift. I looked forward to it in fact!
There she would be, sitting at her favourite spot on a chair in the sun at her enormous loungeroom windows… the spot where she had the wonderful view of her garden and a watchful eye on the next visitor she could throw her arms around and give a great big squeeeeze to!
Really if it wasn’t so heart-breaking, it would be lovely.
Recently though, Ruthie had started calling me Wendy.
Which is fine by me because you can imagine it happens a lot in this line of work (I’m also known as Debbie, Louise and Margie with some of my other cognitively-challenged clients). Let’s face it, remembering each carer’s name, rank and serial number is understandably not high on the priority list for some seniors – especially when they no longer know their OWN name!
I knew something had started to change in Ruthie when one day – the hugs stopped.
And another cruel stage of the Alzheimer’s curse set in… Ruthie Cuddlepot started to become aggressive.
Without much warning her moods became erratic and it eventuated that Ruthie couldn’t STAND to be touched. Not even a handshake or a gentle pat on the shoulder. You just wouldn’t dare in case she would flare up and start screaming and punching the air (or anything else within proximity) in what appeared to be the ultimate frustration within Ruthie’s muddled-up brain.
This most heartless and indiscriminate disease had finally taken hold of her … it has been just awful to watch.
Finally, after accusations that Ruthie had started slapping and pushing her carer’s, we were told there was a serious incident last week where she had to be whisked away by ambulance and sedated in hospital.
Quite honestly, it became apparent to us all, that they didnt know WHAT to do with her!
After all Ruth’s organising, having purposely prepared herself and her future to remain forever being tended to in her own home by an army of paid care-working bees, it now seemed this was no longer a viable option.
I wonder now looking back, how Ruthie could have possibly planned for this gloom-ridden stage of her illness?
Perhaps she’d anticipated that by this late phase: 1) she wouldn’t know where she lived, and 2) she wouldn’t care?
I hoped so for her sake.
The poem was right, and the best of Ruth had gone.
And yes, we had failed in standing beside her. Basically, it had become too unsafe to do so! Poor Ruthie had become a danger not only to herself, but to everyone else as well. And if a support worker is under any threat whilst looking after an elderly person in their home, then the people in charge needed to move to an ulterior arrangement.
I was informed only today that the once proud and brilliant Ruth Cuddlepot had been relocated ‘indefinitely’ into a High Care facility.
Just like the poem had foretold she was now sad and sick and lost. Her beautiful forward-thinking mind now full-to-capacity on sensory-depriving medication to keep her comatose and manageable (for her own protection, we were told).
I have deliberated greatly about going to visit Ruthie but honestly, what would be the point? Without sounding totally selfish – I don’t think I could bear it.
The worst part is finding out she doesn’t even have a window.
I received this email from my cousin Rochelle recently.
Thought I’d share it here (because I can), and also to emphasise how shitty and random Dementia is. Not to mention the despair and frustration for families who are left heart-broken as they watch on hopelessly; it is totally NOT FAIR.
Aunt Winnie taught me that girls don’t have to aspire to be receptionists or “office note-takers” or run around after others… “unless you want to, then that’s fine, too.”
Instead, if you’ve got the gumption (her favourite word) – you can make a great career doing something you love, settle down and hopefully find a nice boy “wearing not-too-tight slacks” to make a good enough life together.
It has eventuated that I have done both.
Aunt ‘Winnie-the-Poo‘ – – – YOU ROCK!
(We miss you so much).
To my dear family,
I’ve been back from overseas for almost 2 weeks and there have been a few changes with Mum (our Winnie), so thought I’d send a group email update so you all know where that’s at.
Unfortunately, and as predicted by most of us, her mental health has declined significantly.
I took her to her GP and she completed a MoCA test (half hour competency testing), where the results were not flash: ie: 10 out of 30 is bad.
Poor mum scored 2…(TWO!) Is that even a number???
Thank the Lord she defiantly remembered where she was from, although truthfully, I think she must have fluked the second point by just sheer good luck!
We also discussed her anxiety levels and turns out, they’ve put Mum on a little ‘upper’ to assist with her mood. Arthur is great with mum and loves her to bits which I could cry with relief about cos he’s such a caring wonderful man.
Obviously, as a retired school teacher, he revels in the role of directing and correcting! (Plus, the Citalopram will be doing it’s job – keeping Mum calm and ticking along, happy to stay back after class with another special Arthur ‘detention’ !!!)
In the meantime, the Geriatricians will without doubt, assess Mum for ‘Care-Home’ level care, and I assume officially diagnose her with Dementia. This should happen soon. Hopefully, while I am still in the country – although I may be called up any day now so not sure what we do then…
Thankfully, in this zippity-do-dah-modern-day (haha another one of her ‘funnies’) most stuff can be sorted online and organised via email etc. And legally, I don’t need to go to the lawyers- which is just perfect.
The best thing is that the staff at the Respite home where Mum is now are all on the same page as I am. And they have been concerned with her deterioration for a while – the head nurses have an amazing rapport with her, plus they’ve kept me fully up to speed on things.
I am just SO impressed with the set-up there!
Win gets to stay in her current apartment WITH Arthur – and the Care Team actually comes to her! This includes 3 showers a week, getting dressed daily and undressed, breakfast, lunch and dinner, dispensing medications, clothes washing, housekeeping etc.
At the moment, Mum is just having shower and dressing assistance (extra $100 a week). Once the new level of care comes through, we will apply for a subsidy as their combined total assets is less than $119k.
This new level of care will be paid from Dad’s deceased estate account (ie: $23k – and then the good old government takes over…PHEW).
I did have Mum come stay with me by herself last week (and my girls too, much to their horror), for a night recently. She spent the WHOLE TIME thinking Arthur would be coming to pick her up at any second – watching out the window, pacing up and down etc.
I could tell she really would have preferred to go back ‘home’ to Arthur; we had to phone him a few times during the night when the panic set in.
You should have seen it the next day, though, when they re-united. I just about died… they had the biggest SNOG I’ve seen in ages….in front of all the staff…everyone…THEY DIDN’T CARE!!!
(I think I was actually JEALOUS!)
Mum’s just fine where she is and like I said, Arthur loves her to bits. So as weird as all this is, Winnie’s definitely safe and cared for. She actually does realise her memory is bad (kind of), but quickly seems to forget she had that flash of realisation and so we just move on.
She happily accepts shower assistance, and for her own dignity and personal presentation, I’m terribly thankful for that. Physically, Win looks and IS well.
Don’t know what else to say but I really hope this email doesn’t cause any concern for you guys. I really feel she is in the right place and I think we should all feel blessed that she married Arthur last year – as crazy as that seemed at the time…. WHO IS THIS MAN WITH THE GIANT MOUSTACH WHO IS IN LOVE WITH MY MOTHER?
Because it certainly takes the load off me – not that I’m complaining…
It’s just hard, you know?
Anyway, I hope all is well with you guys – sorry if I’ve rambled on but I wanted to put you in the picture seeing as you are her family,,, the people who love her the most.
God, does she even remember?
You know what…I really don’t know any more. Today for example, she called me Geraldine. As in Aunty Gerry, her twin, who died when they were in their 20’s. And I can tell when she looks at me that she’s not ‘Mum’ anymore. I hate that the most about this awful disease.
Anyway, I’m waiting for confirmation of my next placement abroad – not sure when or where that might be but I’m loving my Oncology nursing and the fabulous people involved in the industry so that makes it all worthwhile (as well as being the best distraction from the Win & Arthur show!)
Will keep you all updated as the rest of the saga of our gorgeous mum/sister/aunty’s life unfolds.
Love you guys,
PS: please, don’t worry about mum. She is fine, really.
PPS: we must all get together in the SAME room one day. Life’s too short. – I could end up losing my mind, just like Mum. ARRRGGGHHHH!
I witnessed the most perfect display of selfless and unconditional love today. An unexpected, yet beautifully-presented scene that just randomly played out before me – in a rotten old Target store, of all places.
And while I’m pleased that I happened upon such a thought-provoking little interlude, I’m also doubly chuffed that I managed to snap a very nice photo of it as well. Working in the aged-care industry, I’ve long since realised the value of capturing the special moments as they come along – no matter how inconsequential they might seem at the time.
A picture is worth a thousand words, don’t they say?
I hope you’ll find this heart-warming piccy, which I’ve saved ’til the end of my story (hee hee because I can), worthy of being talked about.
In the meantime, a picture of some cheeky looking Galahs to tide you over:
Let me set the scene:
Firstly, and you may not know this, but shopping centres during the week days, transform into what can only be described as the perfect pensioners paradise!
Yes, indeedy. For while the rest of us are off being dutifully occupied at work or school (or ‘other’), teams of opportunistic Retirees get to roam freely in herd-like fashion throughout the malls. Albeit a silver-haired, slowwww moving herd – but a herd all the same.
Hey, they’ve got the time – why shouldn’t they make a day of it?
Chatting leisurely with other like-minded Golden-Agers, casually pushing trolleys or towing low-maintenance free-wheeled trolley devices… they get their errands run unhindered, unflustered and un-rushed. Enjoying the shopping experience safely at their own pace and without judgement or pressure from any of us raucous unruly lot, thank you very much.
Not to mention packing out cafes and teashops to the brim when it’s half-time and they’re primed for the proverbial nice hot cuppa. (Cream cake too, if blood sugar meds allow it).
Fear not though, for by the time we self-appointed important people all barrel into the shops and the supermarkets to hunt and gather for the family din-dins, these older folk are long gone. Back at home, unpacked and un-shoed…they’ve completed their quests and are now poised in recliners awaiting the next thrilling instalment of Family Feud.
Yet, here I found myself today, thanks to a late cancellation, breaking all of society’s sacred unwritten rules… I decided to make an impromptu visit to my local shopping centre.
And as I stood in the Toiletries aisle languishing in such mid-morn freedom, deliberating on whether to go the strawberry or the vanilla flavoured lip balm (it’s a tough life), I could hear a softly-spoken male voice at the cosmetics section behind me. Upon changing my angle, I saw it was an older gent with white hair standing alongside what was evidently his matching elderly wife in a wheelchair.
With stiff stooped shoulders and her wasted hands lay motionless in her lap, she clearly had serious health problems (I speculated she may’ve had a stroke or maybe MS, but hard to really know). However, that wasn’t an issue for this pair who, oblivious to me and my life-threatening lip balm dilemma, were focused on choosing lipsticks.
And even more fortunately for her, I thought – her husband was doing it spectacularly!
“Honey Beige, Melting Melon, Glazed Caramel… what the heck? Some of these colours, Lois… sounds more like food to me. That reminds me, we’ll do the groceries after this”.
Lovely-sounding-hubby was now donning his reading specs in order to decipher the ridiculously teeny tiny writing found on most lippys. A man on a mission and with no shop assistant in sight, he clearly felt at ease in what was typically a woman’s domain. Regardless of her health state, his wife was still a lady and therefore there was no reason in the world why she shouldn’t maintain the beauty regimes that allowed her to feel feminine and ‘normal’.
“Pink Opal… Berry Beauty… Flushed Fuchsia. But they’re ALL pink! There’s just such a lot to pick from, Lois. And I was thinking ‘pink’ was just PINK!”
In my head I had to agree…. STUPID SAME-COLOURED LIPSTICKS!
“Good gracious me, darling… a bit naughty-sounding some of them, might be a bit much?”
I laughed out loud at this comment, nearly blowing my cover but managed to change position while edging closer to the action.
“Here, let’s try this one, Lois. Forever Precious it’s called… that’s definitely you my darling. And it’s such a pretty pink.”
As Lois sat motionless, in her purely supervisory capacity, her adoring spouse crouched down before her to apply yet another shade of pink to the back of his wife’s lifeless hand. They’d obviously been at it for a while because they seemed to have the routine down pat. He would mark her skin for testing, pause to stand back and admire, then discuss yes? Or no? (with himself) before a gentle wipe with the tissue in preparation for the next one.
So, yes by now I was melting on the inside – it was just gorgeous to watch!
“This Smokey Pearl one here… that’ll match your new pink blouse, Lois. The one we bought for Bryce’s graduation. But let’s get the Charming Coral one as well. Just in case, yes?”
Apparently, Lois could speak but it must’ve been only just, as he had to lean his ear right into her face to hear her.
“Ha ha yes! ‘Charming’ – just like me! Ha ha ha… good one, darling”
Brilliant! Lois was being silly too!
“Here’s one…Spiced Coffee. Oh, for goodness sake, Lois! How about we have a think about it all and go get some ‘spiced coffee’ of our own at that nice café over there; they might have some ‘glazed caramel’ we can chew on too. What fun!”
As they wheeled off out of the shop, I couldn’t see Lois’s face, but I felt sure she would be smiling and thoroughly enjoying herself. Having such a kind and genuinely loving man by her side, helping her choose lipsticks no less.
WHAT MAN DOES THAT?!
And how he spoke to her…. the way he interacted with her! Such patience and grace, the undeniable care and commitment he showed for his dear disabled wife; it was truly truly admirable.
In fact, I had no doubt that Lois, in her sad wheely-bound existence, thanks to this sweet and devoted man – got to smile every single day of her life .
“It’s all fun and games… until someone loses their bladder!”
I’ve noticed lately that a lot of jobs advertised in the Aged-Care sector are now listing ‘sense of humour’ as one of the more desirable personal characteristics required from potential applicants.
Right up there alongside the usual skill-set buzzwords: compassion, empathy… yadda yadda… time-management, communication, etc etc etc it seems that a lot of Care providers are now recognising the merit to be gained in employing Support Workers who are capable of seeing the lighter side of their roles.
Not that we ‘funny-bunnies’ don’t consider our work with older adults as meaningful or important. Ahhh no, quite the opposite. In fact, more is the case where those who CAN have a laugh (and don’t feel they have to take everything so seriously all the time), end up with far greater job satisfaction as a consequence of receiving such fabulous positive feedback from their much-amused clients!
Because there’s little doubt how beneficial humour can be when meeting an elderly client – especially for that harrowing first time. Not meaning you need to perform party tricks or stand on your head and act the clown. More just in understanding your client; seizing those unexpected instances as they occur and utilising them to develop a good happy, healthy relationship.
You know… tell them the silly story about your wheelbarrow at home with the dicky wheel or how your new kitten got into your knitting bag and found itself tangled in a ball of red yarn under the sofa – and then let them share similar humorous anecdotes with you.
We all know that there’s nothing like a good ol’ laugh to improve overall wellbeing, to strengthen friendships or just to promote a jolly good mood.
So, as a care-worker in your client’s home, merely being observant and discovering what interests your client has, understanding what makes them tick… can make it a heck of a lot easier for you to change tactics if required, and direct your game plan accordingly.
As a coping strategy, too, an intuitive carer should also understand the benefits of how a funny story, or a witty one-liner can be tactfully used to distract an ageing adult who is clearly agitated that you have arrived at their home in the first place. They’ve decided in advance that they won’t like you and therefore will be totally resistant to your charms. No matter what!
“I DON’T NEED YOUR HELP, MISSY!”
In my experience, discretely changing the subject, injecting a fresh but genuine perspective into the conversation can diffuse most potential challenging behaviour before it gets a chance to gather momentum.
Just by sharing a refreshingly waggish viewpoint in a senior’s often mundane existence can be enough to crack even the hardest of old nuts (yes, a lukewarm smile still counts). Achieve this and you’ll gain trust and win them over before they’ve had a chance to realise how much they actually DO like you after all.
The awkwardness of nudity at shower time is always a good test of a carer’s inter-personal communication skills. But be brave, just chat away and show how you thoroughly enjoy the company of your new NAKED client, ever so much!
In fact, I’m often surprised, how even the most insignificant occurrence or absurdity, can turn a stilted situation into a side-splitting laugh feast in an instant!
Take my new client from yesterday morning: a frail and reluctant 91-year old Gladys Liverspot. Obviously already annoyed and feeling quite indignant that “my-regular-girl-Angie” was not available to help her shower – she’d been informed by the office that she was stuck with me instead.
Oh, I’d attempted to initialise conversation for sure. I was bubbly… yet professional. I showed genuine interest in the brand new kitchen cupboards she’d just had installed. Plus, I’d admired the heck out of her grandson’s never-ending pile of wedding photos.
But as we progressed through her showering routine I got nothing back from Gladys. Instead, she seemed damned determined to remain cool and aloof.
That is, until it came time to wash her ‘lady bits’ and, as I do, I asked Gladys if she wanted help with that.
“Oh, you mean my Fanny-by-Gaslight!”
Well, that was it! Such a random unexpected thing to hear a little old lady say – I cracked up big time.
And blow me down… Gladys clearly LOVED me for it! In fact, she joined in too!
Seemingly, my hysterical response to her quirky turn of phrase was just the reaction Gladys needed to accept me into her world. It showed her that I understood her; that I was on her wave-length. I was someone who could appreciate her inanely dated comment and therefore I was worthy to be part of her day.
Before I left (and still giggling like schoolgirls), I was rewarded with a nice cuppa and the ginger crunch slice that Gladys usually reserved for her special visitors.
So there! Take that, “My-regular-girl-Angie”...!!!
Ironically too, there are days where laughing at yourself can be all that keeps you sane. Nothing like putting your foot in it with a slip of the ol’ verbal faux-pas; those unintentional moments when you haven’t thunk before you’ve opened your gob.
Here’s a couple of my finest:
Offering left-arm amputee Sheila Greensleeves to help wipe down her bench top… “Can I give you a hand with that?”
Or saying “Gee that IS a big one!” … the exact same moment Terry Wang drops his tweeds at shower time (I was actually referring to the giant mutant cactus plant towering outside his bathroom window, truly I was)
And just out of habit, to my new and totally bald-headed client, Jim Wiggington…“Are we washing your hair today, Sir?”
As soon as I pop these humdingers out – I kick myself. But at the same time, it shows I’m only human and, as unbelievable as it may seem, I make mistakes too. Thankfully, all my clients (thus far) have forgiven me whenever I’ve let slip and more often than not, we end up having a bit of a cackle about it as well.
It’s all in the way you handle the situation and anyway, they know it was not intended. I’m just happy that my dear clients can relax enough and feel at ease around me to have a laugh in the first place.
“Oh Dollie, you are a ONE”, they say.
And I guess I am.
Reciprocally, I love those unexpected humorous one-offs that my clients can spring on me, too!
Incidental quips they throw in along the way like an off-the-wall remark that takes you by surprise and makes you realise that being old, doesn’t necessarily mean you are any less witty than the rest of the wacky world.
And you are most certainly not laughing AT your clients; you are laughing either with them or it’s just the situation at the time when something comical has occurred.
Like the time I was applying skin lotion to the legs of a very fragile and diminutive, Mr Eddie Shuffleboard.
Sitting patiently on the edge of his bed one morning, I squatted in front of Eddie, fiddling about with the pair of most unyielding compression stockings versus his clammy freshly-moisturised skin (the bloody things never want to play nice). After several minutes battling away, huffing and puffing all the way, I finally managed to wrench the stockings into position on Eddie’s legs.
VICTORY SHALL BE MINE !!
From the sheer exhaustion of it all, I then went to plonk myself on the bed beside him. As I landed on what had to be the world’s most ultra-springiest single mattress, like a stunt gone wrong out of Cirque du Soleil… up poor old Eddie went BOINGGGG! Catapulted straight into the air he ended up falling squarely onto my knee in a position similar to a toddler sitting on his mother’s lap.
Then, without missing a beat, Eddie announces with the cheekiest smile on his face:
“We really have to stop meeting like this, Dollie!”
Surely one of the most hilarious (and perfectly timed) moments I’ve experienced on the job and after chuckling our way through the rest of the shift, it was locked in that Eddie and I were to be bestest of buddies from then on.
So, don’t feel guilty about enjoying the funny side of your client’s antics or worry that you’re being disrespectful or insensitive to their needs…OH MY GOD, YOU DON’T CARRRRRE!
Because of course you do.
And don’t forget, encouraging laughter during a tense or delicate moment can actually offer relief to a fraught pensioner who may find solace in seeing you appear so calm and unflappable.
Embarrassing little interludes too, can have the edge sliced off them with a nifty bit of light relief.
Like the time I went to assist the delightful 94-year old Reggie Windbottom out of his armchair, just as he let rip an extremely loud FART that startled us both and made his trusty Border Collie leap up onto the couch.
“Outside, Wally!” Reg and I both bellowed at the same time. (If in doubt, blame the dog).
Oh my, how we laughed!
But most of all, and because it reminds me a lot of my own grandfather and the funny stories he used to tell us growing up… I love it how some of my elderly gents (hardly ever the ladies it seems) have a wide-ranging repertoire of good old-fashioned punchlines that they love to rattle off whenever you visit.
For example, here’s a couple of pearlers from 92-year old Dermot O’Farrell, one of my favourite yarn-spinners. Of course, his Irish accent makes them that much funnier – even better when he has his teeth in!
Did you hear about Bruce who lost his whole left side? He’s all RIGHT now.
What do you call a fly with no wings? A walk.
What time did Bob go to the dentist? Tooth hurt-y.
A mushroom walks into a bar and orders a drink. The bartender tells him to get out. The mushroom says, “But why… I’m a fun-guy?!”
A blind man walks into a bar….and a table… and a chair… and a door… and and and…
To conclude folks, laughter may not be the best (and only) medicine your elderly client has to take, but if you can lift spirits by slipping a bit of jocularity into their day, it’s a grand way to start.
As the irrepressible Dermot so eloquently likes to put it: “If you can’t have a good laugh at yourself – then you’re just a miserable old sod!”
“It seems the SKIN… that I’m IN… is terribly, terribly… THIN!”
Ever wondered why you never see a loofah brush, exfoliating mitt, nor any other type of abrasive body-scrubbing device in an elderly person’s bathroom? That’s not counting the mandatory piece of dried-up pumice stone once used to file corns and callouses from busy hard-working purposeful feet of a lifetime ago.
Well, there’s good reason for it apparently. Summed up perfectly by 89 year old Lizzy Waterduck as I chatted to her during her shower last week:
“At my age? Crikey, I’d end up skinned alive like a Chinese dog if I used one of those now!”
Understandably, for most of the older adults I visit in their homes, their skin is a fairly pertinent issue. They know only too well that if something new or unusual appears on their outer – there’s a darn good chance that something more threatening may be happening on their inner.
Physiological changes such as connective tissue breakdown, the lessening of elastin and collagen production, a limited ability to retain moisture, plus an increasingly slower metabolism in general – all contribute to the breakdown of our skin’s integrity as we age.
And as a consequence of this dermal deterioration, we then get to watch in despair as the inevitable creases, folds and ridges creep leisurely onto our skin’s surface to create that familiar ‘old person’ look…
Come on, sing it with me now: WRINKLES!
Throw in the exhaustion of the juicy subcutaneous fat layer beneath, too, means the natural oils which once protected us from damage and gave skin it’s firm, voluptuous appearance – are depleted. Leaving elders with a moisture-less, thinned barrier that’s vulnerable to anything untoward.
Oh yes, defences by this stage, are most definitely down!
Understandably, with skin that’s as delicate and translucent as Lizzy Waterduck’s, the last thing she’d ever consider doing as part of her shower routine, even if she might have done regularly in her decadent middle-aged years… is to slough off yet another (possibly the last) layer from her precious epidermal.
Of course, other contributing factors such as lifestyle, genetics and diet can also throw a pensioner’s skin balance out of whack. Interestingly, one of the major roles of our outer dermis is to maintain the body’s natural thermostat. Which explains why so many seniors seem to spend most of their days grumbling how cold they are, even in the height of a summer heatwave.
“Brrrr… shut the dam door, girlie!”
Progressing into our ‘twilight’ years, means we might also get to grow the odd unsightly skin tags, unflattering strangely-shaped moles and, prevalent on the backs of hands, balding heads, ears, arm, noses and necks… are the browny-coloured ‘liver’ or sun spots we immediately associate with ‘being old’.
These annoying tell-tale blemishes are a result of spending entire lives being hat-less and factor-less for long periods exposed to the outside elements. And declaring “but we didn’t know any better”, does nothing to fix the skin damage already caused.
Sadly, it doesn’t matter how much sunscreen grandad coats himself in now, it’s a case of too-little too-late for these old timers.
And there are other less than delightful skin conditions we become more predisposed to as we age. Dermatitis, eczema and pruritis are afflictions which are all identifiable with dry, ageing skin and will continue to drive itchy, older folk to reach for the tried-and-true camomile lotion by the gallon.
But flaky, scaly skin is a bad thing when you’re an older peep because when skin has become so dry that it’s now irritated and cracking open, there is opportunity galore for serious infection to enter and thrive it’s head off.
With immunity already compromised in sick or frail seniors or those suffering with pre-existing health complaints, the skin, whose job as the built-in protection layer stopping the big bad germ-laden world from entering our bodies and making us unwell, becomes weakened and unable to hold ground when it’s really needed most.
A seemingly small injury to a mature-ager’s cutaneal areas (even the slightest scratch), if not treated appropriately, can easily lead to serious complications and a much longer recovery time leaving an elder either in hospital… or in a very, very bad mood!
Indeed, depending on the state of it – our skin can quite literally mean the difference between life and death!
More significantly for an anxious pensioner, it can also mean the difference between remaining at home or being despatched to live in an aged-care facility… ie: the dreaded nursing home.
I get to observe a lot of elderly skin when I visit my clients at this stage of their lives. Assisting them to shower and maintain regular hygiene habits is integral to self-esteem, dignity and indicative to the rest of the world (ie: suspicious adult children) that they’re still capable of living independently.
And although not medically trained, an experienced carer can become quite astute in recognising symptoms of potential health issues, merely by observing the condition or noting even slight changes in a naked senior’s skin – especially at shower time.
Bruises, for example, can be discovered during Personal Care shifts and might be the result of a fall, walking into the coffee table – or possibly from something more sinister? A quick mention here regarding Elder Abuse and that ALL suspicions of such should be reported immediately and without hesitation.
Haematoma (bruising) can look dreadful on pale older skin and thanks to sluggish metabolisms, may take months to totally heal and fade. Not helped by certain medications used to control inflammatory conditions so common in old age (stiff joints, arthritis, COPD, diabetes etc) which, as a pesky side-effect, can leave seniors exceptionally prone to bruising.
Such as one of my clients, 79 year old Hilary Greentree who relies on steroidal drugs to control symptoms of her advancing emphysema. These powerful meds offer a fabulous quality of life and are literally life-saving for someone like Hilary.
More importantly (she informs me), they allow her to be top of her game on the golf course!
BUT… it was discovered recently, that Hilary’s skin had in fact become so thinned and susceptible to even the slightest touch that something as silly as the seam on her new golf slacks is enough to cause extensive black and blue marks down both her shins.
I mean, did you EVER?
For obvious reasons, assisting a senior to wash their outer body involves common sense, a good bit of empathy and patience… plus a WHOLE LOTTA care and attention. Jagged fingernails or solid objects such as jewellery, rings etc can inflict catastrophic damage to paper-thin skin – and often with very minimal force applied.
Cringe-worthy is the story about a carer once who, worrying about getting to her next job on time, ripped an enormous gash in her client’s calf while attempting to yank up his support hose (commonly used to control circulation probs in the lower limbs). In her haste, she hadn’t realised the tag on the garment had accidentally embedded itself into the poor old gent’s skin which then sliced deeply all the way up his leg as she pulled.
Ohhhh, THE HUMANITY!
Which explains why some of my more delicate ladies fear using a standard flannel or wash cloth that the rest of us ruffians take for granted. Instead, they prefer to wash with a tiny square of baby muslin or light-weight sponge, both of which seem so floaty and flimsy – you wonder if it’s worth bothering!
There’s certainly no RUBBING or SCRUBBING involved. Just a lot of gentle circles and tender dabbing to ensure their sensitive aged skin is left suitably cleansed, and more importantly – unbroken.
Thankfully, it turns out that the older you get, the less cleansing your skin actually requires. With retirement marking an inevitable slump in physical activity, there are now far less occasions to get a big ‘sweat-up’ like we once might have. Common thought now is that it’s more than adequate for a senior to instead shower every other day (or less), thereby allowing natural oils in the skin a chance to replenish and build resistance against all the nasties.
“And so I can get my GLOW on!”
As one of my lovelies, Gladys Gigglestick, proudly preaches.
Funnily enough, Gladys swears by sweet almond oil as her choice of showertime lather – and NEVER soap.
“Because soap is just too harsh and leaves me dry, rashy and itchier than an old man’s tweed vest”.
Which is fair enough when you’re 95 and you’ve been in this bathing game long enough to know! Admittedly, the almond oil (which smells devinely like Christmas pudding) does leave Gladys’ skin noticeably well-nourished and ever so moisty.
Although, when she holds my arm stepping out of the shower, I have to make sure I plant my feet firmly to keep us both steady… blimmen ‘eck, she’s as shiny and slippery as an eel!
What do you see nurses? . . .. . .What do you see? What are you thinking .. . when you’re looking at me? A cranky old man, . . . . . .not very wise, Uncertain of habit .. . . . . . . .. with faraway eyes? Who dribbles his food .. . … . . and makes no reply. When you say in a loud voice . .’I do wish you’d try!’
Who seems not to notice . . .the things that you do. And forever is losing . . . . . .. . . A sock or shoe? Who, resisting or not . . . … lets you do as you will, With bathing and feeding . . . .The long day to fill? Is that what you’re thinking?. .Is that what you see? Then open your eyes, nurse .you’re not looking at me.
I’ll tell you who I am . . . . .. As I sit here so still, As I do at your bidding, .. . . . as I eat at your will. I’m a small child of Ten . .with a father and mother, Brothers and sisters .. . . .. . who love one another A young boy of Sixteen . . . .. with wings on his feet Dreaming that soon now . . .. . . a lover he’ll meet.
A groom soon at Twenty . . . ..my heart gives a leap. Remembering, the vows .. .. .that I promised to keep. At Twenty-Five, now . . . . .I have young of my own. Who need me to guide . . . And a secure happy home. A man of Thirty . .. . . . . My young now grown fast, Bound to each other . . .. With ties that should last.
At Forty, my young sons .. .have grown and are gone, But my woman is beside me . . to see I don’t mourn. At Fifty, once more, .. …Babies play ’round my knee, Again, we know children . . . . My loved one and me. Dark days are upon me . . . . My wife is now dead. I look at the future … . . . . I shudder with dread.
For my young are all rearing .. . . young of their own. And I think of the years . . . And the love that I’ve known. I’m now an old man . . . . . . .. and nature is cruel. It’s jest to make old age . . . . . . . look like a fool. The body, it crumbles .. .. . grace and vigour, depart. There is now a stone . . . where I once had a heart.
But inside this old carcass . A young man still dwells, And now and again . . . . . my battered heart swells I remember the joys . . . . .. . I remember the pain. And I’m loving and living . . . . . . . life over again. I think of the years, all too few . . .. gone too fast. And accept the stark fact . . . that nothing can last.
So open your eyes, people .. . . . .. . . open and see. Not a cranky old man . Look closer . . . . see .. .. . .. …. . ME
(Originally ‘Crabbit Old Woman’ by Phyllis McCormack (1966); adapted by Dave Griffith)
An Aged-Care Worker’s Guide for Initial Contact with New Clients
Knocking on the front door of a newly-assigned elderly person’s home for that very first time is always an anxious few seconds, but understandably even more nerve-racking if you are a newbie to this ‘caregiver’ caper.
In fact, I recall many years ago the day of my first shift ever… standing at the top of the steps, staring at a stranger’s doorbell (of someone I would shortly be helping undress for their shower) and wondering if it was not too late to turn and run for the hills!
What if they don’t like me?
What if I run out of time?
WHAT IF I DO IT WRONG?!?!
I remember, too, thinking how I hadn’t really been forewarned on the reality of what to expect when arriving at a sceptical senior’s house for our first meeting. I knew that I needed to be confident and professional in order to gain trust, but it turned out to be instinct I relied on to provide my client with a warm friendly vibe, that put them at ease. I wanted them to know that not only was I was good at my job, but that I was a genuinely kind, empathetic person – and that I CARED too.
Luckily for me, my first client was the most adorably grateful, yet desperately frail gent who didn’t give a toot that I was a learner. He was just so relieved to have me there.
Which I guess at the end of the day is what it’s actually all about… THEM.
And NOT me.
So, I thought it might be helpful to list some essential, yet often over-looked pointers, to ensure the initial meet ‘n’ greet with your new client is as successful as it can possibly be. That brief, but impressionable moment where you get to reveal your amazing self and to plant the seed for a future mutually beneficial and respectful working relationship.
Appearing at your client’s door with the cheeriest, beaming-est face you can muster, will often be enough to knock the wind out of a potentially grumpy or resentful elder’s sails.
Include a hearty ‘smile’ in your voice as well, which should nip any bad temper in the bud before they’ve had a chance to remember what they were cross about in the first place!
Trust me, it works a treat – and what have you got to lose?
2. Use formal address – ALWAYS
Make a promise to yourself as an accomplished carer, to always use your client’s official title – especially for that initial intro:
“Hello, Mrs Picklehead, how are you today?“
Older generations were bought up believing that this is the ultimate sign of respect – and it’s never to be messed with. If you are unsure of their marital status (you will come across the odd hard-nut spinster out there who’s never married and who will soon let you know if you dare to assume she’s a Missus) – in this case, it’s best to opt for the full name approach:
“Good morning… Marjorie Jackhammer, is it?”
And as daunting as it may seem, you should always attempt to pronounce your client’s surname, regardless of how tricky it might look on paper. That’s including the culturally curly ones that contain just about every letter in the alphabet – including all five vowels TWICE.
I will never forget standing outside Mrs Gina Kantezkantopituolos’s door in a cold sweat at the thought of insulting her by ballsing up her name and having her hate me forever. She actually confided in me later that she’d appreciated me having a try (as feeble as it was) because others never even bothered. For that reason, she’d eventually become known as ‘Mrs K’ for the obvious reason.
“For efficiency’s sake”, she’d say.
Ultimately, ‘Gina’ and I got on so famously she insisted I call her by her first name anyway. Phew…problem solved.
3. Introduce yourself
You’ll discover as you become more experienced and worldly, that some of your more dependant or unwell clients may have a whole army of carers, case workers, nurses, health professionals, specialists and home support people coming and going on any given day of the week – and sometimes ALL AT ONCE.
So to avoid confusion or client embarrassment it is vital that you clearly state your name, rank and serial number when you meet for the first time. That is before you launch into your work.
Also, say where you are from and what you intend to do to them!
There is nothing worse than arriving with your bucket and mop to do a Home Care cleaning duty only to discover your client has since stripped off down to her petticoat in anticipation of having her wound dressing changed by whom she thought was the District Nurse instead.
Not that that’s ever happened to me.
No! Not at all, she said.
4. Confirm that your client UNDERSTANDS you
This is not as silly as it sounds. And an accomplished careworker can determine a lot about someone who appears to be hard of hearing or can’t comprehend what is happening (and has no idea what you are babbling on about.)
You’ve got several logical explanations:
your client suffers from deafness (the rational and most common one)
your client is from a non-English background
your client is sick
your client is cranky and in a very, very, very bad mood (is it too late to run away?)
The answer for all of these situations is to slow your speech down, maintain eye contact and modify your voice and tone accordingly. You can find out later on (when you are friends) what the real story is.
Use hand actions if you need to and don’t be afraid to YELL. I can spend entire days bellowing at elderly clients who have hearing issues only to get home at the end of the day and continue the trend with my family… aren’t they lucky!
5. Compliment your Client
One of the best bits of never-fail advice I can offer all budding carers (or anyone trying to make someone else like you) is that you need to find something about your new client to compliment them on.
It could be that their hair or make-up looks nice, you just love the colour of their shirt, they’re wearing a pretty-coloured lipstick or they’ve had a haircut and are looking exceptionally spruced-up.
Or… if you’re really struggling to find something nice to say about your client, then admire the lovely photo of their grandchildren, the enormous cermaic vase in the loungeroom, the beautifully manicured lawn or the fabulous blooms on the camelia bush.
Whatever, doesn’t matter.
Older adults feel proud and pleased with themselves when they are told they have something that others might appreciate or find attractive. It has huge impact and lets them know their contributions are still valued and more importantly – that they are people, too!
And it’s a superb way to break the ice and show that you at least seem interested in them. Who knows, you might even CARE for goodness sake!
6. Acknowledge your Client’s Spouse
As an observant caregiver, it’s important to be aware that your new client may live with a husband, wife (or other family member such as a partner, son, daughter, niece etc). These onlookers can offer valuable insight on the person whom you may be about to help shower or spend time with in, say, a Respite capacity while their regular family caregiver has some time away from the house.
It is in your best interests, therefore, to butter-up these people and get them ‘on side’. They have a whole plethora of useful information about their parent, grandparent or great-aunty Doris that will make your job significantly smoother if you take heed of it; information that you won’t find on the Care Plan or in the medical notes.
When you take Uncle Reg on his walk to the library… he loves going via the paddock so he can say hello to the horses. He needs to stick to this routine or he will get quite upset and then we will ALL pay later tonight!
Mum only likes using the pink towels… never the green ones as they were (deceased) Dad’s towels and she will get upset if you try and use them during her shower.
Little stuff like that, but it’s important stuff. And it’s stuff that will help you develop a good healthy rapport and eventually, a trusting relationship with your client AND with their live-in family.
7. Acknowledge Pets
Seniors literally GLOW when you show interest in their animals and I can guarantee you, without hesitation… they will instantly adore any visiting carer who does this.
I’ve broken down many a barrier by patting the mangiest of dogs, admired weepy-eyed cats and even whistled at the odd tatty budgie in its cage.
Fake it til you make it, don’t they say? It’s definitely worth it in the end, so do whatever it takes to gain your elder’s approval.
Rub the tummy of flea-bitten ‘Ol Yella and say something silly to the cat – you’ll win over the faith of your brand new judgmental client… and you can disinfect yourself in the car later!
8. LISTEN to your Client
Every aged-careworker knows that communication is what it’s all about. Speaking yes, but possibly more importantly: LISTENING.
So when you’ve rattled off your initial intro, make sure you take the time to hear what your new client has to say in response. And if their speech is slow or they are struggling to get words out (for whatever reason) DON’T be tempted to talk over them or pre-empt their sentences.
Show patience and be respectful in what they are telling you.
Be open-minded and NEVER make judgement.
Sounds a bit like the Ten Commandments really…Thou shalt not pass judgement on thine old lady client!
Let’s face it; most of this is common sense. Isn’t it?
An astute and qualified carer can evaluate a lot about a new aged client in that initial meeting at the door. Body language, the way they talk, their hearing and vision, their coordination and mobility – all can reveal potential physical health problems, mental conditions or emotional issues.
And all are clues that are handy for you to be aware of even before you’ve entered their home.
Take note of bloodshot or droopy eyes, the condition of their skin, breathlessness, disorientation or confusion, complaints of pain and weakness can all mean something is not right and as their carer you will need to investigate further. If only to pass it on by reporting your observations to a supervisor for follow-up which may then lead to further assessment or review.
Unfortunately, not only can you hear and see signs, but you can smell them too.
Take note of cigarette smoke, gas, alcohol, rotting food odours (ick) or stinky human excrement smells (double ick) … these are just a few indications of the way your beloved senior lives and that there may or may not be serious health problems afoot.
10. You’re In!
Well done! Superb job!
You’ve passed the probing and interrogation stage and your shiny new elder has allowed you to enter their world.
It’s now up to you to maintain your exemplary high standard of caring and strong positive work ethic. Enjoy getting to know your new elderly client, but remain vigilant and remember there are professional boundaries. And don’t be tempted to cut corners – because it will most definitely bite you on the bum later.
Work hard, and always have pride in being able to provide a service to people who need your help if they intend on staying in their own homes. And who on the most part, are actually very pleased to see you.
I came across this advertisement while perusing a magazine on a plane recently. It caught my eye for two reasons:
1. I’d only just written an article about the ‘Worst Xmas Gifts Ever’, and…
2. Why was this cheery, yet smug-looking woman in beige slacks STANDING ON A TOILET???
The Best Xmas Gift Ever!!
“Usually for Christmas, my children buy me towels or pillows or once even a basket for the cat. Last year, after a wonderful lunch in the park with my family, we came home and I found that for a Christmas gift my son had organised the replacement of my old toilet seat with an electronic Bidet toilet seat. I had seen them advertised on TV and thought what a great idea.” After two weeks of having my new Bidet, I wondered how I had ever survived previously without it. All I have to do is sit down on my nice warm seat and go to the loo. Once I am finished I simply press a button and I get a warm water rush and a stream of warm air dry. Now almost a year later, it has changed my life. I have saved a fortune in toilet paper and, I see going to the toilet as a time of luxury. It is the best Christmas gift I have ever received!” – Sylvia Ross –
Upon reading the ad, I discover that the extremely chuffed ‘Sylvia’, is actually the proud owner (and driver) of a shiny new Bidet-style toilet seat attachment, secretly installed by her son as a surprise for Christmas.
Indeed, not an advert for your traditional (and kinda terrifying) stand-alone bidet, ahh no.
Instead, Sylvia introduces us to the wondrous Electronic Bidet Toilet Seat. A magical two-in-one appliance that means upon completing her regular toileting ablutions, Sylvia gets to be luxuriously “warm water washed” and “air-dried”.
And without having to budge – ahhh BLISS!
I later showed the mag clipping to my own mother just out of interest. Similar in vintage to Sylvia, it was interesting to hear Mum’s views on the whole BIDET topic. From the perspective of someone who, much like most of us who find those ‘odd-shaped water fountain thingies’ totally intimidating, she admitted that if she had to use a bidet – she really wouldn’t know where to start.
“It’s more of an upper-class European thing, isn’t it… or is it something the prostitutes in Amsterdam use?”
“My friend from bowls has a bidet – but she washes her Chihuahua in it.”
“I’d be scared it might explode… crikey, I could end up being given some sort of a nasty enema!”
All silliness aside, I did start thinking that perhaps Sylvia was ON to something (literally haha). And the more I thought about it, the more it seemed there were massive advantages to be had by a sensitive senior considering enhancing their current loo to include a shiny new automatic built-in bidet.
Interestingly, (but a bit odd too, I thought) I discovered after a bit of research, that the word Bidet comes from the French meaning ‘small horse’.
“Oh, so you strap yourself on and ride it like a pony?”
Yep, thanks Mum.
And that apparently, it was the Japanese who first invented the modern integrated ‘toilet-bidet’ as a nifty space-saving device. Without need of a plumber, it is supposedly simple to install and something an older adult (or obliging family member) could manage without too much fuss.
Merely replacing the current tatty old dunny seat with a fabulous whizz-bang electric one. Easy peasy… botty-squeezy!
Being suitably impressed by this snazzy new bathroom gadget (and without sounding like I have shares in the company), I have since started singing the praises of these electronic bidet toilet seats (EBTS) to some of my elderly clients.
Especially for those suffering from never-ending incontinence or constipation episodes; or pesky mobility issues due to frail, weakened bones and stiff arthritic joints. I reckon it would be hard not to appreciate the enormous potential health benefits an all-in-one EBTS might provide. Not to mention for those in their twilight years being more financially set to ‘splash out’ (ahem) and spoil themselves on a nice bit of luxury during their retirement.
8 Ripper reasons to get an Electronic Bidet Toilet Seat (EBTS) for your elderly parent:
1. They can do their ‘business’, then clean-up, dry-up all in one hit… in one SIT?
2. The EBTS means seniors stay safe. Not having to go ‘up down’ twice from a toilet to a separate bidet means less chance of a skate on slippery tiles.
3. Personal hygiene is improved and more effective due to not having to awkwardly reach around to wipe. Tender, sore and ‘ouchy’ bottoms can stay cleaner – and heal faster.
4. No hands required. Mission complete – without having to touch your bits!
5. Issues such as constipation can be eased (or ‘eased out’) by caressing streams of warm water – in all the right places.
6. Seniors can feel ‘shower fresh’ using an EBTS without having to fully strip off and endure the physical ordeal of an actual shower.
7. The EBTS assists elders to depend less on their caregivers – which means preserving self-confidence (and their dignity).
8. The warm-air dryer of the EBTS means older adults with ‘greenie’ tendencies can feel most satisfied that they’re saving “shit-loads” on toilet paper – HOORAY FOR THE ENVIRONMENT!