The aide saw me from a distance. She wanted to make me feel welcome. ‘Hurry up, there is someone coming behind you.’ She tried to rush the elder woman inside the community room. First, pushing her from the back. The woman kept on walking at her own pace, one step at a time, pushing her walker. ‘Come on, the lady wants to come in.’ I was still far away from the entrance, and in no hurry, but the aide saw some urgency. She moved in front of the old woman, grabbed her hand, and tried to drag her along. The woman finally had enough. She pushed the aide away. ‘Go! Go!’ She was mad. The aide let go reluctantly.
A short vignette, that illustrates what can happen when care partners loose sight of the experience and needs of the ones in their care.
Take two of the same situation could go something like this:
The aide sees me from a distance. She acknowledges me with a smile, and goes back to being present with the old woman, making her the center of her attention. She walks slowly by her side, and matches her pace. How different the feeling left in the elder’s heart compared to what happened! And also, what a different impression made on a visitor like myself . . .
That one real incident with the pushy aide…overall it might be a good facility, with considerate aides. But this one incident, for that elderly woman, that aide will (barring the convenience of forgive-and-forget dementia) will always have an edge in that woman’s mind. She might try to avoid her, rebel against being changed and bathed by her, be on guard too much, fear reprisal.
Now old woman had “declined” into more combative stage of dementia, so sad…or so it seems to others. The woman’s honest emotional reactions against a rude person now “is the dementia”…and she could be prescribed a med to calm her down or sent to the next ward over, where all the other screamers are kept.
I think what is actually diagnosed as stages of dementia, looking at situations in nursing homes of mental and physical decline, can be tracked to nursing home or family caregiver behavior. Like not caring for itchy skin, not cutting nails, and now skin is bruised and gashed and poor person is labelled “self destructive” and given a sedative or encased in padded tubes. Cause, lack of consideration for old person’s skin.
This “consciousness” has to come into play all along. Oh, not that…you mean I have to be aware and considerate. Don’t be paid enough to be that, do that… indeed.