15: An Experienced Caregiver Talks from Experience

15: An Experienced Caregiver Talks from Experience

From Chicken Soup for the Soul: Family Caregivers

An Experienced Caregiver Talks from Experience

A Note from Joan

I want to introduce you to a very important person in my life, James Ashley, the man who is in charge of the daily care of my 93-year-old mom, Gladyce. To truly understand the level of James’ compassion and understanding of the elderly, I must first tell you a little about the man himself.

When James was born in Santa Monica, California, it was a bittersweet moment for his mom Betty. Betty was married, but it was while her husband, a soldier, was overseas during the war that Betty had become pregnant by another man. Betty was ashamed and devastated by her situation. She was also let go from her job because of the pregnancy and ended up living in the back seat of her car.

When her obstetrician heard of her bleak dilemma—that she had nowhere to live—he invited her to come and live with him and his wife and spend the remaining months of her pregnancy with them. The doctor’s wife was also expecting to deliver about the same time. When little James was delivered, Betty left the hospital and gave the baby up and the doctor and his wife agreed to take little James home with them to raise him along with their own newborn son. However it was a bit more than the couple had bargained for, raising two young boys at once, so when good friends of theirs from their church expressed the desire to have a child, the doctor arranged for little James to make his new home with Dr. and Mrs. Robert Ashley who lived in Napa, California.

James had a wonderful life with the Ashleys, who also ran nursing homes and were very much of the missionary spirit. James worked in the nursing homes caring for the elderly alongside his father. After college and four years in the Air Force, James was working in contracting, which took him abroad, where he met and married his wife Rowena in the Philippines.

James had been told at age seven that he was adopted and he had always wondered what happened to his birth mother. He very much wanted to meet her. When James was 44, with the help of an adoptive search group, he finally found his mom Betty in Los Angeles. Betty had never had any other children and her husband had left her, so she was alone in the world. The two met, and over the years they established a warm relationship. As Betty grew old and frail and could no longer live on her own and had no one to care for her, James moved her into his home. She was 87 when she came to live with him and his wife Rowena. Today James takes care of all of Betty’s needs and she is thriving at 92.

Years before, James and Rowena had already taken his elderly adoptive mom into their home and cared for her in her final five years. And then they had also brought Rowena’s elderly parents from the Philippines to live with them. Clearly James’s desire to care for others—especially the elderly, who he believes are all too often deprived of compassionate care—has been a dominant force in his life. Five years ago James decided to make this passion his life mission. He bought a house near his own home and established a senior care facility that would house six residents.

James says he loves caring for the elderly, although he is quick to point out that it is certainly one of the most difficult jobs, one that requires constant attention and personal dedication. He says, “You can’t fake being a good caregiver.” James feels he is blessed with a gift—the gift of truly enjoying interacting with the elderly. He says he doesn’t really have to work at it.

I always marvel at how lovingly and respectfully he interacts with each resident. His face lights up when he sees them and his effervescent smile is absolutely contagious. He talks with them about their life’s accomplishments and what they did “back in the day.” He may have heard the stories a hundred times, but he is just as interested at each telling. And the residents revel in sharing their life memories. James points out that this is not always so easy for many people, since they may have had difficult relationships with their loved ones. These situations make it much harder to be a loving compassionate caregiver.

I feel James has a unique perspective, since he deals with the elderly and their adult children on a daily basis and he sees how they interact. I asked him what advice he would have for others who are providing care for loved ones, and here is what he shares:

Joan: James, how do you help the elderly find some happiness in each day? What makes a person happy at that elderly stage of life?

James: The most important thing for the happiness and contentment of the elderly is for them to be able to feel like they are not alone—they don’t want to feel like they are just a number—they need to feel like they belong. You can accomplish this by treating them like they are special and by telling them each time you see them how nice they look. Tell them that they are looking very healthy—sometimes that can make them feel better. Then I talk to them about things that THEY want to talk about, NOT the things that I want to talk about. Let them know you care! It doesn’t always matter who gives them caring attention; it’s just really important that they are getting the loving care and attention.

As dementia increases in the elderly, they are not connected to the world in the same way as the rest of us, and they are not comfortable being made to relate to our reality. For instance, with your mom, Gladyce, I don’t talk to her about things going on in politics today since she doesn’t connect with that, but we have great conversations about things that happened 10 or 20 years ago. I can always get a happy and lively talk going with her if I talk to her about life with your dad, and about you and your brother growing up. Your mother has never been able to accept the death of your brother Jeff, so I usually speak of him as though he is alive today. I call it a “therapeutic lie.”

You can’t argue with dementia. You need to connect with the elderly in their reality. You just can’t expect them to come and live in your reality. Don’t argue with them or keep telling them they are wrong when they are confused and disoriented. People desperately want their loved ones to be a part of their world, but the more dementia sets in the more we must let them live in their world because that is where they are comfortable.

Joan: I notice that some of the adult children who come here to visit their folks will sometimes complain that they feel their parents should read more, exercise more, walk more. It’s always something. And I’ve often wondered what seniors really want to be doing. What do you feel seniors really want to do all day long?

James: Many adult children have an agenda for their parent. For example they will tell me, “My dad should shower and shave every day. He should go out and take walks and be active and he should go to bed early.” However Dad or Mom may have their own likes and dislikes and sometimes they just don’t have the energy to do what their kids think they should still be doing.

I always try to find out what my residents enjoyed doing when they were younger. If they loved to draw or paint when they were young, I go out and get them art supplies. If I find out that they played a musical instrument, I try to get that instrument for them. It’s sometimes amazing how they can pick it right up and play it again. Quite often the elderly will tell you that they are not interested in any of it. However all you have to do is break out the paints and paper, set up the Bingo game or start singing, and before you know it they will join right in and their spirits will be lifted right away. Don’t tell them to sing—just start singing and they will join in with a smile.

Joan: I was amazed when you told me that my mom often joined in the singing—my mom was always so shy about singing, I don’t think she even sang “Happy Birthday” at my own birthday parties. And she was never really a card player or one who would join in games. So I never would have predicted that she would be your reigning Bingo champ. What advice would you give to adult children like me to make your job easier?

James: In order to provide the best quality care, it takes a team, and we need the family on our team. It’s a very difficult job when the family just drops their loved one off and doesn’t give you ongoing input. If the family will join the team, that will always bring a better level of care. The family knows the resident’s medical history and their interests, and this is incredibly valuable information. With this kind of information I can make their loved one safer and more content.

I think that grown children may not think their visits really matter, however visits from family members can absolutely make the day for their loved ones. Trust me, even when it seems like your loved one isn’t connecting or recognizing you, it still makes a huge difference. And when I see that the family cares, it makes me want to try even harder to make their loved one happy.

Joan: When a family checks out respective places for their mom or dad to live, what should they be looking for?

James: Of course it’s important to check for cleanliness and to make sure that the facility is organized and keeps good records—they are going to be in charge of your loved one’s medications and wellbeing. Meal preparation is also very important. Go into the kitchen and open the refrigerator and look inside. Check to see what kind of food is inside. Do they have fresh fruits and vegetables? Do they cook fresh or are they using frozen prepared foods? Do they bake fresh? Food is so important for the elderly. The elderly often lose interest in food and stop eating as they get older and dementia creeps in. So it’s important to keep them interested in eating so that they thrive. In addition to providing a good level of care it is also important that the staff will pay attention to the residents.

If you are hiring a caregiver in your home, make sure that they have references and that you call all of those references. You must also do a background check and fingerprint check to be sure they have no record and won’t steal from your loved one. They also need to have a sufficient grasp of the English language so if there is an emergency situation they can talk to emergency care workers. As caregivers, we are part humanitarians, but it is also a business and you must pay attention to the details and the business side.

Joan: So what are the most important suggestions you would give to the caregivers reading this book?

James: #1. Don’t wait too long to take action! Don’t wait until Mom or Dad isn’t able to handle taking medications properly. You don’t want them to end up in the hospital because they overdosed themselves. Don’t wait till they are eating cold food out of cans because they aren’t cooking anymore. Don’t wait till their clothes are filthy or smell bad because they aren’t showering or doing laundry. Don’t wait! Everyone waits till a crisis hits. And more often than not, it was predictable. Talk as a family and plan ahead. When folks age, they often get stubborn and they don’t want their kids telling them what to do—this turns kids off and makes them back off, when this is the time when they need to be involved. Every family needs to have a plan in place. Figure out how you are going to do it or better yet, get professional care to help you (or assist you).

#2. Don’t try to do it yourself—I advise finding professional help when looking for qualified senior care. Find yourself a senior advocate. Call a reputable senior referral service like A Place for Mom, to help you determine the needs and desires of your loved one and find the right living arrangement for them.

#3. Don’t abandon them! Once you find a place for them don’t abandon them. Everyone is busy, but visits are so important. If that means sacrificing some time to go see aging parents, just do it, it’s that love connection that allows the elderly to thrive. Don’t ignore them. Hug them, kiss them, and talk to them. Bring up their past. Show them pictures from their lives. These are the important things that help the elderly experience moments of happiness.

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