While I’m trying to get an interview with full-time x-ray employers (only one for per diem so far besides the part-time job I have), I’ve opened up my job targets to include, well, anything vaguely medical in the immediate vicinity. Mikey gots bills to pay. Today was my first day as a care-giver at a dementia facility. That means change, dress & feed, for 10 bucks an hour. It’s good exercise, and challenging to get people whose brains don’t work properly on your side so they will be cooperative. The residents deserve dignity. It is, however, impossible to do this job in an entirely dignified manner. You can do it joyfully and efficiently and properly, but there’s no way to make wiping grown-ups feel dignified. It is honorable work though, and even fulfilling.
There are many kinds of dementia, and different ones are represented at this facility. This is a lesson for me in communicating effectively when words don’t always have the expected effect. There are 27 residents in this care home currently. Only about half of them understand verbal requests, and can respond intelligibly. One-quarter respond in what’s called word-salad. They will appear to listen (and perhaps they are) then respond with words that make no apparent sense.
I asked one lady if she wanted applesauce. She said, “Fine, but tick-tick unless you get to stand up, stand up.” Another woman (who loves music) drifts in and out of a dream-like lucidity. Her diction is clear, but she will speak non-sequitors in response to no one visible. She ate a piece of cake at lunch, sat motionless with her eyes glazed over, then said calmly, “That’s not very nice.” She then got up and began to wander the hall with her head cocked to one side. It’s not the same as insanity. It is more like un-soundness.
Part of dementia is having clear moments that are too brief to guide the person for long. One man everyone calls “Doc” acquiesced to being showered and dressed with barely a word or nod. Then in response to being asked whether he wanted to go down to lunch, Doc replied softly, “I just go where they tell me.” A charming wheelchair-bound woman with an impressive vocabulary tossed a lot of word-salad until she stopped for a moment, sighed heavily as if she understood her condition with complete clarity and said, “I’m so dormant now.”
Some of the residents were highly educated and intelligent. One lady of that sort has learned how to have a kind of control in a life she largely can’t control. She offers a never-ending list of requests in a whisper. “Would you put these two tissues over there by that glass?” “I want to wear the vest I had on before.” “That’s not a good color. I want my other lipstick.” “I want my chair closer to the table.” “Not that close.” “The blinds are glaring.” “That’s too dark now.” She also follows rituals in sort of an ocd fashion. It’s always two tissues, two on her lap, two for under her room key arm strap, two more closed into her spectacle-case. The care-giver must follow an elaborate procedure involving the speed and direction of her wheelchair into the bathroom, and how to transfer her to the toilet. These rituals make her more comfortable.
I don’t know if I can possibly afford to keep this job. I’m still in my orientation period and the benefits package hasn’t been explained. However, if I can manage somehow, I do want to keep doing it. Maybe I’ll win the lottery. Maybe my wife’s 99-year old aunt (who has dementia) will die in time to leave her something. Maybe I’ll only do it until I can’t physically lift people any more. Or I’ll just become a saint.