Why We Dread the "Ucky" Side of Elder Care
By Paula Spencer Scott, Caring.com senior editor
What's the difference between handling your baby's diaper rash and your parent's bedsores? Or between Junior's spit-up and Grandpa's drool? Sorry for introducing a not-fit-for-the-dinner-table conversation here. But it's another of those under-discussed dark sides of caring for aging parents or other elders that so many of us nevertheless confront: Having a difficult emotional time with the "ucky" personal-care side of the business.
"I draw the line at smearing foot cream between atrophying toes," an otherwise-selfless, giving caregiver told me the other day. She's deft with medications and cleaning where the commode was missed, but she insists her husband apply her father-in-law's toe cream.
She's not alone at drawing lines at -- or silently dreading, or even panicking over – certain aspects of personal care. Common biggies include bathing, hair washing, incontinence, ostomy bags, bedsores and other skin problems, and those dismaying feet.
So here are a few explanations for those perfectly understandable reactions – and some ideas to help you along.
Uckiness cause #1: General squeamishness There's one direct link between how plenty of new parents feel about projectile vomiting and diaper blow-outs and how some adult children or spouses feel about certain personal care issues. Things that involve bodily fluids or other unattractive sights are just naturally unpleasant to a great many human beings.
What helps: Practice. If a first encounter causes an unexpectedly strong response in you, know that the feeling does tend to soften some over time the more deft you get at a particular chore or the more often you see it.
Uckiness cause #2: It's Mom! (Or Dad!)
Unlike the oblivious baby having his diaper changed, a parent knows exactly what you're doing. And you know, too. That can make both of you uncomfortable. Your parent may hate to need help and you may hate the idea that he or she needs help.
What helps: Remembering that your parent will always be your parent, but right now he or she also happens to be an individual who needs your help. For many people levity is the grease that gets the job done. Cracking jokes defuses the tension in the air that both sides are probably feeling.
Uckiness cause #3: Heebie-jeebies about privacy This one is kind of a corollary to #2. Adults are accustomed to privacy, and sharing normally-intimate business can conjure up a lot of discomfort.
What helps: Respect the person's privacy as best you can. Take care of personal needs in a private area or, in a small house, keep others out of the room. Provide a robe and place strategic towels during bathing. Certain parts of personal care simply can't be completely private, but you can give the elder the respect of being as discreet as is feasible.
Uckiness cause #4: Thinking, Hey, I'm not a nurse
There's a certain technical element to personal care. This, I think, was the biggest bugaboo for me when my mother was ill. At first, I simply didn’t know what to do. (I scored really, really low on the "nurse" portion of those high-school career-interest surveys. Meanwhile I scored really high in only two areas, "writing" and "outdoors." Since I'm not a forest ranger, here I am.) I tried to pay attention to the visiting nurse's instructions but mostly felt a deep inadequacy.
What helps: Brush up on the basics of how to handle specific situations like bathing an elder, bathing someone with dementia, changing [adult diapers] (http://www.caring.com/questions/i-live-with-my-grandmother-who-is-incontinent-and-she), and so on.
Another option: If there are more than one of you, divide duties among those who feel best suited to handle them, if you can. I was Mom's chosen child (for some reason) to clean her dentures; maybe this is what helped me dive easily into this task. On the other hand, the adult diapers, the dry shampooing, the bed changing, et. al., I left to siblings who felt more comfortable with it.
Outsourcing particular tasks, such as biweekly bathing, to a nursing aide is another possibility, if you can afford it.
Ultimately, personal care is as personal to you as to the elder you love. It's not easy, only necessary.
Are there tasks you dislike – and if so, what helps you get through it?
For all of you who are "too squeemish" or find elder care "too personal" and/or "private," give yourself the gift of a reality check by reading the lyrics to the song below. (And if you're really brave, go online and listen to the song)! The first part of the song is spoken word. The artist, Pastor Shirley Ceasar narrates the tale of a child who has written a list of his many contributions around the house, and the resultant sum that is now due to him: For mowing the yard: $5 And for making up my own bed this week: $1 For going to the store: $.50 And for playing with little brother while you went shopping: $.25 For taking out the trash: $1 And for getting a good report card: $5 And for raking the yard:$2 Total Owed: Fourteen dollars and seventy five cent! The Mother looks at her little boy standing there...expecting...and a thousand memories flashed through her mind. So she picks up a pen, turns the paper over and this is what she wrote: For the 9 months I carried you, growing inside of me: $NO CHARGE For the nights I sat up with you, doctored you, prayed for you: $NO CHARGE For the time and tears, and the costs through the years, there is: $NO CHARGE When you add it all up, the full cost of my love is: $NO CHARGE For the nights filled with dread, and the worries ahead: $NO CHARGE For advice...and the knowledge...and the costs of your college: $NO CHARGE For the toys, food and clothes, and for wiping your nose: There's $NO CHARGE son When you add it all up, the full cost of my love is: $NO CHARGE These same people - husbands, wives, parents, grandparents and family members who now make you "squeemish" and "embarrassed," are the people who diapered and wiped YOUR smelly butt, kept clean bibbs around your neck for YOUR smelly drool and spit-up, sucked snot into their own mouths out of YOUR stuffy nose (before bulb syringes came into vogue), worked, cooked, cleaned and managed a house for you to live in while they were in a near comatose state from keeping watch over YOU all night long when YOU were colicky or sick, only now that its time to give back, you punk out with these lame excuses! I'd be willing to wager that at least 9 out of 10 of the "shrinking violets" who are unable to stand the sight and smell of regurgitation, or wash the genitals of a sick parent or loved one, are the same people who have no difficulty sitting down to watch complete strangers copulate in X, XX and XXX rated films and movies! If I sound angry, I am! Now that the Baby Boomer generation is coming into their senior years, our country's health care system falls apart. Without caregivers who are willing to remember the love that was so freely handed to us, we stand to see sites far worse than the drool, poop, urine, vomit and genitals of our parents and loved ones! Some of these same people that you guys are blushing and getting queasy over, are the same people who dedicated their very lives to you in your formative years! In response to her role as caregiver for her now elderly parents, 9 months ago Jaye said: "I was well cared for as a baby and a child. I just feel it is my turn now." Had I read her post first, my response comment could have been 2 sentences long instead of 2 pages!
The other day, when I was changing my Mom's diaper, she said she wished that I did not have to do it. I told her that SHE taught me how to give loving care and now I was able to give it back directly, which resulted in a big hug. It definitely does freak me out, though, mostly as I've been through it before when my husband was dying. It's such a clear sign that the end is getting near.
What a great post! I really appreciate the frankness of it, the absence of squeamishness in talking about what can make us squeamish. When my dad got to the point of having constant personal care needs, my sisters and I were fortunate that he could afford professional care...most of the time. When it did come down to us, though, I was more uncomfortable than my sisters, although we all had our share of confronting accidents and emergencies. In an effort to allow my dad his dignity, I tried to take my cues from him as to how intimately I would be involved. Unfortunately for me, he had grown up on a farm and had no compunctions at all. :-)
I did some of the sqeemish caretaking for my Grandmother because her adult children could/would not do them and because she was in assisted care and they were not nearly as attentive as they should have been. I would not want to go through this again. It was just too personal.
"Take deep breaths" is great advice for many situations. Thanks.
I feel like Jaye, it is a privilege to take care of my parents, there were five of us, we were all loved and cared for, if I could be half the woman my mom was I consider myself blessed. But the key word "WAS"' The key words to resolve issues are TAKE DEEP BREATHS and RESPECT. June
I have cared for my Grandparents and am now helping my elderly parents. I have always counted this a privilege. I was well cared for as a baby and a child I just feel it is my turn now...