I have worked for two years as a Caregiver. I previously worked in a cozy Family Home and I have just completed my first 12 hour shift in a high-end Nursing Home. I assist a woman whose sole communication is laughter. She laughs as she is introduced to me. Her eyes are terrified.
“She’s our happy camper!” the floor manager says. I push her wheelchair to the dining area. The laughing woman must be fed because, although she is physically capable, she does not function mentally on a level that she can feed herself. She seems lost and stares blankly most of the time. She opens her mouth obediently to each bite. Aides must be careful when feeding her, the portions are large and she will eat until she vomits. Each aide assists 2 or more diners.
The second woman I am helping has a honey-thick diet; all food is liquefied and combined with starch into a slime that is spooned into the mouth or sipped from a cup. She opens her mouth if the lower lip is touched. Her eyes track nothing and her body is rigid. She does not speak.
At the end of my shift I am asked to put these two clients to bed. There is a mechanical lift called a ‘sit-to-stand’ used for both of them. The rigid woman’s torso must be pushed and the body harness wedged in between the chair and her back. Once this is accomplished she is not difficult to put in bed.
The laughing woman is more challenging because she resists. If I put her hand where she should grip, she pulls it back. She is unable or unwilling to heed instructions. Unable and unwilling become fused with dementia patients. I am told she will listen to men, but not women.
When I finally get her in the standing position, I have to stay 25 minutes later. She had a firm bowel movement during dinner and it is mashed deep into the folds of her buttocks and labia, putting her at risk for a UTI. I will use half a pack of baby wipes, a stack of wet paper towels and an adult diaper to ensure she is clean before bed. The nearest shower has crap for water pressure and I want to maneuver her as little as possible, every transition puts us both at risk for injury. She is over 200 pounds and quite strong. I feel the strain as I position her in bed.
In the Family Home where I worked I could talk with the patients. I was closer to them than my own family. I often hugged them goodnight and tucked them in. It is impossible to give those loving touches to my clients here. I have no idea how my actions would be perceived. Would they feel kindness, assault, nothing?
“I hope I’m as well taken care of when I’m at this stage.” I hear this sentiment often from my former boss and staff members. It baffles me. Is it some kind of defense mechanism to imagine themselves completely dependent? Does it create empathy? Have they accepted this as inevitable? Does that help? I don’t want my death to be a slow crawl to oblivion, killing my identity, one piece at a time.
“Someday that will be me and my wife,” the floor manager says. He is talking about a married couple sharing a room, both confined to wheelchairs. The wife pushes and pulls her husband’s chair while scooting around in hers. She regularly gets stuck or pushes him into a corner. I hold her chair back while the physical therapist works with him. She becomes distressed if anyone else is with him. This is behavior goes on all day, the wife attempting to be with her husband, to care for him and take walks with him, getting stuck against a wall, setting off an alarm when she rises to fix it. Workers call it cute. I try to see it that way but it just comes back as depressing.
She has no idea where she is or who we are. I have indications that he is still aware, but imprisoned by advanced Parkinsons. In a rare moment of interaction, he lifts my scrub sleeve and looks at my tattoo. “Why?” he asks in a raspy, weak voice.
“Life is too short to not be colorful, Doctor.” I say. I do not know what kind of Dr. he was, just that he was. The beautiful watercolors he painted decorate their room, the last one dated two years ago. The others are wedding pictures, he and his wife are newlyweds, married after their respective spouses died.
I am getting him dressed and he is embarrassed, trying to cover his genitals with a sheet, his hand shaking. I wish I could tell him it means nothing to me, the sight of genitals, but that might make him feel worse.
I left the Family Home for many reasons, one being I was shutting down. The workplace makes me feel numb between the eyes. I imagine heaviness on my chest like a weight used to sink bodies to the bottom of a lake. At 46, I can see the skull under my face. The sockets under my eyes are pronounced as are my cheekbones. Death is letting me know it is inside and will come out and take over, very slowly.
I am writing this at 4:30 in the morning. I have to. I woke from a dream about my ex. He was violent and charismatic. He used both guilt and anger, in turns, to control those around him. He was, and still is, a dark pit of neediness and arrogance. I dream he is stroking a baby goat with a curved knife. “This is how you do it,” he says. “The neighbors don’t know how to do it. You get the animals used to the knife. Do it so they are not afraid, until they feel so safe they will sleep.” I know what is coming next. I run screaming. The blood from the little goat splatters on me.
I feel horror and deep grief for the innocent creature, disgust that I did nothing to rescue it. My ex was, in reality, a lover of meat and a butcher of animals. Over 20 years with him, I allowed myself to become desensitized to a level of degradation and filth that astounds me now. In the dream, my ex’s current wife tells me that the soup I brought is bitter, like cleanser. “Throw it out then,” I tell her. I wake up and can’t sleep.
A thought is repeating in my head. ‘You have been living under a collective psychic debt.’
That is what I do. I find the vortex and throw myself at it. My ex’s neediness kept me with him for far too long. I prove my worth by going where I am needed, where my effort will make the difference between life and death. My ex’s neediness was a reflection of my own. His bizarre behavior made him oblivious to my quirks.
Like many oddballs, I have had my difference drummed into my head, as a child. “You are just doing that for attention.” “Why do you act like that?” “Just be yourself.” My favorite, “How do you expect to have friends when you act so strange?” None of these social corrections ever gave me any idea how to act like everyone else. They did create a primal fear of exile. I tried to hide my strangeness by camouflaging it with counterculture. For all its artistic merits, counterculture turned out to be a façade of cold indifference and its populace fast fading into the nearest portals of warmth and familiarity or addiction and death. I moved into a house of infinite need and now I have found another. I have done so in order to avoid my own vacancy. Too terrified to face the deeper truth within, I sought out others troubles.
I habitually rip every idea apart to find its meaning. All conversations and interactions are mined for the deepest layer. Working amongst the dying has given me hints at a terrifying meaninglessness, the inevitable sacrifice of the sleeping goat. Bearing witness to the infirmity of age yields a dark pit of unanswerable questions in me.
I want to believe in the rightness of life and death, that there is good and order in all this. I see only suffering. I see men with tiny trusting animals and knives, women wringing their hands in useless consternation. I see good people, who lived according to the morays of their times, suffer the indignity of becoming Halloween props. My vision is blighted.
On my last day at the Family Home, my boss gives me a farewell gift with a card that reads; No matter how far you travel, may your road always lead you back here.