What Caregivers Say Reveals
How Much They Care
By: Lance Youles

The sun is slowly disappearing behind the stately two-story nursing home. Dinner is coming to a close with the usual poky residents massaging cold food around their plates. A traffic jam of wheelchair travelers blocks the dining room exit, but a passing nurse untangles the island of white hair, chrome, and rubber. A nurse’s aide feeds a frail resident lying upright in a reclining Geri-chair, while a sleepy resident across the table takes a nap slumped to the side of her chair. The sharp metallic clang of food carts echo with steady frequency as staff scramble to remove soiled food trays before taking their dinner breaks. Tabletops are cluttered with food particles, spilled drinks, and rolled up bibs. The dining room is a flurry of motion, yet the atmosphere is regimented and sedate. Residents venture back to their rooms to prepare for the night ahead.

A vigilant daughter stands guard at the doorway of her mother’s room. A call-light globe flashes overhead in unison with a faint audible signal from a distant nurse’s station. In the shadows of a quilt-covered bed, a resident sits motionless trying to suppress her aching bladder. Minutes seem like hours in a desperate race to avoid a shameful episode of incontinence. Convinced she must abandon her lookout post after 25 minutes, the frustrated daughter contemplates assertive options. Acting from instinctive devotion, she wheels her mother into the small adjacent bathroom. As she positions herself for a toilet transfer, her fragile back condition suddenly registers, and she draws back in a head held moment of tearful defeat. She quickly collects herself and applies a reassuring kiss to her mother’s cheek. She was always there for me, she thought – I can’t let her down. "It’s ok dear," the mother tells the daughter, "I can wait here until help arrives." Determination turns to furry as the daughter departs the bathroom on a mission to kidnap and return with a caregiver.

(2) Not My Resident

The annoying call-light beacon grows louder as the daughter draws closer to the nurse’s station. She can see the protruding Formica counter top now, but to her surprise, there still isn’t a caregiver in sight. She glances into a passing day room and notices a nurse’s aide standing alone facing a large screen television. The daughter immediately enters the room and announces her presence with a noisy "sigh." Relief is finally on the way, she mutters to herself. The startled nurse’s aide turns around sharply, like a child caught doing something wrong. She stares at the daughter with contempt for a moment, wondering what the abrupt intrusion was about. "My mother needs assistance, can you please help her use the bathroom," the daughter asks in earnest. The nurse’s aide looks down at the floor with a solemn facial expression, and slowly nodes her head up and down.

The nurse’s aide follows the daughter, but immediately reverses her course when she discovers who the resident is. Sensing the footsteps behind her stopped, the confused daughter looks back. To her dismay, the nurse’s aide is returning to the day room. The daughter pursues the nurse’s aide at a frantic pace until she is close enough to call out. "Hey" she screams, "what are you doing?" The nurse’s aide turns slowly and faces the daughter, contemplating her next evasive move. I tried the cold shoulder routine, she thought, but the daughter obviously didn’t get the message. The nurse’s aide didn’t expect a confrontation with the daughter, and she resented having to defend her motives for abandoning her. The time for subtle diplomacy was over, so she approached the daughter until they stood eye to eye. Rolling her eyes, with her hands planted on her hips, the nurse’s aide sternly informs the daughter, "She’s not my resident – leave me alone!" Shocked and speechless, the daughter watches the aide slowly walk away flinging her arms about, mumbling something about being overworked.

How could someone be so cruel and cold hearted the daughter asks herself. What did the nurse’s aide mean by the phrase – not my resident? Did my plea for help violate some sacred caregiving protocol I should have been aware of, she asked herself? Surely nursing home employees don’t ration their contributions and compassion to a list of resident names on a piece of paper, she reasoned. The prospect of nursing home care with rigid impersonal boundaries never crossed her mind, until now. Her confidence in facility management and the nursing staff was severely shaken. For the first time, she feared for her mother’s well-being.

(3) Not My Resident

Frustrated, but not defeated, the daughter hurries back to her mother. She is determined to end this caregiving nightmare, even if it means injuring her back again. She is nearing her mother’s room when a bulky medication cart abruptly blocks her path. "Excuse me," said a smiling nurse, as she piloted the boxy cabinet on wheels out into the hallway. The daughter stares at the nurse for a moment as though she is facing a ghost. How ironic she thought, I can’t find a caregiver to assist me after searching the building, but I nearly collide with a nurse outside my mother’s room. "Can you find someone to assist my mother," sputters the horse-voiced daughter. "I can help you," the nurse replies, as she maneuvers the cart to the side of the hallway and locks the drawers. She quickly proceeds to the bathroom, and within seconds, the torturous ordeal is over. "Thank you dear, you saved me from a terrible embarrassment" the resident exclaims! "I’m sorry you had to wait so long," the nurse replies, as she places her hand on the resident’s shoulder.

Standing next to the nurse outside the bathroom the daughter asks, "is my mother one of your residents?" "Why yes," the puzzled nurse replies, why do you ask?" "You were eager to help me, so I assumed that my mother was assigned to you," the daughter replies. "I tried to get assistance from a nurse’s aide down the hall, but my mother wasn’t assigned to her, so she wouldn’t help me." "She said my mother wasn’t one of her residents." "That attitude is inexcusable, "replies the angry voiced nurse! "Resident assignments are not designed to restrict caregiving. Assignments allow staff to focus their contributions on a particular group of residents, but they are expected to assist any resident they encounter who requires immediate attention. Unfortunately, this level of personal accountability is difficult to enforce. As far as I am concerned, they’re all my residents," the nurse proclaimed! "That nurse’s aide wouldn’t make that callous statement in front of me!"

The daughter was comforted by the nurse’s intervention, but she was worried about the next time her mother required assistance. What happens when I am not here, she thought. Sensing the daughter’s anxiety had not passed, the nurse offered some reassuring words. "This deplorable situation doesn’t happen very often around here," she explained. "Most of our staff is very attentive and caring. Unfortunately, the harm caused by one misguided employee can overshadow countless contributions from their co-workers."

(4) Not My Resident

"It takes a special person to meet the physical and emotional needs of nursing home residents," the nurse continued. "The true measure of that spirit seems to play out over time. Some caregivers begin their career with noble motives, but personal distractions at work and home gradually erode their enthusiasm. As a result, the I’m going to make a difference crusade gives way to inanimate caregiving. Unfortunately, you can’t restore a spirit of caregiving that wasn’t genuine to begin with. I treat care-giving as a ministry, and so do most of my co-workers, the nurse proudly confessed. There are caregiving rewards far greater than money and praise, but you must have conviction of the heart to receive them. Caregivers who are driven by self interests do not belong here, and usually don’t last long. I would choose this facility if my mother required nursing home care. I love working here!" The daughter hugged the nurse in a tearful display of gratitude. Her faith in the facility was restored. She could go home now.