On different occasions, my family has hired professionals to help care for my mom. Some people seem to thrive in the job and others just didn’t impress us. To get a better picture of who enters the caregiving field and understand why some succeed, I’ve been interviewing people involved in the care industry.
Nicole W. is a 27-year-old who began her journey in a personal care home with a relatively small number of beds. Given the vast differences between facilities, this was probably a good place for her to start. Before getting the job, Nicole had completed a course to become a Certified Nursing Assistant (CNA). This is a credential to ask about when hiring a caregiver through a service — or if you are checking out an adult day program. Companies that hire CNA’s as caregivers are offering you more than a “baby-sitter.”
As any family caregiver knows, formal training by itself doesn’t prepare people for the trials of working with dementia patients. Nicole felt that being on the job was like a second phase of training that revealed the mental challenges of the work. Fortunately, she started off in a setting that provided patients with a lot of stimulating activities. The facility was also clean and well-organized. From the beginning, she felt like her “work made a real difference for people.” Unfortunately, she was also faced with the tough reality of many jobs in the caregiving industry: the pay was relatively low and they did not give her enough hours to earn a decent salary. So she moved to a new site where she now assists with skilled nursing patients.
As part of the team in a hospital-based facility, she now has duties focused around helping people with the physical impairments brought on by their disease. The toughest issue in her current job is one that distresses many family caregivers: incontinence. There are lots of theories about how to support people as they lose control of their bladder and bowel functions. But in any facility, not all staff members use the same techniques. Once caregivers take away patients’ responsibility for managing their bathroom needs, those with dementia quickly forget what they are supposed to do. If you are researching care options with different providers, make sure to ask about their strategy for dealing with incontinence. Family caregivers know it can be a HUGE, daily challenge.
Nicole believes that as these problems arise, good caregivers must make a deeper emotional journey. At first it was very hard for her to keep from crying when patients would beg repeatedly for things she couldn’t provide. Many cried out for their mothers, their families, their homes — people and places long erased by death or change.Her advice to those newly faced with these situations is to develop a deep reservoir of patience. Not everyone can stay calm while listening to an endless refrain of dementia questions. On our best days it can still be hard to respond with kindness to the 25th repetition of, “Where is my hat?” But Nicole noted that even if you are answering them for the 25th time, a dementia patient thinks each of your responses is your first. She observed that “the caregiver must change their mindset, because the patients can’t change theirs.” Nicole also emphasizes the importance of maintaining your own physical and mental health. She recommends yoga because of its holistic health benefits and she suggests finding a hobby or pastime that you love — because you need to keep regenerating yourself if you want to provide compassionate care.