“I’d like to volunteer with Physical Therapy, and also in one other place, just for perspective and experience,” I told the Volunteer Coordinator. “I don’t really know what I’d like it to be, so I’m open to trying anything, as long as it isn’t working with elderly people.”
I explained that with two of my grandparents in the state of “disaster waiting to happen” and one as an on-going disaster (he’s dying of Alzheimer’s), I just felt emotionally spent in the case of caring for failing elderly people. Maybe at some other point in my life it would mean I was very well equipped for caring for the elderly, but at this point in my life, I felt like it would be hitting far too close to home to be dealing with age-related failure.
Murphy’s Law being Murphy’s Law, I spent almost all of this Friday either feeding a patient with advanced dementia or sitting with an unresponsive 91 year old man.
It wasn’t deliberate, on either my part or the Volunteer Coordinator’s. We had decided to supplement my Physical Therapy with Orthopedics, as working with the hip/knee replacements at the “Joint Academy” seemed like a good complement. Basically, you get to see what the patients have to go through before they are even good enough to attend the Physical Therapy downstairs. Unfortunately, the first day I volunteered in Ortho, it was a Friday. Friday is the least busiest day at the Joint Academy half of Orthopedics, so I was mostly back in with the more long term patients (joint replacement patients are out within days).
I think I was mostly proven correct on all issues. I had a hard time not making disapproving faces with the person showing me how to feed the lady said dismissively, “She has very advanced dementia, she doesn’t know what’s going on around her.” I rankled when all the staff talked to her in baby-like sentences. I am sure she did have advanced dementia and I’m sure she was easily confused. She also had a very weak, very quiet, wavery voice, and you just about had to put your ear to her mouth to hear what she was saying. And you did have to speak slowly, so that she could understand you. She obviously had difficulty putting her sentences together, but she could communicate and they were very real thoughts, issues, struggles and confusions, and I am 100% sure she could understand how people were treating her.
So I found it very sad that the only people who seemed to be treating her as 100% human were me and a lady who I presume was her daughter, who showed up later. The staff didn’t treat her poorly; they just seemed to treat her as though she was stupid—instead of merely confused, forgetful, and frightened. She responded well to syrupy remarks of what a good job she was doing eating lunch of out of relief that they weren’t saying something was wrong or she was doing something wrong. Syrupy remarks are much more welcome than finding out once again what a scary, confusing life you are living in. But it still seemed to me that the staff didn’t have a good idea of what dementia was. A person can become crippled without becoming a lesser human. Their brains may be becoming as fragile as their bones, their memory breaking like a broken leg, but that doesn’t mean you dismiss them. It may become harder and more difficult for the person within the body to communicate with you, but that person is still there, and they can understand attitudes easier than words.
Unfortunately, the relief from watching a frail confused woman asking me “How did I get here?” was only to sit with a woman watching her father dying in the bed beside us. He had fallen and broken his hip, and I guess the strain of that and the corrective surgery was too much for his already ailing body. He appeared to be sleeping, breathing deeply (with the aid of an oxygen mask), but was entirely unresponsive and unable to wake. Most patients are accompanied by a close relative or friend, and I, coming from a very private family, recoil at the thought of intruding on such a personal time. But this lady was alone with her unresponsive father; her one sister lived on the other side of the continent, and her other sister had left on a cruise when the father appeared to be on the upswing (I believe the father fell after she left for the cruise).
I know well enough to know that time only goes more slowly when you have nothing to do but contemplate the awfulness of the situation. I had no doubt that it was a real service to sit and talk with her; but in talking we were both merely trying not to think. She was trying not to think about her dying father, and I was trying not to think how he looked so much like my grandfather (not in facial appearance, but in posture and frailty), and how my grandfather breathes with just as much of a rasp already, and how easily he could fall, and how easy it was for life to become too difficult for frail bodies.
So we talked. For hours. About Spring, and flowers, and gardens, and smoking, and families, and growth spurts, and we tried to ignore the sound of the oxygen machine. I felt bad to leave, but it seems they were getting ready to move him to Hospice, and it was time for me to go home. So I left.
And then I almost had an emotional break-down in the volunteer coordinator’s office.
I have come to realize that’s the way I work. I ignore, ignore, ignore and ignore, until something “triggers” me, and then there’s no avoiding it. Grandpa has pretty much plateaued, and I have simply become accustomed to the “new reality” of how Grandpa is, ignoring the thick clouds of doom and foreboding that try to overshadow and suffocate. But it is altogether impossible to avoid drawing the line from the frail body in the bed, wasted away and sucking oxygen, unresponsive and quiet—-to another body, my grandfather’s, just a few days previous. He fell asleep on the couch, using my leg as a pillow, his body scant more than skin and bones, exhausted from the effort of staying alive one more day. I had stroked his hair and his face, and listened to his deep breathing, rasping a little from years of smoking. He was curled up like some poor sad thing you had to protect, but he was only sleeping. Sleeping deeply would mean that the next day he would be more able to communicate, more able to eat, more able to live. But he is right on the edge; I cannot imagine it will take much to push him over to the point where it is no longer deep sleep that strengthens but unresponsive sleep from which he does not have the strength to rise.
And I recoil from that reminder. Oh, my heart does go out to the lady, and if they are still in Hospice when I get to the hospital next Wednesday, I will certainly stop in. But when you are working in PT, there is hope. People heal. People get better. People stop hurting. You can encourage people that things will get better. But it’s a hollow, empty lie once you get past a certain point. One of the staff came in, I think it was a kitchen person, and told they lady “You’ll see, he’ll wake up just like that, he’ll bounce right back.” I couldn’t say that. There are always miracles, you can’t say never. But I can see the frailty of his body, I know it has been through great amounts of damage. It is wearing out; it is used up. Death happens. You cannot deny it, you can’t say “It’s okay.” It’s not okay. You can’t say “It will get better.” It’s going down, it’s failing, there will be no rebound. There will be loss.
I know there is no avoiding this, in any life. And I know that it was far more comforting for that lady to not have to sit alone. But my mind flees being a spectator of this. It recoils away from watching grief and pain, turns away from any reminder of what inevitably will come. Isn’t it enough to deal with the hardship of your own life without having to drink in the loss and pain from others’ lives as well? I cannot do this.
I know that I can’t, yet I know that if He wants me to, He will make me able. Isn’t drinking in someone else’s pain so that there is less for them what bearing someone else’s burdens is about? Helping others is never an easy, light thing. You always have to sacrifice something of yours to help someone out. It may just be your time you have to give away, time you could have spent doing something else. But sometimes it is your safety—the safety of not feeling pain or loss or grief. To stop wrapping yourself up in the safe little cocoon of your own world, where if it is not happening to you than it cannot hurt you.
I didn’t want to go sit down next to the foreshadowing of my grandfather’s dying for several hours. But I didn’t want to leave her there alone in the present reality of her father’s dying. I couldn’t take away the reality of impending death, but I could take away the alone. I could take away the “nothing to do but sit and watch and wait for his last breath.” But to stay was to cause my own pain, only adding to pain I would inevitably have down the road. I could have avoided it. I could have spared myself. I wanted to avoid it, I tried to spare myself. But I was compelled to go in, to take some of the misery off her shoulders and put it on mine.
Now starts the bargaining. “Okay, so just this one time. I’ll be with this one lady this time, but next week I’m going in on Joint Academy’s busiest day. I will be far too busy to go back and sit with any dying people. Do you got that? Just this one time!” My empty defiance of God mocks me; instead of feeling confident I won’t have to do that again, I dread my next trip to Orthopedics, because I don’t want to see another confused dementia patient, I don’t want to sit with dying people. I see enough of that on Mondays, and I’m not looking for more. In reality, there probably won’t be a dementia patient there next time, and the dying people are usually very quickly moved to Hospice. But Friday made clear it wasn’t my choice to chose, and that He never promised me it wasn’t going to hurt. I want to chose the safe, happy places, where everyone gets better and nothing goes wrong. He put me in an awkward, uncomfortable, painful place, where I probably did more good than I ever did on a PT day. And I don’t really want to go back to it. I’d like to say that I do, that I would gladly give up my own safety and comfort in return for giving some to someone else. But I’m a selfish human being, and all I really want to say is, “Scary, runaway, runaway!” and not look back.
Well, as much as any person can say it, I am going back to Orthopedics next Wednesday. And it will be the busiest time for Joint Academy, but that hardly rules out dementia or dying people. In fact, even my safe-haven of PT doesn’t rule out either of those things. God grant me the grace.