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Not the Usual Scene

May 9, 2012

Ten years ago, while working as a home health nurse in a rural community I cared for a 93 year old woman. We’ll call her Lola. She lived her entire life in a cabin originally homesteaded by her grandparents in the 1870s. She’d married, raised her family, and watched her husband die in that cabin.

So, you may be asking yourself, “What’s interesting about this situation?”

Lola was the family caregiver (remember she’s 93) for her 72 year-old daughter, Abby. For 72 years Lola had cared for Abby in that cabin. Why? Abby was beautiful, but she had the emotions and mental function of a four-year old in a 72-year old body.  Both women used walkers to navigate through their home. Lola cooked, cleaned, and cared for Abby as she had since Abby’s birth.

In another home Tammy, a junior in high school, was the family caregiver for her mother, Kate. A motor vehicle accident the year before left Kate paralyzed on one side and unable to talk although she still had all of her mental and emotional abilities.  When Kate was ready to be discharged from the trauma center the doctors wanted to admit her to a nursing home for life-long residency.

Kate knew that if she went into a nursing home the kids would be placed in foster care. Tammy met with the doctors and convinced them that with physical therapy at home she could care for the other needs her mother had while also attending school and caring for her younger brothers. Their father had passed away suddenly a few years earlier.

What does a 93 year-old woman have in common with a teenager?

Both women were family caregivers which left them subject to BURNOUT. Caregiver burnout is an equal opportunity phenomenon. There is no discrimination based on age, sex, education, religion, race, creed, color, or socio-economic status. Sooner or later CAREGIVER BURNOUT knocks on the door and wreaks havoc.

Lola found herself uncharacteristically snapping at Abby and not sleeping at night. Her appetite disappeared and she lost her desire to quilt or crochet.  Tammy found herself unable to concentrate in school and withdrawing from her friends. Her normally healthy eating habits couldn’t control her insatiable cravings at all hours.

Lucky for both families the home health team recognized the symptoms quickly and took immediate action. Lola’s younger sister was contacted and arrangements were made for a two-week visit, away from home, where Lola could rest and be pampered. There was money in a special account to provide additional services for Abby so  personal caregivers were hired to take over during Lola’s absence. Since this arrangement had been used before Abby was familiar and comfortable with the caregivers. Abby’s routine continued without a hitch while Lola got some much needed attention herself.

Lola enjoyed visiting her sister, having breakfast served to her each morning, participating in group quilting bees, and playing cards most afternoons. Her appetite returned, she slept well, and she enjoyed leisurely walks in the garden and along the river. By the end of the two weeks with her sister Lola was refreshed and ready to resume her caregiving duties at home with Abby.

Tammy couldn’t leave town in the middle of a semester at school so arrangements were made for her to spend two weeks at a friend’s home. Kate’s mother and sister agreed to care for the boys and take over the household routine during Tammy’s absence. Before leaving Tammy made sure they were capable of assisting with Kate’s physical therapy routine three times a day and getting her in and out of the shower with the wheelchair. Kate and the boys had competent care while Tammy was able to just “be a kid again” for a couple of weeks.

Tammy attended her classes, spent some afternoons at the park with her brothers  playing on the swings and enjoying Frisbee golf. On weekends she slept in, went to the movies, chatted with her friends, and went on family outings with her host family. Her appetite returned to normal, she regained her usual energy levels, and was able to ace her mid-term exams in order to keep up her high GPA. After a talk with the counselor at school she understood that her life was different from her fellow students and that she shouldn’t feel guilty about enjoying her time away from home to be a normal teenager.

Respite is vitally important for caregivers and can can take many different forms. Successful respite for the caregiver takes planning and collaboration in order to meet the needs of the caregiver and the person requiring care.  If you are a family caregiver, or know someone who is, please look out for the following signals before BURNOUT take it’s toll.


*** Change in eating habits


***  Change in sleeping routine


***  Loss of interest in normal activities


***  Withdrawing from friends or family members


***  Overly emotional reactions


***  Loss of patience over minor things; snappy, grouchy, sarcastic, behavior changes


There are programs available to help arrange for respite care. We’ll explore this subject through the remainder of the month of May.


Please feel free to share your stories, comments, and/or questions.

 If you know someone who would benefit from this post please feel free to pass it on.

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