The High Jump Jiggled my Brain

I wonder when i get old if I'll suffer from denmtia. I've met several people who are all suffering different forms of it, and it seems so different for each of them.

I was in my Team Meeting today talking about the status of our clients when they came around to talking about M. She has been living in the Nursing home for some time now. "Oh she thinks she has to pick people up and drive them, home!" One nurse says with a sad face. They all nod and continue to talk about her care.

When it gets to my turn, I agree that often she starts talking about how there are places she has to go, and isn't her husband so good hearted to let her have the car for three weeks. Everyone in the room knows her husband is dead, so they look sorrowful at this bit of news.

"But" I say "i try to get her to talk about herself and distract her." I started telling them about how M. didn't want my services at first because she didn't have any money to pay me. I convinced her that she didn't have to give me any money, and she readily accepted, though she couldn't understand why anyone would go around rubbing people's feet for free. She told me about how she got her first vericose vein in highschool doing the high jump and the long jump. She one $14 in 8th grade because she was able to jump the highest. "I could have gone, higher" she said. I asked her if she liked all that jumping around and she said she probably like it too much and it jiggled up her brain.

I had the room laughing and the nurses that hadn't met her, wanted to meet her. I felt like I had something special with M. I had made a connection with her and her jiggled up brain. This is where the hard part of my job starts to show up. I know that with in weeks or months, M. will get worse and that breif connection we had will be lost. Do I distance myself from it or relish it while it is still there. I've only known her a short time, who am I to hold on to this part of a stranger?

For now, I will continue to joke with M. and not think about the end until it's closer. But then I will have to put my attachment to the side and see the situation as part of my job.

Talking to yourself

This morning I was all set to complain about work. The endless red tape and nonesense that's involved with committees and board members. This is an aspect that i don't like about my job. The very real behind the scenes busy work of it all. Documentation of every single word that is said to every person and the look on their face when you told them. It is tedious to say the least. But I am not going to complain any more about my job today.

****

Today I went to see E. She is about half an hour away in a small town nursing home. I've been seeing her longer than six months, and we all keep waiting for the call to say that she has died... but she hasn't yet.

She is difficult for me to work with because her disease causes her to hold her arms stiffly at her sides. She doesn't talk, though she will follow you with her head. I'm not sure if she understands what I say to her or not. I am afraid I am going to break her arm if I force her to move it. When I first started seeing her, I tried to move her around a bit, but the look she gave me stopped me in my tracks. Whenever I announce my arrival her eyes open wide and her chin shrinks back into her neck. It is a cross between a look of disgust and dismay. As if to say "oh no! She's back! If only I could speak so I could tell her to go away!"

I don't know if she's thinking that or not. I didn't really feel confident with what I was doing with her. So much of my work is based on feed back and with E. I couldn't tell if it was negative feedback or her disease causing her resist me.

Frankly, I don't think I'm doing her much good and I don't know why she makes me so nervous.

I arrived one day and the RN from hospice was still there taking down her vital signs. I sat and waited and watched while she finished up. The nurse wasn't nervous or shy or unsure about herself. She treated E. as if she could understand her, because she didn't know either, and it was better to err on the side of yes. As I watched her, I realized I was making it hard on myself. It wasn't E. being difficult, it was me being afraid of what I didn't know. I didn't know what was happening, so I did nothing, or the bear minimum.

It took my a couple of visits to get over myself. Today I think I made a big step. I talked to her about a lot of things and told her what I was doing with her therapy. Her body wasn't any easier to work with, but I felt at least like I was doing the best that I knew how.

Demons and Delusions

The first time I went in to see I. she almost refused my service. She didn't need a massage. She had better things to do. She was upset with her doctor in fact. She was mad because she had been complaining about this pain in her jaw for months and just now they told her that she had cancer in her jaw and that it was terminal. Maybe she should change doctors and get a second opinion. I convinced her that since massage was included in her hospice care that she should accept my services.

Soon, she looked forward to my visits, though she could never remember when they were supposed to be. Often she would complain. She would complain about the care she was getting (which wasn't bad), she would complain about getting too many visitors, she would complain about not getting enough visits from her son, or that her hair looked a mess!

She always had something to complain about and was really a difficult and hard to manage patient, but I liked her anyways. We talked a lot about things that made us happy. She was so proud of her children and thought they were beautiful. Angel food cake was her very favorite and she became almost giddy when someone brought her a piece. Often she asked if I could stay for tea and have some cake with her.

After a few months she started forget more than what time my visits were supposed to be (which were around the same time every week) and then she started to nod off before I arrived. Then she would still be in bed when I arrived and though she was embarrassed that she hadn't gotten out of bed yet, even though she was too weak to do so. I wasn't too concerned about her because I knew this was going to happen at some point.

But then... then she started looking forward to my visits. Not because I was going to give a massage, but because it was me that was visiting. She seemed so relieved that I came I realized that there was something more to it than I had thought. Maybe it was because I was someone she recognized when she had begun to forget, or maybe because I reminded her of her daughter and we had similar names and haircuts.

I came in around my usual time and knocked on the door. "I., it's me, the massage therapist from hospice." She opened her eyes and looked and after a minute registered that someone was there. I sat down and took her hand and looked into her eyes. Her face was thin, about a third of the size it had been when I first met her. Her jaw on the right side was huge in comparison, but that was where the cancer originated. She opened her eyes as I took her hand. I could tell that she recognized me, but wasn't quite sure who I was. "it's me, the massage therapist from hospice" I say again.

"Oh" she said. She looked away for a second and then open her eyes again. She looked at me closely, but didn't say anything more.
"I'm here to give you a massage" I reply, as I always do, because I'm never sure how much my clients will remember, even if I've been seeing them every week for months on end.
She looks at me again and says :I'm don't know"
"what don't you know, Irene?" I ask.
"I don't know what I"m supposed to do" she says.
"You don't need to anything, you just lie here and relax while I massage your hands like we did last time" I reply with my standard response.
"I don't know what to so she says' as she pulls me towards her closer. She wants to tell me something. Something important, I can tell.
"I don't know what to do, but I can trust you, you won't try to do it"
"What is it, Irene, that I won't try to do?
She pulls my arm and thusly my ear closer to her and I lean in to hear her.
"I'm afraid" she says
"what is it that you're afraid of?" I ask. I expect an answer about her upcoming death. She has brought this up before. "what will it feel like?" "how will I know?" I didn't have the answer then, as I didn't now. I'd never been near death, or felt I was dying before. I had no clue. I didn't know what she needed to hear.
"I think they are trying to kill me" she says while clutching my hand and pleading to me with her eyes to save her from her cancer that has spread from her jaw to her brain and caused her to believe that her impending death is being orchestrated by her caregivers and not by her disease.

I tell her she is safe with me and not to worry and she relaxes a bit and nods off to sleep.

The Beginning

At 30 years old, I found myself in a place I swore I would never go. I was NOT going to be a caregiver. I was not going to be a nurse, I was not going to work with the elderly, I was not going to deal with death, dying, or the stress of it all. My mother has worked in Nursing homes since she left nursing school 35 years ago and I grew up with the stories and the smells of it.

I went to art school. I'm not to shabby with a camera or a paintbrush. I worked in graphic design and hated it. Loathed it in fact.
So much so that when the cultural revolution of the clinton years ended any everyone with no real talent was laid off (including myself) I took the sage advice of my inner loathing and changed careers to massage therapy.

While techinally this is a caregiving career, it had nothing to do with what I had feared since childhood: death.

As, you may have figured though the interweaving of the fates I have found myself working as a massage therapist at the hospice department of the local hospital. Not only are my clients elderly, and diseased and dying... they have less than six months to live.

A writer friend of mine insisted that I write about my expiereces for my own edification and for others enjoyment. So I thought I would try it. Be warned. I have trouble spelling many words, but it isn't for lack of trying.