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Wednesday, March 26, 2014

Top Ten Things I've Learned from Working with the Elderly

Jules here-

As some of you know I do have a side-job to my homeschooling, homemaking, and parenting- I am a home care occupational therapist. I wanted to work in healthcare since I was 5 years old when I read a story about Clara Barton; at thirteen, I volunteered at a nursing home, and I eventually worked there for five years.  I had read this book about a girl who volunteered with the elderly, and it seemed so interesting and fun!
Working with the elderly (and I mean 80+ years old....) can be rewarding, challenging, and just plain funny.  After 20 years of interactions with the senior population, I have definitely gleaned some wisdom from them.

10. All bodies wear out.  As much as Maybelline ads try to convince you otherwise, wrinkles and sagging happen to everyone.  I have had former Rockettes, models, and athletes; yet, gravity and the sun reduce all of them to a wrinkled shadow of their former beauty.  Does that sound sad? NO! Instead, it makes me realize that beauty is only skin-deep. The elderly who embrace their age (I'm not saying that they "let go" of themselves) always age more gracefully.  They wear age-appropriate clothing, they don't slather "young" make-up all over their faces, and they keep their hair manageable.  There is a beauty in aging; I've seen hundreds of elderly bodies and their scars, wrinkles, and sagging tell the unique story of their lives.

9. Old people are people. Sounds obvious, right? We had a 98-year-old guest lecturer teach a class in college, and she began it by asking us to describe old people.  Words such as "cute, confused, crotchety, smelly, grumpy, sweet.." etc. decorated the board.  She then asked us, "Which of these words could only describe an old person-- we couldn't find any.  Do you know some grumpy, rude 30-year-olds? Guess what? They typically turn into grumpy, rude 90-year-olds.  I've had the sweetest, smartest elderly patients, and I've had the meanest, rudest ones too...

8. You can always wash your hands. Anyone who has worked in healthcare knows how gross our jobs can be.  From adult diapers to wound care, I have experienced some revolting things.... however, I have the mantra, "You can always wash your hands" and wear gloves.  So when I had children and had to change an infant diaper, I thought, "Well, this is easy."  I never cringe when poop gets on my hands or vomit hits the floor (o.k... vomit gets me a little) . 


7. Use your brain. A lot.  Dozens of studies have reinforced the logical assumption that if you use your brain, you won't "lose it".  Engaging in challenging games, completing crossword puzzles, and reading books/newspaper can help keep your brain "young" as you age.  Patients who play cribbage or learn new games to play with their grandchildren always are more engaging and sharp-witted.  So that's my excuse for my online word-gaming addiction and hoards of sci/fi & fantasy novels....


6. Never say never.  Many people develop living wills when they are in their 40s and 50s thinking, "I would never want to be tube-fed" or "I would never want to live if I couldn't walk!"   From 14 years of rehab experience, you will never know what your actual situation will be. I've had people who have a swallowing dysfunction who need to be tube-fed, yet still can walk, think, and even talk!  So you might want to appoint an advocate to interpret your living will, so doctors don't do it for you.

5. With age comes wisdom.  Are all elderly people brilliant? No! BUT, think back to yourself in high school, wouldn't you want to yell "WHO CARES WHAT OTHER PEOPLE THINK?!" or some other choice words? I look at myself three months ago and want to scream sometimes.  Imagine being 97 years-old and working with a "young-un"--their words to me are often so much more poignant and credible. Their perspective often helps me view a personal situation with more clarity.  Always ask an elderly person about "their story," I often find out the most fascinating war stories, romances, and accomplishments of my patients just by engaging them in conversation.  I've had the patient who created the door mechanism on the infamous Enola Gay, a national geographic photographer who survived a shark attack, and had a couple who had been married for 77 years....of course I want to learn something from them!

4. Moderation works. Don't get too fat OR too thin.  That's my best health advice for living a long, full life.  Obesity contributes to heart failure, diabetes, joint discomfort/break-down, etc.  Conversely, being too thin contributes to osteoporosis, weak muscles, an increase in falls, etc.  Keeping your muscles active and strong helps moderate your weight and prevent weakness.  Not smoking or drinking heavily helps too....

3. Forgiveness should trump everything.  I have had patients who have long-standing feuds with sons and daughters; their own resentment and loneliness taints their entire perception.  Resentment festers inside people, and my most crotchety patients typically have burned every bridge in their family. Some of my oldest and wisest patients have admitted that their own stubbornness created their lonely existence.


2. Social connections matter.  When an elderly patient is connecting with his/her community, he/she has an unparalleled support system.  I have a patient right now that never married, yet, she was a volunteer with Meals-on-Wheels for twenty years, attended church regularly, and hosted a bridge club.  Since coming home from the hospital, she has had dozens of visitors who bring meals, flowers, and well-wishes.  Though she is in chronic pain, her friends and neighbors offer her the hope, kindness, and physical assistance she truly needs.

1. Empathy.  Any profession involving caring for the sick, dying, or disabled requires patience and understanding.  As a rookie O.T., I often cringed at some of the menial and disgusting tasks that I had to perform.  One especially caring coworker of mine said once, "Imagine if this patient was your mother or grandmother. How would you want someone to treat her?"  So no matter how challenging a patient is, I reflect back on those words.  I try to recognize the humanity in each of my patients, and try to give them dignity, respect, and kindness.  And if they are especially cranky, I try to imagine how lonely they must truly feel.



And for a heartwarming tale, watch this:


I will eventually do a post about the funny side of working with patients-- I might have some guest-contributors for our top ten favorite hospital stories....

Easy Rule #3908- Let's be a society who appreciates the wisdom of the elderly, and treats them with respect and kindness.

Easy Rule #59098- Working with patients isn't for everyone... but if you do--appreciate what they can offer you as well!

Easy Rule #459- Always wear sunscreen.


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