I have told you some about my client who won't shower. Her situation is such a complicated dynamic. I wish I could just lay it all out here for all of you, because its kind of a fascinating story. To me at least. But for obvious reasons, I need to be careful about how much I share here...privacy laws being what they are.
When I first began this job, I didn't want to do it. I was trying to eliminate work, not add more on, but for various reasons I said I would evaluate this situation and before I knew what had happened, I was knee deep in the middle of it and finding it hard, if not impossible to walk away. For weeks I plotted how I could gracefully quit. This was a particularly difficult client. I had just left a challenging client and really felt I NEEDED a break. I needed an easy run, a sweet little old lady who adored me would do just fine, thank you very much.
This woman didn't want a caregiver and made no bones about telling me I had "stupid" ideas, America was filled with stupid people, only idiots didn't understand the worth in bartering, on and on it would go.....she would become angry and tell me to get out of her house in very colorful language. The good thing, if there is anything good, about Alzheimer's is that you get constant fresh starts. I would leave the room for a few minutes, come back in and it was like I was just arriving and the previous tantrum had never occurred. I was figuring out how to approach this woman through trial and error and it was draining. Remember, I am a people pleaser. I want everyone to like me!
She used to be a medical professional, a big deal in her profession. (And here the poor thing is stuck with me as her caregiver! lol) Her son was here last week visiting and we spent a lot of time talking and he told me her story. I heard about events from her childhood that quite clearly formed her adult choices and responses. I won't go into the details, but there were some tough events. From this conversation, I understood so much. It made so much clear to me.....control equals fear and this woman's control issues were so deeply ingrained in her, for good reason.....I was filled with empathy for her. I started thinking of how I could approach her while honoring her need for control. Not stripping her of it.
Meanwhile the son went into the bedroom to talk to her and mentioned that he had a "nurse" (me, which is a blatant lie) there to clean her up. Hearing that a "nurse" was here changed her whole attitude. A nurse was someone she could trust. Someone she respected. That term had some bearing on her past life, something she could relate to. Having titleless me come in meant nothing to her. "Who the hell are you?" She had nothing to tie me to, no touchstone to reassure her that I knew what to do, that I was a safe person. With this revelation, I began to formulate my plan.
I arranged to come during an evening hour on a day that I don't usually come as the evening hours are better for her. I arrived wearing scrubs (I never wear scrubs) and told her I was a nurse sent there by her dr. That she had an infection that he wanted me to check on and clean up and that we would need to go into the bathroom and do it in the shower. She got up and went in without question. One thing led to another and she let me scrub her hair not once but twice, she let me scrub her body from top to bottom, she let me slather her in lotion and baby powder, she let me trim the back of her hair, she got into clean clothes and climbed back into bed, clean and smelling nice. In 45 minutes I had accomplished what I had spent weeks tip toeing around and trying to find a way to gently bring her along in.
I am not a liar. Lying goes against everything in me and I hate doing it, and really, I am not very good at it either. As I told her my tale I felt anxious and nervous in my stomach, and I had to work at speaking in an even and confident voice. I was just waiting for her to sit up and yell, "Thats not true you liar!" Which of course never happened. Lying to an Alzheimer patient is actually a tried and true method of treatment.....meeting them where they are at, otherwise known as validation therapy.
Our new plan is that I will add this extra evening visit, impersonating a nurse, to our weekly schedule. My other two visits I get to come as myself. What this does for us is sets us free to do whatever she wants to do on those two visits. It keeps the "nurse" separate from our fun times.
Getting to know the *why* behind her behavior made all the difference. I quite literally, as I watched her shuffle into the bathroom to do what I was asking, felt my heart open up to her. This woman who has done so many honorable and wonderful things during her life, who has lived her life being so strong, who now lashes out, pushes away, who is so tired at this point, but valiantly keeps on exerting her control... today, I feel honored that I get to be the one who takes care of her. I think God put me exactly where I needed to be. I think she and I have some lessons to teach one another, some things to learn still.
This video below is so touching....Naomi Feil using validation therapy with Gladys Wilson. It is never too late to connect with someone or to bring comfort with acceptance.