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The following is an Assisted Living Services, Inc. guest post from Geriatric Care Manager Bernadette DiGiulian of Elder Caring LLC.
Families often enlist a Geriatric Care Manager when they are living at a distance from an elderly relative or when their lives are very busy and they are unable to manage a comprehensive approach to the care of their loved one. Geriatric Care Managers assist clients in achieving the best quality of life possible. When a client is at a point where twenty-four hour/live in home care is necessary, their lives are usually quite limited. A person who may have been very active in the past, is now for the most part, confined to home. The person may have been very active in sports, clubs, dancing, intellectual pursuits, church etc. but much of this is no longer possible.
I believe that although a client may have diminished health and age related losses, much of what that client is interested in can in smaller ways, be recreated in the home with teamwork between a Geriatric Care Manager, a 24-hour caregiver and their supervisor, as well as other caregivers.
In the case of John and Louise Higgiston, as the Geriatric Care Manager, I did thorough assessments and had ongoing conversations with the couple, knew them to be people who had been very much aware of their physical, social, spiritual, intellectual and psychological growth. They had been athletic, had been dancers together, both graduated first in their college class, were avid readers, were devoted to their faith and their church and had to cope with a lifetime of caring for a handicapped child who spent 60 years living with them at home.
Akua Fisher, the 24-hour caregiver employed by Assisted Living Services, Inc. was very intelligent, astute and willing to learn. From the time she was hired, she was very much involved in conversations with me and asked questions about all aspects of life and care. She grew devoted to the Higgiston couple and began to provide many interests the clients had enjoyed in the earlier part of their lives. She would always accent the devoted ways they are as a couple. Although John has advanced memory loss, he never looses site of the fact that his wife Louise is the love of his life. He still winks at her, looks to her for clarification and can talk about many things of the past. He can share the story of their meeting and courtship and Akua listens and encourages this story over and over.
John and Louise loved to sing and dance together and their dancing as they say “took everyone else off the dance floor”. I got them a CD player and many CD’s with their favorite songs from the past including Irish songs that John loves, songs from World War II, and Gene Kelly’s “Singing in the Rain”. Akua did not simply accept these but she too has learned all the words so that she can play and sing with the couple, to encourage this wonderful memory. Although John can no longer dance, he enjoys watching Louise when she moves to the music. Stories then are told about their dancing days from the past.
Louise was a terrific tennis player and John an avid golfer. Along with conversation about the sports, Akua finds special tennis and golf games on TV that they all watch together. Recently when the US Open Tennis was on, Akua knew all the players, who won, who lost and shared this daily with Louise. The interest was high. John talks about playing golf (in his dreams as we know) but he is encouraged to continue talking as if he is an outstanding golfer. Akua dresses him in golf shirts and sometimes even a golf hat for going outside.
The couple is also very religious. Hymns are played and sung and the caregiver has a nightly ritual with the couple. They say their prayers together with her help, they kiss each other goodnight and then off to bed.
Akua gets the newspaper and encourages some conversation about the news and the weather. A continual awareness of local news is stressed.
Akua calls the Geriatric Care Manager with any changes, or new concerns and together solutions are found and the best possible care is provided.
Recently, John went on Hospice Home Care. Now, the Hospice Nurse, the Hospice Relief Aide, the Hospice Social Worker, Akua, the supervisor from Assisted Living Services, Inc., and and I all work together to encourage quality of life even in some of John’s more difficult days. Most importantly, we all strive to keep this couple in their home together.
Because John and Louise love celebrations, parties and a good time, we provided a great birthday party for each of them in the home. They choose their favorite foods and I give Akua a night off from cooking and bring the food. Akua decorates the table beautifully and uses all of the old “company dishes”. Favorite music is played, and songs are sung. A favorite birthday cake is presented for all to enjoy. At John’s 92nd birthday, he was singing “It’s a Long Road to Tipperary” (video below). Although John would not remember this the next day, in the moment he is very much present and having a wonderful time. He is truly “in the moment”, something we all could learn to do…to be in the moment.
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As recently as last week, we (John, Louise, myself, and the Hospice Aide) gave a birthday party for Akua. Foods she requested were brought in, bubbly drinks were provided, glassware raised and “clicked” for a toast, and African music was played.
Louise at 92, danced with Akua to her native music and John smiled widely as he enjoyed watching his wife and her dancing talents. Jokes were told, and after much food was eaten, chocolate and vanilla birthday cakes were brightened with candles and everyone sang Happy Birthday whole heartedly, John and Louise were giving the gift of a birthday party to their aide who they love and appreciate. Of course their aide felt loved and appreciated. And I and the Hospice aide did all the cleaning up!
In all this, life goes on in what most would call a compromised situation, fun, love and care are always present. The physical, social, spiritual, psychological and intellectual needs, which are appropriate for the time, are being met…and this is possible with teamwork and deep care for the highest quality of life for this couple. Their life and their interests do not stop. With the quality of care Akua administers, with her support network, this couple is truly living and the caregiver is truly appreciated.
Bernadette DiGiulian
Elder Caring LLC http://www.shorelineeldercarealliance.org/members/bernadette-digiulian[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
