HELP LINE: There are steps to making in-home care work

LET’S BEGIN TODAY by making what might or might not be an obvious observation: The vast majority of us will never see the inside of a nursing home, unless we (a) work there, (b) are visiting somebody there, or (c) are in for short-term rehab, so if that’s something you’re walking around being afraid of rest assured that it’s statistically unlikely.

Given that, let’s move on to overstating the staggeringly obvious: The vast majority of us would prefer to live out our days at home.

Granted home might be a retirement community, an assisted living facility, a stick-built house, a mobile home, a yurt or an igloo, but home is home, and that’s where we’d rather be. Period.

So what?

Well, I spend a lot of time talking to families about how to help Mom or Dad or both or whomever do exactly that, because (a) it keeps me off the streets, irresponsibly consuming precious parking spaces, and (b) those families want to help Mom or Dad or both or whomever do what they want to do, so do you know what we often talk about?

Right: Getting help into that home.

And help usually will take the form of another human being, whether that human is called a caregiver, an aide, a nurse, a housekeeper, a companion or a live-in … live-in?

Yeah, we’ll come back to that, but first, consider this: Do you know what all those names and titles have in common?

Right: A stranger.

Oh, sure, sometimes you can find somebody you know, have met or who comes highly recommended by a friend, or maybe a friend or family member leaps into the breach, but often, help equals stranger.

The first miracle was probably getting Mom or Dad or both or whomever to even accept the idea of help coming in, because you know what message that sends?

Right: You can’t do it alone.

Would you want to hear that? Neither would I.

And now I’m being told that I have to accept help in my home from a stranger?

That’s going to go down sideways; in fact, I’ve seen care receivers torment (and, sometimes, inadvertently kill) people they purport to love because they insist that they will only accept help from her or him, but that’s a tragedy for another day.

For today, let’s just stay with the idea of a stranger.

Think about it: If it were you, what comes to mind?

Oh sure, we’ll assume that you (or someone) has done all the obligatory background checks and double-checked references and blah blah, so the possibility of paying (yes, paying — remember, this is a business relationship) a predator has been minimized, but still, what comes to mind?

Someone who cleans differently, cooks differently (never mind probably eats different foods), cleans up differently, goes about things in a different order, probably has different preferences about temperature, light, noise or pets.

Someone who will have to park somewhere.

Someone who will have to put their stuff somewhere.

Someone who might want to take a break or get a phone call.

Or eat. Or sleep.

Or have things come up in their lives that they have to go deal with.

Depending on what kind of help we’re talking about, such as the very personal side of personal care, people who might bathe differently, or even (yes) toilet differently. Wow.

And if this person is going to live in, everything we just mentioned plus about a million other little day-to-day realities will be magnified magnificently — it will change your life.

Are you ready for that? No?

Then why, pray tell, would you expect Mom to be?

It’s absolutely true that we all hear wonderful stories of paid caregivers and care receivers who have bonded and become “family.”

It happens and it’s lovely.

We also hear stories about predators that can even sink to abuse and financial exploitation.

It happens and it’s horrible.

But the vast majority of these situations are somewhere in-between, and in spite of everything I just said (barring the occasional personality conflict), they work surprisingly well most of the time.

Here’s what makes them work:

• Good, decent people on both sides of this business relationship genuinely trying to make it work;

• Everybody remembering that underneath it all it is a business relationship;

• Patience;

• Honesty;

• Flexibility;

• Everybody genuinely trying their best to listen, to hear and to be fair;

• And negotiation.

Right: Negotiation. Ongoing negotiation.

Start slow, if you can — an hour or two, here and there, doing easy stuff. Has anybody killed anybody yet? No? Good.

Then, maybe a few more hours, here and there, maybe some harder or more personal things, step-by-step, day-by-day. Be honest, listen, negotiate.

Tell the truth: This is an invasion. It is an intrusion. There have to be … adjustments.

And remember that caregivers have lives, too.

Again, this is a business relationship, not indentured servitude.

You want to be treated well? Or have your loved one treated well?

Then, treat the people who are helping you or them well.

The Golden Rule isn’t rocket science.

And here’s one more thing that most of us need to remember:

Respect, like contempt, is earned.


Mark Harvey is director of Clallam/Jefferson Senior Information & Assistance, which operates through the Olympic Area Agency on Aging. He is also a member of the Community Advocates for Rural Elders partnership. He can be reached at 360-452-3221 (Port Angeles-Sequim), 360-385-2552 (Jefferson County) or 360-374-9496 (West End), or by emailing [email protected].

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