Since Dad came home from hospital it’s become part of my morning routine to visit him before I go to work. This is apart from my evening visit which I’ve come to enjoy very much. I’m not really sure if the morning ritual is to make me feel better or to make sure he’s getting a good start to the day. I guess it doesn’t matter much. I drop in at the newsagents to buy a newspaper and fresh rolls. A daily paper has been a priority for Dad as long as I can remember and the rolls mean he has something to eat in the afternoon when his stomach tells him dinner time is too far away. If I don’t bump into the carer I check he’s had his medication and breakfast and that he’s got everything he needs and that the place is tidy. If I do bump into the carer and it’s the one that makes thick and lumpy porridge (she can only make it in the microwave apparently and he doesn’t have a microwave because he almost blew the last one up!) I’ll make it instead. I’ve become much better in the porridge making department and realise that the phrase ‘novice to expert’ doesn’t only belong to the nursing profession.
I think about choices and notice that Dad’s independence is giving way to paternalism that’s been lurking in the shadows waiting for permission to come out. But I know what it’s up to and I’m about to reel it in.
I’ve been asking myself if person-centred care is completely achievable or is it simply aspiration. What does working in partnership really mean and what about being open to rethinking ‘recovery’ and the possibilities that brings?
I put myself in Dad’s position …
If I wanted a long lie tomorrow morning I couldn’t because the lumpy porridge making carer comes in at 8.20am to shoe-horn me out of my bed (so she can make it) and talk me into having toast (that’s too dry and catches my throat since my stroke) or cornflakes while I take my tablets that I can’t be trusted to take by myself any more. I should tell her I like grapefruit segments. My daughter also arrives around this time to make sure it’s all happening. Oh, believe me, it is. She bustles about (fusses too much … I wish she’d just sit down and have a cup of tea with me) and makes sure there’s boiling water and Steredent for my teeth and, if I’m not still in my pyjamas, she checks I’m buttoned up, zipped up and tidied up. While I’m adjusting to waking up, busyness has moved in in the form of two women and taken over my flat and my life! I’ll be glad when the carer’s done her bit and recorded it in the book she records things in and the daughter’s away to make a difference in the world of mental health because all I want to do is watch the news and channel hop hoping to avoid another episode of Tricia. Sigh.
There is a tendency to group older adults together into one homogenous blob. I’ve seen it. We do it with young people too. My own fear is that one day, when I’m 81 (or, perish the thought, sooner) I’ll end up with a short curly perm that makes me look exactly the same as every other 81 year old because the hairdresser comes on a Tuesday and thinks that’s the best option to last till next Tuesday and I wouldn’t have the confidence to say no (even if asked) and nobody else notices or cares enough. Frown.
I understand the need to create a world where older adults feel valued and respected. A place where the words hope and recovery and dignity can be used freely and without fear because people realise the potential in these words.
I’m learning that recovery for my Dad isn’t about returning to how he used to be. How can it possibly be? It can’t. Instilling hope means me stepping back as he leads the way. My job is to help find ways to help him live as meaningful a life as possible despite the mental and physical health problems that have been verified by diagnosis. We all long to be recognised as the unique individuals that we are. This doesn’t stop or change when we get old. We need care that is personalised and co-operative.
Person-centred care isn’t easy. It takes patience to be an observant listener with a willingness to exceed expectations. It’s not a dream. It’s what we should be striving for. If we fail we rob people of their uniqueness and make less of their lives than they truly deserve.