Monday, February 23, 2009

Tell Me, Doctor

I recently proposed to teach a course on caregiving for seniors to a noncredit educational program that would focus on financial concerns, getting and giving care, nurturing relationships and facing challenges of extended caregiving. The course was approved, but it had to be canceled because of insufficient enrollment. Now I can imagine that the economic downturn was a factor in the low enrollment, but I can't help but wonder if another factor had even more weight. Caregiving is perceived as something not worth studying.

Perhaps it’s because many caregiving tasks are viewed as common, normal activities, like preparing food, making appointments, getting groceries, doing laundry. What’s the big deal? These activities may be part of our normal daily routine, but when we are doing them for someone else on a protracted basis, we are assuming responsibility, whether a little or a lot, for the care of another adult human being. Whether preparing a meal or dispensing medication, caregiving becomes a big deal over time.

So many times I have heard caregivers say, "if only I'd known…I would have done things differently." Too often caregivers find themselves committed, but unprepared to meet their loved one’s escalating needs. The older we get the more likely it is that our friends and family members will need care, just as we will one day need care. Wouldn't it be wise to learn as much as possible about the subject? Wouldn't it be a good idea to acquire some skills so that we didn't have to learn only from our mistakes?

The low enrollment for my course offering was disappointing, but as often happens with setbacks, it got me thinking. The only way to get folks to even consider taking classes on caregiving is for doctors and hospitals to recommend them, like Lamaze classes for pregnant couples. This would require that medical professionals acknowledge that much care now happens in the home. They need to be open and honest about prognoses and the amount of care that may be required as the illness progresses.

I envision a day when a frustrated and frightened family member can ask her mother’s physician, “Tell me, Doctor, what should I do?”, and hear something like the following. Your mother has severe chronic obstructive pulmonary disorder. Here’s the prognosis…. She will need…(equipment, services, resources). Wherever she is living will gradually become a mini-nursing home. Her care needs will escalate over time and this situation could go on for several years. We have a class here that can help you to learn more about giving and receiving care in general and for COPD in particular. This way you can be prepared.

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