Picture this: a busy emergency waiting room, noisy, chaotic. The triage nurse finally has a moment to take a breath and notices an elderly woman sitting by the window. She realizes the woman has been sitting there for a long time, yet has never come to the triage window. Approaching the woman, the nurse notices confusion, and the odour of urine. Pinned to the woman's coat: a note that says "We can't do this anymore."
The story is, unfortunately, true. There have always been cases of what we call the "suitcase sign," where families bring elderly parents to the ER with a suitcase, clearly not planning to take them home. Lately, there have been more of these drop-offs; sometimes, family members rush away and turn off their cell phones, or say they'll be back and don't return. The note pinned to a coat, without even approaching triage, that was new.
"We can't do this anymore" may feel like a cop-out, but it is clearly a cry for help. It's a call out to the so-called support services to "keep people at home;" a statement on the general stress and burnout of caregivers. Years of COVID restrictions, loss of activities, loss of socialization, loss of services, and many of our elders are now weaker physically and mentally. Caregivers cope with all the stressors of the pandemic aftermath: rising costs, workplace changes, manpower shortages, medication shortages. Picture an elderly parent or spouse: perhaps confused, falling, incontinent, wandering at night, aggressive. Maybe the caregiver is elderly as well, or there are multiple generations living together. Maybe the caregiver lives out of town and now realizes daily care is required. What are their options? Home care is stretched to the max. Private help costs money. Even the Senior's Day Program, while essential, would be more helpful if there were different levels of activity. Like kids, people don't want to go if they aren't stimulated, or if they feel they're being pawned off on someone.
Ideas: a drop-in centre where caregivers could sign out for a couple of hours, either to get time to themselves or to socialize with others.
-Education for managing difficult behaviours, falls, incontinence (education how? when? where?). All must be low or no cost, preferably bilingual or multilingual, easy to access, culturally appropriate. That's a tall order, of course.
-Training younger/able seniors to help out with older/less able seniors. Or, trying to get younger people interested in elder care (eg. high school volunteer hours, arrangements where students live with elders needing assistance).
These are all difficult options to consider: logistics, training, liability. All I know is, something needs to change, because people will keep aging and falling and getting dementia and cancer, and we're going to need a plan to support them, and their families. Any ideas?
Hi, I'm Karen. This space is a chance for me to get some of those notebook sessions out there: Motherhood, medicine, writers and writing, the state of the world. Non-published, sometimes non-polished, just a chance to open a discussion. Let me know what you think!