HEALTHCARE AT HOME:
THE  ROWAN TECHNOLOGY REPORT

Serving the home health, home care and hospice industry since 1999.

Like many in their age group, my parents, at 91 and 87, still live in the house they bought shortly after they married. Though the fact of that is not constantly front and center in my awareness, its significance hit me squarely between the eyes earlier this year when I visited my childhood home for a few days to give my mother, Dad's primary caregiver, a few days off.

As I helped Dad navigate his morning routine -- bed to walker to bathroom to walker to the table in the extended kitchen he built with his own hands -- the bathroom, admittedly an odd place for deep meaning to present itself, spoke to me. Modern cabinets and fixtures faded from my view as 50s-era linoleum and sinks reappeared and the shadowy figure of a very familiar-looking little boy appeared, perched on an antique training seat atop the toilet.

Shaking off the vision, I removed a soiled pair of the "special pants" we had to force on Dad last year and replaced them with clean ones. As I guided his halting footsteps toward the commode, the boy said, "He used to do the exact same thing for you in this very room."

The realization transcended mere memories of the days when Dad was big and I was small. It was more important than that. Here I was, caring for my frail, incontinent father, not just in any room but in sacred family space, the same room where he had cared for me, given me baths, bandaged my knees and taught me to shave.

Dad does not often speak today and, this time, it was just as well. If he noticed the redness that was surely visible in my eyes, the redness that returns as I write this, he did not mention it.

Dad's legs barely hold him up today, partly from age, partly from living 68 years with some kind of primitive cement-based compound that was inserted in his right shin in 1943 to replace a 4-inch piece of bone that had been shattered by a sniper's tracer bullet. According to a hometown news report at the time, he had apparently run screaming and waving his arms down a Belgian hillside to draw the sniper from his nest, where the sniper was holding a company of G.I.s at bay. The small band of brothers did finally take the town; one small, forgotten component of the Allies' victory at the Battle of the Bulge. "My buddy got the guy who shot me," was the legend I grew up with.

His actual brothers once pointed out to me a three-story Pennsylvania house where they had lived, three-to-a-bed, during the Great Depression, apparently anxious to ensure I knew my heritage fell somewhere between courageous and nuts. "Your father used to do handstands on the top of that chimney," they claimed. It was not fraternal joking; the story turned out to be true.

These are the kinds of memories that make tolerable the work of the family caregiver, a person continually aware, "This is a human being who, though approaching the end, was once young and self-sufficient, a breadwinner and parent, who coached Little League and met his life partner at a square dance, who was capable only a couple years ago of cradling his great-grandchild in his arms."

Certainly, family caregivers work hard and grow weary, sometimes short-tempered. Yes, they often compromise their own health by putting someone else's health needs first. Of course, they save the Medicare Trust Fund millions, perhaps billions, of dollars every year. I have written about these things with an air of "this is newsworthy" but, it turns out, they are secondary to the family caregiver experience.

What is primary is that ever-present awareness, "This shrinking body and slowing mind are not the full story of who this person is." It would be a great gift if they could put across the full story to people who meet him at age 90 for the first time, people such as home health nurses, therapists and aides.

Family caregivers do not see a 90-pound 90-year-old, they see the soldier, the square dancer, the Little League coach. Whether dressing him or cleaning him or reminding him of his grandchildren's names, there is no moment when the feats and legends of his youth are not vividly present, living not only in what is left of him but in the people who inhabited the house he built and made sacred by more than 60 years of memory-making.

Every time I walk him from the bathroom to the kitchen, I steal a look over my shoulder at the seemingly ordinary suburban bathroom. A little boy smiles up from his comic book at me and says, "Take good care of him. He's my Daddy."

Tim Rowan
December 7, 2011