I just finished listening to the premiere of Capital Public Radio’s multi-media documentary series looking at the lives of family caregivers, aired in its slot, “The View From Here.” If you missed it, it airs again tonight at 8 p.m. (listen live here).
Our local NPR affiliate chose to name the special, “Who cares?”
That provocative title was chosen in recognition of the financial, physical and emotional strains that an estimated 65 million Americans face as family caregivers.
I’ve been a family caregiver, and I know two — right now — who are dealing with the kinds of challenges the special describes. I won’t kid you. This special does not pull its punches when describing the hard, day-in, day-out grind of caregiving for children, parents or spouses who are unable to care for themselves. As caregiver Rick Rayburn put it in his interview for the special, “It’s like Groundhog Day every day…”
The special asks an important question, “Who cares for the caregivers and what are they doing to care for themselves?”
Rick’s story really struck me. In it, I could hear echoes from both of my friends who are caregivers right now. For several years, one has been caring for her husband at home; her husband was diagnosed with Alzheimer’s more than 10 years ago. On Monday, he was admitted into hospice, recognizing his accelerating decline and weight loss. The other is also a spouse-caregiver, but a husband who is caring for his wife after a rare disease caused her to have six strokes in a row last summer, at just 60 years of age. Both are loving and devoted spouses, but man, what they are doing is HARD, and they do it largely alone.
In the radio series we meet Rick Rayburn and his wife, Marianne, who contracted a viral brain infection two years ago, and ended up in coma. But even before the encephalitis, the family had noticed signs of dementia. She is able to walk and talk, but has virtually no short term memory, needs to be guided through daily tasks, and alternates between reality and fantasy.
Rick says, “I’m 100% responsible for her wellbeing.” Sometimes, perhaps after he lays out her clothes for the day, she will say, “I don’t know who you are.” “I can run out and empty the trash cans,” Rick says, but he worries about staying away for more than a short period.
Meanwhile, he is facing health issues of his own — light headedness and dizziness that doctors have not been able to explain. He recognizes that his ability to care for Marianne depends on his ability to keep going. He tries to go to the gym and wishes he could go for a run, but when he does, fatigue and vertigo get in the way. When he cannot, he is self-critical.
This caregiver story shines a light on one of the hardest aspects of caregiving: isolation. Rick has a great family, but their network of friends has slowly melted away. It’s a practical problem — as a caregiver, you just can’t get out much — but it also has to do with avoidance by others, and their discomfort with the changed reality.
Rick explains: “Less frequently, people are asking, ‘How are you doing?’ This sucks when you lose your wife or your best friend. It’s hard to relate to people… in a way that doesn’t turn them off. …Sometimes you don’t see people you used to see. …I’ve read that caregivers die before their patients, generally speaking. The kids are going, ‘whoa.’… My daughter wants to know how I am doing, both physically and mentally. She’s the one person I talk to about the difficulties I’m having.”
The radio special included a taped conversation between Rick and his daughter, in which he describes an unpleasant incident earlier in the week. Marianne was trying to go out the front door to wherever she thinks is home.
“She gets kind of entrenched,” Rick told his daughter. “I hollered at her. … You feel kind of helpless at moments like that…. It’s one of those things that degenerates…. She gets mad and gets her stuff, and I have to take her stuff away… She doesn’t want to be with me. I have to go grab her on the porch. That’s atypical. The evenings have been really good.”
His daughter says that she is most worried about her Dad. I know what she means. With my two friends, I know their loved ones are as comfortable as they can be, even happy most of the time. They’re doing a great job of providing loving care. I worry most about them. She says, “He’s doing the best he can. I worry that he’s wearing himself out… And it’s lonely, it’s really lonely.”
Rick talked about the erosion of friends. I’ve heard from family members of head trauma survivors that most of their loved one’s friends can’t adjust to the changed person. “You just wish that good friends of Marianne would drop by every now and then,” Rick told the interviewer. After a brief visit by some friends, Marianne stood on the porch and waved to them. “She said, ‘Thanks for coming, guys.’ It was so heartfelt. I appreciated that they came by. It was something so simple. That moment just struck me so much, how important that was to her…. It is human nature, things begin to fall off. It’s sad to see that happen. What you need to do and I need to do is make those things happen.”
Rick’s mission is “to make every day a good day, despite dementia.” I see my friends trying to do the same thing. “Rick is on his toes all the time, just to keep her in the present,” comments Rick’s daughter, “He is now Marianne’s tether to reality.”
Somehow, when I was a caregiver, I kept going. Even at times that I felt I was crumbling. I see my friends doing the same thing.
How do caregivers keep going? They pray, they accept help, they give themselves pep talks. Rick notes “there are the moments you get really sad. Then you say, ‘let’s get with it. Quit feeling sorry for yourself…. stick with it’. Oddly enough, it does work. It takes you back to ‘this is the deal’ and it’s too bad, but this is the deal.” Another clip of the interview with Rick had this: “With change there’s an upside and a downside… knowing that you will get through it. That’s done a lot to ease the anxiety in this whole deal.”
The other stories are also well worth listening to. Believe me, they will make you count your blessings.
Loretta Jackson cares for both her father, who has dementia, and her sister, who suffered a stroke and is severely disabled. She says she does what she just has to do. She says her doctor tells her, “Quit stopping em, sit back, accept the help.” She admits, “I had to learn how to accept help from others.”
The Lees are parents of Justin, a 16-year-old boy who was born with a brain abnormality that resulted in cerebral palsy. He is nonverbal, has seizures, can’t use his limbs, and is gastric tube fed. He can give a long eye blink to indicate “yes.” Justin’s disabilities are so severe that he would need institutional care if not at home. His parents are deeply committed to making his life as good as it can be, and keeping him at home.
Toward the end of this morning’s piece, Rick tells the interviewer, “Your love doesn’t change,” noting that he and Marianne have been married for 42 years. “Changed as she is she’s still a wonderful person, and thank God she’s still with me.”
Full length stories can be found on Capital Public Radio’s website, which also lists resources to help caregivers (and those who love them).
Author’s note: I typed quotes as fast as my little fingers could go. My apologies if I didn’t capture every quote perfectly. Hat tip to my Dad, who made me take typing in case I ever needed to support myself. Grin.