Essaying the Situation
Saturday, December 18, 2004
 
Caregiver's Day
    Ever wonder why there's a National Secretary's Day but not a National CEO's Day? Of course you haven't. CEOs are well enough compensated, not only for their position but for their years of what may have been undercompensated apprenticeship.
    Every wonder why there's a Mother's and Father's Day, even a Grandparent's Day, but not a Kid's Day? Of course not. Every day's a kid's day, some days, such as religious celebrations involving gifts and birthdays, more so than others.
    The people who have "Days of Appreciation" scheduled for them are exactly the people who don't receive nearly enough compensation for or help with what they do. Their "Days of Appreciation" are an attempt, I think, to mollify them so that they don't, during a particularly stressful stretch of service, go off the deep end and suddenly refuse to serve in the undercompensated capacity to which society has assigned them. It's a shallow and not wholely successful attempt, to be sure. Despite a glut of "Days of Appreciation", our society continues to foster droves of parents (primarily fathers, interestingly, considering that men are more used to the idea that service demands adequate compensation) and service workers who "inexplicably" abandon their duties and leave those depending on them in the lurch.
    It wouldn't surprise me if, as I write, someone, somewhere, noticing the ever increasing number of what could be considered avocational caregivers being pressed into service and the ever decreasing number of inadequately compensated, thus, unreliable professional caregivers, is trying hard to establish a "Caregiver's Day", under the assumption that it might help ease our increasingly tense national caregiving situation and allow some breathing room for people (on their own, of course, and, primarily already involved caregivers) to figure out how to modify this situation to everyone's benefit.
    No one likes to squarely face the state of service work in the type of economy in which we live. Having to do so appears, initially, to undermine all our hopeful "positive thinking" philosophies and starkly keep-the-money-flowing "Thank You, I Appreciate You" holidays. Such considerations also appear to threaten the possibility that people, primarily women, will continue to devote themselves "naturally and selflessly" to the care of our children, our elderly and our infirm. I think, though, that the difficulties have to be faced, squarely and uncomfortably, in order for the current caregiving situation to change. Let me tell you, from the front, without delicacy or apology, how it feels to be "appreciated" for my caregiving.
    Curiously, the only "thank you's" I receive that don't, in some way, irritate me are those from strangers who notice my mother and me and in public, approach me and thank me for taking care of her. Sometimes these are people who have taken care of parents. Sometimes they are people who are related to a dedicated caregiver of one of their parents. Although I'm open to the unabashed goodwill of such thank yous, it has puzzled me why strangers would thank me for taking care of my mother. The opportunity recently arose for me to question a stranger who was so moved. The blogger brainhell's reply was as follows:
I guess I thanked you for taking care of your mom because we all like to do good things for other people, and like people who do good, even though the actual doing is so hard. And I guess maybe it's some form of wanting to receive mercy if or when we ourselves are in straits. You could call it selfish but it's probably agape.
    The honesty of his response brought another consideration to mind: Often it is awkward and difficult to thank a family member for taking care of another family member because there is an unspoken undercurrent of, well, something unpleasant detected in the caregiver. I am no exception. My mother and I enjoy cut flowers so much we often buy them for ourselves. We love cards, especially those with newsy letters attached. Although it's neither fun for me to admit this nor pretty for anyone to hear, the truth is, with every bouquet of flowers, card, or verbal thank you I receive from my relatives, underneath my sincere delight and appreciation is an ashamed, internal, automatic reaction: "Well, there's another day someone won't be available to take over for me; there's another care-free vacation from caregiving I won't be able to take; there's another inadequate attempt I'll have to make to partially refresh myself in the midst of my constantly intensifying responsibilities; there's another doubt that, if something should happen to me, no one I trust will be prepared to adequately pick up the slack in my mother's life."
    I try very hard to hide the force of this undercurrent. I don't want to lead people, especially those I love and who I know love me, to believe that I don't revel in the few but magnanimous times when a relative has covered for me; when one of them has performed indirect but complimentary chores for my mother and me; the flowers and cards and profuse thank yous and notes of appreciation my mother and I have received (pretty regularly around recognized holidays, birthdays and during very occasional visits); the extraordinary sounding board I have in one of my medically trained sisters who has been invaluable in helping me gain the knowledge and confidence to defy the medical establishment when necessary; the thoughtful, much appreciated gifts. In fact, I am full of inadequately expressed gratitude for all these, especially considering that I almost never have the mental or emotional space to acknowledge their birthdays, holidays, etc. My life's history is not that of an ungrateful, unperforming wretch. If it had been, I wouldn't be here with my mother, I wouldn't have spent the last 10+ years taking care of her, and I wouldn't experience the many periods of exhilaration, gratitude and reverie afforded me by not only doing this for and with my mother, but being available (through situation, character, and the peculiar way I've lived my life) to do it. Yet, the gods forgive me, I remain so completely overwhelmed by the task of taking care of my mother alone that I periodically have to fight both anger and depression and am not always and completely successful. I know that, either by social sense or reading my "therapeutic outbursts" in my journal, all my relatives are a little afraid of extending themselves in whatever ways they are able, simply because they might risk a face-to-face outburst. In addition, the matter is complicated by knowing that all of them are independent, underappreciated (if not by their families then by their society), unpaid primary family caregivers who are trying desperately, as all caregivers do, to seek their compensation in the only ways this culture makes available: The twin practices of positive self-talk/taking themselves to task for feeling unrewarded; the sentimental published homilies provided by those who have never given intense care or are master self-illusionists; and, not only cherishing but worshiping the times when they hit their stride and are experiencing, unadulterated, the inspiration and exhilaration inherent in caregiving.
    I have the support of a family of friends who have been extremely helpful, in a variety of ways, to me as I give care to my mother. The primary caregiver of this family took care of her elderly father in home for several years. During some of those years I was able to help her out. When they visit, their eyes are as trained on my mother as mine are. Never does an extended visit go by but what they don't tell me to "go take a nap" while they "keep an eye on Mom", of which I gratefully take advantage. When the primary caregiver of this family detects that I'm going through a caregiver funk she blatantly tells me she's worried and immediately responds with ways to try to ease my burden or my feelings. I perennially forget to expect their concern and their help and yet, there it is, regularly, touching me on the shoulder or, sometimes, grabbing me by the scruff of the neck when I get in so deep I am foolishly refusing contact and help. Interestingly, they have never thanked me for taking care of my mother. In fact, the thank yous, generously, rightfully and sometimes, I regret to say, not often enough, flow the other way.
    By now, everyone is tired of hearing, "It takes a village to raise a child." Why? Because no such village exists in our culture and our cultural propaganda is that it is "natural" that mothers be the almost exclusive primary caregivers to children, that children be the almost exclusive primary caregivers to elderly parents and that any relative who's available be the almost exclusive primary caregiver to those with "special needs", and, as well, that professionals not only can but should be relied upon for help above and beyond family and are a concern free resource; if the caregiver can't let go of her concerns, that's her problem. If our cultural caregiver set-up is so natural, how is it that, in other parts of the world, exactly the opposite is considered "natural"?
    The resistance to our cultural recognition of caregiving as a community affair that can and should be compensated with elevated survival status to everyone who gives care doesn't only come from those who have never practiced primary caregiving. Just as there is an undercurrent of resentment in every informal (and, many undercompensated formal) primary caregiver(s) who ever accepted a "thank you" from a family member who is unable, for whatever reason, to participate in caring for a shared relative, there is a social undercurrent of resentment among all types of caregivers in this nation toward any caregiver who complains about the lot of caregivers, in particular or in general. The consensus is that millions of people (primarily women) throughout the ages have met these challenges "adequately", often without complaint, "I'm" doing it, too, so why can't "you" just shut up, buck up and get back to "your" job? Millennia of the neglect and abuse of caregiving due to staunch individualism, though, is not a reason for the situation to continue. This is no way to honor the memories of our past primary caregivers, let alone the reality of our present primary caregivers. If our culture is so damned good at producing and supporting primary caregivers, why is our international status as a nation who cares about its children so low?
    If I was to design a Caregiver's "Day" that was truly useful to me, here's how it would play out:
    One day every month someone who knows my mother or is interested in getting to know my mother, perhaps a relative, perhaps not, would show up. This person would follow me around from an hour or so before I awaken my mother until after she retires and I have performed the last chore directly related to taking care of her. This person would take notes (both of her/his own accord and at my direction) on every item and issue involved in my mother's care, observe what I do, how I do it and how I interact with my mother under all circumstances.
    On a second day every month this person would appear at the same time as previously. She/he would give care to my mother under my supervision while I observed, suggested, reminded and corrected him/her. This second monthly day would allow my mother and the substitute caregiver to become familiar with one another, adjust to each other's personalities and methods and design a relationship which both my mother and I could trust would be in her best interests when I need a vacation from caregiving.
    Both of these days would happen once a month because my mother's care changes, either in intensity or by method, at least once a month. Having these two days a month under her/his belt would allow the substitute caregiver to observe these changes so she/he wouldn't be thrown by new routines or conditions that need to be addressed on a daily basis. As well, some of these months would no doubt happen during periods of time when my mother was enduring short term out-patient treatment for some medically related condition, or hospitalization. Thus, the substitute caregiver would be exposed to the oversight caregiving necessary when medical providers come into play.
    Then, during predetermined times throughout the year, my mother would experience periods when this well prepared, very familiar substitute caregiver was her only caregiver. Because the caregiver would be so familiar with my mother and her care and have a working relationship with her, I'd be able to refresh myself without concern about whether my mother was being accidentally or purposefully mistreated, whether she was safe and receiving every aspect of care that is and might be needed and I'd know that, if urgent medical conditions arose while I was vacationing, they'd be taken care of adequately and with only as much of a possibility that my mother would be medically mistreated as exists when I am overseeing her medical care. I would also be sure that, in the event of a personal emergency that took me out of the primary caregiver racket, my mother's care would continue satisfactorily without reason for me to worry.
    I'd also have a type of partner in my mother's care who would automatically provide me with a specifically knowledgeable sounding board, would be motivated to think about my mother's care both "on and off duty" and offer meaningful suggestions and feedback. My mother would benefit from the stimulation of having at least one other person provide, in her/his eccentric style, the type of interaction that is autonomic assurance that she exists within a community of people who not only appreciate that she is alive but consider her life a resource worth many continued visits and interactions.
    So, whatever you, as a nation, do, for or to the growing ranks of caregivers to the elderly and infirm, give us some days to prepare you then give us some days when you are the caregiver, but, please, don't give us a "Caregiver's Day".
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