As a PCA (Personal Care Assistant) I work with many different people. I don’t have a specific set schedule but I fill in for regular pcas when they can’t make one of their scheduled days. In the process I come in contact with people that have a lot of physical and mental issues. Sometimes they have problems coming to terms with what is happening to them.

I am not a psychologist. I can only listen to them and perhaps offer an opinion if they ask. For example, I have one client who seems to have been hit with a lot of things at once. Instead of being able to work on one problem at a time he is overwhelmed with trying to come up with solutions for all of them.

• These are some of his current issues:Just this past Christmas he needed an operation on his lower back because his spinal cord was being constricted by cartilage. Ever since he has been wheelchair bound. He is able to move himself around his apartment but if he goes outside he needs someone else to push him. This is very different from when, as a carpenter, he would be up and down ladders all day building houses.

• His brother died last year. This was the last of his siblings. Something like this can really emphasize your mortality.

• He and his wife have spent the last of their money. Now they are living on her social security check. This means that they have had to move from a decent 2 room apartment to a smaller 2 room subsidized apartment. This has the affect of making him feel like a failure at taking care of his wife.

• More and more medicine has been prescribed for him lately. Now he is suffering from side effects. For example, some of them can cause short term memory loss. And now we find that he will repeat a question over and over again because he has forgotten that he has asked it already. Now certainly this can be the start of Alzheimer’s but when several meds suggest this as a side effect, it is something to look at. But for him it is just another sign of losing his independence. He has to rely on people to take care of him.

• He still owns a car but since the fall he has not been able to drive it. It just sits in the driveway. His pcas all do his shopping for him now. If his wife needs to go on an errand she will call their neighbor. They are also paying too much in car insurance. His decision after a lot of soul searching and talking to his wife is to sell the car. She told me that when they discussed it she cried and perhaps he did too. The man has been driving since he was 10 years old on his father’s farm. That’s 75 years. Yet another sign of lost independence.

• And most recently he complained about pain and swelling in his knee. It appears that he has “water on the knee”. He doesn’t remember falling or bruising it so the cause is a mystery. I was contracted to take him to a doctor. It wasn’t as bad as everyone had thought and the decision was to put him on physical therapy for a couple of weeks. This was more evidence of him getting old and his body failing.

With everything hitting him at once like this he has become very unhappy. I can’t say that he is suffering from depression. That will be something that a doctor would have to determine but I know he dreads ending up in a nursing home. If that happens, he says, he will get into bed, turn his face to the wall, and wait for the end.

I have heard a lot of people say things like:

“Come on, he is in his 80′s now. He should expect these things to be happening.”

“He is lucky to even be alive at this age.”

“He should just slow down and accept any help that is offered.”

“You know if I was his age I’d love to be going into assisted living.”

But I’ll tell you a secret. These people will say this now but when they actually get that age they will be resistant to the change as well. Why? Because they will find that they are losing their independence. They won’t have any control anymore over the things that they do or how they spend their money. Or worst of all, keeping their bodies from falling apart.

This is where my client is at. He has gone from being a strong robust independent man to an invalid. His wife is also in her 80s and she has been declining so she cannot help him very much. This means that he has to rely on strangers to take care of him. He has been having a very difficult time coming to terms with all of this.

When I am with him we get to laugh a lot. To him I am “the kid” even though I’m in my 50s. I do as much as I have to to get him where he needs to be but otherwise I let him do as much as he can himself. And I listen to his stories. He’s got a lot of them.

When I am his age I hope I have lots of stories to tell my son who is 9 now. Max has been trying to make sure I stay healthy.

He gets me working out constantly: “Max, how many times do you think I can run around the track??”

He is after me to lose weight: “Come on Max, I’m not that heavy!!”

But you know what, I can see myself in 30 years being in the same place my client is. I see it as part of my job to help him transition from unhappiness to acceptance and perhaps be able to take a more active interest in life again.

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