The Caretaker of my Caretaker

We needed a substitute attendant, so the service sent us someone to get trained.  We knew we were in trouble when the scheduler admitted sheepishly, "I thought she spoke better English."

Having both been English as Second Language teachers, Tamara and I remained optimistic. We knew exactly what to do.

"Just speak very loud, and wave your arms a lot," I jokingly told Tamara, "Everyone understands English if you're really loud."

"Ha, right," she half laughed.

We labored through the demonstrations of the equipment and routines.  The attendant, though very nice and eager, did not seem to catch on.  We quickly suspected that her English was even worse than advertised.

Conversations went like this:

Me:  "Next, you measure water to this line and pour it into the bag."

Her:  "Ok, yes."

Me:  "Do you understand how the pump works?"

Her:  "Ok, yes."

Me:  "Where is Savannah's hair tie?"

Her:  "Ok, yes."

"Can you lift her?" Tamara asked, making the heaving motion of lifting Savannah.

"Ok, yes."

"So, can you transfer her from the chair to the gurney?" Tamara asked.  She spoke very slowly.  She pointed at Savannah, demonstrating the lifting motion again.  She mimed laying Savannah on the gurney.

"No," the attendant shook her head.

Tamara turned to me, "Now, we have a problem."  She faced the attendant, "Mr. David will help you."

"Ok, yes."

We both knew at that moment that the training was over; we would have to attend to the attendant.  If you can't transfer Savannah, you can't be left alone.

The attendant sat in the play room at the nurse's desk watching Savannah, who watched a dreary documentary on PBS. Savannah was very tolerant, but I could tell she was bored. I put one of her favorite DVDs on for her.  What Savannah really wanted was for the attendant to talk to her, sing to her, read to her.  But, we couldn't get the woman to understand how to satisfy Savannah's intellectual needs.

Nurse C. came at noon and took Savannah swimming.  The attendant accompanied them.  Savannah came back smiling and giggling.  Nurse C. stayed to bathe Savannah, having quickly realized that the attendant couldn't properly perform the task.  After Nurse C. left, I asked Tamara, "Is Sunday swimming part of Nurse C.'s schedule?"

"No, she does it because she knows how much Savannah likes to swim."

"Amazing," I said, mostly to myself.  "Nurse C. is a keeper."

"Yep," Tamara said, "She really loves Savannah.  You've seen the way she talks to her, reads to her, is gentle with her."

"She is pure gold."

 By the end of her shift, I didn't bother coaching the attendant through the steps of how to operate the enteral pump.  I just threaded the tubing through the machine, booted it up, and ran it without narration.  We had tried her, and it wasn't going to work out.

With nurses and attendants we've had everything from competent to incompetent, loving to unfeeling.  We've had chatty, nosy, unreliable, caring, thieving, and even conniving, psychotic, and dangerous.  We share our home with these strangers... these employees.  We entrust them to the care of our most vulnerable family member, the only one who can't tell us her desires, her needs, and her fears... the only one who can't complain that someone is hurting her.

At the end of her shift the attendant told Tamara, "I sorry I no eh-speak English."

"There is nothing to be sorry about," Tamara said.

And she was right.  This woman might be a perfect fit for another family.  We do not have the ability to accommodate the special needs of an employee who is our house to accommodate our special needs.

In my Adult Educator hat, the one I wear at my day job, I would have taught her, worked to remediate her skills deficits, but in my employer hat, in my real job as a tired father and nursing supervisor, I need a worker that will care for my child, keep her happy and safe, and be able to communicate clearly and precisely about the critical nuances of our complicated life.  Her inability to take direction and give coherent reports posed a serious health risk that we were not willing to incur.  As a result, there was no professional development option, no performance improvement plan, only one remedy:  not have her back.

I don't have the physical stamina to be the caretaker of my caretaker.

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