Out on the Town with our Minds out to Lunch

Working as an in-home caregiver doesn’t mean my clients and I never leave the house. Part of my job is to help them stay connected to the outside world through walks, store visits, doctor visits, and visits to fast food restaurants where they’re likely to run into old friends. As such, we wind up interacting with many people in customer service jobs who are undoubtedly busy with their own stuff and might be unsure how to deal with our particular brand of crazy. Maybe that’s you? Even if you’re a nurse or medical receptionist, perhaps you’re not trained specifically in geriatric issues or aware of what it’s like on our end. It’s not especially complicated. Just slow down and really listen for a minute.

So we’re a bit late. Please forgive us. Getting ready alone would’ve taken me at most ten minutes, so I budgeted us an hour. I had to get an adult-size toddler fed, dressed, and to the bathroom. Everything centers around routine because if it didn’t, her world would crumble into utter chaos. But she might get stuck on a particular step of a task or become agitated or any number of odd, unforeseen things might crop up. We could be taking things as slowly as is feasible, and she’d still feel rushed some days. Please don’t look at me in disgust because her shirt buttons are misaligned or her hair is uncombed. Sometimes she still wants, insists on maintaining little bits of independence and it’s easier not to fight it as long she looks halfway decent and is fully covered in clean clothes. Don’t assume I’m incompetent. Ten bucks says there’s no way you could’ve gotten her here quicker or looking more presentable.  Sure, we’re ten minutes late, but we made it through all the essentials without a fight, she’s semi-lucid and I’ve got the paperwork prepared, so stop judging us. If I was a mom with two or three messy kids in tow, would you have the same attitude? Because whatever your answer to that, you need to put yourself in other people’s shoes more often and realize what’s easy for some is like scaling Mt. Everest for others.

Uh-oh – you either just processed a ton of paperwork only to discover my client’s already on file or we went in thinking she was on file and it turns out she’s not. I am so sorry. Déjà vu is a big thing with dementia, weirdly, in places where it would make no sense, like first-run daytime TV shows and news programs mentioning events that are unfolding in real-time. It gets really complicated when it comes to discerning whether a care client has been to a particular place or seen a particular physician before. She’s been alive half a century longer than me and none of her personal records are sensibly filed and easy to locate. She may remember being someplace before without being able to provide any details of the place. Is that memory real or imagined? Way too often, receptionists immediately start getting frustrated by the uncertainty, as if I should’ve walked on the scene knowing these things. Just please, look us up on the computer the first time we talk on the phone, or maybe check the yet-to-be-uploaded old files. You might be the only one left holding clear records of whatever issue we’re here about. It might seem ludicrous that no one on my end can provide clear answers or insight, but that’s where I’m coming from and if you work with me now, you won’t have to deal with more headaches down the line. Are you swamped in the office and unable to take a long call right now? That’s okay. I’m flexible. Schedule us and call me back later so we can work this out before the appointment without putting undo stress onto your shoulders or mine.

Maybe you’re a store associate and my client’s looking for a product I haven’t heard of. Please, bear with us. The details are sparse, strange, and far-flung, but she’s not going to give up on this easily. Which brings me to a another issue: fixations. Believe me, this is infinitely more frustrating for me and for the family members than for you. We’re dealing with a  person no longer capable of remembering when she last ate or that ringing means answer the phone, yet she’ll drone on and on about the same issue every time she talks to you for days on end. Sure, distraction helps, but it only goes so far if I can’t get her out of the environment that reinforces the idea long enough to break her out of her rut. That’s where you, dear store employee, come in. You are wearing a uniform. You could be a wearing a baseball uniform or a barista uniform and it wouldn’t matter. The point is that you broadcast authority to my client. She won’t believe what I say, because I obviously know nothing about this store. But you, you MUST know what she’s talking about. Humor her. Look the product up on the computer using her details, take us down the aisle where it “would be if you had it”. Tell her you must’ve stopped stocking it. Commiserate. It doesn’t matter if your store hasn’t stocked the product in thirty-five years. It doesn’t matter if the product couldn’t possibly exist. All I’m asking for is five minutes and for you to treat my client like any other person, like she’s her old self. If you don’t, it might take me an hour to convince her to give up and go home. She might throw a tantrum in the aisle. It’s important to go out regularly and get exercise with the support of a shopping cart in an area that is relatively unchanging and comfortably well-known. That’s why I didn’t come alone. Usually, we do fine. But occasionally, we have bad days and this is one of them.

So, down to the nitty-gritty…

Three basic rules for the customer service peeps we interact with:

  1. Be patient. If you’re too busy or under too much pressure, try to arrange a better time or get a colleague to take your place in working with us.
  2. Treat my client like any other adult human being. Maybe nothing she’s saying sounds rational or lucid, but that doesn’t mean she doesn’t deserve your basic respect or understand that you’re being rude and condescending. Quite the opposite. Even if she’s really out of it today, she will pick up on your mood and tone, and take your frustration personally. Suddenly, it’s her fault you’re upset, she doesn’t know what she did to cause that, and those two things combined make her more upset in a vicious cycle.
  3. Understand that people you meet might be dealing with invisible problems. Regardless of appearance, of apparent age or beauty or whatever, please don’t assume the worst or treat us like we should know better, act better or otherwise rise to meet your physical or mental expectations which might be, for us, wildly unreasonable. Accept us as we are. Catch the curveballs we throw. Don’t judge or gossip while we’re still within earshot. Do the best you can.

And one huge tip to make things easier:

Don’t bombard a dementia-afflicted person with new questions or clarifications. Ask one question using simple wording. Wait forty-five seconds for a response. They’re still processing, forming an answer. If they don’t respond, repeat the question exactly as before. When you jump in right away with “helpful” clarifications, you’re really just adding more information that must be processed and ultimately, overloading them. I’ve heard many sources say it could take the person up to around ninety seconds to fully process your request. So during that time – no new additions. Wait and remain engaged.


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