This is Part 1 of a series about Kate, who was admitted to Hospice with end-stage congestive heart failure. Kate was born in West Virginia, married at 17 and migrated to Southern Ohio, where she’s lived most of her adult life. Kate loves nature and wildlife. As a young girl in West Virginia, she loved to shoot a .22 rifle, and bragged, “I was a pretty good shot.”
When she was 10 years old, their disabled neighbor sent his son over to their house to buy a couple of chickens. Kate recounted, “I asked him if he wanted them today or for later, and he told me his father would like them for supper that night. I told him I already let them out and couldn’t get them back, so I would have to go up in the woods and shoot them. We always let our chickens run around in the woods. When they run around in the woods like that, they get as big as turkeys. So I went up to the woods where they were. I whistled, and when they stuck their heads up to look around, their heads made good targets. I shot both of them. A few days later, the old man next door told me, ‘If you can shoot like that, I know I’m not going to mess around up there.’ I told him that he didn’t have any business messing around up there anyway.”
Kate is now a spry, strong-willed 90-year-old widow who lives with her daughter and son-in-law, Rose and Bud (yes, their actual names). Kate has a perfect setup. She has her own apartment on one end of the house with an outside exit to her own deck. Kate is barely able to stand and walk by herself now, but insists on doing so anyway. This was a point of contention between Kate and Rose when I made my inaugural social work visit.
Rose was understandably worried that if her mother walks without assistance, she might fall and fracture a hip. We were standing at the foot of Kate’s bed when Rose pleaded, “Loren, will you tell Mom not to try to get out of bed and walk to the bathroom by herself?” I replied, “Rose, I don’t think I can do that. Your mom is a 90-year-old adult and is of sound mind, so I have to respect her right to make her own decisions.” Kate explained, “Rose and Bud’s room is all the way on the other end of the house, and I don’t want to disturb them in the middle of the night every time I need to get up and go to the bathroom. So what I do is pray and I ask God if it’s okay if I get up by myself. If He says it’s okay then I get up.” How can anyone argue with that?
It took Rose by surprise when I encouraged Kate to go ahead and take the chance, but to “just use good judgment.” Therefore, I felt the need to explain where I was coming from. I explained that my father-in-law, Dave, suffered a series of five strokes, and like Kate, against our advice, he frequently tried to walk without assistance. Consequently, my mother-in-law called me on numerous occasions to lift Dave up off the floor. But it was during the following particular occasion that my attitude and approach was turned upside down, or perhaps right side up.
When I arrived, Dave was lying on his side on the living room floor. I proceeded to scold him, “Dave, how many times have we told you not to try to walk by yourself!?” I would have never dared talk to Dave like that when he was healthy and standing on two feet. I will never forget his defeated and resigned reply, “Okay, I’ll never walk again.” I felt terrible. That was the day I realized there are some things worse than a broken bone, and that’s a broken spirit. So I told Dave, “I’m sorry, go ahead and walk, but just use good judgment. And no matter how many times you fall, I’ll keep coming down to pick you up.”
Kate, Rose and I spent the remainder of my visit talking about how caregiving involves a delicate balance between providing support and supporting independence; knowing when to push and when to back off; knowing when to caution and when to encourage. We agreed that there are some things worse than a broken bone. Rose concluded: “She’s going to do what she wants to do anyway.”
Loren Hardin is a social worker with Southern Ohio Medical Center-Hospice, and can be reached at 740-356-2525 or at firstname.lastname@example.org. You can order Loren’s new book, “Straight Paths,” online at Amazon and Barnes and Noble.