Caregiving in America is in great demand, from
adult foster home owners offering familiar surroundings, to assisted
living center staff patrolling hallways to answer assist request
buzzers and lights. Rehabilitation centers employ physical
therapists, speech therapists, occupational therapists, and the
caregivers on site. Some nursing homes have as many as twelve
“patients” for each worker. They are all on the job and working
They all knew men like Grandpa Ken, men who
needed to stay on their feet. Some staff could assist him with a
walker; some couldn’t, but tried anyway. It takes acute balance and
lightning quick anticipation to keep someone like Ken on his feet.
My name is Dave and I met them all when my
father-in- law got Parkinson’s disease.
From one unfortunate experience after another,
Ken entered the hospital for the last time. His room had the whole
end–of–life package, his legs wrapped in circulation pumps, IV and
oxygen tubes taped in place. I was with the gathered family when I
noticed Ken’s doctor pass the door.
“Excuse me, Doctor,” I said.
He looked up from his charts and focused his
attention right on me. He knew Ken’s situation better than anyone
and gave his sympathy.
“Hello, David. How’s he doing?” he said.
“Comfortable. He’s comfortable.”
Being comfortable was the main goal at this
“I’m glad. He seems like a nice man.”
“He is. Doctor, how long does he have, if you
took a guess.”
“I can’t say, it would be…”
“I’m a former Army medic; you can tell me.”
I was a staff tech in a civil service clinic,
not a battlefield doc, but he didn’t need to know that.
“Two days. Maybe.”
Two days? Maybe? Two days? One? It dawned on
me to make the only gesture that mattered. For two days, I could
earn a lifetime of good merit points in heaven. Not that I need
them; but if the entrance requirements change, I’d like some extra
credit points. So I did it. I said it.
“What about taking him home for his last days?
We can do that, can’t we? I’d do it.”
The doctor bowed his head in a solemn nod.
“That is always the best.”
I don’t know if he said it as part of the
insurance script to get patients out of the financial stream, or a
hospital policy to open up another bed, or the heart-felt words of a
compassionate fellow human being, or a little of all. What matters
is I volunteered for the second time in my life. The first time was
the Army for two years; this time as a caregiver for two days.
Death with dignity. I went in to talk to my wife, mother-in-law,
and two teenaged sons.
Four years later, after a series of fortunate
caregiving experiences, Grandpa Ken has slowed down a bit. From his
death bed in the hospital where he could barely move one finger, he
climbed stairs with assistance a month later. Instead of an IV
tube, he took his meals at the dining room table. Keeping him
moving was the key.
Today, he moves around in a wheelchair instead
of a walker, and I feed him in his recliner, but he is still on his
feet. He stretches out and makes the moves needed to get from his
recliner to his wheelchair and back. These are moves the
professional in-home caregivers cannot perform due to licensing and
insurance considerations. In their view, Ken would be best treated
if he were bed bound.
Over the years, we’ve interviewed agencies, as
well as private caregivers, to come in for a few hours. Some came
ready to keep him moving, realized the challenge, and quit after the
first day. One quit on the first chair- to-chair transfer attempt.
One agency sent a man in his seventies as a caregiver. It continues
to be an interesting adventure, and now I’m the only person in the
world who can move Grandpa Ken; the world champion of Grandpa Ken
What is the difference between me and the rest
of the world? The first is that Ken and I talked about what worked
best with him before he went silent. No one else knows his likes
better than me, and no one ever will. Second, I have an acute sense
of balance and anticipating movement. It’s the sort of training you
can only find in one place, a wrestling practice room. As I’ve
said, I am a former Army medic, but I’m also a former high school
As a one-time Greco-Roman champion, I studied balance and footwork
to avoid being tossed on my head. Literally. Footwork is something
you don’t forget, like riding a bike. Applying the same skill set
to caregiving makes for an ideal caregiver move.
A formally-trained wrestler has better
caregiving transfer instincts than any other athlete. In no other
sport do participants regularly hook their arms under their
opponent’s arms and lift them up. In what sport do they recognize
the steps that lead to tripping, or not tripping? On a wrestling
mat, you look to trip, watching the other guy’s feet shifting
weight, then sweeping their lightened foot with yours. Getting a
guy with Parkinson’s to back up is impossible unless you shift their
weight and move their light foot back with yours. Only a wrestler
knows how to do it safely. A soccer player might give it a try, but
only if Grandpa Ken wears shin guards.
The characteristics former wrestlers bring to
caregiving are determination, compassion, and competitiveness. The
statistics on Parkinson’s guys say they will die from either
pneumonia or falling. Grandpa Ken had pneumonia after eating an
ill-prepared meal at one facility. He’s fallen at others. My goal
is to provide him, and my mother-in-law who shares in his care, the
best environment possible, one absent the fears of growing old and
vulnerable. Keeping him on his feet is the best way to accomplish
that. I share my goals with Grandpa Ken, treating him more like a
training partner than a geriatric patient.
When he came home from the hospital, I wanted to
reach him where all others’ had failed. When a man’s time comes up,
so it seemed, they turn off the senses. I knew Ken had been in the
Marines, and I knew how Army Drill Sergeants spoke, so I had
first-hand experience when I pulled a chair up and gave him his
first Parkinson’s Boot Camp pep talk. It went like this:
“You and I will work together. We can do
everything we need to do if we cooperate with each other. The only
thing that will try and ruin our work is Parkinson’s. Parkinson’s
wants you to curl up in a ball. It wants you to sit, leaned over in
your wheelchair with your chest on your thighs. It wants you to
fall. Parkinson’s wants to choke you. But we’re going to fight
Parkinson’s every day, every minute. We’re going to bring our
A-game and we’re going to compete. Parkinson’s is tough. It’s
challenging you. I can help you give it a fair fight. It’s taken
its share of opponents, won it’s share of matches, but we will fight
it together. If it’s only you fighting, Parkinson’s wins easily.
If it’s just me, and you don’t help, Parkinson’s has already won.
But if we hit it together, if we surprise it and hit it where it
doesn’t expect, then we have a chance. That will give us a chance
every day and the first thing in the fight is getting out of bed.
With an old wrestler’s sense of body leverage
and balance, I helped Grandpa Ken out of bed. He took a few steps.
The next day, he took a few more, until he was taking laps around
the center staircase, moving from hardwood floors, to carpet, to
brick. He wasn’t wearing his Nikes, but he should have been. It’s
never a fair fight, but as long as you move with it, you get a shot
in now and then.
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