One of the hospice home health aides (HHA) arrived at a patient’s home. Her to-do list would include bathing a patient with more than eighty candles on his cake. Let’s give our HHA a fictional name like Fran. (That is my mother’s name, so I’m openly providing a clue for my good thoughts about this part of the hospice team!)

Soon, the bath was underway.

“About how much longer do I have?” the patient asked. (And let’s say his name is Arturo.)

I don’t know if this was Arturo’s first bath, or if Fran had given him a number of baths over the prior weeks. In hospice, the aides are a critical part of a patient’s care. They do the grunt work of supporting the patient when he or she is most vulnerable: showering or bathing, brushing teeth, commode duties, and helping ensure there is safe movement from a wheelchair to a bed.

Maybe a patient is incontinent with bowel or bladder. Some patients complain often, others make every visit a delight. In certain homes, the patient’s spouse, adult child, or other family member is the primary caregiver and dreads making a mistake. The HHA will teach—a literal show and tell—the most efficient ways to accomplish the simple tasks for a loved one. The tasks of caregiving, however, are not simple. Any idealistic thoughts about how great it is to support a dying loved one at home can quickly change with the actual day-to-day demands. Caregiving is hard work. A good HHA will try to make the family’s “job” less stressful. Read More →

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