By Dr. Mohamed Elmasry I am going through a personal experience of caring for my brother who suffers from bone cancer. He is 68 years old and diabetic. He is immobile in a Toronto hospital bed, 2 hours away from my home for the last three weeks. Family support includes daily visits from his wife and his three children. I visit him on weekends and I talk to him on the phone daily. I watch the huge effort by the nursing staff in looking after him. I talk regularly to his doctors. My job is to keep his moral up. All my know-how dealing with persons in his condition is not enough. The illness takes away not only his physical strength but his emotional and spiritual ones as well. He passed the denying stage and accepted the fact that the Lord could call him when his time comes. He is now in peace with himself. I tried to change the subject of our conversation away from his condition and knowing him I even try to be humorous. But it is tough. I introduced my brother to his room mates. I gifted them with my book on spiritual fitness. They appreciated the gift. One even read the book in three days and shared it with his family. We; I, my brother and his roommate had a pleasant conversation during my visits. I did try to recall what I read on the subject of caring of the elders and the terminally sick and the lectures I have attended on the subject as well. I want to share this with the readers. Here is one. "So, you think care work is easy" was the title of a talk given by philosophy professor Monique Lanoix to SWAG (Social Workers in Aging and Gerontology) in Ottawa sometime ago. She is in the Faculty of Philosophy and the School of Public Ethics at St. Paul University, where medical ethics and political and feminist philosophy are her areas of interest. She noted that one of the challenges facing institutional caregivers is the heavy paper work, documenting in detail the chores accomplished. However, lost in the shuffle is time spent listening to residents and in demonstrating caring in non-physical ways. Yet, such use of caregiver's time is central to provision of good care. Nursing, she noted, includes emotional labor such as this as a prime function of the profession. The institutional caregiver is burdened with an ever-increasing workload, both in number cared for and in complexity of needs. At the same time, the caregiver frequently finds himself in a precarious work environment. It has been found, she stated, that secure employment of caregivers means better caring for the residents. Insecure employment—temporary, part-time, contract work—is all too common for caregivers. Institutional caregivers provide care that is close and sustained, but their role is not familial. The danger is that following the detailed regulations to the letter may lead to bad work. Violation of these regulations may be either good or bad. She gave a couple of examples. One situation involved transferring a man into bed. The regulation stated that such a task requires two people. The caregiver, faced with a lack of an immediately available person to assist and assured of his own adequate strength, undertook the task on his own. Unfortunately, as a result, the resident fell against the headboard, causing a bruise on his neck. When the incident was discovered, other things went wrong. The caregiver did not immediately acknowledge what he had done. His supervisor did not report the incident up the line. His colleagues rallied to his support, asking that the incident be overlooked. In the other example, a resident was clearly unhappy. Staff knew of her love of knitting, but the nursing home had a policy prohibiting sharp objects in the hands of residents. Staff broke the rule and gave her knitting needles, much to her satisfaction. One of the SWAG participants at the meeting noted that homes are very reluctant to take risks, leading to overprotection. Lanoix spoke of rigid rule following as "normal pathology." In the case of the woman allowed to knit, her needs were accommodated. On the other hand, the incorrect transfer to bed was not adequately addressed. There is a possibility of a slippery slope to poor care. For Lanoix the fundamental question in caregiving is this: Are caregivers encouraged to accommodate the needs of those in their charge, or are they encouraged to work badly? I pray for all those professionals who take care of the elders and the terminally sick. And I pray for all of them as well including my brother. Egyptian-born Dr. Mohamed Elmasry is emeritus professor of Computer Engineering at the University of Waterloo. He is the author of Spiritual Fitness® for Life – a term he coined and patented. Dr. Elmasry is also a founding editor of the online alternative news-and-views magazine, The Canadian Charger www.thecanadiancharger.com
