For centuries, the pyramids of Egypt have been a symbol of mystery to archaeologists and average folks, alike. At some point, we discovered that they were actually tombs of pharaohs and high ranking officials of various dynasties. In my view, looking at especially the earlier versions, such as the Pyramid of Djoser, they serve not just as tombs, but as a metaphor for the stages of our lives:
OK, I hear more than a few of you asking if I now need one of the caregivers from my own home care agency, Support For Home. Well, we could have a long discussion about that, but let me explain what I mean and why I have been carrying this image around in my head for quite a while.
Life may be a bowl of cherries, but real cherries have pits. Likewise, life is not a straight line ascending into the heavens. Rather, a better musical lyric (I believe written by Isaac Newton) would be, “What goes up, must come down.” That pretty much reflects the life cycle, as well.
But what does that growth and decline look like? Thankfully, it does not usually look like the later Egyptian pyramids:
When we finally get to the top, we really don’t want to just slide down the other side, out of control.
In reality, both the way up – and the way down – constitute a set of plateaus. On the way up, we want to make our stay on each plateau as short as possible. On the way back down, we want each plateau to extend as far out in time as we possibly can. In childhood, many of us cannot wait to get to the next phase of our lives. The “leap” from grade school to the plateau of high school is enormous, then, perhaps to college, the workforce, relationships, a first home purchase, raising kids, … But, for most of us, the notion that “time flies” does not relate to this side of the lifecycle. We are often impatient with the plateau we are on and cannot wait to get on with the next phase of life.
It is in the second half of the lifecycle – I speak from experience – that time can seem to fly. As noted above, as we reach a certain plateau / stage of life, we cease the upward climb and face the fact that the next plateau we experience will be at a lower level, physically, than the one we are on now. It does not mean that an emotional, psychological or cognitive decline will automatically take place, but, physically, we are going to experience a downturn. The issue, at one point, may be as innocuous as struggling not to lose 10 yards off your drive, in golf! 🙂
Eventually, however, it may involve plateaus concerning vision or heart health or mobility or [fill in the blank]. It may, indeed, mean cognitive impairment, for those who develop a form of dementia. As we all know, life is fragile, no matter what plateau we are on at any point in time. It certainly does not get less so in the second half of the lifecycle.
So, why is all of this pushing itself out of my brain and on to “paper,” at this time? Very simply, it is because of the mission of home care companies like ours, at Support For Home In-Home Care.
Most home care agencies think about the role of their caregivers being simply to provide support for Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) that their clients can no longer manage independently. In our view, that focus just represents a set of tasks to address the symptoms of what is actually going on in the lives of their clients.
For us, the real mission of our Home Care Aides – of the organization as a whole – is to help our clients remain on whichever of life’s plateaus they happen to be on, for as long as we possibly can. If we can extend the current plateau of health and well being for an additional two or three years, by helping to prevent a fall and a broken hip or recognize the very beginnings of a UTI or pneumonia for one of our clients, we can take action to ensure a potential problem is addressed before it becomes a real one that causes a “drop” from one plateau of health and well being to the one below it. If a caregivers is supporting a pre-Diabetic or Diabetic clients and understands that increased thirst, increased frequency of urination or serious fatigue may point to high blood sugar, the caregiver can initiate action to address what could, if ignored, lead to a drop off the current plateau.
At the very least, we are focused on ensuring that the movement from one plateau to the next one is managed as well as possible. The second half of the lifecycle is inevitable. Moving down that side of the step pyramid cannot be avoided, just managed well and delayed. If it is not, the alternative is much worse. We do not want to fall of the cliff, or to have that happen to a member of our extended family of clients.
So, how do we, at Support For Home, focus on preventing the disaster that produces the abrupt fall of that cliff? It is all about our Home Care Aides’ careful observations of our clients, watching for any early / developing change of condition. If our caregiver sees a small change in mobility, it may be time to get Physical Therapy involved. It is certainly time to find out! If the client shows more confusion than normal, there could be a number of reasons, from a UTI to dehydration to a TIA to … The bottom line is, there is a change – hopefully a small one – that our Home Care Aide notices and reports, so that we, working with appropriate clinicians and other healthcare partners, can address a potential, emerging problem and prevent a larger one.
Our mission, and one that all home care agencies should adopt, is not simply to make life easier through support of ADLs and IADLs. Our mission must be to help our clients maintain whatever plateau they are on for as long as is humanly possible.
Your thoughts and responses are welcome. Best wishes. Bert