The Difference Between a Care Giver and a Sitter

As an academic professional in the nursing field, I have experienced a number of interesting and unusual situations both in the hospital, the clinic and elsewhere that have influenced my life. I have taken care of the rich and famous as well as the psychotic, discovering that it is not only "famous" celebrity who is deserving of more compassion than they receive.

Since health problems often limit one's activities, there are times when it is necessary for the nursing professional to offer services that go beyond the call of duty. Care givers, in particular, have been known to refuse to do more than just "sit" and watch their patient. Because they lack the education and experience, sitters are often older adults who need extra income. Since they have no formal training, they often are unable to distinguish between compassionate care and services that are required.

There are many companies who specialize in geriatric care who hire untrained people to go into someone's home, providing daily care for patients who can no longer do for themselves. Care givers are expected to perform light duty, providing nourishment at mealtimes, washing dishes, accompanying the patient to the bathroom as well as securing their environment from potentially hazardous situations. However, the care giver is not required to perform duties they are not trained to do.

Many older adults choose to live out their lives in their homes with family so that they are not "put away" into nursing homes. Because they fear being forgotten by their families, they have chosen an alternative means of maintaining independence by allowing families to contract services from companies who hire untrained personnel. Many of these geriatric patients have difficulty transferring from one position to another without help. Alzheimer's patients are a particularly vulnerable group who have greater needs and require the services of someone who is trained in caring for a person with that disease.

When an untrained person is allowed to care for a patient with advanced Alzheimer's disease, they are often unaware that patients, once they stand up, sometimes "forget" how to bend their knees. They forget how to walk up and down steps, and even though many patients have a love of wandering, the untrained employee has no means by which to maintain a controlled atmosphere of safety and comfort. In addition, the patient with advanced disease has difficulty swallowing when eating, often choking on the tiniest of morsels. They become angry very easily, having been known to become violent and attack their care giver.

Faced with this type of situation, many employees quit on the spot, panicking and forgetting to phone their employer for a replacement, thus forcing management into a ticklish situation by their lack of foresight. Allowing an employee to go into a situation in which management is unaware of what is happening is simply asking for trouble. More than once, I have been called to replace personnel who are unable to deal with the special challenges that some situations require.

In one case, I accepted an assignment at the home of a well-known country music singer who was unable to care for herself, yet had great difficulty over the years in finding a full-time personal assistant who would be able to handle her special needs. She had suffered having strangers come in to see her while she was recovering, lining up after paying a price for "admission," having people she did not know steal her personal belongings from under her nose, and had her home burglarized from agents, her peers, and her fans who desired a piece of a famous person's life to brag about.

She had suffered the indignity of having a visit from Social Services, who had attempted to cite one care giver for neglect simply because she had not gained weight in two weeks. She suffered abuse from her family, being unable to trust anyone she knew except her own children. When I came, she had not been bathed in over two weeks.

In another case, I was sent to replace an employee who had refused to get her patient a plate of food from the kitchen. This particular patient had been given a liver transplant, but not told that a transplant only buys the patient more time. Since he had refused to return for a check up, lesions had formed, growing out of control so that his entire body became swollen, and he was unable to fit into any clothing. He suffered agonies of regret, unable to leave the house, unable to go swimming in his own pool, abandoned by the medical community because he neglected to follow instructions on the importance of check ups.
Essentially, he was sent home to die.

Another patient was sent to the hospital for observation upon being observed to having a change in mental status. This particular woman, upon awakening, proceeded to soil herself, spread feces over every surface of her room, left her room and attempted to leave the hospital, and then begged for someone to call her a taxi and give her some shoes to wear. She refused to stay in bed, and it took five nurses and two housecleaning personnel to get her settled so that she could get her MRI without further incident. Upon receiving the results, there was evidence that the patient had suffered a stroke in a certain area of the brain that caused her to manifest symptoms of psychosis.

Offering comfort care often requires action to allow the patient to endure in comfort, whether it means to help staff to reposition a patient every two hours or whether it means to just talk, setting their minds at ease. One should be willing to give with a willing spirit any aide that is needed, even if doing so puts one outside of his own comfort zone.

Caring for the sick, the elderly or the dying can be a humbling experience, allowing you to see reality in a totally different way, teaching you lessons you could never hope to learn in any other profession.