A Fresh Start: Sandra Morse's Story

Sandra Morse has taken on the role of Direct Caregiver later in life. She was approaching retirement after years of working behind a desk and felt the need for a change. Part of that was a desire to do something meaningful, something that would help people. Working as a PSS in an assisted living facility is a far cry from the stressful office environment she left behind. Meeting new people and feeling like her work is worthwhile has been revitalizing for her, and with this new energy, she's also taken on additional responsibilities as a Peer Mentor and member of Maine PASA. She clearly loves the interactions she has with the residents in her facility, and talks about how she could fill a book with the whimsical and often joyful moments that happen there each day.

A New Direction

I got into the job as a PSS a couple of years ago because I had worked in an office for sixteen years and had just had it. In five years at that place, we had two mergers and in three years we went through five different managers. It was going crazy and I was so stressed out I couldn't imagine working until retirement in that position. I was able to take a year off, and when I needed to start job hunting, I looked for a receptionist job because that's where I was most experienced, but nothing worked out. When I saw an ad for this in the paper I thought, "That sounds low stressed; I'll be helping people and I won't be sitting behind a desk. I'll be up and moving around." I've always liked the idea of helping people, so this just clicked. Now that I'm in a job I really like, I can see working for many more years.

I'm on second shift, so I come in the afternoon and just go around and check on everyone. We may change beds for people who are having a shower that evening, pull the laundry and take everything to the laundry room. Some people need a little help in the bathroom before dinner. Dinnertime gets busy, but after that we get about half an hour where the PSSs will sit down together to eat. There are some activities now and then, or a movie will be shown in the TV room, but generally the residents are tired and winding down for the day. I help them get ready for bed or tend to their needs as they settle down to read or watch TV for the evening. I like second shift because it's not busy-busy all the time, but the residents are still awake and I can chat with them. What's interesting to me is getting to know everyone. We've had some brilliant people here and it's so interesting to listen to their life stories and about their accomplishments. Actually, I'm here because I like spending time with the people.

We are advocates for the residents in many ways. Someone will tell me something that's bothering them, and tell me that they're planning to take it up with the nurse or the activities person who's here during the day. Well, more than likely they will not remember it the next day. So we advocate for them, and when someone mentions a problem to me I pass it on for them. Some of the people who are losing their memory will put up a cover. They'll forget things or start to wander, but they can always give you an explanation for everything. In a way, they're trying to convince themselves that there isn't any problem. It takes a while to see how far the memory loss has gone because they are bright and alert, but then you realize all the things they can't do. I don't want to approach someone the wrong way, so I keep an eye on them without letting them know it.

For a lot of the people working here, I know it can be stressful. After I worked here for a while someone asked me if I was interested in being a CRMA and I said, "Nope. I don't want to get involved in medication decisions, or do all the extra paper work. I'm happy with what I am doing now." I like having so much contact with the residents. When you give meds, you're just in and out because you have to get it done and get on to the next one. The times when my job is stressful are when someone isn't doing well, and when residents fall and hurt themselves. Usually, second shift is evenly paced. I like to spend the time with the residents while they are winding down for the day. There aren't too many ups and downs in my job. It can be pretty peaceful.

Family Caregiving

My mother is in her 80s, and before I became a PSS I learned quite a bit about working with the elderly because I had lived with her for at least two years before I started this job. She needed a little bit of assistance. She was pretty much taking care of herself at home, but there were little things coming up like forgetting to change the cat box, or needing some help with cleaning and finding things around the house. I think my mother accepted it because she knew things weren't as they used to be and she became aware of her memory problem. I lived with her for five years, and her great sense of humor made it easy. When we lived together, I did all the cooking and the heavy cleaning. I was able to get her up in the morning and spend time with her during the day. Thus, when I started here and came in for the evening shift, it worked out well.

With my mother I learned about short-term memory loss and how it progresses and affects people. She hated the word bath. As was her routine, she believed that you bathed every so many days, but then she'd forget and when I'd mention it to her, she'd say, "Oh, I took a bath yesterday." Generally with things like that, rather than correcting her I would try to get around it some way. To people who are suffering from memory loss, you must be sensitive to what they are saying. You have to understand and remember how they truly believe that what they are saying is right. How would you like someone to tell you that you didn't take a shower yesterday when you remember having taken one?

I have two sisters and one of them stayed with my mother temporarily before I moved in. When my father was living, mother was a housewife. She had her own small circle of friends but she wasn't involved with attendance at meetings or other such activities. She was content with being at home. My sister who was living with her thought she should be out and about, getting more involved with groups and other things of that nature. But in aging, one doesn't like change. If she didn't do it before, she wasn't going to want to start now. Later on, when my mother's memory loss became more advanced, she couldn't remember exactly the times my sister would try to get her to do some things, and she would imply that my sister was a little "pushy." She doesn't remember any particular situation, but she still maintains that feeling about her. I find that with people here, too. Often they don't remember a situation, but they do remember how they feel toward someone. If you are negative when first approaching somebody, they will thereafter continue to feel that negativity regardless of whether or not they remember the reason for it.

My mother did have a stroke just about a year ago. When someone has a stroke you don't know how much they lose until you start trying to bring them back. She would have come here for rehab but they didn't have a bed for her, so she went to another nursing home instead. Originally, my sisters and I had planned to bring her home after the three months of rehab were up, but she couldn't walk, and was losing a lot more of her memory. She couldn't remember from day to day why she was doing the rehab. She would never have been able to be left alone. I would have been spending most of my daytime with her, then someone would have to be there in the evening, and if she were up at night I would have to be up with her. I couldn't have done it. We talked about it at length, but her level of care was just too high.

It seemed to bother us more than it did her to know that she was going to remain in that facility. By the end of three months, she had settled in, and she likes it there. They are very good to her and she seems quite content from day to day. I have seen both sides because I work in the field, so when it came time to choose this facility, I checked it out very carefully. The first thing I noticed was that the same employees were always there; one lady had been there for over ten years. If there is not a big turnover, that's the sign of a good place. One day I came in and the housekeeper was sitting on the bed in mother's room just chatting with her about something. That was a nice thing to see. I'm sure that place has its problems just like every other place does, but she's content and well taken care of, and I feel comfortable having her there.

Learning From Experience

I've been involved with Maine PASA a bit, and with the LEADS project as a Peer Mentor. If new PSSs have problems, instead of going to the supervisor whom they might be afraid of, they can come to me. We haven't had a big turnover of people so there's not a lot of mentoring going on, but I enjoyed the training and I liked working with the girls who have come into the program. I am a part of it, too, by being a good employee and giving them the kind of advice they might not get in their training. Number one, you need a lot of patience in this job. If you are helping someone get ready for bed, and they take half an hour to brush their teeth, it's not going to benefit either of you by trying to rush it. You have to relax, find little things to do, chat with them, and learn how to operate at their speed. For most of them, that is pretty slow. We have to remember that this is their home. We wouldn't like having someone hovering over us and trying to get us to hurry when getting ready for bed. The way you approach someone is very important. When they are not approached in a calm and respectful manner, the residents remember it, and a bad feeling will persist.

Another thing, which I think is important in this job, is to have a good sense of humor. You learn a lot from being around people so much. Most of them do have a fine sense of humor, and being lighthearted keeps the spirits up. You learn after you've worked with them for a while how to bring that out, and a lot of it has to do with how comfortable the residents are with you. The other night there was a lady I was helping, and as she prepared to go into the shower she caught a glimpse of herself in the mirror. She kind of sighed, looked at me and said, "I think we look a lot better with our clothes on." We both laughed. I could write a book about those kinds of moments. The best days are the ones when I walk down the hall and see the residents sitting there laughing with the people who work there.

I like my coworkers. Thank goodness they all have a sense of humor, too. After the residents are in bed, we get a chance to sit together while we're doing the books. Sometimes we'll have a gripe session but no one is really being mean. It's just part of the job. I think the hardest times are when there are residents who aren't well, and we must see them go downhill. But then you can view it as helping them in that time of their life. That gives you another outlook, to be helping them cope when their families aren't around. They say you shouldn't get attached to residents, but you can't help it. Of course you're going to get attached to someone you spend up to an hour with every day.

Eventually, most people will go on to a nursing home unless the family hires extra help to come here. Some people will have a CNA who comes in when they need care beyond what we can do for them. This facility has a skilled nursing unit, a memory impairment unit and a nursing home as well as assisted living. If someone has gone beyond the point where it's unsafe for them to be in assisted living and needs more care, they can continue to stay here by just moving to another unit. A continuum of care is what I like about that. I might continue to see them now and then and I know they are getting excellent care because the staff in every unit is wonderful. When I think about how much I love it here, I know it has everything to do with the people. The administration, the residents and the workers are great. When I was at my office job, I couldn't even imagine working for another two years. This job has been a fresh start. I could do this forever!