Only Anecdotal

The last week was a sea of phone calls, visits, and trying to stay organized and focused. I was also trying to finish long-overdue reports. It is an arduous process, namely because the data we collect does not match up with the data that is requested for one particular program’s report. Therefore, instead of hitting a few buttons and spitting out data, I need to go back and do it by reading notes and making tally marks–remembering in the process the details of daily life of every person I saw during the quarter. Sometimes it kind of gets to me.

It is the nature of the job that everyone I see in my work is in some sort of crisis situation. From the hospital (where I often meet people for the first time), they may often go to short-term rehabilitation hospitals (or to nursing homes that fill that function), and then home by the end of my time with them. The best-case scenario, I have to admit, is when a person never wants to talk to me again.

It happens fairly often. An individual is in the midst of catastrophe at one moment, but it is over after a time. Life goes on, and rarely does anyone want to remember any details from the lowest point of a tough spell. When someone says, “No, we are all set,” I am happy about it.

But this is not always the case. Many people simply die.  Or sometimes I am unable to reach people for months, but they turn up years later, with more problems, greater financial burdens, and perhaps loss of hope. Other times, they hang on, calling often for some sort of help, hoping that among my “options” is one that will actually remove the barriers that keep them so far from being the people they are, or were. Sometimes there is something that does help. Sometimes I see people I met previously, sitting in a restaurant, laughing with friends–when months earlier they were, say, in a nursing home. This is a good day. Most of the time, the best I can do is listen, and not lie when I say that itwilltaketime or youdonotqualifyforthat or youaredoingallyoucan. My role is limited–I cannot be a companion, or even a friend–as so often becomes quite obvious.

I have been thinking of this quite a lot lately, that going into people’s homes, entering into moments of great change with them… it is so difficult to remain neutral and unattached, but it is all in the name of survival with so many people to see. It is also what we are trained to do, in the name of professionalism. I don’t mean that we are expected not to care. We are just expected to remain objective and fair. It is a tough balance to do that, and then also to remain healthy ourselves.

I have been on the other end of all this support, especially when my boys had in-home services. At times, my family life revolved around whichever therapist was due to show up that day, sometimes (when we were lucky) joining another support person who came everyday. From the receiving end of these sorts of in-home supports, I have signed agreements of understanding that the relationship is limited, and not permanent. People who came to help my kid could not accept an invitation to bring their own families over for a friendly dinner with us later on, no matter how close we felt to them, no matter how well they fit into the fold of our family. It is dramatically difficult to be in this situation, to need someone hands-on for such enormous quantities of time (time that then cannot go toward reaching out to make a new friend, who can actually be a real friend–and isn’t it ironic that everyone keeps telling you to do this!), and then to say goodbye.

It is difficult, as a professional, to sense the intense isolation, the inadequacy of things like transportation, to see the gaps in much-needed assistance, the fear in people’s faces as you close the door behind at the end of the day–and then to walk away, to have to refuse to give that ride, to stop off and run that errand, to spend a little extra time when others–many others!–are waiting for not-en0ugh-help. It is sometimes a guilty feeling, too, to be relieved to get away from the people who try our patience and drain us… They are nearly always lonely, too. The health risks of loneliness have been documented (http://www.ncbi.nlm.nih.gov/pubmed/20652462), but we have yet to figure out a solution to the isolation, other than institutional care. There must be a better way to preserve individual choice, and yet at least support the means for people to sustain friendships and not just caretaking relationships.

So we leave our home visits, and we see the pain in the lack of connections for so many of the individuals we see. Sometimes we feel it ourselves, in our own desire for meaning, but ultimately in our utter inability to supply the one thing that people need the most–which is one another.