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Managing The Stress ~ Making The Decisions ~ Discovering The Meaning |
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Caregiving |
Solutions To Your Caregiving Situations Throughout Your Caregiving Years |
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Their Past and Our Present Health care settings may stir up tortured memories of past Imagine living through the Holocaust and all its horrors. Then, imagine, almost sixty years later, being placed in a nursing home, institutionalized at a time when the aging process and its losses trigger buried memories. What we may think of as schedules and treatments meant to keep a care recipient healthy may mean the exact opposite to a Holocaust survivor. To help health care professionals who care for Holocaust survivors in hospital, nursing home and home care settings, David Bier, MSW, Holocaust Community Services Program, Skokie, Ill., offers a two-part training program throughout the Chicagoland area. Through the training program, Bier helps health care professionals understand that a care recipient's perceived act of aggression may be better understood as an act of survival from the past. In his training class, Bier describes normal circumstances in a health care setting which can trigger upsetting memories, leading to difficult responses for professionals to manage. To help professionals manage these difficult responses, he offers ways to understand the causes of the behavior and some possible ideas to remove or minimize the trigger. Some triggers, responses and interventions* discussed in his class include: Triggers: Darkness Reason: Many Holocaust survivors may be terrified of the dark, a time when terror may have been heightened. Intervention: Nightlights or leaving lights on low or playing soothing music may help. Triggers: White lab coats or uniforms. Reason: Guards and soldiers in uniforms tortured and terrified civilians. And, "doctors" wearing white lab coats performed cruel and painful medical treatments. Anyone wearing a uniform, police offer, doctor, postal worker, maintenance staff, may awaken a terrifying memory. Interventions: Remove lab coats, wear plain clothes instead. Remove the survivor from situations in which he or she may encounter persons in uniform. Triggers: Hiding or hoarding food; eating too fast. Reason: Wartime, prison and concentration camps meant limited availability of food; rationing and stealing food often were the only means of survival. And, severe hunger pushed persons who received food to eat very quickly. Although assured that meals will be served regularly each day, survivors may not trust staff to provide these meals. Interventions: Allow survivors to store food that won't spoil, such as canned food, in their rooms. Snacks on demand or a small refrigerator with food choices also may comfort survivors. Triggers: Taking a bath or shower. Reason: In the death camps, hundreds of thousands of persons were sent to "the showers", which meant they were gassed to death. Others directed to showers feared the worst, and found that they actually were deloused under showers of cold water. Nazi "medical research" on concentration camp prisoners left prisoners in freezing water to measure endurance and estimated length of survival time for downed pilots. A fear of showers or of being bathed today rarely means a simple fear of water or being clean. Interventions: Health care caregivers can learn how survivors washed at home and then re-create such rituals in the facility. Offering survivors a choice, such as a hand-held shower that they can use or a bath, may also minimize fears. Showing survivors that the shower does indeed disperse water, and then testing the temperature with an elbow in front of the survivor may help lessen fears. And, adding simple decorations to a shower also may increase a survivor's comfort level. Bier stresses that the approach of finding the reason behind the response and then forming an appropriate intervention can be used on all patients of trauma, not just of the Holocaust, in health care and home settings. "The responsibility falls incorrectly on the care recipients for being difficult," Bier says. "We have to work together. Our goal for our care recipients should be dignity and independence." Understanding the reason behind an angry, fearful or distrustful response--and then removing that reason--ensures we all offer dignity and independence to our care recipients. *Triggers and interventions adapted from a training video, Painful Memories: Understanding the Special Needs of Aging Holocaust Survivors, from Menorah Park Center for the Aging, Cleveland, Ohio. Health care settings may stir up tortured memories of past Survivors can’t tell, but also can’t forget When they change for the better What is Posttraumatic Stress Disorder? |
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