Thursday, September 22, 2011

The Cost of Care - Part 1

I love food. In fact, I eat recreationally. The only reason I don't weigh 300 pounds is that I'm a fan of The Biggest Loser workouts. My mother on the other hand, has to be inveigled to eat (she also has to be inveigled to exercise but that's a whole other post). Every meal requires a negotiation. I've taken to not negotiating but rather to saying, "You need to come down for dinner" and then disappearing. It's simply easier. If you linger, you will be forced to negotiate.

What I find fascinating though is that the disease's goal seems to be to starve the patient. Mummy used to feel hunger, but these days it seems as though the whole 'hunger' sensation is a thing of the past. In the not-too-distant past, Mummy would come to the table and as she began to eat she might say, "I should have eaten half an hour ago" or "I didn't realize I was so hungry". These days, she simply eats and extremely slowly. Clearly there is no driving internal force pushing her to consume her meal. Even though I always start after her, I'm serving so that's natural, I will typically finish eating before her. The caregiver's role then, is to stand between the patient and the patient's body's apparent intent to go quietly into the night.

Alzheimer's patients who receive reasonably good care live longer and are not prone to dehydration and malnourishment because someone is taking care of those details. They are healthier not because their bodies are holding up so much better, but rather because someone else is holding them up. This weight-carrying takes a toll though. None of this long life business comes without some price. I now fully understand why it is widely believed that care-giving shortens the caregiver's life by ten years. This makes perfect sense. If I carry you, I can't also carry me. Even if I am able to carry both of us, one of us is going to get short shrift because the resources of time and money are finite. Guess who that's likely to be?

Care-giving, it seems, is a zero sum game. The resources are finite. If I give some to you, there really is that much less for me. Perhaps this is why, in spite of everything on my plate, I still carve out time for a workout. It's one of the most important slices of 'me' time in the day.

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