Things in the healthcare system are changing every day as the demographic of our society makes shift. Our population is inevitably growing older. Because of this fact, the number of older adults continues to increase meaning that the same is true for the number of patients that are older adults. As future nurses, we need to know how to be there to support older adults in their achievement of living a quality life as independently as possible. However, this isn’t always the case. As demonstrated in the novel, Bettyville, sometimes, there is no road back to independence. Thus, it is important to know what to expect and how to prepare yourself to properly provide care. In this paper, I want to discuss the novel and how it pertains to this preparation. There are many obstacles in elderly care and it is important to have people you can rely on and how to deal with your feelings in the process.
In his novel, George Hodgman discusses what his life had become when he had to move home to take care of his sick and elderly mother, Elizabeth Baker Hodgman who is also known as Betty. George had left his hometown of Paris, Missouri, for New York City where he became very well known in the realm of writing, especially when it came to publishing and editing. When George's mother’s illness gets to a point where she cannot be on her own, he dropped everything to move back home and take care of her. During their time together, they share many memories and laughs as they discuss where their lives are now and where they will be down the road. They also discuss the challenges George has faced and the topic of homosexuality.
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George’s mother, Betty, was very vibrant as he remembered her, and having to deal with her decline was very difficult for him. Even so, he wants to make every day for her worth living and put a smile on her face if he can. While, he did consider placing Betty in an assisted living facility, at the end of the day, it was decided that her willingness to leave was absent to none and the care she needed would not be met satisfactorily if she was not at home.
Being in his childhood home brought back brutal memories of growing up and how hard it was to be homosexual. It felt to him as though he was reliving the cycle of bullies in school and not ever finding his place. Even his parents would not openly say he was gay and it made him feel unwanted and ashamed. While there were tough times though, he also remembered the good. George took his mother to many doctor’s visits, dinner, ice cream, and a beauty salon to keep a routine in her life and make everything seem as though it was okay and normal. However, it wasn’t normal. In his book, he talked about when she is afraid, repeating words and sentences, and repeatedly asking him the same questions even if she had just asked not too long ago. This makes him sad that she could never understand his new life and journey that he has in New York. The longer George remains with his mother, the closer they become and he is devastated when he finds out that on top of the dementia, she also has cancer. Being the good son he is, he was willing to drive one hour each way to the hospital to visit her for days until she can come back home. At the end of the book, Betty is 91 years old. George decides that he should stay in his hometown where he has spent so much time and cares for her. It leaves him confused as to if he should even return to the “new” life he made in New York.
As mentioned before, George often struggled with his relationship with his mom as well as his relationship with those living in his home community. Looking at it from Betty’s perspective, it can be easy to say that social relationships can influence the health and well-being of older adults. She needs someone to be there for her and take care of her. Having social support reminded her of who she was, and her own sense of respect, and kept her social and not isolated. While these are all important things, it is important for those who are doing the caregiving to have social support as well. I do think though, that George did receive some support in that friends would invite him over for dinner and he often had people ask if they could help by watching Betty so he could have some time to himself.
Stepping back and looking at this from a nursing perspective, it is important to understand that most patients have families that are providing various levels of care. For this reason, we can look at caregivers as patients in a way too if we want to provide family and patient-centered care, which is the overarching goal of the health profession. With that being said, caregivers who have to balance caregiving with their other activities, such as work, family, and leisure, may find it difficult to focus on the positive aspects of their lives. As evidenced in the novel, George often struggled with this and at many points had to relive trauma while trying to be the rock for his mother. This was burdensome for him like it is for many people who give up their lives to take care of their elderly family members. In my opinion, many caregivers do not seem to want to ask for help or do not know who to turn to. You may not want to put your “burden” on those around you or have too much pride to admit that you are overwhelmed. Being able to understand that others can help you is extremely important. Help can come from the community, other family members, friends, and healthcare professionals. Reaching out for help when you need it is a sign of personal strength. George even quoted his frustration by stating
“The thing about being a watcher is this: You are never really a part of things, especially if the person you must watch is yourself, always, just to make sure no one ever really sees you. .” (Hodgman, 2017, E-book)
In my opinion, it can be hard to leave behind a life to become the primary caregiver of a loved one. However, it almost seems like the right thing to do as they were the ones always caring for you. The plain truth is that assuming the responsibility of caring for another person dramatically alters your life, but it may be a necessary alteration. This change can happen abruptly, or it can subtly creep in over time. Either way, most caregivers are eventually struck by the realization that their present situation they expected. When you have to put your life “on hold” becomes the new norm, a mental adjustment must be made. This usually includes acknowledging and dealing with difficult emotions like resentment. I think this goes along in the healthcare field as well. It is easy to get tired and become drained when you are caring for someone who is at or towards the end of their life. Doing heavy lifting as well as performing daily tasks for them--that you can easily do for yourself and do--can become exhausting which leads to workplace fatigue and becoming too comfortable in our jobs. Whether it is your job or duty as a relative, it can be hard for loved ones whose plans and expectations take a turn. Resentment isn’t a pretty emotion, but can be impossible to avoid as a caregiver. Being able to admit those feelings, however, can help us better understand how to cope.
No matter how you begin your caregiving role, you will have to make changes in your life. Of course, being able to plan for this gives caregivers more time to acclimate and prepare for the future, but this is usually never the case. As George talked about, it can be difficult to uproot your life, but it can be beautiful as well and teach you many things about yourself. When looking at this from a healthcare perspective, I learned that tackling a couple of fundamental goals, like setting boundaries, mastering flexibility, and trying to understand the need for this care is crucial. You must begin to plan if you are not going to undermine your own physical and mental health while caring for others which is something I hope to take into my career as a nurse.
References
- Hodgman, G. (2015). Bettyville: A memoir. [E-Book] New York, NY: Penguin Books.
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