Who the other is: HUMAN VULNERABILITIES AND GIFTS
Caregivers have to be very tuned into the life-story of the person and the significance and impact of inner vulnerabilities; we must also be astute at seeing or even sensing the life-giving gifts of each person such as forgiveness, curiosity, hope, and the slightest hints of a hunger to connect with others.
Vulnerabilities can be caused by a sorrowful, often undefined, vague, but morally defining, memories of years of segregation, loneliness, scorn, institutionalization, racism, sexual abuse, societal prejudice, illiteracy, poverty, imprisonment, neglect, war, dictatorship, torture, the loss of family members, political isolation, and poor health care. These experiences and often vague and ill-defined memories can be worsened by our lack of attunement or empathy for these conditions, ignoring their long-term effects, or taking a “lift yourself up by your bootstraps” attitude. Internal vulnerabilities can come from psychiatric conditions such as schizophrenia, manic-depression, depression or the often condescendingly cited “borderline” personality. Caregivers frequently fail to recognize or understand the hidden power of past memories and the end result is comments such as knowing better, being manipulative, or attention seeking.
They can be made more difficult by physical disabilities such as seizures, sensory disorders, or the side effects of medications. The presence of developmental disabilities can make it more difficult for the person to defend self and reach out to others.
Our human strengths and weaknesses are shared with those whom we serve. Each person is a unique expression of the human condition. Some are more troubled or burdened than others, but we all share the common thread of humanity. Within this fragile thread lie the values that bind us together. In our own personal lives, these vulnerabilities can arise at any time and threaten our well-being.
The question is to what degree does any individual need support when threatened by these and other forces. We need to recognize each person’s vulnerabilities and find ways to reach out to those who are more threatened. They are more than persons with vulnerabilities, mental illness, or behavior problems. They are full human beings with a range of gifts and vulnerabilities, a deep inner life that beseeches and long ago our attention, and longings that call for fulfillment.
While recognizing the need for teaching functional skills, our central caregiving role must focus on teaching each person to feel safe with us and loved by us. Although professional measurement tools to define the degree or absence of functional behaviors can play a useful secondary role in care giving, if the central developmental milestone of feeling safe and loved is not achieved, then any further discussion can be fairly shallow. If the center of the human condition has not been achieved or has been broken, the rest of learning is merely peripheral. If we can help form the center, skills will blossom. The assessment of our companion or becoming-companion is based on the assumption that we must focus on the center and then the periphery will take care of itself.
John J. McGee
Common Situations: Refusal to Participate
If the person refuses to participate,
• Make sure there is a structured flow to the day, not just the emptiness of custodial care.
• Be aware of other caregivers who might be coaxing, cajoling, or bribing the person to participate.
• Bring about minimal participation by doing activities with the person.
• Continue to dialogue.
• Emphasize valuing and elicit it during any movement toward the slightest participation.
The major challenge in this situation is to make valuing occur, even in settings that contradict it. Many caregivers work in almost hopeless situations: institutions where the mentally ill are herded like animals, nursing homes where the aged are left to fade away, homeless shelters where the poor are warehoused for an evening. Although we need to fight for social justice and establish decent places for people to live, work and play, many caregivers still need to create hope and feelings of companionship where there is none. Thus, if we work alone in a setting that seems to be the antithesis of valuing and engagement, we have a special and difficult role: to bring hope where only despair reigns.
We will often be ridiculed for our idealism and seeming naiveté. Yet we can express valuing and create feelings of companionship even in the midst of hopelessness. Our interactions are what matters. If the person in the most forsaken institutional ward runs from us and falls to the floor, we can keep on teaching the meaning of human engagement. If the person lashes out, spits, or screams at us, we can move toward him or her and continue to bring about engagement and give unconditional valuing. We are challenged to enable participation and establish feelings of solidarity regardless of the hellish reality in which we find those who are marginalized.
-John J. McGee, PhD
We need to rethink how we define “community”. People will say things like, “lets go out into the community”, when in fact we’re already IN community. We all make up the community; just being you makes you a part of it! Embrace what’s around you!
“In the beginning we must always be in the moment with two bits of knowledge focused on giving a feeling of being safe and loved. We should avoid lengthy case histories and cleanly typed plans. If need be, do these requirements. However, our task is to be in the moment; it is not to change anyone’s behavior, but to teach the person to feel safe with us and loved by us.
The present is a series of moments that tumble into the future. Yet, we should not worry about the future, only the present moment. The here-and-now becomes the future with each ticking second. Our encounters transpire in the moment and then transform the next moment.
Whether a mother, father, grandparent, or a person whom we are supporting, the most important variable is the moment, not the future, not a projected plan with outcomes, not behavioral change. No, it is our being present in this very moment and all the person sees, hears, touches, and feels in this mutual coming together. It is the tiniest amount of time, perhaps two or three seconds. Then, these moments are linked together with other moments and it is these moments that become new moments; it is the evolving chain of moments that creates our moral memory in us as well as a memory in the other person.
Caregiving’s simplification involves teaching caregivers to be in the moment:
- In bad moments this equates with forgiveness rather than control;
- In all the good moments this involves a series of accidental and intentional encounters throughout the day focused on safe and loved;
- The accidental encounters are merely brief moments of passing by and encompass a wave, a wink, a smile, a name, a thumbs up, maybe a hug if there is time, a whispering of “You are so good.”
- The intentional encounters are a bit more planned and involve a chunk of caregiving time—from a minute or two or a half hour or more. The time depends. It should be structured in the day with the only purpose being to give a memory that the person is safe when with us.
- The key is to stay in the moment. Joy is found in the moment.
Our task is simple, just being in the moment with the gift of helping the person to feel safe and loved:
- Not a moment before,
- Not a moment after,
- Just in the now.”
-John J. McGee, PhD