Caregiving at its worse causes stress, but at its best can lead to self-fulfillment and rewards. Challenges are common, but depending on the attitude of the caregiver, caregiving can provide returns that are invaluable. One of the Veterans in the Home Based Primary Care Program at the G. V. “Sonny” Montgomery VA Medical Center in Jackson, Mississippi, is fortunate to have a daughter who is always positive and upbeat. She is able to manage his tremendous number of needs with much positive physical, emotional, and spiritual energy.
Janis is not a trained medical provider, but she is an educated and dedicated daughter and caregiver both to her father, the Veteran, and her mother. Janis’s mother developed Alzheimer’s dementia several years ago and recently sustained a hemorrhagic CVA that left her with increased dementia and confusion, ataxia, and dysphagia. She alone requires twenty-four hour care to prevent complications from her multiple medical conditions. She had a PEG tube placed after the stroke to help maintain her nutrition and provide Janice with hope that her mother with the grace of God and her help would regain her ability to swallow. After discharge to home and with the doctors’ admonition that her mother would not survive much longer, Janis took it upon herself to work with her mother on swallowing. The speech therapist had provided education on exercises and tips to help her mother, but did not hold much hope that Janice’s mother would ever regain her ability to swallow. Janis started slowly and carefully offering small sips for her mother to attempt to swallow. She used baby cereal to thicken certain liquids and carefully positioned her to prevent any aspiration. She used a pacifier to develop her mother’s muscles and found substitutes for expensive thickening agents. Patiently, she literally and figuratively provided the support for her mother to relearn how to swallow. Her mother is now swallowing, gaining weight, and singing through her days thanks to Janice’s determination and encouragement.
Janis managed to do all this to help her mother while caring for her father. Mr. L. is an 83 year old World War II Veteran who has multiple diagnoses that require multiple specialists and VA care. He lives over 70 miles from the Jackson, MS, VA in a rural area and has been a patient of the Home Based Primary Care Program for almost 7 years. His diagnoses include diabetes mellitus, type 2, insulin dependent; hypertension; tachy-brady syndrome with coronary artery disease; sleep apnea; seizure disorder;COPD requiring continuous home oxygen, and Class V renal failure necessitating dialysis three times a week. He was recently diagnosed with metastatic melanoma. He is not bedbound, but has vision loss and weakness related to an old subarachnoid hemorrhage. His care requires assistance with blood sugar and blood pressure monitoring and control, transportation to dialysis and multiple medical appointments, and frequent medication and dietary adjustments.
Janis developed her caregiving skills at a young age. When most young couples were enjoying their young children and their relatively new marriages, Janice’s husband was diagnosed with liver cancer. She maintained her positive attitude and willing spirit while caring for her terminally ill husband at home and caring for her three year old daughter. Janice herself said about those days, “My mom and dad helped care for my daughter while I was busy caring for Gary [her husband]. I owe them.”
Janis helped care for her husband providing all of his terminal care and meeting his needs. Not long after his death, her father’s and mother’s death began to decline. She felt that she had learned much in caring for Gary and recognized the importance of returning the favor to her parents when they became in need.
Janis has added an additional component to caregiver. She researches many of her parents’ problems on line finding solutions at different sites including the VA’s webpage. She has educated herself on many services available for her father allowing her to help manage her father’s health and obtaining the things her father has needed becoming an active partner in his care. Through computer research, she has learned about VA, Medicare, and Medicaid programs that can help provide options for her father’s and mother’s care. Her ability to communicate her father’s needs to the provider has made it easy for the VA to provide him with necessary medical equipment, medications, services, and financial support.
Janis has been a devoted caregiver with a wonderful aptitude that can understand the workings of the VA and the medical system. One explanation of a necessary procedure or a medication change and Janice can grasp it. She is able to ask intelligent questions that belies a thorough understanding of her father’s and mother’s multiple medical problems. She is able to supply information to the provider that allows insight for the provider to establish a plan of care that is specific to their needs. In her caregiving role, Janice is an important member of the Home Based Primary Care team.
Janis does all this for her mother and father while working two jobs to provide financial support for her family. She is a diligent, caring, and energetic caregiver who can be a role model for every caregiver. She recognizes the fact that caregiving is hard work, but she also understands that it is a way for her to give back to her parents what they gave to her.
If I could give every chronically ill person a present to assist them in their care, I would give them a Janice—a person who reflects the positive side of caregiving and is able to see the rewards it gives to both her parents and herself.