One in eight Americans is over 65. Many of them suffer from Alzheimer's, a degenerative and incurable brain disease characterized by short-term memory loss, spatial disorientation, trouble with words and arithmetic, and some impairment of judgment.
The aging of the US population is expected to intensify the demand for caregivers who have to take a certified nursing assistant training course, First Aid, CPR and pass a background check. If they want a fair wage with medical benefits, they need to have a Social Security number, which means they have to be greencard holders or US citizens.
Many Filipinos have set their sights on working as caregivers, thinking it is going to be a piece of cake. What they may not be aware of is that aside from changing diapers, lifting patients and pushing wheelchairs, they will have to deal with patients who suffer from dramatic mood changes, hallucinations, severe disorientation and paranoia.
Giving psychotropic drugs may not always solve the problem. When overused, these drugs may cause depression and agitation. A number of nursing homes had been found guilty of overmedication and abuse of patients that their licenses got revoked. Filipinos who work in some nursing homes attest to difficult patients being given pills or shots to knock them down. With a ratio of one caregiver to every 10-20 patients, it is impossible to supervise all patients so sedating the "unruly" ones has become routine. There had been cases of elderly slipping out and walking aimlessly in the streets. Still more fell from their beds and had to undergo hip and back operations.
A number of caregivers are new immigrants and poor, single mothers with low educational attainment. Tourists also work as relievers on weekends. I met a Filipino seaman who worked in a nursing home owned by a former Marcos crony. He said he had to look after someone with bipolar illness. Being a caregiver is like an initiation rite to most Filipinos, whatever may be their profession or social standing in the Philippines. Male caregivers are now preferred because the task requires heavy lifting and men are more up to this task.
While taking paralegal studies in Washington, I visited some adult family homes owned by Filipino acquaintances who were encouraging me to put up one. An adult family home normally admits five to ten elderly residents who pay from $3,000 to $8,000 each depending on the level of care they needed. A nursing home can admit as many as a hundred patients. An assisted living is for seniors who can still manage on their own and just need occasional help.
What struck me most about the elderly who suffer from dementia was how they acted out their memories, or what remained of them.
An 84-year-old lady was always in a hurry to leave, saying she had to go home and cook for her husband who had long passed away. Another woman in her mid-70s would chant “Put the reindeer in the oven” countless times until she fell asleep. A 99-year-old lady would not let any male come near her whether he was ten, twenty or eighty. She was the toast of their town in her youth and had countless suitors. In her old age, she still thought she was irresistible.
A man in his 80s would wear his elegant suit each morning and attempt to leave for the airport, thinking he still worked as an airline pilot. His roommate was bedridden. Whenever someone cleaned him up, he would get abusive, calling everyone a "square head". He wrestled with alcoholism and drug addiction all his life.
The owners of the nursing homes often joked that perhaps, when they got old, they would also betray their lifestyle, or worse, their obsessions. One said that he would not want to start his sentence with "When I was in Las Vegas...."
I realized that due to their circumstances, old people mainly live by their memories. They are bitter if their memories are mostly bad. They are cheerful when memories are good.
The late Luis Buñuel, founder of surrealist cinema, said that "you have to lose your memory, if only in bits and pieces, to realize that memory is what makes our lives. Life without memory is no life at all.... Our memory is our coherence, our reason, our feeling, even our action. Without it, we are nothing."
As Alzheimer's disease catches up with America's graying population, children find it difficult to deal with their folks. "They often have this blank look in their eyes. It's as if they have lost their soul,” a daughter said.
What is interesting is that caregivers themselves eventually absorb their patients’ dementia as they do not get enough sleep and they work for months without a dayoff. Half of all Alzheimer's caregivers reportedly struggle with clinical depression.
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