‘After visiting them daily for months, it felt like family’ says a former caregiver about her experience with patients.
Juliana left Ireland a little more than a year ago but never forgot what her experience in the State taught her. Coming to the country to study English, she left behind her life as a project manager in a big company in Brazil to work with elderly care and learn the language.
The estimated population of persons aged 65 or over has been consistently increasing in the last ten years, and the Central Statistics Office (CSO) expect this population to double to 1.6 million by 2051. Almost a third of people aged 65+ have a long-term health-related limitation.
These can be cognitive limitations due to dementia, or functional limitations in daily activities, such as getting in and out of bed, dressing and undressing, cooking, cleaning, eating, showering, or shaving. One of the best options when an older person becomes unable to live alone, through illness or disability, is care provider companies, which can be an alternative to avoid long-term residential homes.
When Juliana Crispim left Brazil, she would never guess the turn her life would take. “I decided to start caring thinking about the language learning. I knew that I would have direct contact with Irish people every day, and that would help me with the culture and language” she says.
When she got a job in a care company, she had no experience. They gave the new carers a one-week training, provided handouts with the basics of the job, and lectures with experienced professionals explaining how to manage the patients.
“It was an intense week. Starting in the morning and taking the whole day learning everything, from changing incontinence panties and bed baths, to how to manage the client and avoid hurting or bruisers.”
There are some options for families wanting to avoid nursing homes, like the HSE Home Support Service, and The Healthy Age Friendly Homes Programme, but home care private companies are still the most common services.
In May 2022, the Age Friendly Older Peoples Conference happened for the first time in three years. The main issue discussed was the shortage of staff to deliver home care, especially on weekends or in rural areas. Age Friendly Ireland is an organisation affiliated with the World Health Organization (WHO) and is responsible for the national age friendly programme.
Juliana explains that this type of service depends on the patients’ necessities, and visits can last from one hour to a maximum of twelve hours overnight. “Usually, we had an hour with the client. That was the minimum amount of time we spent on every visit. But some patients needed two, three hours.”
As she came to learn the language and had classes every weekday afternoon, most of her clients were one-hour visits to help with dressing, making tea, and helping with anything they needed. “I was there to keep them company while their families were out for work or other obligations, to guarantee the patient would never be alone in case something happened.”
The Alzheimer Society of Ireland has carer training for families who want to learn how to care for their elders, understand the condition and what to expect. But not everybody can quit their jobs to be home all day with their older relatives, so having the option to hire someone is a good help.
During her school holidays, Juliana started to take overnight shifts. She reminds her only highly dependent patient, who was one of her overnight clients. With a soft smile, she talked about the relationship she built with him and his wife.
Being so far from home and having daily visits with some customers created a sense of family in the relationship Juliana had with them. It was a mutual affection, she cared for them as they were her grandmother and grandfather, and they loved her as she was their daughter.
“He was in bed, the poor thing, couldn’t walk, talk, and barely eat. But his wife loved me! She treated me like a daughter and gave me containers of food every evening, we got used to each other, and I really liked them. I was caring for him for a few months when he passed away.”
Juliana changed her tone suddenly and started to talk about the pandemic. She reminds It was a complicated moment, once they were directly working with people at higher risk, and with the patients’ lives practically on their hands. Any mistake could result in a patient being infected.
She said they wore gloves, masks, and at some point, protective clothing. However, they could not stay two metres apart from the clients, most of the patients needed direct contact, physical help like dressing, bathing, or assistance to walk.
For her, the most difficult part of the job is psychological. She had to work with many sick people, and on two occasions her clients died. With a sober expression, she reminded receiving the news of her patients’ deaths.
The office would let her know before the visit, by phone and assign her a new customer. “It was my job. I needed to be working, so I would just visit a new client and keep my day going. But it was hard, I cared for these people for months, and we built a relationship! I felt like a relative of mine had passed away.”
Caring for someone can be overwhelming and demanding, many times leading to some sort of mental health issue like anxiety. The HSE website has a carer support section for new carers, those caring for a family member or anyone in need of assistance while caring.
After two years, it was time for Juliana to go back home. She laughed saying that some of the clients did not take the idea well. They loved her, and after so many months (some patients receiving daily visits) she was an active part of their routines. “But it was time”, she reaffirmed, “Two years away from my mam and brother, and I had learnt a lot. Not just the language, but also how to understand people, how to be more patient, and after two years of working with people with dementia, I knew that I wanted to spend every second of my life with my family. I wanted to create the most beautiful memories with them while we could, but I will never forget those two years. So, thank you, Ireland.”