Dementia in lockdown

There has been a lot of talk about how people living with dementia will cope with COVID-19. When we think about it, let’s ask ourselves “what will change for them?” Considering life in the average Care Home for a person living with dementia, how often do they go on outings? How often do they get to walk to the shops, go and buy an ice cream, have a glass (or two) of wine? How often do they get to decide, on the spur of the moment, to go and visit a family member? Let’s face it, most people living with dementia are in a continuous state of lockdown, either literally, figuratively or both.
We have become so used to the living arrangements that have become the status quo and accepted norm for those living with dementia. Up at 04h00, sitting in the lounge, breakfast, lunch, supper, teatime, bedtime. Maybe a bit of singing here and some colouring there, one day floating into the next. Tuesdays Bingo, Sunday church.
So many of us are going through a tough time at the moment. We know this is temporary. We are not confused or forgetful. We are mostly in our homes, we can determine our own pace and do our own thing. We can read, write, cook, play with the dogs, sit in the garden. And yet, we mostly feel completely overwhelmed, anxious, depressed, helpless. ALL. THE. TIME. We wake up at odd hours of the night, we are grumpy, irritable, weepy. Aggressive. Snappy. I find that I wander up and down the garden. I go from the couch to my desk, then before I know it, I am lying on my bed at 11h00, having a nap.
For those working in Aged Care and with people living with dementia, does the above sound like most of your residents? If you took them to the doctor and described these behaviours, I can guarantee you that, without hesitation, the diagnosis would be “behavioural and psychological symptoms of dementia.” Done. Dusted. Medicate. Whilst many specialists would note that “non-pharmacological interventions” should be the first port of call, the offerings are mostly patronising and often elicit more distressed reactions.
Very few of the above mentioned reactions are directly related to the cognitive impairment of the person living with dementia. They are often the result of frustration as a result of being locked in, restrained and bored. The feelings of having no agency, of not having much choice, etc. I think you get the message, as this is exactly what many of us are experiencing at the moment.
Will COVID-19 bring us to a point where we can actually begin to see what the impact of a “lockdown” is? Will we begin to see how our well meaning approach to institutional care can be so detrimental to the wellbeing of the most vulnerable people in our society? How taking away agency and freedom and choice can lead to reactions that in turn lead to a further decline into a lifelong prison sentence?
Let us open our eyes and ears and hearts and minds to see and hear and feel and think differently, now that we have experienced the horridness of a loss of agency. For those of you who manage to do all the gardening you ever wanted to do, learning new skills, catching up on the backlog of filing and writing and learning new skills during this period, I salute you. For the rest of you feeling as down and unproductive as I am, let’s talk about the plight of people living with dementia…and take your pick of which of the “non-pharmacological interventions” listed below you think would choose to make you feel better right now..
Table 2. Non-pharmacological management strategies General principles • Provide a ‘dementia-safe’ and friendly environment • Maintain a set routine • Avoid over-stimulation • Psychoeducation for family/caregivers • Adequate training for caregivers • Reminders and repetition of information • Orientation with clocks, calendars, newspapers • Regular social interaction and activity Behavioural • Regular exercise • Wandering paths (secure) Psychosocial interventions • Reminiscence therapy • Validation therapy • Resolution therapy • Pet therapy • Respite care to relieve caregiver burden • Supportive counselling for family members, e.g. dementia support groups 1) Management of behavioural and psychological symptoms of dementia With the steady rise in numbers of the world’s elderly population, the behavioural and psychological symptoms of dementia (BPSD) have become increasingly relevant to both clinicians and families. Carla Patricia Freeman, MB ChB, FCPsych (SA) Department of Psychiatry and Mental Health, University of Cape Town Carla Freeman is a psychiatrist currently sub-specialising in the field of neuropsychiatry at the Department of Psychiatry and Mental Health, University of Cape Town. Her areas of interest include substance abuse in the context of HIV infection and old-age psychiatry. John Joska, FCPsych (SA), PhD Associate Professor and Head of Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town John Joska is programme manager for HIV psychiatry and Cape Town Metro West old-age psychiatry.

Being vs Doing

Being vs Doing. In many Care Homes there seems to be an obsession with “doing” – creating an environment where people are kept busy and entertained and cajoled from the morning to the evening. Apart from the fact that there is no evidence that this has much positive results, I often feel for people who are not able to escape.
Activities are important, I do not argue with that. However – how many activities do we perform outside of our daily routines? I do ceramics once a week – that is my activity. I often wonder if we do these activities for our own sake or for the sake of the Elders… Is it our way of keeping ourselves busy? Or maybe a way of making the time pass….?
As emphasized in yesterday’s post, just BEING with someone who is forgetful (or sick, vulnerable, old) is the biggest gift that you can give. For being with someone is validating that their presence counts, that you do not have to make things or do things to connect.
So many Caregivers are not allowed to just sit with an Elder – in fact many are being watched on cameras to make sure that they are “working”. It is impossible to always be busy doing things with people living with dementia. So many end up in front of a television…
Being fully present with someone who is living with a different reality means that you honour THEIR reality, you will respect THEIR space/thoughts/feelings and meet them where they are at, with your full being.
This is something I am beginning to understand more and more within myself – to actually BE with myself. I practice being alone, quiet, still. I would not call it meditating, never have been good at that. But just simply being – staring at the waves crashing on the beach, watching the clouds passing above, the little sugarbirds drinking from the red water that I put in the garden for them. And maybe one day when I start to forget I will have perfected the art of being.
The biggest gift then will be to be alone in nature. Do not try and cajole me into doing anything. Music maybe – Liszt to cheer me up, Schumann to calm me down. I will be happy to sit and look out the window. And to be in the presence of kindness. That will be enough for me.

Being a Caregiver

“As the population ages, more of us will be called upon to care for others. So we must understand the importance of recognizing and honouring the intrinsic worth of others, regardless of age or disability. Caring for another human being is sacred work that should have the essence of preserving human dignity at its heart.”
(Amanda Waring, The Heart of Care)
Over the years I have had the honour of working in many Care Homes across South Africa. I have done the direct care work – helping people to eat, bathing, showering, changing incontinence wear, brushing teeth, etc. I have worked shoulder to shoulder with Caregivers and management. I have trained more than a thousand Care Partners.
It is one of my favourite opening phrases when speaking at international conferences – “in South Africa, we have the best caregivers in the world”. I repeat – “we have the best caregivers in the world in this country”. When saying this in South Africa, I am often met with a blank stare. I can see the thoughts going…”what about the Carte Blanche episode of the Black carer slapping the white Elder?” Or “what about the Huisgenoot story of the Carers who threw the frail Elder out of bed?” This happens all over the world, not just in South Africa. It is not the norm. It is a sad part of the human condition that not all people are kind and humane. However…
Why would anyone want to work as a Caregiver in an “Old Age Home”? Twelve hour shifts, minumum wage, terrible abuse, demanding Elders and often even worse family members. (Trust me on this one, I have been on the receiving end of the most horrible verbal abuse. And I am a 6”3’ tall white man – I have been reduced to tears by a daughter-in-law of an Elder!) Cleaning soiled incontinence wear, scrubbing dentures, fishing old food out of someones mouth that they have been chewing on for sometimes an entire day, trying to get someone to eat pureed food that looks like – ok, you get the message. Caring is not a glamorous job – it is mostly a dead end job that can destroy your back and your selfworth. Why would anyone sign up for this job, willingly? “They only do this for the money” I am told over and over again.
I disagree – when you can earn substantially more money waving a red flag at roadworks working eight hour shifts, you will NOT become a Caregiver “for the money”. According to research, most non-Western Caregivers do this work because it is “a spritual calling”. They want to care, they want to make a difference.
Another interesting fact of this research – why do so many people leave the care sector? (Globally, the staff turn-over in the care sector ranges from 40% to 100 % per annum!) The number one reason why Caregivers leave their jobs is because they are not respected. They are not regarded as professional people – yet we “trust” them to do the most intimate work with our vulnerable family members. When Caregivers were asked what they mean by not being respected, the answer was “no one ever asks our opinion”.
So what is the point of this story? Our African and “coloured” Caregivers in South Africa do this work because it is a calling. They care instinctively, genuinely. What kills the calling is the lack of respect – NOT a lack of training or discipline, not a lack of policies or procedures. Respect. And the institutional system.
I always ask the management or professional nursing team in charge of Care Homes: “who knows the Elders the best?” The CEO? Nope! The Caregiver and the Cleaning Lady. Do the Elders miss the CEO when he/she goes on holiday? Nope! Do they miss the Cleaning Lady who spends time in their room every day? Hell yes!
If we want to tap into the spiritual calling that brought our Caregivers to our homes, we should start honouring them for the work that they do. We should acknowledge the relationships that they form with our Elders, the knowledge that they have of the needs of the frail and vulnerable. And we should start TRUSTING their instinctive caring, creating a supportive environment.
No amount of discipline, rules, policies, procedures, cameras will change the behaviour of adult people. Trusting and respecting them will go a long way towards bringing the best out of them at work. But more than that – being the person whom they want to emulate is possibly the best “training” that you can give to a Caregiver. We try and “teach” the values of respect, dignity, care, gentleness. Ask yourself the question – “how do I SHOW respect, dignity and care, respect towards the Caregivers who work with me, in every interaction that I have with them?” Do you mirror the behaviour that you want “them” to have in everything that you do?
We have the best caregivers in the world, in South Africa. If you do not agree with me, go and look in the mirror to find the reason why for you this is not the truth. I dare you!

The art of caregiving

The art of caregiving. How do we teach caregiving? Is it at all possible to “teach” someone how to care? I am not so sure…
I have studied many training manuals over the years. I have developed some myself of which I was very proud. I have presented workshops at international conferences on the topic of “non-Western adult learning theory” and trained more than a thousand caregivers. And somehow, I doubt that the “training” had an impact.
Essentially, what we try to achieve through “training” is to encourage people to BE differently in the world. To react in a different way, respond in a different way to the stimuli of what they perceive to be a need from an Elder. So – I see someone that is thirsty – I give them water. Or not. I see someone struggling to peel an orange, I do it for them. Or not. I am told that an Elder needs to have a shower/go to the toilet/needs help eating, I go and shower/help them to the toilet/help them eat. Tick – good carer! Happy manager. Simple. Trainer paid well. Please come again? Maybe not.
What makes a trainer or a training program successful? Having changed the way that Caregivers act or behave? Changing the way that they respond to the needs of those whom they care for, being more attentive, more engaged, doing as much as possible for the Elders without them even asking for help? OR NOT! In this country we have sadly grown up with a “Madam and Eve” mentality. Madam asks, Eve does. This is how we create “learned helplessness”. We create needs and provide care, instead of encouraging Elders to do as much as possible for themselves. We quickly hear perfectly capable Elders saying “I pay your salary!”, demanding that Caregivers are at their beck and call 24/7. In so-called “upmarket” establishments, quality of care is advertised as having a dedicated Caregiver for each Elder. (One on one care). This, in my opinion, is one of the worst trends in our care sector. NO one, and I honestly want to say not a single person on this planet, wants to have another person in their presence 24 hours a day, waiting to “help” them whenever they would need to lift a finger. This trend created helplessness, takes away autonomy and fosters dependence.
So what is the answer? True caregiving is an art. It is the art of forming authentic relationships, of getting to know each other through shared stories and creative engagement – in both directions. Dr. Bill Thomas said: “if your employee’s children are performing better at school because their Mother works in your Care Home, THEN you understand what care is”. This to me is probably one of the most profound statements I have ever heard. Think about it. Caregivers are not JUST Caregivers. They are the people closest to the Elders, who know them the best. Do you know the names of the children of the person who is your Mother’s Caregiver? Do you know in which grade they are in school? Their hobbies? Because that woman who leaves the Care Home tonight at 19h00 after a 12-hour shift is NOT JUST a Caregiver. She is a Mother, maybe even a Grandmother. And she is going home tonight, most probably only getting there at 21h00 or 22h00, taking taxis and trains and walking miles. She has to cook for a family, help children with homework, be a wife. Her children’s performance at school in the morning is dependent on the ‘mood’ in which she will leave work tonight, the energy that she has left to share with her loved ones.
Think about that for a moment. And then realise that genuine human care can only flourish in a reciprocal relationship where the Caregiver feels, yes FEELS, that they are also cared for, that their story is known, that they are seen and heard. That they are not told “you must leave your personal problems at home”, but that they are well known for the human beings, the Mothers and Grandmothers that they are. THEN they will honour their spiritual calling and be the Caregivers that we try and teach them to be. THEN they will honour the sacredness of the human spirit of every Elder much as their spirit is honoured.
I no longer want to do “training”. I simply want to sit and listen to stories and honour them. That is the way, I believe, we will make this country a better place and create environments of genuine human caring. Sela.

Written a year ago…

Without becoming overly philosophical, I am intrigued by the ‘mind’ and what happens to the subjective experience of Self as we age and our cognitive abilities change. We hear people say “he has lost his mind”. Can one “lose one’s mind”? What/where is the seat of the mind – is it a purely cognitive function of the brain, or is it an intricate symphony of many instruments that fuse into a harmony of knowing? Is the mind factual or emotional, or a combination of facts and feelings that we ascribe certain meanings to?
We know that feeling in the gut when we get shocking news – and feel ‘gutted’. Well, we have exactly the same feeling when we get exceptionally good news or when we get a fright – it is all in the gut! But, we somehow process the ‘gut feeling’ based on perceptions of good or bad or happy or sad.
Is the link between the emotional experience and the interpretation of this experience short circuited for the person living with cognitive impairment? Do they just express emotions not really knowing what they feel?
The subjective sense of Self, the mindfulness and the emotional awareness of people living with dementia is (in my opinion) elevated to a much higher level. Their intuitive sense of their own vulnerability is like standing naked on the highway – vehicles rushing past at incomprehensible speed, people staring, hooters blaring. Very few stop and offer assistance. It must be unbelievably frightening.
Often their only defense is to withdraw, to go inward more and more, to consciously cut off. And as Naomi Feil once said – “become living dead people”. Not because of dementia, but because the world simply is no longer their place of belonging. It is the world that robs them of their identity, security, connectedness, autonomy, meaning, joy. (The Eden Alternative Domains of Wellbeing).
When a person living with dementia is seen as someone who can no longer grow, a slow death sentence is imposed – again, not by the disease, but by society.
Growth is spiritual, it is our own ‘becoming’. It does not have to entail learning new words or concepts. Growth can be a meaningful journey of becoming your true Self, divinely connected. Of truly becoming the new, different you, being with your own Self, learning to dance with the dis-ease rather than to fight it. Learning to honour the new reality. Exploring a mindfulness of spiritual awakening.
I so hope that we will start learning from some African cultures who revere older people who’s minds have changed. That we see this as a progression to a higher state of being – “with one foot on the other side”. Imagine a world where we seek to understand this state of being in order to learn from it….
I will never forget, as long as I live, looking into the eyes of my maternal Grandfather when he stopped communicating verbally. I looked straight into his soul, seeing the most mindful human being that ever crossed my path. I saw his respect for nature, his love for his family, his life of devotion to his God, and his unconditional love for me.

Another two weeks

So our lockdown has just been extended until the end of April. For many people the biggest challenge will be that they run out of alcohol…
What does this mean for our Elders and Care Partners? Considering how many Elders have no children or relatives, or whose loved ones live abroad, it will be business as usual. In fact, the fact that some Care Partners are in lockdown with the Elders, it might result in stronger and closer relationships.
So many of the Elders never leave the Care Homes in any case, so for them it will be business as usual. For the Elders living with dementia, the world will feel a lot more anxious, and it will most certainly affect them. How would we alleviate this anxiety?
In a session on mindfulness today I was again aware of the power of the Mind, and how easy it is to focus our intentions. Most people living with dementia have perfected the art of being in the present, in spite of popular belief that they all live in some long-ago memory world back in the 50’s. Considering the prevalence of memory loss, this makes little sense. The constant efforts to “take them back” could be more distressing than soothing if they realise how much of their memories have disappeared.
I also think that it is often more our need to take them back. Perhaps, it is also our struggle with being in the present that makes it easier to go back to the past. People living with dementia often function very well in the present, if we can BE with them in the present. Having a meal, drinking tea, walking in the garden, even just sitting quietly can be immensely reassuring. For them. And for us.
This is something incredibly valuable that people living with dementia can teach us – BEING. Just simply being. If we can let go of our need to DO, to entertain, to be busy, we will discover the greatest gift from people living with dementia. Naomi Feil, founder of Validation Therapy, talks about “centering yourself”. If you can really center yourself, if you can BE with the person in that moment, not thinking of the past or what you still have to do, your stillness will be transfused.
We all have “monkey minds” – jumping from one thought to next, chatting away on the internal dialogue at break-neck speed. Being in the presence of someone living with dementia can be such a gift, if we open ourselves to it.
The next two weeks will not be easy for those caring for people living with dementia. Well, unless we can take on the challenge of being mindful. Try it! Be still. Center yourself. Really look the person in the eye. Try to hold their gaze with intent. Think of them with kindness and compassion, honour them as your teacher, not your charge. Miracles will happen.

Monday blues

I have nothing to complain about, nothing to worry about, nothing to fear. There is no reason for me to feel anxious. Yet, today I really felt out of sorts. Somehow I feel compelled to carry on as per normal. I have reliable people running my business whom I trust with my whole heart. I am optimistic by nature, always seeing the bright side of things.
I find that I am deeply concerned for people living in informal settlements. Not so much that they will contract COVID-19, but for their reality under this lockdown. The men who wait by the side of the road every morning, those who beg at the traffic lights. On my way to the shop I see a group of children playing on the field opposite the informal settlement. How can we expect them to stay indoors in a shack? Last night as I snuggled up in bed listening to the beautiful sound of the rain on the roof, I wondered how many people were cold, shacks leaking, with no dry wood to make a fire to keep warm.
I feel helpless. And yes I help where and as much as I can. Anyway, that set the tone for today. Feeling miserably at a loss and out of sorts. We all have these days, I try to console myself while I eat another McVitie biscuit with dark chocolate lounging on the couch with the dogs.
Tomorrow I will take the day off from my cellphone. If I have to listen to another self appointed guru who suddenly decides to put up a video of themselves telling us how to make lemonade whilst the lemons are coming at us at the speed of light, I might not be responsible for my reaction. I wonder what would happen if all social media would be banned for 21 days…(say I writing yet another epistle for Facebook! Or is it a diatribe?)
Somehow, we are all feeling at the end of our tether, to some bigger or lesser degree. We all sit with our inner dialogue that is on full volume, racing at breakneck speed through our heads. Grand plans that come to nothing. Creative projects that are half done. Baking, Netflix and Facebook seem to be the top of our lists. We all know that this will end, yet we act as if we are trapped for life. (The royal we – I have heard this from some friends too.)
We are not trapped for life. Our inner dialogue is real, and we can manage it. We are free to vet in our car and go shopping when we want to.
Imagine being old, living in a care home in one small room, 4m x 4m. For life. Imagine your inner dialogue being muddled, not having control over the discourse. Imagine not being able to get in your car to go shopping, not being able to make yourself that cup of tea before you go to bed. Imagine being locked down behind security gates with people whom you don’t like, whom you don’t know, and who are driving you more crazy than you already think you are.
I have seen too much of this to ignore it, to pretend that it does not exist, to be told “it is not that bad”. It is that bad for millions of people all over the world. And worse.
So what?, you may ask. I don’t know “so what”. I want to raise our consciousness, I want to beg people to start thinking of creating a new system, to reconsider the way that we deal with ageing. In this lockdown, I want people to feel deeply, to dive deeper, to consider and contemplate how we have cut ourselves off from older people. Like we have pretty much ignored talking about death for a few decades, we have to renegotiate our relationship to ageing and death.
This is a good time to do so, don’t you think? Death is on our doorstep, knocking frantically. The best we can do is to engage with it, to talk about it, to hear how others feel about it. Now is as good a time as we’ll ever get. Let’s do it?

Day three

Where is this going? What is our next step? What do we do? We don’t know. We have never experienced something like this on such a global scale since World War 2. The entire world has come to a standstill. People are frightened. Petrified. We see the worst in people coming to the surface – racism, xenophobia.
Why is this? What is it that we are so afraid of? Why are we all in lockdown, why has the world stopped? DEATH – there, I said it. We are afraid of dying. We are all scared that we, or someone we love, will die. We have implemented the most extreme measures the world has ever seen, because we do not want to die.
In certain countries, if you are over 60 or in some places 70, you will not receive medical care that involves being put on a ventilator. Those will be reserved for “younger” people who have more to contribute to the economy. Yes, you understood right. This is what it has come to.
I wonder if anyone has bothered to ask people over 70 how they feel about this “arrangement”. The thought is unthinkable. Yet, that is the current status quo. But I would love to know what older people think, how they feel about this. Because, I think we are missing something in our petrified and scared state of mind.
I wonder how many older people fear death. Ironically, I have just started a series of talks on dying when Covid-19 came to throw a spanner in the works. And oh, then my own Father died on the 21st of February. Bad timing. He was good at throwing a spanner in the works and getting his timing wrong.
I was just about to explore how older people felt about dying when my 84 year old, very fit and healthy biker Dad, had a stroke and died two weeks later. What did I learn from this – that it is time we started talking about dying. That we stop pretending that we are going to live forever. That we are NOT immortal, that the only thing we can be sure of is that none of this will get out of here alive. We are all going to die. And that thought will spur us into Living!
No, I do not want to suffer or die from suffocation. Yet, why do we think that WE should be spared from this thing called death? Why do we think that it is something that mostly happens in Italy or Spain? Their old people are usually held as the beacons of good health – all that sunshine, the Mediterranean diets, the red wine. Hell, why are they suddenly all dying? We thought we had it figured out.
Nope. We have not figured it out. And all the lockdown and masks and billions towards finding a vaccine…whatever. We are still not going to get out of here alive. Maybe not from Covid-19, maybe not soon, but trust me, you are going to die!
I know this is not what anyone wants to hear right now. No no no, we want to create activities for older people, keep them safe, find ways to communicate with them, keep them busy. How about we all shut up and start having the most valuable and meaningful conversations with each other, about our mortality. We have not conquered death, and Covid-19 is a reminder. Yes, it is not a gentle reminder, it is more like a siren waking us from our peaceful slumber, cutting through flesh and bone right to our marrow.
This is our wake-up call. I hope for once we are going to listen. And that when this is over, we will not celebrate the fact that we “beat” the virus, that we “won the war”. I hope that we will become quiet, introspective, contemplating the gift of Life. The precariousness of our Being here in this reality. That we will see and hear and feel and smell the transient nature of our time on this planet.
And I hope that we will change our ways. That we will rethink the role of Elders. That we will see them as valuable assets. Contributors, not consumers. I hope that during this crisis our Elders will step up. We say that our Elders should live in an environment where they can give, and not just receive. I hope this crisis is waking up Elders across the globe to smell the coffee.
Elders, wake up! You are not the vulnerable victims of a virus. Wake up and take charge again of your environment. Stand up now, your country needs you! Take charge of your own Life and see how YOU can change the course of history alongside Covid-19. In The Eden Alternative we use the acronym GROWTH. I love it! It says Get real. Reach out. Open up and dream. Work up a plan. Take action. Hold fast….
This is what the world needs from every older person now. GROWTH. Get real and face the music. Reach out to those around you and open up and dream. Then work up some plans on how you can get involved, help, support, guide, entertain, pray – whatever you think is needed. Then, take action. Get off your backside and make yourself useful! Now is not the time to sit and wait to be served – now is the time for you to be of service, in whatever small or big way that you can!
And then, hold fast. Don’t let go. Even when this pandemic is over, hold fast to living your life. If you are still here, you go. You grow. Human life should never be separated from human growth. This is truer now than ever before – now is the time for GROWTH!

Day two

Is it Saturday or Sunday? Somehow it feels like Sunday. Must be the silence… I can vividly recall Sundays in the school hostel. Most employees left just after lunch. We got sandwiches for supper that were made on Friday afternoon already and kept in the fridge. Sandwich spread. Marmite. Jam. Soggy and cold when we got them unwrapped on a Sunday afternoon. But today is Saturday. I think?
I vividly remember the trappings of institutionalisation. A bell ringing to announce supper/study time/bedtime/ getting up time. A routine menu – Friday fish. Pudding three times a week. Toppers. Sago pudding. I hated it. Every single moment of it. Perhaps that is the reason why I feel so passionately about changing the system of locking older people up in so-called “care” homes.
We create dependence. We kill individuality. We discourage individual thinking. Would this virus perhaps contribute to a global rethink of locking down people simply because they are old? Would it make us rethink our attitude towards older, vulnerable people? Maybe it will take a pandemic of this nature to make us change our minds.
I am intrigued by the lack of resident participation in some of our homes. Why do residents not queue to offer their help? Why are not volunteering to assist the employees who are skeleton numbers? Are they lazy? Scared? I don’t think so. I think we have created a system where very few residents have the confidence to step up, to offer their help. We have created a generation of older people in care homes that have lost their individuality, their gravitas. We made them helpless.
Somehow, I hope this virus will change this phenomena. I am waiting for residents to see how much we need their help, how valuable their contributions would be, how needed their wisdom and guidance and support are to the employees. Maybe this virus will bring about an awakening, a realisation that they are not old and useless.
Maybe this virus will encourage and engage people to see how privileged they are to live in a Care Home where everything is provided for them. I hope so. I really and truly hope that we will have see a change that comes with the threat. A change that will bring about an opportunity to give and not just receive. To be of service and not just to be served.
Every Elder is equipped with a lifetime of experience. Now is the time to explore this, to bring out of the mothballs. To participate and activate and celebrate. Life is precious. Now is the time to live it!

Day zero

What a surreal day. Tonight at midnight we go into lockdown. The concept means so many different things to so many people. In our world, it means that our Care Homes will be shut from the public, with only employees going in and out. The risks are frightening…
Four of the homes have decided to go into quarantine. No one will be allowed to enter the premises. Employees will stay on the premises for the next 21 days with residents. I wake up with a feeling of urgency…
My cousin Martin works at the Westin Grand Hotel in Cape Town. He offered and arranged for us to collect used linen from the hotel for employees who will move into the Care Homes. Friends rally to help – we collect four car loads, a trailer and two small truck loads of sheets, duvets, pillows, covers and gowns. The amount of stuff is quite overwhelming.
I take one of the loads to Stellenbosch where we deposit everything. From here, our senior staff will distribute to the homes. The roads are eerily quiet. People congregate at malls and shops to stock up. I decide to visit our managers at the homes that will go into quarantine.
Joggie, our manager at Vonke House, comes to the gate. No one is allowed inside, not even me. We stand on either side of the big metal gate, simply holding each other’s gaze. I cannot speak. Looking at Joggie I am overcome with emotion. Awe. Respect. Gratitude. Humility. “Ons gaan ok wees meneer. Moenie worry nie.” I leave without being able to say a word. The best I can do is to share a Namasté (I bow to the Divine in you) and walk away in tears.
At Robari I speak to Jacqui, our assistant manager. She is tiny, looking younger than what she is, yet she exudes strength. Again, I am the one being reassured that they will be fine. Ju-Ann, the manager, says they opened the hair salon today, as GERATEC employees offered to do the resident’s hair!
At Silver Oaks, Marietjie and I are both equally emotional. They have prepared everything – tomorrow there will be a braai for the residents. I cannot believe that they actually made sosaties for all the residents for a braai!
Lynn and I have coffee at the mall, as I cannot enter their village. I feel such incredible support from each and every employee! There I thought I was going to see them to support them – yet I feel held with such grace and kindness by each and every one of them.
In Fish Hoek the same applies. Our managers are strong, confident, the employees positive. “Give us a permit, we will find people to bring us to work”. “Meneer moenie worry nie, meneer ken ons mos”. On Chapman’s Peak I have to pull off the road, I am so overcome with emotion…
We are facing a nightmare. We have no idea what to expect. We are all holding our breath. Everyone wonders in which home the virus will show up first. We are petrified. Yet, they carry on. Strong. Confident.
I come home and crawl into bed with the dogs. Exhausted. At least the employees in lockdown will have beautiful sheets, pillows and duvets tonight. I am in awe of these (mostly) women and men who are prepared to sacrifice everything for the residents. They could choose to go on leave, to stay at home. Yet, they firmly volunteered to stay with the residents.
Tonight Victor and I are quiet at home. Messages keep on coming in, urging Victor to now take a break and look after himself. Whatever lies ahead, we will be strong. Our Elders will be held with love, kindness and grace, that I now know for sure!