Confessions of a Personal Care Home Social Worker **

People often ask me if my work as a Social Worker in a Personal Care Home is really meaningful. They wonder if you can really make a difference in someone's life when they are really at the end stages of life.

Whenever I am asked this, I think of Mrs. Smith.  I met Mrs. Smith in hospital while she was awaiting admission in PCH.  She was so remarkable because she was unremarkable.  The average age of admission to PCH is 87.  She was 87.  The average female comes in with 5.8 disease diagnosis and 4.2 medications.  She had 6 diseases and 4 medications.  In every way, she was unremarkable and completely average.

However, I knew Mrs. Smith was going to be remarkable when I phoned her only daughter to offer a bed for her mother.  Mary told me that she would accept the bed for her mother and that she would ensure that her mom had everything she needed, however, she likely never would visit her mother. She told me her mom had been miserable and negative throughout her life.  She never saw her mom experience any joy and she never saw an example of beauty in her mom's life.  I was a little taken aback and didn't want to judge, however, I saw an opportunity to make a difference.  Maybe I would be able to reconcile this mother and daughter while there was still time.  

I strongly suggested to Mary that she come once a week to see her mom and that I would be there to mediate and to keep the conversation going.  I was hoping that they would magically see how they really loved each other and end up having a great relationship, thus both heaping gratitude on me.  It didn't really work out that way.  Mary was right, her mom was extremely miserable, but she wasn't the only one.  The apple didn't fall from the tree.   I couldn't even get these two to agree on why they didn't like each other. 

I quietly continued my mediation sessions, also known as the most painful hour of my work life, and Mrs. Smith became remarkable to the rest of our team.   She started to fall.  At first, she fell once a week, they a few times a week, then everyday, then every shift.  The team was extremely worried and thinking that her next fall could be her last.  

During this time, Mary came in for one of her weekly meetings.  Mrs. Smith was requiring some care from a \Health Care Aide so we waited outside the room until they were done.  We heard Mrs. Smith talk to the HCA.  "You are so kind to me dear, and take such good care of me, I love you more than I love my daughter, and I wish you were my daughter."

Mary was devastated.  She ran out of the building.  I was too sad for her to run after her.  

A couple of weeks had passed and I didn't hear from Mary.  I guess I had to face facts.  These two would never reconcile.  

A month went by and I couldn't really take it.  I phoned Mary at work only to find that she no longer worked there.  What had I done?  While trying to save one relationship, I may have ruined two lives.  I sheepishly called Mary at home.  It was a good thing I did as another hour and I would have missed Mary.  She was heading to the airport bound for a cruise.  She explained that hearing her mother express love to a health care aide was the best thing to happen to her.  She realized she was just like her mother - miserable, without a friend, and without any beauty in her life.  The difference between her and her mom was that atleast her mom had her.  Mary was single and had no children.  Who was going to look after her?  She realized she had done nothing but work all her life and had saved almost every penny, so she really didn't need to work anymore.  She took early retirement and was off to find some beauty in her life while she still had time.  I was so pleased with her.  

Another month went by and then I got a very distressed call from Mary that she needed to see me. She had started the process of cleaning out her mom\s home to get it ready for sale and she found something.  She came to my office with a tear stained face and showed me a painting.   I told Mary that it was beautiful.  Yes, she said, it is beautiful and the attic is full of them.  I have never been allowed in the attic in my life as it was always locked.  I had to get a locksmith to remove the lock because there was no key.  It turns out that my mom had this whole different side to her and that she had beauty in her life, and she never thought enough of me to share this beauty.   If she had, both of our lives could have been different.  

Despite being very frail from her frequent falling, Mary insisted on confronting her mother.  She needed answers.

It wasn't easy but Mrs. Smith agreed with her daughter that an explanation was needed.  It took her a long time, but she told her story.   Mrs. Smith was an incest victim for as long as she could remember. Multiple perpetrators from the time that she was 3.  No one helped her, no one cared, no one stepped in to rescue her.   She had no voice, just pain.  Eventually, she found some solace in art.   She drew pictures and that gave her some strength to deal with her life.  She hid all of this from everyone as she didn't want anyone to judge her negatively.  She kept her past a secret from everyone, and did her best to even deny it to herself.  She retreated to her art as her own private way of dealing with the world.  The outside world saw her as a miserable.  To her, she found a way to create beauty.  

I don't know if it was harder for the mom to tell or for the daughter to hear, but, it certainly was an ice-breaker.  Mom cried as she apologized to the daughter.  She just didn't know how to love and she wanted to protect her daughter from the evil in the world so she taught daughter to be miserable and to reject the world before the world got a chance to reject her.  

Of course, you don't repair 57 years of a dysfunctional relationship overnight.  It takes time, But,  atleast they had a joint project to work on together.  Mary contacted an art restorer and was working to restore some of her mom's work from decades earlier.  Mary decided not to sell her mom's house but to turn it into a tea room.   Her mother's art was on every wall and it became a refuge for mother's and daughter's who needed a place to talk together over tea and share the beauty in each other's lives.  

I often wonder if the work I did with this family was meaningful.  I wonder if it really did make a difference.   I don't really know for sure, but I can tell you one thing.   256 days and \\Mrs. Smith has not had one fall.

** Like Law and Order, the preceeding story was fiction.  Any resemblance to any real persons are completely coincidental.


After almost 13 years, I have officially ended my association with Revera, and I did so on my terms.  When the weather improves, I will be throwing myself a party.  Revera has also given me their blessing to write a book.  I hope to write a book called "Enhancing Lives".  I will write alternating chapters detailing examples of extraordinary care given to residents and also dealing with examples of how they have treated their employees.  All names will be changed and sources anonymity will be maintained.  If you or someone you know have something to share, please contact me via private message.