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    Given all the hullabaloo these days about baby boomers aging, Alzheimer’s becoming epidemic and caregivers in shortage, the question looms: exactly what is adequate care giving, and are people with these meritorious skills born or made?  In past days when many elders still lived with their families, it was assumed that the wives of these families knew how to dispense physical care and T.L.C. in such a way that usually no outside help was sought.  Was it solely because one was a relative that she was able to provide this?  Yes and no.  While physical care and semi-medical skills needed to be learned somewhere, what seemed to come with least effort was the T.L.C.  This was thought to be intrinsic to the relationship of care giver to care needer.
    Today we pay strangers to get involved in our loved ones’ most intimate functions.  We barely have met these people.  They are wont to get to know the older person now absorbed in malaise and oft times with verbal skills decreasing or non-existent.  If we’re expecting T.L.C., where could this possibly come from?  Praying for a Mother Teresa to enter our door would be one approach.  Alternately, we could adopt a vision of care giving not as discrete tasks but as a rarefied opportunity to engage in helping a soul transition from one life form to another.  Is this too airy-fairy to really motivate anyone to handling tasks that mostly have to do with transmission of bodily fluids?
    Try this—beneath outer appearances, what are most of us searching for in life?  I would say finding a way to have our individual life experience validated and being able to really get the life experience of another.  Ah ha!  A connection.  When we are truly connected, we feel a surge of energy, life becomes alive, and for those moments we are not in this swarm of flapping creatures all by ourself.  While an older person in the throes of dis-ease may not seem like a fount of energy, in reality they are a living, breathing repository of life experience, a time capsule of 70-80-90 years of history on this earth.
    Think of the strata of a mountain.  We see the granite on top, yet can only intuit the subterranean Pleistocene era.  The older person in a care facility whose chart reports that he/she is now “a diabetic with congestive heart failure and a super-pubic catheter” could have been a dancer, a romancer, a jokester, an avid hiker, a rogue, an adventurer, a trauma survivor, a faithful adherent, an agnostic, a radical, a soldier, a spy, a drum major, etc.  Those who believe in the intrinsic energy of a talisman, like the Blarney Stone or rock crystals, might approach these interspersed layers of life in the same way.
    We are seeking.  They have something to offer. But how might we actually connect?  This is where our ability to receive more than express must be part of our communication process.  Instead of asking the patient how he/she is feeling or trying to ‘cheer them up’, suppose we found a way ‘to BE’ together in time and space without needing to embellish or change a thing?  This would involved slowing down, breathing, eye contact and touch.  The life energy that is emitted through the senses can enable us to experience the essence of a person.  We can follow their lead and pacing and start to tune into a relationship that is not dependent on knowing their medical diagnosis.  What we can experience through touch, the words of a familiar song, sharing spontaneous laughter may do more for human connection and healing than myriads of ‘procedures.’
    The patient can intuit those moments as alive and meaningful.  While overall life energy and focus may be ebbing, there can still be points in time and space when a person-to-person link can flow.  This is the essence of heartfelt care giving.  It is not what the caregiver ‘does’ for the older person.  It is what they can genuinely share that enlivens and elevates both of them.
    When we tour fancy new assisted living quarters with high fashion carpet and advertised gourmet meals; when we investigate nursing homes that claim to practice “resident centered care” (what else is there?)—it is this issue of care giving that is actually most essential for us to attend to .  Are people working there just to do a job and count the hours, or do they embody care giving from the heart?

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