Home Care Workers Grieve

home care workers aides patient grieveIn July I attended the funeral of a wonderful woman who I had the good fortune to work under for many years. Attorney Eve Paul graduated from Columbia Law School in 1952 near the top of her class and served as an editor of the Columbia Law Review. When Eve initially sought work as an attorney, however, she was offered only secretarial jobs at the New York law firms where she applied because, she was told, fellow [male] attorneys would not feel comfortable cursing around a women lawyer.

When I met her, Eve was General Legal Counsel for Planned Parenthood Federation, a position she held for 25 years, mentoring younger lawyers and ensuring that women and men all over the country had access to reproductive health care. It was an enormous, demanding job, requiring a brilliant intellect, a fighting spirit, a love of humanity and a great sense of humor – all of which Eve had in abundance.

The day of her funeral on Manhattan’s Upper West Side was hot and clear. The chapel was crowded with family and the many friends and admirers lucky enough to have known Eve. As I sat chatting before the service with a number of friends Eve had mentored over the course of her long career, two women, home care aides who had seen Eve through the worst of her long fight with cancer, sat in the pew before me, talking quietly, holding hands, dabbing at their cheeks with handkerchiefs from time to time.

As I noticed these two women, I was reminded how surprised I was to learn that home care aides are sometimes prevented by the agencies they work for from having contact with the families of a client who dies.

Not just a job

A research study published in April documented the ways in which home care workers “often develop close ties to patients and their family and . . . experience significant grief when a patient dies.” I would add that home care aides are sometimes the most constant presence during a frail person’s last months or years, which is why, very often, they are found sitting alongside family members at funerals.

The purpose of this study, published in the journal Home Healthcare Now, was to determine the effects on job satisfaction of policies restricting aides’ contact with a client’s family after a death. Data gathered through interviews with home care workers show that when agencies restrict a worker’s contact with the family of a deceased client it lowers job satisfaction, makes it more likely that the worker will quit home care for another kind of work, and – not surprisingly – makes it difficult for the worker to process grief related to the death.

Certainly, such policies strike at the heart of what it means to be human; they also run counter to what family members naturally hope for in an aide taking care of a vulnerable loved one: genuine caring beyond the mechanical aspects of assisting with dressing, feeding, bathing and so forth.

During Eve’s funeral service, I listened as her son and daughter, and her grown grandsons described her long life as a women, wife, mother and grandmother, as well as a groundbreaking attorney and advocate. Their love and pride filled the room. As her daughter, Sara, thanked us all for attending Eve’s funeral, she had some special words for the two women seated before me.

“It would have been impossible for us to give our mother the care she needed when she was so ill,” she said, “without the dedication and attention and patience you brought into her home.”

I thought, then, of the home care study I had read. It was one of those moments where I wondered, Why do we need a research program to prove the obvious? Home care workers often need and deserve the opportunity to grieve when a client dies. Policies that prevent this have no place in the business of caregiving because, at its best, it’s far more than just a job.

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