- BIOETHICS FORUM ESSAY
Help, I’m Drowning! Rescue Swimmers for Family Caregivers
During the 17 years I took care of my late husband, who was totally dependent because of a severe traumatic brain injury, I was frequently overwhelmed. Most family caregivers feel the same – sometimes, often, or always. They say, “I’m drowning” or “I can’t keep my head above water.”
And yet, health care and social service professionals typically say, “There is lots of help available, but caregivers don’t ask for help or don’t know where to go.” “Where to go” often means a phone number to call, where “information and referral” specialists send the caller on to other places to call. Hardy and persistent caregivers can find some help through these sources, but those who are already drowning usually give up and sink further below the waters.
Here’s an idea for a different approach, adapted from – of all places – the United States Coast Guard. Its mission includes rescuing people from sinking ships. But even when the helicopter rescue teams are on the scene, if the people in the water are so depleted and debilitated that they can’t get into the rescue basket by themselves, the mission will fail. A terrible incident in 1982, in which 33 members of a ship’s crew died while the helicopter crews hovered just a few feet above them, led to the creation of an elite team of “rescue swimmers.”
The idea is simple, although the training is arduous and requires mental and physical toughness. The rescue swimmer jumps right into the water, even in the worst weather conditions, and helps the people in distress help themselves. Once in the rescue basket, they can be lifted into the helicopter and flown to safety.
Apply the analogy to the caregiving situation. When information and referral are inadequate to help a caregiver in so much distress or so depressed that he or she is immobilized, a specially trained “rescue coach” could be assigned to jump into the waters right along with the caregiver. That would mean spending a day and ideally a night in the home, working along with the caregiver, directly observing what is happening, making suggestions on the spot, and also taking notes for future training, assistance, or whatever is needed. Unlike the person taking a phone call, the rescue coach can evaluate the whole situation and give realistic advice.
Don’t home health care agencies already do this? No. Home health care is highly regulated and organized around the needs of the sick person, not the family caregiver. Nurses are able to spend only a brief time in the home, and social workers are rarely deployed. The rescue coach idea, however, could be a special service available through home health care agencies. Paying for it would admittedly be a challenge, but its effectiveness and costs could be assessed.
There is of course no safe haven in caregiving, as there is in a successful helicopter rescue. But getting the drowning family caregiver to dry land would be a very good start.