(In) Continental Drift
Incontinence is no laughing matter and it's likely that anyone or anything that has it would probably rather not. Of course the world of men's and women's diapers is such a growing field that analysts are citing the market as becoming a saving grace to the paper industry which has watched demand for its standard products (the world of printing and office paper) steadily decline. And of course the world of disposable baby diapers* just continues to grow as any new parent knows; pretty much gone are the days of washing and drying cotton diapers (now replaced by bamboo diapers for those parents still wanting to avoid the high cost of the disposables) or at least the process of such being done at home (as with hospitals and restaurants, linen delivery services have taken up the slack). But if there was any more memorable scene of a new parent's introduction into the world of baby's first poop it would likely be Michael Keaton's reaction in Mr. Mom where he wore goggles and garden gloves and braved the soiled diaper with long barbeque tongs (if it's any consolation, baby's poop generally only smells after the introduction of solid food). Throw in the field of hospitals and people dealing with bacterial infections such as C. Diff and the incontinence issue appears to be something coming out of the woodwork, so to speak.
As with most folks, incontinence was an issue I often relegated as happening to an older but silent crowd, never really knowing if my grandparents dealt with this or not (as if they would tell me); trying to place myself in their shoes I doubt that I would reveal to my own friends and most family members that I now had to wear an adult diaper (I don't, in case you're wondering). But we've all been there, the occasional flu bug or bit of food poisoning or hard sneeze and the realization that "something" may have happened which you couldn't control and off we have to run in embarrassment...that is, when we are able. Suppose you're on a long flight, trapped in a middle seat and it's an all-nighter? Or you're sitting at a concert or lecture or interview? Or you're working in some customer service job facing a line of people when it's most busy? Or you're babysitting and are the only adult there? Or a hundred other situations? Now imagine that such a thing happens only you couldn't do a thing about it...you're sleeping or you're incapacitated or you simply aren't aware of any changes. There was a piece in TIME about the joys of becoming old but this particular paragraph stuck out for me: There is, similarly, what Rauch (author Jonathan Rauch) describes as an older person’s ability to normalize crises. Life can be a series of experiential typhoons, both good and bad—falling in love, falling out of love, marriage, divorce, new job, lost job—and every one of them feels overwhelming at first. But there are only so many Category 5s that can be thrown at you before you realize that the clouds will eventually part and you’ll probably be left wet but standing.
My mother dealt with this a year or so after entering an assisted living facility, her "control" now diminished (primarily because the facility told me and that I needed to begin bringing a steady supply of adult diapers). It was embarrassing and humiliating for her, as it would be for any of us, being told to just "go" while sitting since she had on a diaper (she was in a wheelchair at this point) and that she would be "changed" as soon as possible. I'm not sure if she ever got used to the idea of just giving in, her holding things as long as she possibly could simply because there were so many others facing the same problem and also needing changing. A Category 5 as the above paragraph mentioned. Jump to new parents who contentedly hold their baby then quietly reach down to "check" and discover that oops, time for a diaper change. As a new parent, it simply becomes a natural thing, a duty of sorts, to take care of things and give your baby a clean and a new diaper. But what if instead of your newborn it was your spouse or your parent? Bring in outside care or place them in a facility? What about the costs (the average assisted facility in the U.S. has jumped to about $7000+ per month or $84,000 annually) and your work and your children and, well, you. Said another piece in TIME: 16 million Americans...serve as unpaid caregivers to someone with Alzheimer’s disease or dementia. Because the tasks involved are so intimate and expensive to outsource, caregiving often falls to loved ones rather than professionals. And the number of caregivers is projected to grow: a recent study estimated that Alzheimer’s diagnoses will more than double over the next four decades as the U.S. population ages. Research shows that Alzheimer’s caregivers face significant physical, financial and mental burdens. In an October survey by the Associated Press—NORC Center for Public Affairs Research, about a third of caregivers said they struggled to manage their own health and had skipped going to the doctor—even when they were sick or injured—because of their duties. That’s especially concerning since dementia caregivers are themselves an aging group: 34% are now 65 or older.**
Said another piece in WIRED about the shortage of caregivers: ...between 2010 and 2030, the population of those older than 80 is projected to rise 79 percent, but the number of family caregivers available is expected to increase just 1 percent...The number of those older than 65 with a disability is projected to rise from 11 million to 18 million from 2010 to 2030. Given the option, having a digital companion may be preferable to being alone. But, as the article goes on, not everyone agrees: Sherry Turkle, a professor of social studies, science, and technology at MIT and a frequent critic of tech that replaces human communication, described interactions between elderly people and robotic babies, dogs, and seals in her 2011 book, Alone Together. She came to view roboticized eldercare as a cop-out, one that would ultimately degrade human connection. “This kind of app—in all of its slickness and all its ‘what could possibly be wrong with it?’ mentality—is making us forget what we really know about what makes older people feel sustained,” she says: caring, interpersonal relationships. The question is whether an attentive avatar makes a comparable substitute. Turkle sees it as a last resort. “The assumption is that it’s always cheaper and easier to build an app than to have a conversation,” she says. “ We allow technologists to propose the unthinkable and convince us the unthinkable is actually the inevitable.” The "human" side of this app are people living in Mexico and the Philippines and Venezuela and being paid about $2 an hour, and for the most part they don't understand this "no time to care for relatives" attitude; in theirs and many other cultures around the world, the elderly or disabled are family and without question family comes first. Even in the U.S., the aides who do the cleaning and changing of people in care facilities, no matter how expensive, are paid between $10 and $13 an hour on average...
So why bring all of this up? Partially because one doesn't understand the stress and strain of it all until one becomes immersed in it. The reality for many is that the expense and time needed will force decisions to be made, many of them unfavorable (cut down on work, take out savings, skip one's own health concerns), not for everyone mind you but for far more than one would imagine. And bit by bit, patience wears thin and backs begin to hurt and stress seems to begin its slow crunch into your body to become as damaging as a fast-growing tumor. So one of our German shepherds is now in her 15th year, her hind legs' strength just able to hold her up to squat but little else. She has thyroid problems, is arthritic, and now incontinent...but #2 incontinent. This means that we wash 4 to 5 large bed pads at least 3 times daily, not to mention cleaning her regularly, checking the bottom of our shoes when we take her outside (she can still hold her #1 and moans when she has to "go") and waking up at least 3 times during the night to move her and give her a clean pad (on schedule in the early morning hours: 1:30, 3:30 and 5:30). We've had friends over who witness this caretaking and simply shake their heads, telling us, "I couldn't do it." At one time my wife and I felt the same way: we could never get used to dealing with and cleaning the poop, to washing and bleaching and enzyme-rinsing so much (our washer's pump went out and had to be replaced, another unexpected $400 event), to giving her even more pills (probiotics) since she was cleaning herself so much, to cancelling all vacation or getaway plans since we only had about a 4-hour window before the next "event" would occur. We simply couldn't do it and when the time came we would just have to "put her down." But in fact when the time did come, one look in her eyes told us that we could do it, that there was still a lot of life and dignity and love there and that she didn't want this anymore than we did, that all she wished for was that everything was normal "back there" and not seeping out at all hours like an opened tube of toothpaste. The time does come along with its changes, just as parents know their babies will grow and caretakers know that their elders will lose their will to live or will just give out...but it doesn't make any of this that is happening right now any easier. It is a sacrifice pure and simple, and a personal decision whether to deal with it or avoid it, and the resulting consequences are not for anyone to judge. Rather we should simply acknowledge the work, the Roma side of silently doing the job without complaint, taking the burden off of someone else and wearing it for awhile. It's happening throughout the world, in many shadows and in many homes, people making do by giving of themselves for the sake of another. It's what mothers (and some fathers) do or did, it's what some sons and daughters do (or did)...there's life out there and in there. But there's life in the caregivers as well...if you are one of them, hats off to you. It's exhausting and yours is a struggle few will know...until they go through it.
*Truth be told, the disposable diaper simply means the throwaway diaper and generally not the recycled diaper. Said EcoWaste about these disposables: Diapers can take 500 years to decompose in a landfill, and add untreated sewage to the mix in the meantime, which can contaminate groundwater and soil...The average baby will use 6,000 diapers in their lifetime, Canadian and American women dispose of 1.3 million tonnes of feminine hygiene products annually, and 50% of all nursing home residents use incontinence products...1,000 tonnes of recycling diapers saves 8.7 million gallons of water, 3,400 trees, 145,000 cubic meters of natural gas, 367 tonnes of CO2 emissions, and 3.624 cubic meters of landfill volume. They do list a few cities and companies that will recycle such products, and Fast Company notes that one company, Knowaste, is making a profit doing so, albeit only (so far) from the "dirty man of the Europe," England.
**But it's not just the elderly. In a piece in Kiplinger's on caregiving and millennials (written by a millennial) it said: An estimated 10 million millennials are already acting as caregivers for a parent, in-law, grandparent or other adult, according to a recent report by AARP’s Public Policy Institute. In time, more of us will step into this role. “Economic factors, including the student loan crisis, stagnant wages and the rising cost of elder care, are combining in a dangerous way that makes caring for aging parents different for millennials than it was for previous generations,” says Grace Whiting, president of the National Caregiving Alliance. The AARP report found that millennial caregivers spend an average of 21 hours a week caring for older adults, and those with out-of-pocket caregiving expenses spend nearly $7,000 a year on caregiving-related transportation, home modifications, legal fees and medical costs, which can put a significant strain on your career and financial goals.
As with most folks, incontinence was an issue I often relegated as happening to an older but silent crowd, never really knowing if my grandparents dealt with this or not (as if they would tell me); trying to place myself in their shoes I doubt that I would reveal to my own friends and most family members that I now had to wear an adult diaper (I don't, in case you're wondering). But we've all been there, the occasional flu bug or bit of food poisoning or hard sneeze and the realization that "something" may have happened which you couldn't control and off we have to run in embarrassment...that is, when we are able. Suppose you're on a long flight, trapped in a middle seat and it's an all-nighter? Or you're sitting at a concert or lecture or interview? Or you're working in some customer service job facing a line of people when it's most busy? Or you're babysitting and are the only adult there? Or a hundred other situations? Now imagine that such a thing happens only you couldn't do a thing about it...you're sleeping or you're incapacitated or you simply aren't aware of any changes. There was a piece in TIME about the joys of becoming old but this particular paragraph stuck out for me: There is, similarly, what Rauch (author Jonathan Rauch) describes as an older person’s ability to normalize crises. Life can be a series of experiential typhoons, both good and bad—falling in love, falling out of love, marriage, divorce, new job, lost job—and every one of them feels overwhelming at first. But there are only so many Category 5s that can be thrown at you before you realize that the clouds will eventually part and you’ll probably be left wet but standing.
My mother dealt with this a year or so after entering an assisted living facility, her "control" now diminished (primarily because the facility told me and that I needed to begin bringing a steady supply of adult diapers). It was embarrassing and humiliating for her, as it would be for any of us, being told to just "go" while sitting since she had on a diaper (she was in a wheelchair at this point) and that she would be "changed" as soon as possible. I'm not sure if she ever got used to the idea of just giving in, her holding things as long as she possibly could simply because there were so many others facing the same problem and also needing changing. A Category 5 as the above paragraph mentioned. Jump to new parents who contentedly hold their baby then quietly reach down to "check" and discover that oops, time for a diaper change. As a new parent, it simply becomes a natural thing, a duty of sorts, to take care of things and give your baby a clean and a new diaper. But what if instead of your newborn it was your spouse or your parent? Bring in outside care or place them in a facility? What about the costs (the average assisted facility in the U.S. has jumped to about $7000+ per month or $84,000 annually) and your work and your children and, well, you. Said another piece in TIME: 16 million Americans...serve as unpaid caregivers to someone with Alzheimer’s disease or dementia. Because the tasks involved are so intimate and expensive to outsource, caregiving often falls to loved ones rather than professionals. And the number of caregivers is projected to grow: a recent study estimated that Alzheimer’s diagnoses will more than double over the next four decades as the U.S. population ages. Research shows that Alzheimer’s caregivers face significant physical, financial and mental burdens. In an October survey by the Associated Press—NORC Center for Public Affairs Research, about a third of caregivers said they struggled to manage their own health and had skipped going to the doctor—even when they were sick or injured—because of their duties. That’s especially concerning since dementia caregivers are themselves an aging group: 34% are now 65 or older.**
Said another piece in WIRED about the shortage of caregivers: ...between 2010 and 2030, the population of those older than 80 is projected to rise 79 percent, but the number of family caregivers available is expected to increase just 1 percent...The number of those older than 65 with a disability is projected to rise from 11 million to 18 million from 2010 to 2030. Given the option, having a digital companion may be preferable to being alone. But, as the article goes on, not everyone agrees: Sherry Turkle, a professor of social studies, science, and technology at MIT and a frequent critic of tech that replaces human communication, described interactions between elderly people and robotic babies, dogs, and seals in her 2011 book, Alone Together. She came to view roboticized eldercare as a cop-out, one that would ultimately degrade human connection. “This kind of app—in all of its slickness and all its ‘what could possibly be wrong with it?’ mentality—is making us forget what we really know about what makes older people feel sustained,” she says: caring, interpersonal relationships. The question is whether an attentive avatar makes a comparable substitute. Turkle sees it as a last resort. “The assumption is that it’s always cheaper and easier to build an app than to have a conversation,” she says. “ We allow technologists to propose the unthinkable and convince us the unthinkable is actually the inevitable.” The "human" side of this app are people living in Mexico and the Philippines and Venezuela and being paid about $2 an hour, and for the most part they don't understand this "no time to care for relatives" attitude; in theirs and many other cultures around the world, the elderly or disabled are family and without question family comes first. Even in the U.S., the aides who do the cleaning and changing of people in care facilities, no matter how expensive, are paid between $10 and $13 an hour on average...
So why bring all of this up? Partially because one doesn't understand the stress and strain of it all until one becomes immersed in it. The reality for many is that the expense and time needed will force decisions to be made, many of them unfavorable (cut down on work, take out savings, skip one's own health concerns), not for everyone mind you but for far more than one would imagine. And bit by bit, patience wears thin and backs begin to hurt and stress seems to begin its slow crunch into your body to become as damaging as a fast-growing tumor. So one of our German shepherds is now in her 15th year, her hind legs' strength just able to hold her up to squat but little else. She has thyroid problems, is arthritic, and now incontinent...but #2 incontinent. This means that we wash 4 to 5 large bed pads at least 3 times daily, not to mention cleaning her regularly, checking the bottom of our shoes when we take her outside (she can still hold her #1 and moans when she has to "go") and waking up at least 3 times during the night to move her and give her a clean pad (on schedule in the early morning hours: 1:30, 3:30 and 5:30). We've had friends over who witness this caretaking and simply shake their heads, telling us, "I couldn't do it." At one time my wife and I felt the same way: we could never get used to dealing with and cleaning the poop, to washing and bleaching and enzyme-rinsing so much (our washer's pump went out and had to be replaced, another unexpected $400 event), to giving her even more pills (probiotics) since she was cleaning herself so much, to cancelling all vacation or getaway plans since we only had about a 4-hour window before the next "event" would occur. We simply couldn't do it and when the time came we would just have to "put her down." But in fact when the time did come, one look in her eyes told us that we could do it, that there was still a lot of life and dignity and love there and that she didn't want this anymore than we did, that all she wished for was that everything was normal "back there" and not seeping out at all hours like an opened tube of toothpaste. The time does come along with its changes, just as parents know their babies will grow and caretakers know that their elders will lose their will to live or will just give out...but it doesn't make any of this that is happening right now any easier. It is a sacrifice pure and simple, and a personal decision whether to deal with it or avoid it, and the resulting consequences are not for anyone to judge. Rather we should simply acknowledge the work, the Roma side of silently doing the job without complaint, taking the burden off of someone else and wearing it for awhile. It's happening throughout the world, in many shadows and in many homes, people making do by giving of themselves for the sake of another. It's what mothers (and some fathers) do or did, it's what some sons and daughters do (or did)...there's life out there and in there. But there's life in the caregivers as well...if you are one of them, hats off to you. It's exhausting and yours is a struggle few will know...until they go through it.
*Truth be told, the disposable diaper simply means the throwaway diaper and generally not the recycled diaper. Said EcoWaste about these disposables: Diapers can take 500 years to decompose in a landfill, and add untreated sewage to the mix in the meantime, which can contaminate groundwater and soil...The average baby will use 6,000 diapers in their lifetime, Canadian and American women dispose of 1.3 million tonnes of feminine hygiene products annually, and 50% of all nursing home residents use incontinence products...1,000 tonnes of recycling diapers saves 8.7 million gallons of water, 3,400 trees, 145,000 cubic meters of natural gas, 367 tonnes of CO2 emissions, and 3.624 cubic meters of landfill volume. They do list a few cities and companies that will recycle such products, and Fast Company notes that one company, Knowaste, is making a profit doing so, albeit only (so far) from the "dirty man of the Europe," England.
**But it's not just the elderly. In a piece in Kiplinger's on caregiving and millennials (written by a millennial) it said: An estimated 10 million millennials are already acting as caregivers for a parent, in-law, grandparent or other adult, according to a recent report by AARP’s Public Policy Institute. In time, more of us will step into this role. “Economic factors, including the student loan crisis, stagnant wages and the rising cost of elder care, are combining in a dangerous way that makes caring for aging parents different for millennials than it was for previous generations,” says Grace Whiting, president of the National Caregiving Alliance. The AARP report found that millennial caregivers spend an average of 21 hours a week caring for older adults, and those with out-of-pocket caregiving expenses spend nearly $7,000 a year on caregiving-related transportation, home modifications, legal fees and medical costs, which can put a significant strain on your career and financial goals.
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