November / December 2000 Table of Contents
In this Article
by Kathy Hatchard
Preface
The following story is based upon the author's experiences as a home care
occupational therapist, the use of the Canadian Occupational Performance
Measure and personal reflections on being client-centred.
It was late afternoon as I methodically gathered my daybook and stepped from my vehicle for the fifth and final home visit that hot July day. The role of rural occupational therapist in the countryside north of Guelph, Ontario was a demanding one to say the least. I thrived amidst the unprecedented challenges to my creative energy, tact, and the harsh reality of disability viewed from the hearth. It could easily break you if you weren't astute. If the firmly set expressions of family members as they found their reserves didn't touch you, surely the stark photographs of blurred yesterdays would.
I sifted my brief clues to the story lying within the picturesque stone cottage before me…Complicated grief, not coping with daily routines, visual impairment…and wondered about the sequence of such misfortune. Next door, a gruff, portly gentleman pulled a thumb through his suspenders as he surveyed my arrival. His scrutiny seemed to soften toward a suspicious optimism as he noted the black daybook in my hands.
I had always been somewhat bemused by the vintage signs still affixed to many of the entrances of these stately homes. The signs held the name of the man of the household, his occupation and a date. Some remained long after the occupants had moved on. Some were updated in imitation and respect of the fine old tradition, as was the one behind him. Gills Henderman, Blacksmith, 1955 it read. The data seemed to even the score a little. "She might be sleeping", he said, his voice startling in its gentleness. "She's wore right out". I nodded thanks and carefully negotiated the uneven flagstone steps toward her porch.
Johnson McKee, Stone Mason, 1952, I read as I raised my hand to knock. "Come in" beckoned a refined voice as I lowered my hand to the ornate wooden screen door. Mrs. Elsie McKee* walked carefully toward the sound of my introductions and extended a hand in my general direction. Her eyes were an azure blue, almost translucent. Her gaze was fixed somewhere over my left shoulder. I continued my usual remarks to help her find my location. There was no change in the gaze, no perplexity in the pleasantly lined face. This was not visual impairment. This woman in the charming stone cottage, blue gingham curtains flowing behind her, gleaming hardwood floors beneath her, was blind.
"Would you like some tea?" she asked as if this was the most natural progression to our visit.
I found myself responding with a very rare, "Yes, of course" to a frequently posed question. One had to be vigilant to the fact that first visits became precedent setting. Being seven months pregnant didn't make the acceptance of offered liquids a terribly wise move either.
I followed Mrs. McKee into the pleasant kitchen. Sunlight streamed through the window over the small pine kitchen table, warming the petals of the freshly gathered azaleas in the vase before me. "Gorgeous flowers," I commented.
"Laura, from IODE brought them just this morning, didn't want to come empty-handed. Then it would look like she was checking up on me. Please, sit down, make yourself at home." The generous captain's chair with hollowed floral cushions was a welcome perch. It was rare to feel so at home moments after entering a stranger's abode, especially at a time when the word 'cope' predominated.
I watched Mrs. McKee as she deftly filled the kettle at the sink and placed it on the gas stove to heat. She carefully gathered two china cups and matched them to saucers. She reached for a silver tray carefully housed on a tiny painted shelf above the sink. As she gently placed it to the left of the sink and reached for a silver bowl of tiny sugar cubes nearby, my eyes began to close. The warm sunlight on my face, the efficient rattle of cups, saucers and tiny spoons lulled me in their seeming familiarity. I breathed in the scent of the antique gas stove. I inhaled deeply as my senses took in the harmony of the moment. I smiled to myself with the realization that closing my eyes to rest my weary soul was really ok here. A late afternoon on a hot summer's day… A young woman anticipating a child… An old woman with losses beyond imagining. I let my eyes remain shut as the rustlings of quiet efficiency wrapped around my heart. "There, all ready," came the welcome words. I shook off my reverie as the silver tray landed smoothly on the knotted table, just like a regularly scheduled flight.
Elsie sat down across the table. As she picked up the teapot with her right hand and searched for my saucer with her left, I felt a growing admiration for this lovely woman, so very alone, so unshakeably dignified. As she poured my tea, she gently dipped her left index finger an inch into the recesses of my cup. "I imagine you know lots of better ways to do this", she said as she waited for the pending hint from the hot liquid. The hot tea met her finger, which she then deftly removed. She proceeded to fill the rest of the cup without hesitation. My feelings of inadequacy at how to support improvements in this woman's 'not coping' began to grip me with a knot of growing tension. "I figure that if someone doesn't like me touching their tea, then they don't want my company very much," she proclaimed.
"I couldn't agree more," I said quietly, silently picturing the pages of plastic devices in rehabilitation catalogues, any one of which would destroy the purity of this beautiful scene in a heartbeat.
"You're kind not to ask right away," she said "but, it's been six months...heart attack, working on the stone fence by the brook out behind."
"I'm sorry," I offered.
"Johnson and I were married for fifty-five years. It was always just the two of us. We moved here in 1952 from our first home north of Mount Forest. Elora was the most beautiful place either of us had ever seen. I lost my sight eight years ago. The details are not that important anymore."
"Did you have any help around your home before your husband died?" I asked.
"We decided we would always have a housekeeper. That way I could run things how I liked and Johnson could look after the outside. Jeanne still comes every Wednesday. There's not that much that's different."
Clearly, it appeared that Elsie had tackled the job of grieving her soulmate much like she had traversed previous daunting pathways. I took another sip from the delicate china cup and swirled the warm liquid as I sat in puzzled silence.
"There's not that much that's different-" Elsie repeated, struggling for the words.
"Except you've lost your gatekeeper?" I asked softly. The words emerged with a self-assurance that startled me a little.
"I get so tired, they mean well, I don't want to drive them away-" the beautiful azure eyes welled up. I felt myself begin to breathe more steadily as my hand settled briefly on her forearm.
The tears were few and, as she ran her hand through her closely cropped silver hair, I saw a kind of resolve take the place of frustration. We spoke in hushed, efficient tones as she gently adjusted the azaleas before us. Elsie had a plan. I opened the daybook and penned an appointment time for the following Tuesday. "Late afternoon?" I asked.
"Late afternoon it is," she smiled.
Arriving the following week, I smiled as I grasped the white painted railing and climbed the stairs to the screen door. There was a new sign, this one right on the door itself. Framed in antique rose painted flowers, were the simple words, 'Elsie Rests Between One & Three'. A carefully forged metal hook held the lovely sign carefully in place. "Come in dear" chimed the familiar voice.
I didn't stay long, as there was no need. "Best wishes with the baby," she said as I slipped out. I hadn't told her about the visually obvious, still carrying a sense of my perceived rudeness for having conducted so much of my initial visit with my eyes closed. "It's in your voice," she said "It's in the way someone so young enters my world so carefully."
Elsie's gift to me was not evident at the time as is the way with most gently gathered wisdom. Yet, her message was one that I have long carried with me. Elsie had taught me that being objective didn't mean being invisible. She had provided me a resting place where I had learned that it was all right to sometimes feel terribly inadequate in reaching out to help someone. Clearly, being client- centred had a lot do with being centred oneself, with breathing-and with being real.
* pseudonym used for confidentiality
References
Law, M., Baptiste, S., Carswell, A., McColl, M.A., Polatajko, H., &
Pollock, N. (1994). Canadian Occupational Performance Measure,
(2nd ed.). Toronto: CAOT Publications.
Kathy Hatchard B.Sc.O.T.(C) is an occupational therapist working in acute psychiatry with the Okanagan Similkameen Health Region, British Columbia. She is also in private practice with Creative Therapy Consultants, Site 21, Comp 16, R.R. #3, Penticton, B.C. V2A 7K8. Tel. (250) 490-9162; e-mail hatchardspec@bc.sympatico.ca
November / December 2000 Table of Contents
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