When we learn someone is a licensed direct care worker, it is often assumed that all of their clients are bed-bound, terminally ill, or otherwise 100% dependent on someone else helping them carry out ADLs. For the most part, it is true that if a client is in need of long-term care or home health services, there are likely at least one or two daily tasks they absolutely cannot perform without assistance. If an aide works 8 hours for a bed-bound client who wears adult diapers, they can count on having to clean and change them at least twice (and diapering 150+ lbs of fragile dead weight is not as easy as one might think).
But there are some cases that don’t require as much heavy lifting and backbreaking as they may require some softer skills, such as active listening and empathy. Senior companionship is a real skill and a real job and that fact are justified both by science, social study and by basic human nature.
Firstly, companionship can very easily treat depression. According to the Center for Disease Control, 13.5% of older adults qualifying for home healthcare suffer from depression and more cases may go undiagnosed due to the misconception that depression is a normal part of aging. Individuals of all ages with depression may suffer to the degree of having a risk of self-harm or being placed on suicide watch by healthcare providers. In many cases, companion’s mere presence each day is making a difference in a person’s life.
Healthcare is one of the most diverse industries in the world in terms of race, ethnicity and nationality in its workers, especially in the United States. Depending on where a healthcare provider is located, a particular health-related job can be nearly monopolized by one or two nationalities of people. For example, in the Washington, DC Metropolitan area, the vast majority of home health professionals and paraprofessionals are of African descent. It would be hard to keep your white American client entertained when you two don’t share understanding of the same cultural references (and those come in handy). This cultural barrier only comes second to the commonly large age gaps between aides and their clients. Finding common ground and building a relationship with a client so different from yourself is not impossible, but it doesn’t come easy.
In many other cases, being physically present is only a fraction of the feat. Keeping a client entertained is another element of companionship that should be pointed out. Amateurs and even experienced stand-up comedians find it challenging to keep a room full of people entertained for a whole hour. Imagine having to keep that same room full of people entertained day-after-day for 6 to 9 hours a day. No improv studio is that good. Anyone who has ever worked with an individual with dementia knows that if one fails to tap into some creativity, they can expect to have the conversation. Every single hour. Every single shift. Every single day.
Charisma in a companion is also important for clients still maintaining a relatively high level of physical independence and mental sharpness. Keep them entertained helps with building confidence and further encourages independence and especially mental sharpness.
“Encouraging positive conversation” and providing “emotional support” is a part of most clinical nursing job descriptions as well as healthcare aides’. These companionship skills are important, not just for passing time, but for enhancing a person’s everyday life. Lucky for the shy surgeon, most of his dealings with patients involve them being unconscious.