There is something almost meditative about giving your severely disabled, fragile child a gentle bed bath. Brendan Bjorn loves water. Even more so, he loves having his hair washed. The feeling of warm water running through his hair never fails to bring a look of enjoyment to his handsome face. Today, as I struggled to give him his bed bath because I’ve been sick all week and my hands were trembling, I went especially slow. But in that slowness, I paid particular attention to all of his scars.

And as I looked at all of his scars, I also looked beyond the scars. 

His most recent scars are the first I saw while washing his hair. These are 2 scars on the right side of his neck from having 2 different central lines placed last Autumn while he was in hospital recovering from a spinal fusion. His intestinal system stopped accepting formula PEG feeds. It was the fourth time this has happened. This time, however, was the longest and hardest to recover from and he ended up on TPN for many weeks while we (his medical team and I) worked to slowly reintroduce his PEG feeds.

Washing the scars on his neck made me reflect upon those exhausting 2 1/2 months in hospital, sleeping on a bench, away from my other son, and at times wondering if Brendan Bjorn would even survive.

The next scar to wash was the longest one he has – that from his spinal fusion. Carefully holding his body in place while I washed and dried his back, that tremendous scar reminds me what a warrior my son truly is to have come through such an arduous operation despite his various complex medical conditions.

And I thanked him once again for teaching me how to stay strong.

Not far from his spine, down either thigh, are scars from 2 derotational osteotomies years ago. As I looked at his legs, now once again betraying what should be, sadness came upon me. This is what causes him pain. This is what limits much of his ability to be in different positions. One femur now pointing too far outward, bone on bone in the hip socket. The other, partially uncovered and increasingly pointing too far midline. Both cause increasing concerns.

He won’t be having any more hip surgery, I’ve decided, unless the pain becomes too great. 

Rolling him over, I see the scars from 3 different pressure sores at his left IT point area just below the left buttox. One is concave because that pressure sore was once a grade 3 sore. There is a dark redness once again on one of the scar areas and I can’t help but wonder, if it’s red again now, what will happen when he finally gets his new wheelchair seat and can once again sit upright?

I can only hold out hope that the skin stays intact. If it doesn’t, we are back to being housebound while he would be bedridden. I can’t let my mind go there for too long.

I also bear a scar for Brendan Bjorn. A scar I will be proud to have as long as I live. The scar from the cesarean section which brought him into this world and into my life. The scar which reminds me of the moment my doctor told me, you have a boy! The scar which also holds bittersweet memories of the first few days and weeks after his birth when they all had no idea of the brain damage just waiting to be uncovered; waiting to be seen like the scars he now has all over his frail teenage body.

These scars are a roadmap of our journey together so far. And as I reflect on this often challenging, but always love-filled journey, the scars take on a deeper meaning to me.

 

It’s the end of another Carer’s Week. This post is a shout out to all of the parents who, like me, care 24/7 for their disabled child with profound care needs.

Many of us administer medications on a daily basis which truly save the life of our child. I’m not talking Calpol. I’m talking medications such as epilepsy meds which keep our child from dying in a seizure or going into status or not waking up due to SUDEP.

Many of us monitor O2 levels, heart rate, and lung function throughout the day and night.

Many of us do physio/OT work on our child with hip dysplasia, scoliosis, cerebral palsy, and/or osteoporosis without even blinking an eye.

Many of us give complete bed baths to our fragile child, all the while being mindful of positioning to avoid further complications to an already complex care regime.

Many of us have watched our child turn blue while in a seizure, yet remain calm as we administer the rescue medication and grab the O2 and place the mask or cannula on our child’s convulsing face.

Many of us clear airways, monitor aspiration risks, mindful of positioning while sitting, lying down, being transported or repositioned.

Many of us do this alone as single parents.

Many of us do this despite our own increasing physical and mental health struggles.

Many of us do this work with literally no break, no free time, as our child is housebound or bedridden.

Many of us do this work without any respite or home help.

And we all do this without pay, especially pay commensurate with the level of skilled medical care we provide. Nor do we have a building pension to help care for us when we are the ones who will need the care.

So to all of you who walk this same journey, and as another Carer’s Week comes to pass, I extend my solidarity to you. Let’s keep advocating, keep fighting, until the systems that should be supporting our children’s needs, and indeed our own needs as carers, are reformed to the point we no longer have to fight for even the most basic of needs to keep them alive and thriving. Let’s support each other as best we can while trying to keep our own heads above water. For our precious children.

 

It’s that time of year again. It’s Carer’s Week. The week where carers such as myself are put on a pedestal of praise made of sand, ready to get it washed out from under us later today when the tide rolls in.

I can’t speak for anyone but myself, but I dare say I know that I’m not alone when I say the following:

• I don’t want the praise. I want actions of positive reform to make my life more tolerable…and maybe even a little bit enjoyable.
• I don’t want the free luncheon or weekend away at a resort as a way to say ‘thank you for your sacrifice.’ Anyway, I can’t get out of the house to attend. I would rather see the funding spend on more overnight respite, in home respite, or put into the special medical and educational requirements for children like my Brendan Bjorn.
• I don’t want to read a week’s worth of newspaper articles about the mental health needs of carers in crisis, only to see it once again go nowhere when the week is over. I want to see counseling services made available to carers like me, and our family as a whole, and to be available in home if required. 
• I don’t want platitudes and condescension. I want intelligent, timely dialogue and for our needs to be heard – and then acted upon. 
• I don’t want others making decisions for me and my family, such as the steering group which discussed Loco Parentis last year without including a parent representative. I want family carers like me to be at the centre of discussions and decisions about such important issues that will impact our daily lives.
• I don’t want every single day be such a fight, but it is. A fight for services; a fight to organise my son’s needs; a fight financially to survive; a fight to not completely breakdown or give up, worn out from all the fighting, the isolation, being housebound, and having no help with the nursing level care I do literally 24/7 all on my own going on 15 years now. I want the system to see that parents like me need a wraparound service to provide holistic supports, and then for that system to actually provide those supports. 

And I don’t want to continue feeling the way I do: lost, alone, exhausted, broken.

I want to feel whole again. I want to have a social life with friends. I want to utilise my education and experience outside of the home. I want to have people reach out to me because they actually like me, Tracy, not because they feel pity. I want to be free again to go on hikes, go to the beach, take long walks, or wander around a museum. I want to not feel like my life is passing me by and that I’ll die with these same feelings, nothing having changed.

So, no. Please don’t put me on that pedestal of praise built of sand. I know the tide will come in later today to wash it out from under me. 

 

 

There was media focus last week in Ireland around the mental health struggles of family carers such as myself. The focus was prompted by a study on the same by Family Carers Ireland and the College of Psychiatrists Ireland (see information here). I’m going to apply a bit of “tough love” in this blog piece. And, as always, be brutally honest with my emotions. First, some statistics:

• 1 in 3 family carers is diagnosed with depression.
• Approximately 2 in 3 are providing over 100 hours work per week.
• 4 in 10 are diagnosed with anxiety.
• 2 out of 3 carers have suffered ill health and feel it is linked to being a carer.
• 71% of carers loved ones have NO access to respite.
• 72% of carers worry about not having enough money for the future.
• 40% suffer from back injuries.
• 74% worry about what will happen if they die or get ill and can no longer provide care for their loved one.

Read the above linked report for more data.
Please. Read it. 

Ok, so, now what? What will come out of this important and eye opening report?

As I sit here before giving Brendan Bjorn a bed bath, having read the news this morning that homecare packages are frozen until November, and contemplating the €180 I will spend tomorrow for a mere 4 hours of nursing respite so I can finally leave my house with my other son, Declan, after being housebound for months, I have to ask…what will come of it?

I’ve been writing about the mental health struggles of carers for years now. The last time I was brutally honest about my own depression and anxiety, for which I am on medication, I wrote about having hit a low point one night where I experienced suicidal ideation (but came out the otherside). Brendan Bjorn’s social worker called Tusla to report it. There was no direct contact with me by the social worker about it. No reaching out to discuss options for intervention such as counseling. Just a terribly misguided report to Tusla – which thankfully went nowhere because they realised I was not going to actually go through with the ideation of ending my own life.

So again I ask, what will come of it?

Let’s face some more facts:

1. Here in Ireland, there are plenty of platitudes thrown around about supporting mental health, but when it comes down to actually taking action, very little is done to support the most vulnerable, such as the carers statistically highlighted in the above report.
2. We don’t have enough mental health professionals in Ireland.
3. The waitlists are years long, especially for paediatric services.
4. There are, from what I can determine, no home based counseling services, either.
5. Then there’s the budget. Will the government actually increase funding for such services? I have little to no hope of that happening.

As a former mental health counselor, and as someone who has received in home family counseling supports, I cannot emphasize enough how vital this service is to families like mine who are housebound and/or who are dealing with a palliative care scenario. I would advocate that there needs to be a wraparound, paediatric palliative care service in Ireland which would include in home family counseling. One thing the above report doesn’t address is the mental health impact on the siblings of families such as mine. I can tell you, there is great need but no support. I advocate for Brendan Bjorn’s needs all of the time, and for those of carers, but what I seldom speak publicly about is the equally important – and urgent – needs of children like my son Declan.

Can you imagine what it is like growing up knowing you will one day lose your only sibling? I can’t even imagine that.

Can you imagine knowing that you care 24/7 for years on end, fighting day in and day out for the required treatment and services for your precious child, knowing one day you will have to bury him? That, I can imagine. That, I live with. Every. Single. Day.

I said at the beginning of this piece, I would apply a bit of tough love and be brutally honest. Well, there it is. Unless you have walked on this very journey, you cannot even begin to comprehend what that fact does to your mental health. It’s not the same as losing a parent. I’ve done that, twice, and in my opinion, it’s the natural order of life. But your child? That brings what I have is no doubt the hardest emotional, psychological, stressor one could ever go through: When you would do anything, give anything, to trade places so that your child could live, but nothing –  absolutely nothing – you will ever do could see that desperate desire come true.

And yet, there are no home based mental health counseling services for families with children who have a life-limiting condition. 

Family carers have countless stressors that are out of the norm compared to other typical families. I again refer you to the report above. Carers are truly in crisis, left with little to no supports to continue their 24/7 work, which saves the State €10 billion per year, trying to keep their loved one alive. We have extraordinary financial concerns, fight broken systems on a daily basis, sacrifice our own mental and physical health doing everything required for our loved one, while going relatively ignored in our pleas for help and reform, including of mental health services.

And many of us do all of this knowing that one day we will no longer have the child we love more than life itself, and we will be left a shadow of our former self, broken physically and shattered emotionally, by a system that didn’t care enough to help those who care the most.

Who will be there to pick us up off the ground when there aren’t even mental health services to help us in the midst of our struggles now?