Thursday, July 8, 2010

John Whyte, M.D. - Men as Caregivers

Interesting post - I am reminded of Walt Whitman's civilian service in the Civil War, prompted by the wounding of his brother.

Whitman wrote many poems about the Civil War, and many about his three years as a nurse, a complete volunteer. Because he was a poet and a transcendentalist (and likely gay or bisexual), the government would not employ him and pay him for his service - so he did it anyway.

Men as Caregivers

John Whyte, M.D., MPH

I always ask my elderly patients whether they have children who are active in their care. It used to be that if they replied yes, it implied they had a daughter; sons were rarely involved. But now we're seeing that men are more often assuming the role of caregiver. In fact, data shows that nearly 35% of caregivers to the elderly are men.

This is a big increase over previous years, but many men are still hesitant to assume the role. What keeps men from caring for their loved ones? For one thing, this is a role traditionally dominated by women, so some men feel that their masculinity is threatened by taking on a role that requires intimacy and emotional support. They become worried about how their peers would perceive them if, say, they had to leave work early to care for elderly parents. And consider the inherent double standard - a woman can take her mother to a doctor's appointment with nary a complaint from others, but when a man does it, he is instantly branded a "momma's boy." Also, some men feel unprepared for the responsibility of caring for another human being, and this unpreparedness deters them from embracing the caregiver role. Furthermore, the combined pressure of providing for the family, raising children, and being a caregiver can be very daunting for any gender. Unfortunately, the impending social isolation that accompanies full-time care of the elderly is intimidating. People like to joke that men are scared of commitment - well, caring for the elderly is a big commitment that some men are afraid to make.

Despite these challenges, the baby boomer generation continues to age, so more men will be called upon to provide elderly care in the future. It is our responsibility as a society to remove many of the pressures we put on men to conform to certain gender roles. Also, data shows that men are quicker than women to enlist the help of others when it comes to caregiving, so men who also have to work and raise children can try delegating tasks to other family members. With regards to unpreparedness, there is a wealth of resources in print and online that can guide men on caring for the elderly. Numerous support groups exist specifically for men to share their experiences in caregiving and combat the social isolation that comes along with it.

They say it takes a real man to do a woman's job - but labeling it a woman's job is part of the problem in the first place. I say it takes a real man to be a caregiver. Whether they like it or not, many men will be forced into the position of caregiver, and they must be able to rise to the occasion. Age-old perceptions of masculinity may linger, but now more than ever, men need to redefine what it means to be a family man.

National Alliance for Caregiving. Caregiving in the U.S. November 2009.

Here is a poem by Whitman, a man who gave himself to others for three years during the Civil War, caring for the wounded, talking with them, nursing those who lived back to health.

Walt Whitman:
The Wound Dresser

AN old man bending I come among new faces,
Years looking backward resuming in answer to children,
Come tell us old man, as from young men and maidens that love me,
(Arous'd and angry, I'd thought to beat the alarm, and urge relentless war,
But soon my fingers fail'd me, my face droop'd and I resign'd myself,
To sit by the wounded and soothe them, or silently watch the dead;)
Years hence of these scenes, of these furious passions, these chances,
Of unsurpass'd heroes, (was one side so brave? the other was equally brave;)
Now be witness again, paint the mightiest armies of earth,
Of those armies so rapid so wondrous what saw you to tell us?
What stays with you latest and deepest? of curious panics,
Of hard-fought engagements or sieges tremendous what deepest remains?

O maidens and young men I love and that love me,
What you ask of my days those the strangest and sudden your talking recalls,
Soldier alert I arrive after a long march cover'd with sweat and dust,
In the nick of time I come, plunge in the fight, loudly shout in the rush of successful charge,
Enter the captur'd works-yet lo, like a swift-running river they fade,
Pass and are gone they fade-I dwell not on soldiers' perils or soldiers' joys,
(Both I remember well-many the hardships, few the joys, yet I was content.)

But in silence, in dreams' projections,
While the world of gain and appearance and mirth goes on,
So soon what is over forgotten, and waves wash the imprints off the sand,
With hinged knees returning I enter the doors, (while for you up there,
Whoever you are, follow without noise and be of strong heart.)

Bearing the bandages, water and sponge,
Straight and swift to my wounded I go,
Where they lie on the ground after the battle brought in,
Where their priceless blood reddens the grass the ground,
Or to the rows of the hospital tent, or under the roof'd hospital,
To the long rows of cots up and down each side I return,
To each and all one after another I draw near, not one do I miss,
An attendant follows holding a tray, he carries a refuse pail,
Soon to be fill'd with clotted rags and blood, emptied, and fill'd again.

I onward go, I stop,
With hinged knees and steady hand to dress wounds,
I am firm with each, the pangs are sharp yet unavoidable,

One turns to me his appealing eyes- poor boy! I never knew you,
Yet I think I could not refuse this moment to die for you, if that would save you.

On, on I go, (open doors of time! open hospital doors!)
The crush'd head I dress, (poor crazed hand tear not the bandage away,)
The neck of the cavalry-man with the bullet through and through examine,
Hard the breathing rattles, quite glazed already the eye, yet life struggles hard,
(Come sweet death! be persuaded O beautiful death!
In mercy come quickly.)

From the stump of the arm, the amputated hand,
I undo the clotted lint, remove the slough, wash off the matter and blood,
Back on his pillow the soldier bends with curv'd neck and side falling head,
His eyes are closed, his face is pale, he dares not look on the bloody stump,
And has not yet look'd on it.

I dress a wound in the side, deep, deep,
But a day or two more, for see the frame all wasted and sinking,
And the yellow-blue countenance see.

I dress the perforated shoulder, the foot with the bullet-wound,
Cleanse the one with a gnawing and putrid gangrene, so sickening, so offensive,
While the attendant stands behind aside me holding the tray and pail.

I am faithful, I do not give out,
The fractur'd thigh, the knee, the wound in the abdomen,
These and more I dress with impassive hand, (yet deep in my breast a fire, a burning flame.)

Thus in silence in dreams' projections,
Returning, resuming, I thread my way through the hospitals,
The hurt and wounded I pacify with soothing hand,
I sit by the restless all the dark night, some are so young,

Some suffer so much, I recall the experience sweet and sad,
(Many a soldier's loving arms about this neck have cross'd and rested,
Many a soldier's kiss dwells on these bearded lips.)

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