Table for one
Eileen J. Porter
Moving to a nursing home or assisted living facility, no matter how clean, well-run and pleasant, is not the intention of many older widows.
There are some who live in their own homes well into their twilight years. Eileen Porter, a professor of nursing, talked with 25 of them during her five-year study of “Older Widows’ Experience of Home Care,” funded by a $500,000 grant from the National Institute of Nursing Research. She found the older widows who agreed to help her document their lifestyles have a lot in common.
“This was a fascinating opportunity to learn how widows pull together resources to continue living at home alone,” Porter says.
Her study focused on the widows’ perspective — a natural but somewhat unusual way to collect and organize data for these women, who have maintained their independence despite the need to accept help from various individuals and community service providers.
For home-health nurses, housekeepers, gardeners, home-maintenance workers and other individuals who serve the needs of older widows at home, Porter’s research teaches some valuable lessons.
“To optimize their interaction with older widows, these people, known for my purposes as ‘helper,’ should understand why the widows they work for make the kinds of choices they do,” Porter says.
In this sense, Porter’s work falls into the category of “descriptive research,” in which a group’s actions and statements are analyzed to draw conclusions that may improve professional practice in relation to that group.
Porter’s work also may prove useful to widows themselves. By becoming aware of common situations faced by their peers, older widows may be better prepared to face similar situations.
Far from becoming passive victims of circumstance, Porter found the widows in her study seek to remain in charge of their homes.
“They ask for help when they need it, and they reject it if they don’t need it,” she says.
Although younger helpers who encounter older widows may try to offer specific assistance, Porter found the widows direct the helpers and even work alongside them to make sure the job is done right. As a result, Porter maintains that it is important for caregivers and other service providers to remain centered on the desires of the individuals they assist instead of proceeding with a standard method for completing tasks.
For many, widowhood presented the first need to seek out and hire various types of helpers. This involves jumping many hurdles, such as making initial contact with local agencies and negotiating pay agreements. While navigating these uncharted waters, the widow must also be true to her standards and expectations for any hired help.
“These women do try to understand their helpers’ situations, especially if they are relatives,” Porter says.
This empathetic approach frames many widows’ thoughts about their helpers’ abilities. In what may seem an ironic twist, many older widows express concern about their helpers’ health and general life condition. A good example is the widow who permits a housekeeper with arthritis to skip tasks that require being on her knees.
Another trait is the widows’ attempts to strike an appropriate balance between independence and getting necessary assistance. For many, the need for help marks a major lifestyle shift. Therefore, widows who succeed in living alone must come to terms with their needs and adjust to the presence of helpers.
In some ways, the widows developed fairly sophisticated personnel-management techniques. They juggle family relationships and obligations in order to determine what types of help to accept from relatives.
The four phenomena of home care that are common amongst widows were sorting out which helper could best do what needs to be done, protecting their helpers, mobilizing them to help with additional tasks, and working with them to get the job done.
These women consider the availability and suitability of their helpers for necessary tasks. Availability was gauged according to geographic location and surplus time; while strength or height sorted out who could take on a new task. In addition to physical characteristics, expertise was a key factor in determining suitability.
“To reduce her risk of falling on a steep driveway, one widow asked the daily delivery person to take her letters to the mailbox as he left,” Porter says. “In so doing, she reduced intruding upon her son’s time because he wouldn't't’t have to stop on his way to work.”
This type of consideration also stems from these women’s concerns for the helpers’ well being.
“They put the helper before the job,” Porter explains. “Some of these women intentionally shield their helpers from tasks they perceive are too difficult for them for one reason or another.”
Shielding the helper sometimes involved the widow helping with the job. Several women who were shielding a helper from specific tasks were also designing tasks suitable for the helper.
“Even those women who had helpers stay overnight or live next door would avoid waking them,” Porter says. “They knew their helpers would get up and comfort them, but they didn't't’t want to infringe on their personal time, even when a situation like chest pains occurred.”
The phenomenon of mobilizing helpers can be broken down into several patterns. Widows consciously fit in extra tasks during a time that their helper had agreed to helping them, thus tapping into their helper’s surplus time. Some of the women tried to reduce the risk of intruding by taking advantage of previously scheduled times. However, other women waited until a helper was available.
“For example, they would reduce the risk of falling by negotiating reliance on a helper,” Porter points out. “If a relative is already in the house, these widows feel safer taking a bath knowing their helpers are there if they should fall. The same scenario occurs when they considered taking on risky cleaning jobs.”
Sustaining oneself, in part, means keeping the help one has. Compared to what other researchers have found, Porter’s ideas are different in two ways. First, home care is usually thought of as taking place within the home, but these women mobilized helpers to assist with some tasks that had to be done away from their homes.
Second, most researchers think of home care in terms of service or help, and practitioners are likely to think about which homecare tasks a woman needs and how to arrange for those tasks to be done efficiently.
Porter’s findings, in contrast, emphasize that the women are already operating from the standpoint of efficiency; they are sorting their helpers based on availability and suitability. These findings mean that practitioners must assess the intentions of older women before making arrangements for them.
“Home care must be understood as more than what providers do in the homes of service recipients,” Porter says. “The older woman who lives alone should be viewed as one who experiences home care and intends to negotiate reliance upon her helpers.”
With her data in hand, Porter hopes the world of the older widow will become more understandable even as it becomes more common in our communities.