The Revised Fundamentals Of Caregiving

by Jonathan Evison

The Revised Fundamentals of Caregiving

Paperback, 283 pages, Algonquin Books, List Price: $14.95 | purchase

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Hardcover, 278 pages, Algonquin Books, $23.95, published August 28 2012 | purchase
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Book Summary

After losing virtually everything meaningful in his life, former aspiring poet and stay-at-home dad Ben Benjamin trains to be a caregiver. His first client, Trevor, is a fiercely independent teen with muscular dystrophy. Trevor turns out to be more than Ben bargained for, and soon the two embark on a road trip to visit the boy's ailing father.

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Excerpt: The Revised Fundamentals Of Caregiving

hooked on mnemonics

Chapter 1

I was broke when duty called me to minister to those less fortunate than myself, so maybe I'm no Florence Nightingale. And maybe in light of all that happened with Piper and Jodi, I'm not qualified to care for anybody. The fact is, at thirty-nine, with a gap in my employment history spanning the better part of the technological revolution, I'm not qualified to do much anymore.

But don't get the idea that just anyone can be a caregiver. It takes patience, fortitude, a background check. Not to mention licensing and a mandatory curriculum of continuing education, as evidenced by my certificates in Special Needs in Dementia 1, Positive Crisis Management, and Strategies in Nonverbal Communication. The bulk of what I learned about being a licensed caregiver, I learned from the Fundamentals of Caregiving, a twenty-eight-hour night course I attended along with fourteen middle-aged women at the Abundant Life Foursquare Church right behind the Howard Johnson in Bremerton. Consuming liberal quantities of instant coffee, I learned how to insert catheters and avoid liability. I learned about professionalism. I learned how to erect and maintain certain boundaries, to keep a certain physical and emotional distance between the client and myself in order to avoid burnout. I learned that caregiving is just a job, a series of tasks I'm paid to perform, as outlined in the client's service plan, a binding care contract addressing everything from dietary constraints, to med schedules, to toiletry preferences. Sometimes, that's a lot to remember. Conveniently, the Department of Social and Human Services has devised dozens of helpful mnemonics to help facilitate effective caregiving. To wit:

Ask

Listen

Observe

Help

Ask again

I had a head full of these mnemonics and a crisp certificate when, three days after I completed the course, the Department of Social and Human Services lined me up an interview with my first potential client, Trevor Conklin, who lives on a small farm at the end of a long rutty driveway between Poulsbo and Kingston, where they do something with horses — breed them, sell them, board them. All I really know is, that Trevor is a nineteen-year-old with MS. Or maybe it's ALS. Something with a wheelchair.

I've got one more cash advance left on the old Providian Visa before I'm cashing out the IRA, which will only yield about fifteen hundred after penalties. For a year and a half after the disaster, I didn't even look for work. All told, I can hold out another month before I'm completely sunk. I need this job. My last job interview was eleven years ago, before Piper was born, at the Viking Herald, a weekly gazette devoted primarily to Scandinavian heritage, pet adoptions, and police blotters. The Herald was hiring an ad sales rep at the time — a telemarketing gig, basically. I met with the head of sales in his office at the ass end of new business park on the edge of town. Right away I forgot his name. Wayne. Warren. Walter. Not so much a salesman as a miscast folk singer, someone you might find strumming "Tom Dooley" in the shadow of a cotton-candy stand on a boardwalk somewhere.

"Have you ever sold anything?" he asked me.

"Muffins," I told him.

I didn't get the job.

This morning, I'm wearing one of the button-down shirts my estranged wife, Janet, bought me five years ago when it looked as though I'd finally be rejoining the workforce. Never happened. We got pregnant with Jodi instead.

I arrive at the farm nine minutes early, just in time to see whom I presume to be one of my job competitors waddle out the front door and down the access ramp in sweat pants. She squeezes herself behind the wheel of a rusty Datsun and sputters past me up the bumpy driveway, riding low on the driver's side. The sweatpants bode well, and even with three missing hubcaps, my Subaru looks better than that crappy Datsun.

The walkway is muddy. The ramp is long like a gallows. I'm greeted at the door by a silver-eyed woman roughly my own age, maybe a few years older. She stands tall and straight as an exclamation point, in bootleg jeans and a form-fitting cotton work shirt. She's coaxed her flaxen hair into an efficient bun at the back of her head.

"You must be Benjamin," she says. "I'm Elsa. Come in. Trevor's still brushing his teeth."

She leads me through the darkened dining room to the living room, where a tray table on wheels and a big-screen TV dominate the landscape. She offers me a straight-backed chair and seats herself across from me on the sofa next to the reclining figure of an enormous brown cat showing no signs of life.

"Big cat," I say.

"He's a little testy — but he's a good ratter." She pets the cat, who bristles immediately. She strokes it until it hisses. Undaunted, she forges on until the beast begins to purr. I like this woman. She's tough. Forgiving. The kind that sticks it out when the going gets rough.

"My neighbor has a cat," I offer.

"What a coincidence," she says. "So, tell me, do you have any other clients?"

"Not at the moment."

"But you have experience caregiving, right?"

"Not professionally."

She's unable to suppress a sigh. Poor thing. First the lady in sweatpants, now me.

"But I've worked with kids a lot," I say.

"Professionally?"

"Not exactly."

"Do you have children?"

"No. Not exactly."

She glances at the clock on the wall. "Do you mind if I ask what led you to caregiving?" she says.

"I guess I thought I might be good at it."

"Because ... ?"

"Because I'm a caring person. I understand people's needs."

"Do you know anything about MD?"

"A little bit."

"And what did you think of the class?"

"Honestly?"

"Honestly."

"I thought it was ... uh, pretty informative."

"Hmm," she says.

"I mean, a lot of the stuff was common sense, but some of it was pretty eye-opening in terms of, you know ... just different methods and approaches to ..." I've lost her.

"Benjamin, I've taken the class," she says.

At last, Trevor wheels into the living room, a good-looking kid in spite of an oily complexion and a severe case of bed head. He's sporting khaki cargoes, a black shirt, and G-Unit low-tops. The disease has left him wafer thin and knobby, slightly hunched, and oddly contorted in his jet black wheelchair.

"Trevor, this is Benjamin."

"You can call me Ben."

He shifts in his seat and angles his head back slightly. "What's up?" he says.

"Not much," I say. "How about you?"

He shrugs.

"Trevor is looking for a provider he can relate to," Elsa explains. "Somebody with similar interests."

"So what kind of stuff are you into?" I say.

His hands are piled in his lap, his head lowered.

"He likes gaming," says Elsa.

"What games?" I say.

"Shooters, mostly," he mumbles.

"Oh, right, like, uh, what's it called — Mortal Combat?"

He rears his shoulders back, and hoists up his head, moving like a puppet. "You play?"

"No. A guy on my softball team is always talking about it."

He lowers his head back down.

"Tell Ben about some of your other interests," says Elsa.

The instant she calls me Ben, I feel like I've gained some small bit of ground.

"Yeah, what else are you into?"

Trev shrugs again. "I don't know, not much."

"He likes girls," says Elsa.

"Shut up, Mom," he says. But she's managed to coax him out of his shell. For the first time, he looks me in the eye.

Elsa rises to her feet. "I'll leave you two to get acquainted." And without further comment, she strides across the living room and through the dining room.

After a moment of awkward silence, Trevor whirs closer to his cluttered tray table.

"So," I say. "Girls, huh?"

He casts his eyes down, shyly, and I wish I could take it back. Poor kid. Bad enough he's all twisted in knots — people are always putting him on the spot, pushing him out of his comfort zone, pretending that everything is normal, as though he can just go out and get a girlfriend, ride the Ferris wheel with her, and feel her up in the back of a car. Look at him, staring into his lap, wishing he could disappear, wishing everybody would quit pretending. But it's all just a ruse. Because when he lifts his head again, he swings his chair round clockwise and checks the doorway. Jockeying back around, he smiles and looks at me unflinchingly. There's a glimmer in his eye, a flash of the evil genius, and I understand for the first time that I may be dealing with someone else entirely.

"I'm crippled, not gay," he says. "Of course I like girls."

I check the doorway. "What kind of girls?"

"Any kind," he says. "The kind who want to get with a guy like me."

"You mean because of your ... because of the wheelchair?"

"I mean because I'm horny. But yeah, that too. Do you have a wife?"

"Not exactly. Well, technically yes, but — long story."

"Is she hot?"

"She's hot."

He leans in conspiratorially. "Would she get with me? Do you think she'd get with me?"

"Uh, well, um ..."

"I'm joking," he says. "Why do you wanna work for nine bucks an hour, anyway?"

"I'm broke."

"You're gonna stay broke working for DSHS."

"Does this mean I've got the job?"

"Sorry, man," he says. "But I haven't met all the candidates yet. I like you better than the fat lady, though."

Climbing into my car after the interview, my hopes are buoyed by the sight of a dented white Malibu bumping down the driveway as another candidate arrives from DSHS. The front bumper is all but dangling. The tabs are expired. The guy behind the wheel has a spiderweb tattoo on his neck.

Excerpted from The Revised Fundamentals of Caregiving by Jonathan Evison. Copyright 2012 by Jonathan Evison. Excerpted by permission of Algonquin Books.

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