Caring That Makes Growing Old At Home Possible

BROWNSVILLE/UPPER WEST SIDE – Salimata “Sali” Zonon, 55, from Burkina Faso but more recently – Brownsville, dipped her hand under the running faucet with a fist full of blueberries. She shook the berries dry and mixed them into a bowl of oatmeal. Across the room, Rita Asen, 94, laid her hand on her forehead as she sat at the kitchen table.

“On the days she doesn’t have dementia she eats very fast,” said Zonon, laying down the bowl of oatmeal and a cup of tea in front of Asen.

Today was not one of those days. Asen ate slowly, occasionally closing her eyes in between bites and spitting small pieces out every few minutes into a napkin.

Zonon watched her carefully. She reached over the table and spoke loudly into Asen’s right ear.

“Rita, Rita chew,” she said. Asen nodded her head in acknowledgment.

For the past eight years, Zonon has worked full time as Asen’s home health aide through Partners in Care, an affiliate of the not-for-profit Visiting Nurse Service of New York. She is one of over 170,000 aides in the state of New York who feed, bathe, and provide medical assistance to the disabled or elderly in their home.

By 2050 the U.S. elderly population is expected to almost double according to the US Census Bureau. But over the same period the female working-age population, those who become home health aides, is expected to stay approximately the same. There will not be enough workers to meet the high demand. Home care work is projected to add more jobs than any other occupation in the United States.

The job is both physically and emotionally demanding, yet home health aides are paid minimum wage and many live below the federal poverty line. Caring and competent aides, like Zonon, will be needed more and more as the country’s population continues to age.

Zonon begins her day at 5:45 in the morning. She wakes up and makes a cup of coffee in her small, two bedroom apartment in Brownsville, Brooklyn. She packs her lunch, a grapefruit, and wakes up her 13-year-old daughter, Jasmine.

“She’s always reading,” Zonon said, while her daughter described different characters from the Harry Potter series. “Sometimes I have to take the light bulb out of her room because she’ll stay up all night.”

They head out at 6:45 and take the subway together to the East Village where Zonon’s daughter attends a charter school. Her mother hopes that for high school Jasmine will get a full scholarship to a boarding school under the Prep 9 program.

After dropping her daughter off at school, Zonon takes a bus and train to get to Asen’s apartment on the Upper West Side. Asen, who has mild dementia, requires 24-hour care. When Zonon arrives at her apartment in the morning another aide is finishing up her shift.

Zonon goes to wake Asen up. She helps her to her walker and guides her down the small hallway to the bathroom. They pass by the living room where, on top of a piano, a poster reads, “Happy 90th Birthday Grandma Rita!” Below the text is a collage of photos of Asen as a child, with her son, and with her granddaughter.

“It’s unquestionable that my mom is alive and happy because Sali has been with her for so many years,” said Asen’s son, Robert. “I’m a single dad, in a high pressure job. I travel constantly. I couldn’t do what I do without the care that is provided.”

Although the majority of Zonon’s days are a bit monotonous, Asen’s son relies on her
when something goes wrong.

“She is able to use her judgement, quick thinking and deep understanding of my mother to know when to engage EMS, when to go to the hospital, or talk to the doctor,” he said. “[Zonon] said she is with us for the whole journey until the end.”

But not all aides are as attentive as Zonon. During her eight years as Asen’s caretaker, Zonon has seen plenty of negligent home health aides – including finding sheets soaked with urine and feces left on the bed.

“You’re supposed to be working as a team,” said Zonon.

After breakfast, Zonon grinds Asen’s pills, which are packaged for each day of the week, and stirs it into some yogurt to feed to her. She checks her pulse, blood pressure and weight and jots down the numbers on a chart taped on the side of the refrigerator.

“She hates water so I trick her. I put a little bit of juice in it,” said Zonon as she poured a small amount of cranberry juice into a glass of water.

Zonon spends most of her time during the day coordinating doctor appointments for Asen. Scheduling the car service is one of the most frustrating parts of her job. She has to call 48 hours in advance of the appointment and often ends up on hold for long periods of time. Zonon recalls one visit to the doctor where they waited four hours for a car to pick them up afterwards. Holding the phone up with her shoulder, Zonon writes down the pick up time onto a calendar. Appointments with the cardiologist, neurologist, primary care physician, physical therapist and occupational therapist are all listed.

Asen is silent for most of the day, closing her eyes whenever she can. But she perks up when Zonon mentions her granddaughter.

“Rita, when was the last time you saw Ginger?”

“A long time.” Asen said.

“We’ll call and try and see them this weekend.”

Zonon picks up Asen’s hand in hers and inspects her nails.

“I do her nails every other week,” Zonon said.

Zonon said Asen used to only choose dark colors but recently she said she wanted something lighter. So Zonon brought in a few new choices. This week she chose a vibrant hot pink.