Above Photo: Home Care Aide Isabel Palma works with her Consumer Rebecca Shimko. Isabel and her family escaped civil war in El Salvador in the 80s. Photos by Paul Joseph Brown.
1984 was a frightening time for Home Care Aide Isabel Palma. Civil war had erupted in her country, El Salvador. She knew of people who had disappeared and no one knew what happened to them. And while in Guatemala, Isabel’s husband and brothers were assaulted.
One evening while waiting for a bus, things got worse for Isabel. Men approached her about stealing antibiotics, painkillers, and medical supplies from the government hospital where she was doing her practicum as an Auxiliary Nurse (similar to an LPN in the United States).
Isabel refused to cooperate, but she knew the men were still watching her and later tried to force her into a car. That is when she knew her family would not be safe. With the help and advice of her brother, she decided to bring her family to the U.S. where she hoped to get political asylum. Isabel fled her country with her mother, two daughters and her 8-month-old son.
Today Isabel and her family’s lives look much different in Blaine, Wash., which sits right on the border of Canada. She now works as an Individual Provider Home Care Aide for a Consumer with quadriplegia and as a Nursing Assistant in a 32-resident facility. Most of her life she has worked two jobs and continued to go to school to support her family.
You said you had to sneak out of El Salvador when you left. How did you do that?
Yes, I did sneak out. I hired a man to get us out. I paid him $3,000 for each person. My mom, my two daughters, my baby son, along with my sister-in-law and her children, and I left after dark. The man I hired drove us to Tijuana. We had to walk to the United States from there.
We went through a tunnel and into the mountains where men with guns robbed us. They took $600 from us but thankfully they let us go and didn’t hurt my children or me. We made it across the border and into San Diego. But then we got caught by immigration officers. We were all arrested and spent the night in jail. We were so frightened we would be sent back to El Salvador. Because we asked for political asylum, they let my brother bail us out the next day, but it cost him a lot of money. We were so thankful they let us go.
We got work visas and jobs in Texas. I took the Fundamentals of Care Giving course, but caregiving was such a low paid job in Texas I had to find another way to make a living. So I got a job in a dry cleaner. My grandmother had taught me to sew when I was young and I could do alterations for the dry cleaner.
HCAs Isabel Palma and her husband Jose Palma at their home in Blaine, Wash. Isabel and her family escaped civil war in El Salvador in the 80s. Photo by Paul Joseph Brown.
Were you granted asylum in the U.S. at that time?
No. Immigration wanted more proof that I was in danger in El Salvador. I told my story but I had no one to back it up. There was no one left in El Salvador for Immigration to contact about me. So political asylum was denied. When my immigration officer said my work visa was going to expire, I was afraid of being deported. That scared me but I kept this from my children.
At that time the church had a program to help people from Central America apply for political asylum in Canada. So the church helped us fill out all the paperwork and Canada gave us permanent resident status. We lived in Canada for six years.
What was Canada like for you?
Canada was good. They had programs to help immigrants get established. For example, we could have gone to school in Canada to learn English and the government would support us for a year. But we thought since we were there and we were safe, we should provide for our family and not take support from Canada. So we worked very hard at two jobs and we didn’t have time to go to the English classes.
I did take the Home Care Attendant course there. It was six months of training. But now we think we made a mistake. We should have taken the English classes too. Our grandchildren tease us now because we speak part Spanish and part English. We call that Spanglish.
Do your children and grandchildren speak both languages?
My children do, and my younger grandchildren, too. But the older grandchildren, no. They only speak English. Their father was American and he thought the children should speak English. Now we realize that knowing both languages would be valuable to them.
My granddaughter works as a manager and she is learning to speak Spanish now because it helps her in her job. It is good to be bilingual.
How did you get started in healthcare and caregiving?
I had three sisters-in-law who were nurses. When I was only 13, one of them took me to the hospital with her. She taught me how to give injections and how to draw blood, which you could do at that time without a license.
I spent a lot of time in the hospital visiting my sister-in-law and learning from her about nursing. After I started nursing school, my father had five strokes and got sick. I had to take care of him and that is when I decided the kind of work I wanted to do was caring for others.
How does your experience as an HCA compare to working in a residential facility?
A daily schedule hangs on a door at the residential facility Isabel works at in addition to her job as a Home Care Aide.
In the residential facility there are schedules for most things, like showers, time to get up, mealtime, and giving medication. We take them to the dining room and back to their rooms and help get them ready for bed. We do their laundry and help them dress.
I do those same things for my Consumer at home, but in the facility we have to do it according to the schedule. At home, they get to decide when they want to have a shower, get up in the morning, or eat. It is more flexible. At the facility we don’t take the residents shopping, to doctor appointments, or go out for walks. In home care, we do those things for our Consumer. We also cook and clean for them.
I think there is more interaction with them at home. I can suggest things to do since I don’t have to keep a certain schedule. I can take my home client outside for a walk or to enjoy the beautiful day or take her to the mall if she wants to go. The HCA has a more personal relationship with their clients because of being in their home on a daily basis.
What is the hardest job you have to do for your residents?
The hardest thing I have to do is wake them up in the morning. Some of them don’t like to get up early but they have to get up even if they don’t want to. I have to help them get dressed, wash and do their teeth, and get them to breakfast. I have to keep their schedule.
What techniques do you use to connect with your Consumers?
When you open the door to the clients you have to leave all your personal problems outside and bring a big smile to them. All the worries in my life, they don’t need to know. They are expecting support from me. Sometimes they are depressed or sad and they don’t need to hear the problems I have with my husband or children.
They have the same kind of feelings for us as we have for them. And our problems make them worry and sometimes they feel like they have to help. We are there to help them not the other way around.
What do you miss most about El Salvador?
A lot of things. Good things. Authentic food. Visiting family and celebrating with them and going to the beautiful beach we have. And I miss the weather. The weather is so beautiful there. We celebrated Christmas and New Year’s and Good Friday with a big party at the beach.
What traditional recipes do you like to make?
Pupusas! It is a very famous and traditional food and everybody likes them but it’s not so easy to make. It’s made with masa harina (corn flour) and it’s like tortillas but thicker and softer and filled with chicharron (pork). The chicharron is the hardest part but you can make them with cheese and beans. Or it can be made with different fillings, like bell peppers or even zucchini.
We have a dessert called Arroz con Leche (rice and milk), and it’s good and sweet. Yuca (cassava) is a salty dish. You can boil it or fry it and put it with coleslaw and salsa. The skin is hard to peel but you can buy it at a Mexican store already peeled.
Isabel at a residential facility in addition to a IP Consumer. Photo by Paul Joseph Brown.
What is the most rewarding part of being a Home Care Aide?
When I make someone laugh with my crazy sense of humor. I like to joke around with them. I say, “Hey, it is shower day and it is raining outside, so let’s go out and get your shower.” That makes them laugh. I have one tiny lady who is 98 and she has to take half a tiny pill, so I tease her.
I say, “I have a tiny pill for a tiny lady. Who’s this tiny pill for?” She gets so excited and says, “Me, me!” and she laughs.
What advice do you have for other HCAs?
This job (home care or residential care) is to help us to survive but it is a job that requires feelings. If you don’t have the feelings (compassion), don’t do this job. I’ve seen both sides of good and bad in coworkers. I heard one coworker say that this elder lady is crazy. She is not crazy. She has dementia.
Don’t get stressed if your client repeats the same story every day. Just enjoy them. I really love this job. I even recruited my husband. He is now a caregiver too. Think about someday it may happen to you and how you would want to be treated.
