Life in a nursing home, from the inside - LONG

[KEK1984]

I started class at my local community college today, and they gave us a 50-page handout. in the middle was a story that broke my heart. it's from time, on June 27, 1994, page 11. the column is called "my turn".

http://www.topshot.com/dh/myworld.html

Quote

My world now

Life in a nursing home, from the inside

Anna mae halgrim seaver

"This is my world now. It's all I have left. You see, I'm old. And, I'm not as healthy as I used to be. I'm not necessarily happy with it but I accept it. Occasionally, a member of my family will stop in to see me. He or she will bring me some flowers or a little present, maybe a set of slippers - I've got 8 pair. We'll visit for awhile and then they will return to the outside world and I'll be alone again.

Oh, there are other people here in the nursing home. Residents, we're called. The majority are about my age. I'm 84. Many are in wheelchairs. The lucky ones are passing through - a broken hip, a diseased heart, something has brought them here for rehabilitation. When they're well they'll be going home.

Most of us are aware of our plight - some are not. Varying stages of alzheimer's have robbed several of their mental capacities. We listen to endlessly repeated stories and questions. We meet them anew daily, hourly or more often. We smile and nod gracefully each time we hear a retelling. They seldom listen to my stories, so I've stopped trying.

The help here is basically pretty good, although there's a large turnover. Just when I get comfortable with someone he or she moves on to another job. I understand that. This is not the best job to have.

I don't much like some of the physical things that happen to us. I don't care much for a diaper. I seem to have lost the control acquired so diligently as a child. The difference is that I'm aware and embarrassed but I can't do anything about it. I've had 3 children - and I know it isn't pleasant to clean another's diaper. My husband used to wear a gas mask when he changed the kids. I wish I had one now.

Why do you think the staff insists on talking baby talk when speaking to me? I understand english. I have a degree in music and am a certified teacher. Now I hear a lot of words that end in "Y". Is this how my kids felt? My hearing aid works fine. There is little need for anyone to position their face directly in front of mine and raise their voice with those "Y" words. Sometimes it takes longer for a meaning to sink in; sometimes my mind wonders when I'm bored. But there's no need to shout.

I tried once or twice to make my feelings known. I even shouted once. That gained me a reputation of being "Crotchety". Imagine me, crotchety. My children never heard me raise my voice. I surprised myself. After I've asked for help more than a dozen times and received nothing more than a dozen condescending smiles and a "Yes, deary, I'm working on it," something begins to break. That time I wanted to be taken to a bathroom.

I'd love to go out for a meal, to travel again. I'd love to go to my own church, sing with my own choir. I'd love to visit my friends. Most of them are gone now or else they are in different "Homes" of their children's choosing. I'd love to play a good game of bridge but no one here seems to concentrate very well.

My children put me here for their own good. They said they would be able to visit me frequently. But they have their own lives to lead. That sounds normal. I don't want to be a burden. They know that. But I would like to see them more. One of them is here in town. He visits as much as he can.

Something else I've learned to accept is loss of privacy. Quite often I'll close my door when my roommate - imagine having a roommate at my age - is in the tv room. I do appreciate some time to myself and believe that I have earned at least that courtesy. As I sit thinking or writing, one of the aides invariably opens the door unannounced and walks in as if I'm not there. Sometimes she even opens my drawers and begins rummaging around. Am I invisible? Have I lost my right to respect and dignity? What would happen if the roles were reversed? I am still a human being. I would like to be treated as one.

The meals are not what I would choose for myself. We get variety but we don't get a choice. I am one of the fortunate ones who can still handle utensils. I remember eating off such cheap utensils in the great depression. I worked hard so I would not have to ever use them again. But here I am.

Did you ever sit in a wheelchair over an extended period of time? It's not comfortable. The seat squeezes you into the middle and applies constant pressure on your hips. The armrests are too narrow and my arms slip off. I am luckier than some. Others are strapped into their chairs and abandoned in front of the tv. Captive prisoners of daytime television: soap operas, talk shows and commercials.

One of the residents died today. He was a loner who, at one time, started a business and developed a multimillion-dollar company. His children moved him here when he could no longer control his bowels. He didn't talk to most of us. He often snapped at the aides as though they were his employees. But he just gave up; willed his own demise. The staff made up his room and another man has moved in.

A typical day. Awakened by the woman in the next bed wheezing - a former chain smoker with asthma. Call an aide to wash me and place me in my wheelchair to wait for breakfast. One 67 minutes until breakfast. I'll wait. Breakfast in the dining area. Most of the residents are in wheelchairs. Others use canes or walkers. Some sit and wonder what they are waiting for. First meal of the day. Only 3 hours and 26 minutes until lunch. Maybe I'll sit around and wait for it. What is today? One day blends into the next until day and date mean nothing.

Let's watch a little tv. Oprah and phil and geraldo and who cares if some transvestite is having trouble picking a color-coordinated wardrobe from his husband's girlfriend's mother's collection. Lunch. Can't wait. Dried something with pureed peas and coconut pudding. No wonder I'm losing weight.

Back to my semiprivate room for a little semiprivacy or a nap. I do need my beauty rest, company may come today. What is today, again? The afternoon drags into early evening. This used to be my favorite time of the day. Things would wind down. I would kick off my shoes. Put my feet up on the coffee table. Pop open a bottle of chablis and enjoy the fruits of my day's labor with my husband. He's gone. So is my health. This is my world.

Memo: seaver, who lived in wauwatosa, wis., died in march. Her son found these notes in her room after her death."

I found this to be so sad. It's horrible that our senior citizens might be treated as this poor woman was. Like my instructor said tonight: "Treat every patient as you would want your mother treated, or your father, or sister or brother."

Kim

 

[ohmeowzer RN, RN]

this was wonderful thank you for sharing.

[philanurse74]

I truly believe everyone who is in direct patient contact should read this, hospital or long term care, doesn't matter. People should be treated with dignity, and too often we rob them of it with our busy schedules. I will be reflecting on this at work tomorrow.

[JHansen]

When I was doing my clinicals at the local VA I saw this so much, the sad thing is the state determines the pay for employees and how many employees an establishment may hire. At the same time saying that each patient requires 4 hours of face to face care.

LTC facilities would be so much better if they just paid their employees better and were able to have more people to give care(in my dreams I know) and for non state run LTC places its the insurance companies that run them, perhaps not physically but by dictating the amount of care(what they want to pay) they determine is needed for a patient, but not to improve their quality of life just to keep the status quo. Its a terrible thing.

[hamnurse]

I work in a nursing home.....I try to remember to knock at the door and wait for an invitation before going in my pt's room...but sometimes.. I admit, it's the old "I am so rushed. I just have to hurry" excuse. I am still crying over her notes she left. That could have been any one of our Grandmothers, Moms, Aunts, Cousins, Sisters, or even a daughter. Let's all try a little harder to make our pt's lives more dignified. We LTC nurses should be especially sensitive to God's older children that we have chosen to take care of. Let's do our best to make their last years on Earth as dignified and full of happiness, as well as keeping them painfree as possible until they are called to their final home.

[mondkmondk]

LTC is my specialty...I have read notes similar to this one and always get a lump in my throat and tears sting my eyes. Do I do any of those things to my residents? Probably I have at some point, maybe even more than once.

I have a memory...one of my residents always talked about chickens for some reason; she knew how to chase them, kill them, pluck their feathers, and cook them...so I always called her "chickadee" when I took care of her. She never seemed to mind and she knew that was why I called her that, but never asked her outright if I could. If I get my old job back...I'm going to go in there first and ask her if she was ever offended. I have to make things right.

Anyway, thank you for the reminders in that lovely lady's note.

Blessings, Michelle

[locolorenzo22, BSN, RN]

I always say to myself before I start my shift "Every one of my patients will be treated like they are my family." My grandfather went into a nursing home one fall...he died the next june. I never got a chance to go see him before he died...in a way, it was a blessing. I didn't have to see my grandfather(a proud man with many ideas and friends) lose his dignity...through no fault of his own. I remember a man that I loved and was different.

I hope I am the kind of nurse he would be proud of. I hope the care I give is the care he got....I'm sure it wasn't, but I like to think it was. never forget that even the most demented patient is someone's relation....treat all your patients with kindness and your care will show.

[DA314]

I'm new to healthcare (currently taking CNA class, then hopefully off to LPN school in Jan). This broke my heart.

I am more than likely going to be working in LTC, and I hope that I remember this woman's story when I am caring for other adults.

[woknblues]

Powerful stuff. Thanks.

[CoffeeRTC, BSN, RN]

I had a note similar that I would give to all our new hires and make them read it. I would also let them know how important it is to treat our residents like people..not "work"

A commnet was made about "better pay"....for the most part, in our area, the pay in LTC is rather decent and I think this holds true to alot of areas. It isn't the pay...it is the staffing. Yes, most of the states have ratios, but rarely if ever have I seen a facility cited for poor staffing. Acute care has staffing ratios that are acuity based. I think it is time for LTC to adopt these standards. Untill then...yeah, it has to be more institutional. This is the sad part.

Another thing to consider is how the families force their parents into LTC facilities when is would be much cheaper to keep them at home and just get in home care.

On a brighter note, where I work...we do give choices for dinner, food is served on nice plates etc. Rarely do we let our residents watch "crap tv" (unless they want to, lol) We encourageiur residents to go on mini LOAs when able to and even schedule activities outside of the facility too.

[lpnflorida]

I am so glad you posted this. I believe this will help me at my regular job in the hospital, but as I will be starting prn in LTC this was most pointed for me. It has so opened my eyes.

[One Flew Over]

Makes you think, it does