Mom’s Nursing Home Today After 20 Months of Lockdowns

Mom's Hand

Medicare/Medicaid finally allowed us today inside my mom’s nursing home. I have not set foot inside since March 14, 2020 when she was abruptly moved from her room into isolation with another lady who was also Covid-19 free. Then she was moved back into another room, not her original one. Her personal belongings and everything that decorated her room and made it more like her own personal space were dropped off wherever the movers could find an empty surface.

I expected to find a spotless room since they have locked them down under Covid-19 pretext for almost two years now.  Instead, I found a filthy room, in bad need of sweeping, mopping, disinfecting, and bathroom cleaning. There was no surface in the room that had been cleaned in quite sometime, much less disinfected for fear of Covid-19 infection.

The air in the room was stale, nobody had opened the window to allow fresh air in since the last time I was here. So many months of visiting through a glass wall, through FaceTime, on the patio six feet apart, or no visitation at all for months on end!

I found out that the housecleaning supervisor had not worked for two weeks. One young woman came into the room, as I was trying to trash two years’ worth of garbage, discarded empty containers littering all over the place, pretending to sweep and mop in the small area left in the middle where there was no trash or no belongings discarded in a hurry long time ago, a year and a half to be exact.

People with dementia keep every wrapper that touches their hands and all disposable containers, newspapers, magazines, calendars, bits of paper, etc.

Pills of dubious origin were scattered on the floor, a sign that the patient, my mom, had spit out some of her pills when the nurses were not watching and nobody came to sweep them away in a long, long time. Some of them were beginning to disintegrate from the air humidity and were turning yellow.

Her clothes and blankets were piled high on plastic boxes and on the dirty dresser and nightstand. The closet was occupied to the top with boxes of diapers. Apparently it had become storage for the nursing floor. None of her clothes were hanging there and looked like the hangers had disappeared long ago.

A trunk by her bed had been smashed into three sections with large cracks showing. The drawers were even worse. The furniture looked like it had been picked up on the side of the road, meant for the garbage dump. Dubious stains that did not come off with Clorox wipes covered most surfaces.

After two hours of hard work, I managed to bring some semblance of normalcy to her room. None of her pictures were on the wall anymore, her bulletin board was stuck in a corner, all her artificial plants were missing, and the live ones had been dead for quite a while. Even the window sill was disgusting and dirty.

There has been no Covid-19 sanitizing in this room ever that I could tell. The new owners, Pro Medica, must not care much about their resident patients and the conditions in which they live.

There were large font bulletins posted everywhere stating that, if the staff is not vaccinated, they must wear both a mask and a shield and must be tested twice a week for Covid-19. I venture to say that it is unnecessary, as the patients are more likely to be killed by the filth surrounding them, both bacterial and viral, because nobody seems to be cleaning or disinfecting much.

I left a message with the administrator; they never answer the phone, they are too busy being Covid-19 compliant every minute of the day. Thank God nobody is sick with Covid-19 but I am not sure about other dangerous infections from the lack of sanitation.

I felt like I traveled back in time and found a filthy socialized medicine hospital in a former Soviet satellite country, that is how bad this nursing home presented itself to visitors. I was the only one for those two hours and I was utterly shocked and disappointed that this exists in America.

Nursing Home Pandemonium

My dear mother whom we love and cherish is locked up in a prison not of her own making, in pain and suffering, on oxygen and not understanding why she cannot come out of her room.

Her prison is tightly monitored by staff who were unable to stop the spread of the Covid-virus. Formerly free of it, she was moved from her private nursing home room to a semi-private room, in the very same bed and room just vacated by patient Marlene (not her real name) who was Covid-positive and sick.

Marlene had been moved with the other 75 Covid-positive patients the very same day that my Covid-negative mom was moved into her bed before the room was thoroughly sanitized. To say that the move was irresponsible, it is an understatement. Nobody from the nursing home bothered to call us and let us know of her status or their plans to move her. 

After the fact, a corporate marketing guy from Colorado, not a caretaker or a doctor, called us first to let us know that she was Covid-negative, and a second time to tell us that she was moved from her room.  We made numerous phone calls to the nursing home, but they remained unanswered.

Communication and information from the nursing home has been almost non-existent. The phone rang unanswered and all voicemail calls and questions we left remained unreturned as well. Mom was locked tighter than prison. Wheeling her out of her room to a glassed lobby through which we could have visited for five minutes happened only once.

As some patients went home for brief visits and came back carrying the Covid-virus, the movement of patients even within the nursing facility stopped. The residents became prisoners in their own rooms and the virus spread. Eighteen patients alone in the Arcadia section were sick with the virus. Four staff were Covid-positive as well, a total of 21 as of two weeks ago, as admitted by administration. This prompted the Health Department of Virginia to come and test everyone last Friday, May 15.

Residents have died but the true cause and statistics were not known to the public or to the patients’ families.

The “corporate people” (as one nursing home employee put it) came last week and must have ordered, possibly per Health Department of Virginia instructions, the grouping of positive patients with other positive ones (75) and the negative patients with the rest of the negative ones (26).

Was it wise to move the 26 negative patients into rooms vacated by positive Covid-patients? I am not sure what the intent was with this move, but I know that mom came down with pneumonia three days after being moved from her room. Coincidence? I do not believe in coincidences; I believe in cause and effect.

The emergent evidence of the “plan-demic” has shown that the worst attributes of small-minded people drunk on their own power and control, were magnified, and have robbed the U.S. population of their Constitutional freedoms under the guise of protecting them.  

Euphemistic terms such “social distancing” should be called what they are, “isolation,” there is nothing social about hiding in your own home, behind a mask, or snitching on your neighbors and businesses that may not follow the lockdown dictates.  

The elites videotaping themselves in their mansions to prove that “we are in this together” is so hypocritical to most who have lost their jobs permanently, their businesses, and may or may not have enough savings to feed their families and pay their bills while millionaires are well set in their banks and trust funds.

“Be safe,” and other phraseology invented for the benefit of robbing us of freedom of movement, assembly, right to make a living, and freedom of religion, should have been really called what they are, forced imprisonment into our homes and servitude to dangerous vaccines produced in a hurry, chip implantation, and personal control through data.

Many people were not safe in their homes just as the 101 nursing home residents in northern Virginia were not safe in their lockdown, most of them were positive and many symptomatic.

For the “greater good” is offensive. No good can ever come out when the government chooses who is “essential” and who is “non-essential” to society and to the economy. Nazi Germany picked winners and losers and it did not end well for the Jewish people.

The “new normal” is offensive too. There is nothing normal about anything that has happened to us in the last ten weeks and is still happening.

Egomaniacs and megalomaniacs with a Messianic complex have crawled into the limelight, mostly Democrats at local and state levels, placing healthy people in quarantine as well as sick ones far beyond the normal 40 days, prompting many Americans to demonstrate against insane executive orders and to demand that their churches, schools, small businesses, and doctors’ offices be open after ten weeks of lockdown in various states.

Sound reasoning, proper science and medicine were the last employed in the decision-making process of government in many countries that followed the U.S. lead and example. Sweden who allowed herd immunity to take its normal flu toll has not been any worse off in the number of patients infected and the number of those who have died.

Instead of locking down healthy people, we should have protected the most vulnerable, the elderly in the nursing homes. Instead, we have exposed them unnecessarily and thoughtlessly because they have few lobbyists and champions who defend their rights.

Stop waiting for a new vaccine. Flu vaccines are only partially effective as the viruses mutate. Even Bill Gates admitted, “The efficacy of vaccines in older people is always a huge challenge, it turns out the flu vaccine isn’t that effective in elderly people. And that actual decision of, ok, let’s go and give this vaccine to the entire world, governments will have to be involved because there will be some risk and indemnification needed.”

Update on my mom: She is now free of oxygen and feeling better. The drug cocktail is working and she now breathes on her own,  97% oxygen saturation. I am really happy; yesterday she told me she was hungry. 

It is unforgivable that the nursing home moved her from a private room where she was Covid-negative, into an infected room previously occupied by a Covid-positive patient who was sick. And the room was never properly sanitized. 

Citrus, Chocolate, Lotion, Socks, and the Nursing Home

Photo: Wikipedia

I decided to take small tangelos to the nursing home this week. Last week I took small tubes of hand lotion and small Ziploc bags of Lindt chocolate balls for the non-diabetic residents who either don’t have families or whose families are either too far away to make the trip or never come to see them, they’ve abandoned them to the care of the state of Virginia and its employees who are mostly foreign and do not understand how people can discard their loved ones into a nursing home, a dreadful but necessary place for those who need round the clock care or who truly do not have any family left. The alternative would probably be that they would join the homeless in the streets.

As a foreign born American, two residents affected me most profoundly – a German lady (I shall call her Helga) who has such severe diabetes, her right leg had been partially amputated twice. I speak German and I can communicate with her every time I go. A spark of joy lights up in her eyes when we talk in German. Helga has no other relatives in the U.S.

The second resident is an Italian lady whom I call Maria. She does not speak English much and has advanced dementia but is otherwise calm. Because she is toothless, I have a hard time understanding what she says. The nursing home did not provide her with dentures, they just puree her food. I asked her many times if she has family and what part of Italy she is from. She always responds, I am from Italy, all over, and I have no children. She cannot remember her hometown anymore or her name.

Maria resides in the Arcadia section of the nursing home, a place really far from the mythological Arcadia which was a paradise of sorts; most residents in this Arcadia are locked up since they are ambulatory and might otherwise try to walk away from the nursing home. But Maria is wheelchair bound and has more freedom. She would never remember the elevator passcode but she could sneak into the elevator with a careless visitor. They do wear ankle or wrist bracelets just in case they get lost.

One man managed to escape last week and I witnessed him trying to cross a busy highway intersection with no pedestrian crossing. Three nurses were chasing him with a wheelchair in tow, trying to bring him back.

Obviously the nursing staff is too busy and not very attentive to their patients’ whereabouts and needs, the ratio of care to the number of patients is appalling. My own mother had escaped their care but she did not make it too far, her granddaughter found her, all dressed up to go into town, waiting on a bench outside for an imaginary ride.

Why give tangelos you ask? Fragrant citrus fruits, especially oranges, bring back memories of my childhood under tyrannical socialist society, a nursing home of sorts for able-bodied people from which we could not escape if we wanted to – we were locked up within the borders of our country which served as a prison to keep us in, away from the rest of the free world that lived so much better than we did.

Once a year, usually at Christmas, the dictator would order more food in the stores and exotic fruits would be brought in, bananas and oranges. I loved the oranges wrapped in thin tissue, printed with unrecognizable words from a faraway country, Israel; the fragrant fruit was filling the house with intoxicating citrus perfume. It was such a treat, we placed a few oranges in the Christmas tree, in small paper baskets decorated with colorful crepe paper. Chocolate candy and butter cookies were dangling from colorful threads as well.

Last year I gave everybody socks – a small but such useful gift!  Socks were so hard to find in the communist stores, we had to learn to knit to make our own if we wanted our feet to be warm in wintertime.

I took hand lotion too every year – it is painful to have dry and cracked hands. I know all too well – commies were not producing anything so frivolous as hand lotion. The elites were able to buy Nivea from their own stores but we did not have such imported luxuries.

One patient asked me if I worked in the mall – why else would I bring such stuff to them as lotion, chocolate, oranges, and socks? I must have some overstock in my private warehouse. I just smiled and walked on.

Mom Turned 86 Years Young

Mom turned 86 years young on St. Patrick’s Day. She is a skeletal figure of her former self but she has a strong will to live. Three weeks ago she fell and fractured her hip in at least three places. Dr. Reeves’ skillful surgical intervention put her bone fragments back together again and she convalesced for eleven days in the hospital, in and out of consciousness. She gained nine pounds on decent food and dedicated care. It was stellar nursing compared to ManorCare.

Maybe it was bad luck that she fell; however, if the African CNAs would have come to her help, she would not have fallen in the first place, trying to walk to get some water. Then they let her linger in pain from Wednesday afternoon until early Thursday evening when I arrived from a trip, before they sent her to a hospital to be x-rayed.

She had fallen during the three-year stay at ManorCare more than fifteen times and, thankfully, each time she walked away with a painful bruise or two. But this time her luck ran out. She was gaunt and malnourished because the nursing staff lost her dentures four times and often gave her pills on an empty stomach which caused her to vomit whatever food she did ingest. When she fell directly on her right hip, it crushed it as if she had been in a severe car accident. It was a comminuted fracture.

We could barely dress and lift her onto the wheelchair for fear that we might cause her unnecessary distress. I called a wheelchair van taxi to transport her to her favorite restaurant to celebrate her 86 years of life. I knew she would not eat much, between physical therapy and pain meds, but getting her out of the house and into the world was hope and life outside of four walls.

Mom is now a shell of her former self, frail, child-like, sweet some days, and a hellion on others. After her stroke last year, her incipient dementia had gotten worse and, on most days, she knows we are related, knows my name, but I am either her sister or her mom.

When she was 72, I found her on top of a ladder trying to clean the gutters stuffed with dry leaves. She was very active and moving about all the time. But she had slowed down after a fall on wet leaves in the driveway. She had to wear a corset for six months to repair the hairline fractures in the tailbone and ribs.

Mom took so much pleasure in raising a garden and flowers.  She took trips to Walmart with her Mimi Eileen every spring to buy plants, seeds, pots, and fertilizer. There was a sparkle in her eyes, and a sprint in her walk, as if she was going to a very important event that she did not want to miss. Spring was on its way, mom said, she could smell it in the air and hear it in the melodious birds chirping in the barren trees.

Mom had a green thumb and felt so happy and free among plants and flowers. She brought back to life potted plants our neighbors put out in the street for trash pickup and then she gave them back to the owners green and often in bloom. How did she do that? It was magic.

She was trying to make up for 48 years of living in a communist drab cinder block tiny apartment where the only concessions to a garden were a couple of red geranium plants she grew on the window sill in winter and on the balcony during the summer.

When she first arrived in the U.S., mom had such a large and beautiful garden in our faculty housing yard at MSU that people would drive by in awe watching her toil in dirt with glee, waving at them from her white wide-brim hat. When the eggplants, tomatoes, peppers, green onions, radishes, cucumbers, carrots, okra, and green beans would start coming in, all neighbors had fresh vegetables from her garden.

As mom aged, the large garden dwindled to a few tomato plants and peppers and a few roses and geraniums. I would find her picking Japanese beetle off the rose bushes and putting them in a jar filled with water. Somehow she felt that killing them this way was a more humane way to dispose of God’s creatures that dared to crawl out of dirt to shred her rose bushes.

Every spring, Anthony, our trusted lawn care man, would trim the azalea bushes and the Japanese magnolia we had planted twenty years earlier when we moved into our lovely southern home.  Mom would harass him, trim that, trim this, to my exasperation and his ever patient and smiling demeanor. Anthony had a bossy mom just like her at home and he always did their bidding with an unmistakable southern charm, “yes, ma’am.”

We still talk with love and longing about our fig tree in the back yard that would give so many figs, enough to make jars after jars of preserves each year. The tree was there when we bought the house. If the new owners have not cut it down, the tree is fifty-eight years old now. You never know who will enjoy the fruit of your labor when you plant a fruit tree or a shade tree.

We miss the gorgeous Ginkgo biloba tree in the back yard. Its leaves turned bright yellow in early fall; they blanketed the ground with a thick and beautiful yellow carpet of waxy leaves. Tiger and Bogart loved to chase moles and lizards in this impromptu playground. When Tiger passed, the yellow leaves would cover his grave.

It was mom’s first home since the communists had confiscated my parents’ apartment, their savings, and their pensions. And dad’s relatives took all their personal possessions when dad passed away in 1989. To this day, when she has no clarity, her scrambled brain remembers the confiscation and theft but I am the culprit.

Perhaps she is right, if I had not left the communist country legally, perhaps she would not have followed me here as a defector from communism and would have kept her property. Those commies did not take lightly the acts of defiance of their prison society citizens escaping from their tyranny and oppression.

Mom is 86 years young today. She came a very long way that flew by too quickly, almost nine decades of life full of good and bad experiences. She said, she did not care if she was 100 today as long as she was still alive and breathing, enjoying the sunshine and her plants. She has an assorted collection of small potted plants in her room at ManorCare. When she cannot water or tend to them, she makes sure that Alamatu does it and brings them in and out of the sun.

I have to remember Marcus Aurelius' advice to enjoy the moment because the present is a split second in eternity, minuscule, transitory, and insignificant.

Seeing mom in the outdoors again, my eyes teared up. I thank God, Mom is still with us! I was not sure she was going to make it alive from this difficult surgery. But here we are, we live another day to enjoy each other’s company in the Virginia sunshine, with bright blue skies and a blustery wind.

Blessings

Photo:  Ileana Johnson 2015

Tonight, the much awaited Snowmageddon 2017 came in the form of a wicked icy slush. Nobody must have heard of March snows – March roars in like a lion and goes out like a lamb. Some grocery stores were emptied of milk and bread – the global warmists were afraid they would starve. I rushed to come home from the nursing home for fear that I might get stuck for six hours in an inch of snow as it happened two years ago on the Occoquan River Bridge.

The changing pressure is wreaking havoc inside my painful knees but I must stay mobile to see mom and to help my hubby recover from chemo. Today was a good day, she was happy, in less pain, and recognized me.

As always, I bring candy bars and chocolate to mom’s neighbors who are not diabetic. When I first got off the elevator I encountered the retired sailor with a proud tattoo on his wrist. He is always smiling and watching those who come and go on the keyed elevator. We always chat a bit and sometimes I bring him a couple of pieces of wrapped chocolate.

Mimi and I adopted Lakshmi across the hall from mom’s room. We have no idea what she says, she chatters in her Indian dialect that only her family and personal physician understand. Her room has no decorations at all; as soon as her family puts pictures on the walls, she takes them down. She refuses to wear any other outfit except one favorite dress. When the staff bathes her, they dress her in clean clothes but she changes quickly back into her favorite dress. I take her chocolate every time. We only truly communicate when she greets me with “Namaste.”

Last week Mimi ordered pizza for mom. Lakshmi and Maria came into the room and everybody ate pizza and watched TV – Lakshmi does not have a TV in her room. She is highly mobile and often checks in on mom  to make sure she has not fallen. Mom can barely stand now.

One day mom was eating breakfast in her chair and Lakshmi came in and made her bed. It seemed to give her joy to do that so we let her. It is almost comical to watch them huddled in the hallway, talking to each other in their respective languages, not one understanding what the other said, yet they nod and smile as if they have just shared a funny story.

It is so lonely for these residents, most of them don’t have any family visiting them at all or visit them infrequently. I cannot imagine not going to see my mom two or three times a week. Americans are a funny bunch, they talk about how much they miss their families, especially after they died, yet while the loved ones are still alive, they never take the time to go see them, to tell them in person how much they missed them. As a European who grew up with a very large extended family, I find that odd.

During Bingo days, Mimi and I take hand lotion bottles for prizes and bags of Lindt chocolate as a treat. The social worker makes sure those who are diabetic only get sugar free treats.

Mimi bought a large birthday cake for everyone on Mardi Gras. It was not a King cake, nobody at our local grocery store even heard of Mardi Gras much less bake such a special treat. But the residents were so happy!

I hope and pray that God continues to keep me mobile so I can bring a little joy to a few of the residents in mom’s nursing home, especially those who are immobile and trapped in their rooms. Mobility is a blessing that most of us don’t appreciate until we lose it in the twilight of our years.

Visiting a Nursing Home, a Sobering Reality

 

Photo: Ileana Johnson 2016

Entering the nursing home, I never know what human drama peppered with dark comedy emerges. It is a life that most Americans turn their eyes and minds away from. The residents are the forgotten sick, disabled, recuperating, and old Americans about whom few dare to whisper. “This is where people go to die,” I was told by a very good friend. “I would never put my mom in such a place.” But this is where people live now and they want dignity and proper medical care delivered with humanity and patience.

It is bad enough that they cease to have an identity, they are reduced to a wing or room number. It is bad enough that they feel trapped and isolated as they no longer have the freedom to do things they’ve always enjoyed. It is bad enough that they spend most of the time alone because the families have long abandoned and forgotten them. It is bad enough that they realize their own mortality and understand that, when they leave, it will be because they’ve passed on. It is bad enough that no one takes them seriously anymore. They’ve lost their dignity as they are no longer able to feed, bathe, and wipe themselves. They depend on the kindness or meanness of someone else who is paid to care for them but often abuse or neglect them.

On the positive side, the residents get medical care, however slowly or quickly, three meals a day that they may not have gotten before; they befriend others in the same position in life, and are forced to participate in activities to stimulate their minds and social skills.

The smell of bodily fluids is overwhelming on most days, even for those used to it. Patients are showered twice a week, some screaming for help because they’ve been bathed last month and they don’t need it again. Some don’t speak English but scream and protest a shower anyway. In their third world countries, it is hard to find water and soap or indoor plumbing, so showers are rare.

There are never enough caretakers to handle the entire floor of patients and some are left to wallow in their feces and urine. It is difficult and time consuming to change diapers on someone who cannot move and many are left for 5-12 hours in beds entirely wet. Even babies scream bloody murder if they are not changed every two hours and are left with a wet diaper too long. Patients develop constant urinary tract infections from such neglect. One caretaker to five patients is not enough help. I don’t know what the margin of profit is for nursing homes but the large fees charged per patient should at least include keeping them clean and dry. It is not easy convincing a 160 pound person to cooperate – much harder than dealing with a 10 pound baby.

A few crafty patients escape through the elevators even though they are coded. One man was chased half way down the road on the side of a very busy highway. A woman was sitting on a bench outside, all dressed up, ready to go for an imaginary job interview. Another patient, who can still dial the phone, calls 911 regularly screaming for help; the police comes and stays outside for a while. It is hard to ignore calls of desperation even from a dementia patient. You never know when the call might be real.

Patients are transported to doctors and left there for hours. Nobody comes back on time to pick them up and some are forgotten. When they are discovered missing, a search ensues. A doctor’s office eventually calls a cab, the patient is delivered back to the nursing home and the nursing home refuses to pay the fare. Mary* suffered such an indignity recently when the cabby threw her wheelchair in disgust on the curb, potentially injuring the patient who was semi-mobile. She did not have the $11 to pay the fare.

There is an ombudsman listed on the wall if a patient needs help or is being abused but who is going to call them? Many patients have been abandoned there by their relatives who only show up once a year, usually around the holidays, to make sure their relatives don’t leave them out of the will.

Many patients are so alone, I’ve never seen anybody visit them in the two years I’ve gone by regularly. I advocate for better care for my mom, but most have nobody to make sure their relatives are properly treated and handled with care and respect.

But some staff members really do care, and it is heartbreaking for them to see their patients die - they are sad and shed tears. Encountering mortality and imagining the end of life for every human being is a very sobering experience. Nobody wants to ever live in such a place, they would rather die suddenly.

Jeremy* is the oldest resident, he has few family members left, his parents, who were his caretakers, have passed on long time ago. He still remembers his previous life and talks in halted speech about his mom’s pancakes.

Barbie* kept packing her bags to go home every day for a year and a half. She was sweet, wondering around other patients’ rooms, asking them if they knew when her daughter was coming to pick her up. She died one day when she stopped eating and drinking. She finally went home to heaven without her packed bags. Yesterday I saw her frilly favorite blanket and other personal possessions in a clear plastic bag in the hallway, waiting to be donated.

A Russian man talks constantly about his homeland, his garden, and his wife, especially how beautiful his town was. Nobody knows what he is saying except me. I hear his voice and my eyes tear up wondering how this man wound up in this particular nursing home, so far away from Russia.

The staff is far away from home too, they are mostly African and Asian transplants. Some speak English well, some don’t. Some are dedicated to their jobs, others could not care less. Those are the ones to watch because they are abusive physically, verbally, and neglectful.

They have coloring activities for people with severe dementia; those patients are kept behind locked doors in a wing sadly named Arcadia. The rest get to play bingo, have coffee socials, outings to Walmart, or a Christmas party and a collective monthly birthday party. Musicians are brought in once in a while to entertain those who still have their faculties but are suffering of other illnesses. A beautiful brown lab wonders the halls and enters certain rooms to let residents pet her. She is old herself, with a bad hip, slowly waddling in pain across the hard linoleum.

There is a beautiful Christmas tree in the lobby but most patients never get to see it as they are never ambulatory. Transport vans come and go, delivering the really sick patients on sudden visits to the ER. Some come back, some don’t.

When a new neighbor passes suddenly, the reality of a corpse behind a closed door across the hallway is a very sobering experience. There was once life there, screaming in pain, now it is silence. I am not sure if the soul has gone to heaven or it’s still hovering over the deceased’s bedridden body.

People screaming in pain become a daily reality. There is no medicine that could take their entire pain away. Such a cocktail of drugs would rob them entirely of their humanity and they would become comatose. Staff nurses can only do so much to alleviate their patients’ pain.

A nursing home visit should be a required part of American high school and college education. No matter how ugly, sad, or cheery, it is a reminder of where we all might wind up someday if we live long enough. It’s a vivid lesson about the frailty of human nature, a lesson that nobody should take their good health for granted, and we should behave decently and morally towards our fellow humans.

 

*Not their real names

Sanitized Death

My daughter and I go to the nursing home so often that the head nurse rolls her eyes when she sees us, we are there almost every day. My husband jokes that we must wear a visitor’s badge every time otherwise they might not let us go, thinking that we were patients.

We did not place mom in a nursing home to abandon her there; we wanted her to have round-the-clock care that our small family could not provide. We were told that Medicare only paid for three hours a week of in-home care and Medicaid paid eight hours per day. It is certainly not part of our culture to put a loved one in a nursing home. Back then we had a very large and extended family who took turns to care for someone really sick or with long-term disability. There were few nursing homes in operation and those had the reputation of killing factories.

Today Wendy’s room is empty and is being scrubbed by the staff. The heavy smell of chlorine is permeating the halls. It is not unusual – it happens periodically when Wendy is gone to dialysis. But Wendy is gone forever. Her heart stopped the day before, shortly after her elderly mom and brother left from their trice-a-week visits. Wendy suffered for eighteen years and eventually was brought to this nursing home, blind and unable to talk or move, as her mom became increasingly unable to care for her at home.

Wendy, a tiny and gaunt blue-eyed woman, is in a better place now, no longer crying in pain day and night, only stopping when exhaustion put her into a short and agonizing slumber, or when my mom went in to talk to her in a soothing motherly voice in Romanian.  There was not a spot left on her hands that mom could touch to comfort her that did not have bruises or sores from repeated needle punctures. Sometimes her veins would bleed when she returned from dialysis.

They are scrubbing Wendy’s room spotless. Death is sanitized in this culture. People are so insensitive to dying because death is whisked away. When our loved ones pass, they are whisked away to the funeral home for embalming or cremation. There is no coffin on the dining room table for the customary three-day wake while families in the village or in town come to express their condolences to all relatives present.

Even when our beloved pets die, the veterinarian euthanizes them and disposes of their bodies in an incinerator or the owner buries them in the back yard. It is all sanitized death. We mourn their passing in a very civilized way which whisks the pain and suffering of death away and scrubs all evidence.

People usually die alone in hospitals or in their sleep. Few get their last rites or someone holding a burning candle for them. We are born into this world alone, in the presence of our mothers or perhaps an attending medic if we live in a western culture, and often we die alone, or in the presence of a stranger, if we are lucky to have anyone around at all.

We see sanitized death in movies and gratuitous violence resulting in death, but it is divorced from pain, from reality, it is just celluloid gore and blood.

There are residents in the nursing home who no longer have any relatives to speak for them. As the staff turnover is so constant, I often wonder how well these people are treated. I met a patient rights representative a year ago in the hallway, she gave me a brochure, but I have not seen her since.

We have argued with the medical staff to provide a slightly wider bed for mom because she keeps falling out of her narrow bed when she turns. Bed rails are considered cruel and a form of restraint. But they do not hesitate to strap heavy electronic bracelets on a thin and emaciated wrist to make sure the patient does not wonder off the property.

We were informed that Medicare dictates that a patient must be considerably overweight before a slightly wider bed is allowed. We live in a culture in which we are told, we are too fat for airplane seats and for our own health, but in a nursing home, being fat provides a more comfortable bed.

Every time we visit, we take time to talk to the patients who are able to come out of their rooms, patients we know, who do not have relatives coming to see them, they live too far away or are gone.

We wished the staff would allow us to bring Gary, the longest resident there, pancakes like his mother used to cook for him when she was alive. He still remembers her even though he has difficulty expressing himself. Gary told my daughter how delicious they were and his eyes sparkled with a momentary twinkle of joy. Then his head slumped down in a resigned frown.

Death is sanitized and whisked away from the corridors of pain and suffering.

Life in a Virginia Nursing Home

Old Woman Dozing (1656)
Nicolaes Maes Photo: Wikipedia

I never know what to expect on my weekly visits to the nursing home. The lobby has an occasional patient wheeling herself or pushed by a family member for a stroll around the property. There is a small park in the back with winding paths cracked here and there by the growing roots. Majestic trees surround the grounds.

The elevators and doors operate with codes – they don’t want Alzheimer patients to take off for unknown locales and the highway is too close to the parking lot. I am greeted every time by the same patients and a thin black woman in a wheelchair who always smiles. I wonder why she is there; she is cogent, always happy and friendly.

On second floor, as soon as I step off the elevator,  I see the opened door to the lady on the corner who never speaks and seldom has visitors; only a young woman twice in two years.  She waves and smiles weakly.

Geo, the longest resident, is wheeling himself slowly in the middle of the corridor, stopping from time to time, lost in deep thought.  He told us how much he misses his mom; she used to make him the best pancakes. He knows his parents’ names and his brother’s.  I wonder if they are still alive. I’ve never seen anybody visit poor Geo in the two years since I’ve started going every week. I feel sadness for him that nobody comes to visit. We take extra care to engage him if he is willing to talk.

Silvia, a German lady, always sits in the dining room by herself, watching re-runs of Bonanza on TV or eating her meal. I strike up a conversation with her in German and her face lights up. She lost a limb to diabetes. She has a sister in Germany with whom she talks on the phone from time to time. She always wears institutionalized clothing. We made sure this year she got something nicer from Santa Claus.

An elderly black gentleman walks around with a cane, still mobile enough and seems like his mind is still sharp. He told me stories about his lovely daughter who lives in New Jersey. I’ve never seen anybody visit him either.

Some patients wear alarm wrist bracelets if they were caught wandering away from the building, hitching an elevator ride with visitors. The unfortunately named Arcadia suite is always locked with coded pads because the state of Virginia does not allow patients who may do harm to themselves to be restrained. 

The beds do not have safety rails either. This causes some patients to fall out of the narrow beds and get injured. One has to be hypobaric before they can get a slightly larger bed. The vinyl-covered mattresses are thin and do not seem to offer much comfort to a frail and bony elderly body.

It is impossible to control infectious diseases in this nursing home when so many patients with difficult needs are cared for by orderlies from third world countries who sometimes do not fully understand vectors of disease and do not wear gloves or change them between patients.

Ambulances and medical transports come and go, carrying patients to the hospital, to medical appointments, and to dialysis. Families hope their loved ones are well taken care of in a timely manner. I know that sometimes appointments are missed, paperwork lost, transports don’t show up, items are missing, dentures are lost, never to be found or reimbursed, everybody blames the other party, and clothes and personal items disappear. Who can keep up properly with all the mounds of laundry? No amount of monogramming can assure that items are returned to their rightful owner.

Bonnie has incipient dementia and is constantly packing her bags to go home. Her family comes often to visit and they dote on her. There is a gentleman who is in alcoholic rehab.  Katy tells stories of her past in between cries for help that nobody answers anymore. She has cried wolf too many times. I am glad she spends most of her days in the wheelchair in the middle of the corridor in case she chokes. Her respirator often dangles unattached even though she needs it.

Brenda is very frail, lost her eyesight to diabetes, her ability to speak, and is on dialysis twice a week. In spite of the fact that she weighs so little and is so frail, her strong voice carries across the hallways. She screams gutturally non-stop as if calling for her mom. Her brother and 88 year-old mom come to see her religiously three times a week and spend a few hours talking to her. Her arms are purple and blue from the dialysis IVs.

The staff comes and goes, there is a huge turnover, most of them are Africans from a different culture who try to do a very hard job but the patients are unable to give feedback to their families if their care is adequate or not. You have to be a very hard human being not to be affected by so much pain and need, and to be patient in order to deliver proper care.

In two years, I have never seen a priest or any indication that patients are allowed to pray on the premises or have a place dedicated for prayer. Small choirs of children and visitors from local churches come around Christmas time and Easter to visit and entertain the residents.

A beautiful  golden retriever makes her rounds to see patients on both floors. Lucy loves a good belly rub and stretches lazily on the tiled floor in the lobby during week days.

Commotion arises from time to time when a belligerent patient refuses to bathe and screams for help because they’ve bathed last month, they don’t need it again. Some patients are crying in their rooms that they want to die. Wails of “nurse” are seldom answered and the push buttons don’t really work because the nursing home is understaffed. A patient representative from a lobbying group shows up from time to time to make sure they are treated humanely.

The nurse on duty distributes medicines from the locked cart, taking blood pressure and glucose readings. The meals never come on time, are often cold, and inadequate on weekends. Nobody complains because they can’t or are afraid to. Some have to be fed by hand and others through the stomach.

Some of the patients could be cared for at home but in Virginia, Medicare/Medicaid only provides three hours of in-home care per week. In other states, like New York, the state provides 24 hour in-home care instead of forcing patients into a nursing home where the monthly bill, on the average, is $11,000 per patient.

It’s such a sad and dehumanizing way to spend the last years of one’s life. No wonder people would rather die than go into a nursing home.

When I was growing up, extended-family members, who lived nearby, took turns and cared for their aging parents and relatives until they passed on.

A childhood friend who had married abroad, used to drive several times a year back to our hometown to deliver adult diapers and other items for her elderly mom who was cared for by her brother. In-home adult care products were not available under the communist regime.

These long-term patients were once lively and productive human beings.  They probably never thought that they would ever wind up in a nursing home. Now they are just a room number. It is profoundly sad.

My Mom Has Become the Obama Care "Unit"

My Beloved Mom

The first golden day of autumn has become the cold, barren winter of my Mom’s life.

A week ago I was planning to take Mom on a flight to Romania to see her siblings one last time. As I attempted to renew her passport, I remember wondering if the bureaucratic wheels will turn fast enough in sixty days. Would she still be able to travel then? How prophetic those words have become! Now she is locked inside a body that can no longer move. One moment she was vibrant and mobile, and the next moment her life was turned upside down.

The doctors ordered tests and more tests but were unable to find what caused her ataxia. The hospital staff operated a tight business around the elderly “units” of Obama Care. Everyone wore a cardio monitor and the beds were fitted with alarms in case the patients decided to wonder unauthorized. The goal was to have as few accidents and falls as possible and an ideal infection control.

The nursing staff was fantastic, well trained, and highly dedicated. The doctors, hailing from many third world nations, were too busy with private practices to meet with patients’ families. Their orders for tests, drugs, and charts were relayed through third parties. Most did not even make eye contact with other humans, keeping their faces down in the elevator.

It seemed to a keen observer that the lost art of humane face to face medicine has been replaced by mounds of paperwork, electronic dictation, and non-medically trained baby sitters.

How would they function if the entire Obama Care-mandated electronic system crashes? Would they still be able to write down the patient’s name, medical history, the type of drugs administered, and do simple math to calculate medicine dosage? Who will control and share the patients’ sensitive data and how will it be used to help them or against them?

I had to fill out tons of Medicare paperwork with some highly intrusive and unnecessary questions. Mom had to sign one sheet herself. With shaky hands, she was able to muster the first four letters of her name; the rest became a blob of black ink, a far cry from the beautiful cursive writing of the past.

Without a stroke, a heart attack, or any obvious cause for her distress, Mom was a patient in urgent need of discharge. Her “case worker,” a very cold and businesslike individual, made arrangements to discharge this “unit” before the infection cleared up. The last antibiotic IV dose was finished 15 minutes before she was whisked away in an ambulance. Her bed was needed for the next case.

I wished I could carry mom to the deck, and sit her on her favorite glider. Her colorful straw hat that shielded her eyes from the sun is still resting on the floor. Mom’s usual eagle eyes are dim and clouded with fear and confusion now. She sat in this chair for hours every day, watching the birds, the squirrels, the occasional blue heron, the resident pair of red foxes, the regular deer family grazing in our back yard, and the beaver running from the pond into the woods.

On this beautiful first day of fall, Mom became resident in a rehab nursing home, hoping to relearn how to walk. My eyes filled with tears as Mom scanned my face for answers and I had none, just words of encouragement. She misses Bogart, our Snowshoe Siamese. A highly co-dependent cat, Bogart senses her absence. Meowing at her closed bedroom door, he decides to sleep on the floor as if waiting for her immediate return.

Few well established and desirable rehab nursing homes take Medicare patients. Most are now private enterprises or advertised as faith-based, keeping unwanted individuals away.

Mom survived communism, the drab life there, and socialized medicine. She is making a full circle back to the drab life of survival in a nursing home in the most civilized nation on earth that chose to replace its stellar medical care with the failed socialist model a la Castro Care, in which rationing and “death panels” force Americans past the age of 70 into “unit” status.

I am not sure if Mom will every walk again. God only knows and we pray that she does. It is scary enough being old and sick, but even more frightening for someone who does not speak much English, having to function in an unfamiliar environment, among total strangers who are paid to help her survive, far away from home, far from everything and everyone she holds familiar and dear.