You Too Will Be Old Someday

My beautiful Mom, 2016

Every time I go to the nursing home to see mom, I am reminded how self-absorbed and neglectful families have become in this country. For the last three years, on my weekly trips to see my mom, the patients, whose relatives never come by or only show up at Christmas to make sure they are still in the will, are sadly spinning their hours away in pain, loneliness, and suffering until the final moment when God calls them to Heaven.

Time is a precious commodity and people of all walks of life have become really selfish with their time. Senescence is an inconvenience in our western culture, not a source of wisdom and experience that we should seek and learn from. Many less developed cultures praise old age and respect the experience and knowledge gained from the long life of their elders. They don’t even have words in their language for nursing homes or assisted living, these are alien concepts. The tribe takes care of their sick and old.

The old men and women, who are now patients, were someone’s mom, dad, the soldier, the warrior, the teacher, the nurse, the home maker, the farmer, the mathematician, and the skilled builder who erected your home.  That someone seldom shows their face in the hallways to witness the pain, suffering, abuse, neglect, unsavory smells mixed with yells of help, to check on their loved ones, who were once strong, healthy, and full of life just like you.

We let poorly paid strangers from faraway lands feed mom and dad three meals a day of institutional food, bathe them, change their wet beds hopefully on time, their diapers, their outfits, wash and bleach their clothes to unrecognizable colors,  and give them medicine and proper care.

The nursing homes are always understaffed but it gets worse on weekends. As I limp in pain to see mom, I wished I could take her out of this place and have someone care for her in my home. But not every state pays for skilled nursing care at home. I can’t lift and do all the things for my mom that she needs, even though she has shrunk in size. No matter how many times I go visit her, or how hard I try to make her stay more home-like, it is never the same and I feel that I have failed her as a daughter and as a human being.

There are some patients who have outlived any immediate family or have never had any relatives to begin with. Nobody ever comes to see them. They are all alone in the world, sullen, and silent amid the cold and cruel world around them. Nobody notices them anymore and they seldom make eye contact.

I make a point to talk to some of them, touch them, bring a treat, and say hello. A twinkle of the former liveliness softens their furrowed faces, bringing out a short-lived smile. And a bit of sugar free chocolate sweetens the day, albeit it momentarily.

Catalina Grigore wrote recently about a 70-year old who died in a nursing home.  Having been Europeanized, Romania now has nursing homes, sad places where people go to die. The nurses did not like her, she seemed mean and uncommunicative. She left behind a pointed lesson in kindness that brought many to tears. https://voce.biz/info/2017/mar/23/aceasta-batrana-nu-era-suportata-de-nimeni-din-azilul-in-care-si-a-trait-batrinetea-ce-au-gasit-ingrijitoarele-dupa-ce-aceasta-a-murit/

You see an old lady, senile, with strange habits, a sad face, lost eyes who mentally contemplates times gone by, forced to do things she does not want to do, and stubborn. You think, she interferes with your daily routine, and that’s irritating, but you have no idea who she was or how she got there.

Inside she is the naughty child she used to be, skipping, jumping rope, and climbing trees in her grandma’s back yard; she is the beautiful twenty year-old who just graduated from college, in love, engaged, and soon to be married; she is the forty year-old with kids who are now adolescents; she is the fifty year-old crying into the pillow at night because her house is empty, the children’s laughter is gone, the nest is empty, and the life that revolved entirely around them is now gone; she is the sixty year-old who took care of and spoiled her grandbabies; and she does not know how she got to be seventy and then eighty, and so sick and lonely.

Everybody abandoned her – they either died or moved away and forgot her while living their busy lives.  Her husband passed away and she is frightened. She is now old, no longer the vibrant young woman who could move mountains. She is no longer a mom, a wife, a grandma, a sister, or an aunt. She is just a door number in the nursing home. Her name appears on a small plaque but the nursing staff calls her by her door number. It is much easier than trying to pronounce her foreign name.

Mother Nature is cruel – it robs us in the end of all that makes life worth living. Strength, health, youth, stamina, and joy of living abandon us.

In her moments of clarity, I asked my mom how she felt about her treatment in the nursing home. What she said brought me to tears.

“We are still young inside and healthy, dressed in our finest, ready to go shopping, to work, to a fine restaurant, dancing the night away at a party, loving and living.  But the nursing staff treats us with contempt because we are helpless. They argue with us to do their bidding. They want their shift to go smoothly and fast. Can you not see my soul and my crushed desires behind my shaking hands and my wrinkled face? I lost my children, my family, and everything I’ve ever loved; can you not be patient and kind with me? I don’t have much left in this world, just this old, aching, body who does not want to respond to movement. We are not ready to die and we certainly don’t want to die alone next to strangers.”

Just remember, if you live long enough, you too will be old someday, at the mercy of strangers, helpless, racked with pain, and arthritic.

 

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