Some nurses
and assistants start out and remain caring despite the long hours, the low pay,
the back-breaking work, and the unrewarding environment. Other staff members do
not care and abuse or neglect patients in front of their loved ones.
Perhaps
Americans don’t want to work as CNAs because the pay is low and the hours are
long. Many immigrants, legal or illegal, are more than happy to fill the
vacuum. One thing is certain, as I’ve
experienced for the last four years in a nursing home in Fairfax, the work
ethic in this new wave of immigrants leaves a lot to be desired. There are
always a few remarkable exceptions.
Recently one
nurse’s aide dropped a patient she attempted to hoist with a broken device, the
patient fell and was injured, but she never filed an incident report. She was
hoping nobody would find out as the patient spoke only Spanish. The next day
the patient was covered in bruises but without broken bones.
I arrived
one day to pick up my mom for her doctor’s appointment. She was in wet socks,
no shoes, her shirt was on backwards and food-stained, she needed a diaper
change, and the male nurse handled her roughly causing her unnecessary pain and
suffering radiating from the hip which had been recently operated on. And the
nurse helping her did all of this right in front of me. Can you imagine what
they do to patients in the absence of relatives?
There is an
ombudsman in the nursing home to represent the patients but patients and
relatives are afraid to report anything wrong for fear of staff retaliation. I
learned the hard way that, every time I would report a bad incident, the
nursing staff would treat mother much worse.
Many elderly
are so sick, they never say ‘thank you’ or smile even though they may be
grateful that they are being taken care of – they are in so much pain to
remember to be polite. Other patients no longer know who they are.
Some elderly
patients don’t have any relatives; others do but nobody comes to visit, life
keeps them busy. Yet many have relatives who do come to visit but never bring
as much as a warm blanket which they desperately need because the nursing home
blankets are never warm enough in winter. A few only visit at Christmas time to
make sure they are still in the will.
The elderly,
who have their mental faculties but are immobile, are often depressed despite
the bingo, occasional music, ice cream social, and other activities organized
by the nursing home. Television becomes the only mental stimulation some may
have. A few read Bibles and others wheel themselves in the hallway watching the
world go by.
They cannot
leave the floor without an elevator code and they have heavy alarm bracelets.
Those with their mental faculties who are semi-mobile have hospital armbands
with information which tells the outside world that they are patients in the
nursing home. It is a loss of freedom that is not unlike being an inmate in a
prison. On the other hand, a few patients do not have a clear legal status so
they need these bracelets.
Depending on
the time of day, there is always a permeating smell of urine and feces mixed in
with the smells of food and disinfectant. Diapers, trips to the bathroom, and
showers are never done timely because there are too many patients assigned per CNA.
And if the CNAs do not take their jobs seriously, they compound existing
problems in the quest of earning a paycheck.
Many elderly
refuse showers for various reasons, the major one being that the water is
really cold most of the time, making it a frigid and painful experience,
particularly in wintertime. The elderly are usually cold and should be showered
with much warmer water. I had to shower
my mom in the nursing home and the water was lukewarm even though I let it run
for quite some time.
The lack of
timely diaper changes and showers cause a lot of UTIs in the elderly female
population. Cross-contamination occurs because not all of the staff understands
bacterial transmission through contaminated gloves not changed between
patients.
Other staff
members are really hard-working but the job gets to them eventually after
seeing so much pain and misery. The last
chapters of our human lives are not pretty and are made worse by chronic
disease and pain.
The
indignity of incontinence is very hard to deal with in a fully grown adult. It
is difficult sometimes to change the diaper of a small baby, can you imagine
changing the diapers of adults who cannot be placed on a changing table and are
often combative?
Five star
facilities can be abusive and neglectful too. Many reject people who do not
speak English under the pretense that they cannot meet their needs. It is a
subtle form of discrimination.
Most people
cannot afford the $7,000 per month assisted living fees or the $12,000 per
month in-home care. Insurance does not even begin to cover such outrageous
costs. Medicaid pays nursing homes a little over $6,500 a month for their
patients that require specialized nursing care which is just about everybody
already there.
The
Alzheimer patients are separated in a locked area unfortunately called Arcadia.
Many are ambulatory and would disappear without a trace if left to their own
devices.
Western
societies are supposed to deal with their elderly in a more humane way but, in
the process of insuring that they are taken care of, the family may suffer
terrible financial burden even with two income-earners. And they cannot
possibly care for the really sick loved ones who need shots, blood drawn,
emergency trips to the nearest ER, and other measures to save that patient’s
life.
Because they
do not want to be a burden on their loved ones, many choose to have a do not resuscitate
(DNR) order in their wills and others move to countries that allow euthanasia.
They prefer those measures as opposed to lingering in a nursing home and be forgotten,
neglected, and abused while in pain.
Rhonda, not
her real name, was blind, unable to talk, and on dialysis for several years
before she passed in her sleep. She wailed from the top of her lungs all day
long. She was transported twice a week
to have her blood cleaned. Her tiny bony frame was covered in large, purple bruises
from the dialysis needles.
Some
societies use the entire tribe to care for the elderly in the last part of
their lives. They treat them with love, dignity, and the respect they deserve.
A Nordic country
allows students to live in a wing of the nursing home, rent free, as long as
they adopt an elderly person and interact with them on a daily basis.
But many patients
who still have their faculties prefer visits from and time spent with their
loved ones. They don’t want much as they near the end of the lives, just their
children’s, grandchildren’s, or siblings’ time.
