Tuesdays in the Nursing Home- Raising the Bar

 

He’s 91 and has an eye for the ladies…as well as a lightning-fast set of hands, according to the aides.

His brother says “Yeah, he’s an all-right fella- as long as you keep your legs crossed, that is!”

So I approach Chuck with care and still manage to box myself into a tight corner of the dining room.

He is a perfect gentleman.

When he tells me he wasn’t sent to the nursing home by his doctor but rather, just walked in on his own and decided to live here, I decide to check out his awareness and memory in greater detail.

“So, are you retired?”

Chuck looks startled.  “Well, I certainly hope so,” he says.  “I’m 91 years old- I’d better be!”

Chuck can’t remember how many children he has or what he did for a living.  When I ask him what his father did for work, Chuck rests his forehead on the heel of his hand and sighs.  “Well, now…I never did know the man all that good.”  He struggles for another moment and then I see a slight smile play across his lips.  “Oh, yeah, now I remember.  My father was associated with the bench.”

“Ah, I” I nod, thinking for a second that I get it. Chuck’s dad was an attorney.

But an unconscious flicker of instinct stops me, alerting me that all might not be as I assume.

“Your father was associated with the bench?” I echo.

Chuck grins.  “Yeah, you know, the bench out front you sit on?  That’s the one he was most associated with!”

We laugh our asses off.

Tuesdays in the Nursing Home- Part 2

Today I asked Anna how she could tell the difference between God's voice and the Devil's.

She barely hesitated, rocking back and forth in her chair she nodded, as if this were finally a question worth answering.

"I can tell," she said, smiling softly.  "Oh, it is very easy."

"It is?" I asked.

Anna was quite certain.

"Yes. The Devil is pushy.  God is not."

Tuesdays at the Nursing Home- Spouting Off

Waterspouts- taken by Capt. Brian W., Key West, Fla

 

In the nursing home, aides spin like waterspouts.  They rush across a vast and endless ocean, twirling dervishes in brightly colored scrubs.  At shift's end, they vanish, spent and wasted by the battle.

The ocean waits for another sunrise, offering its silent reminder of all that has been and all that will one day be.

Tuesdays at the Nursing Home- Darla Strikes Back

At first she tries to be nice about it.

"This is a lovely place you've got here," she tells the aide. "And the food was delicious, but I have to get on home."

She checks her Sunday hat in the mirror, ignoring the reflection of the watchful aide behind her. With slow deliberation, she picks up her handbag and turns to leave.

By now the social worker has been called. She steps inside the room, placing herself between the elderly woman and the open door.

"Darla, they're having church this evening. Mary just wants to get you cleaned up before the service starts. We'd love for you to stay."

The social worker is well-intentioned. She edges even closer, trying not to sound as if she is yelling as she raises her voice because Darla is extremely hard of hearing. "I know you like to look your best but, well, frankly, you do smell a bit..."

The social worker never gets to finish. Whap, whap, whap! Darla raises her cane and rains three quick blows down on her new foe. For a tiny lady in her 90s, Darla is strong and deadly accurate with her weapon.

"She got me right behind my ear the other day," her aide, Sally, says later. "And my head is still ringing! They wanted me to file an incident report but I couldn't do that."

"She really packs a wallop," The social worker agrees. "I haven't been hit like that in years!"

And they smile, both of them. They seem proud of their tiny charge, not a bit patronizing or condescending. This is the respect due a worthy adversary. "I like the feisty ones," the social worker confides.

Later, when Darla falls asleep, the social worker steals her cane. It is replaced with a new, lightweight walker. "I'm a big chicken," she confides. "I snuck in when she was taking her nap, grabbed the cane and ran!"

Darla hasn't survived this long without having skills. She lived alone until recently, until her stepson discovered a crack addict had moved in and was slowly siphoning off Darla's food and medication. That's when Billy decided something had to be done and moved her into the nursing home.

Darla has been in the home for a month now but she still wolfs down her food as if expecting the plate to be jerked out from under her.

"Oh, Lord," Sally murmurs, with a sad shake of her head. "That first shower, the water ran black, she was so filthy." She clucks her tongue and glances down the hall toward Darla's room. "The ones living in that house where she was were just terrible to her, just terrible." Sally sighs. "She's started putting some weight back on. She's not all skin and bones, like when she came in. It's a lot better for her here."

But Darla doesn't think so.

She's lost her home and doesn't realize how close she came to losing her life at the hands of strangers.

Her stepson lives too far away to look after her, so he has done what he thinks is the next best thing. He has "disposed" of Darla's "assets," her home and belongings, and brought her to live in the nursing home. She will be safe-er here and her stepson will feel less guilty.

Day to day, when she has no visitors to remind her of what once was, Darla likes her new accommodations.

Her roommate dotes on her, believing Darla to be her mother. This is remarkable as the roommate had the reputation of being the meanest lady on the hall, a woman who couldn't be bothered to make friends and who would like as not cuss you out for smiling in her general direction.

Darla has changed all that.

"Mama?" the roommate asks gently. "Have you had enough to eat? Can I get you anything?"

But Sylvie can't help her make-believe mother.

Darla longs for the home of her remembrance- and a time that has vanished without fair warning.

Technorati Tags: life in the nursing home,aging

Nursing Home Tuesday- Choking to Death on Red Tape

 

She is referred to me because she cries a lot.

I've seen her around the nursing home where I consult one day a week. She shuffles slowly, mumbling to herself, occasionally asking "Where do I go?"

The third time I saw her, wandering and lost, tears coursing down her cheeks, I asked about her.  "She's got Alzheimer's and she thinks her husband's left her for another woman," I was told.

The next time I saw her crying I went up and asked if I could help. "Oh, no. I'm alright," she said softly and slowly walked away.

Finally, they referred her to me. "But not really," they said. "We want your nurse to give her meds. We don't think she would remember anything long enough for therapy to help her."

I met her husband. And the kids. No one is leaving. They love her.

So I spent 3 weeks trying to track her down so I could evaluate her.  Today I finally caught up with her as she shuffled slowly down a hallway, searching for her room.

And guess what?

She knows exactly what is going on- or at least she did today. Of course, that changes day-to-day, moment-to-moment with Alzheimer's patients.  Sometimes they are right there with you, at least in the early to middle stages.

Maggie is in the most horrible stage of Alzheimer's.  She knows she is slowly losing her mind. 

Her husband isn't leaving her.  Her children aren't going anywhere.  It's Maggie who is leaving.

She sits in her armchair on her half of the room, her white hair hanging loose around her bony shoulders, wringing her hands.

"I wish I could die," she sobbed.  "I can go along for 2 or 3 days, taking care of myself and then...it's all gone."

"I used to take care of people. I used to have everything in its place and now..."

Maggie tells me she'd rather be dead than be a burden.

I look into her eyes and consider lying. It would be so easy to say some soft platitude that would carry her past this phase, into the lost woods of nothingness. But when I stare into her gray eyes I realize Maggie is too smart for this, too aware and too honest for well-intentioned lies.

"There are medications that will help," I hear my coward self say.

"But for how long?" Maggie whispers.

Don't you dare lie to her! I tell myself.

"I don't know," I answer. "It's very scary, losing your memories, isn't it?"

She is crying softly, nodding. "Yes."

Beneath her grief, there is something else.  Maggie is accustomed to being needed.  Here, in the nursing home, she is warehoused, a body sentenced to wait for death.

You know what the hell of it is? I could easily help Maggie.

I could get any one of the friendly aides to let Maggie "help" them, like she used to do for the families around town...But the State won't allow it. They say it is an abuse.

The ladies who have folded towels, cared for children, cooked and cleaned for a lifetime, who have valued their ability to care for their families, are sentenced to sitting around waiting to die because allowing them to clean is deemed "demeaning."

Isn't telling them this just another form of abuse?

These women don't want to bat balloons around in activity therapy, or sing stupid kindergarten songs, or paint pictures. They want their lives back.

When Alzheimer's patients use their hands, it coaxes flagging memories forward. It delays the process- I truly believe this and the research supports it. Having purpose and meaning promotes self-worth. It restores dignity.

We let the demented woman who went to Juliard play the piano. She has lost the capacity for speech but she can play brilliantly.

Still, we won't let the other ladies "help" because it's an "abuse."

Well the Piano Lady's free entertainment. Could we not make the case that playing the piano is exploitation of this poor woman's talent?

Give me a freaking break!

Damn it!

Thank God there are people where I work who will listen and try to find ways around a rigid system that means well but sucks the life out of all of us.

 

Okay, done ranting. Thanks for listening.

 

Tin-Hearted Sons and Hard to Hold Parents

Annie Mae is a little bird of a woman, a sparrow poised for take-off, perched on the edge of her white plastic, rolling wheelchair. She is sitting in her room when I find her. Her arms and legs are crossed, as if she's folding up inside herself, but still, somehow, she seems restless. I see it in her eyes- In the quick way they dart back and forth, missing nothing, ever vigilant for danger or signs she's not doing the "right" thing.

Annie doesn't want us to know how lost she is, how much she's forgotten and how useless she feels- but it's never far from the surface.

She smiles. She's overly polite to everyone and that's the give-away. You can see how frightened she is just by the way she smiles and says "Yes, ma'am," even to girls younger than her granddaughters.

Today Annie Mae tells me everything is just fine, then hedges her bets with "But I'm not a hoppin' or a skippin' or nothin'. Not by no means!"

I nod. Her aide comes in and tells me in the overly loud voice only used with toddlers and the elderly that Annie's boy sent her a box of cookies and a letter.

"Oh?" I say, every bit as polite as Annie.

Annie confirms this with a nod. She is content to chat about her "good" boy for awhile, until she's sure I think she's okay. But when I ask if there's anything at all I could do to make things just a tiny bit better for her, she cocks her head to one side and for the briefest nanosecond considers her request.

"Well," she says, hesitantly. "I sure do wish you could get my parents to understand it's okay to have public displays of affection." She rushes on, watching my face as she monitors whether or not she's committed a faux pas with her request. "See, it's natural. There's nothing wrong with it at all- not with a hug or a kiss or touching. Sometimes they don't understand."

I do not let my expression belie my confusion. It's a bit late to convince Annie's parents of anything. They've been dead forever.

"Well," I say, equally reticent. "Maybe they were raised in the old school. You know, their parents might've said no touching."

Annie leans closer to me. "You know, you can get pregnant without even kissing!" she confides.

I nod my head wisely.

"I just...Well, you know, sometimes they're just so..." Annie stops, searching for the right word.

"Remote?" I offer.

"Yes!" Annie cries. "I don't know how they feel. They don't never touch or say 'I love you,' or good job or nothing."

The lights are on and I am finally home.

Sometimes my old guys get the generations confused. Sometimes the nurses and aides get mixed in with their families, especially their parents. The great thing about the old guys is they tell me everything, as long as I understand the code, the vernacular specific to that particular person's dementia.

It is always a joyous time for me when the lights go on and I finally understand.

"I bet you hugged your boy," I say softly.

"Oh, you bet I did!" she says and then sighs, lapsing into thoughtful silence.

"I bet he doesn't forget his Mama, either," I say. This is not a good therapist remark. I am leading the witness- trying to supply an answer that will calm my own anxieties, hoping my own boys won't abandon their mother as Annie's boy has abandoned his. A tin of cookies and a card addressed to "Annie!" Why I could just take a stick to the man myself!

"I don't know," Annie murmurs. "I think sometimes, maybe...but I don't know if...or how deep it runs with him, you know?"

I abandon Annie for a moment to envision hunting down this tin-sending boy and kicking his tail all the way up to see his Mama- because I know what kind of mother Annie Mae is. Her entire life has been spent loving this one boy with every bit of her heart and soul.

I don't tell her I'm sure her son loves her. I don't do her that disservice. Annie may have memory issues, but she's not stupid.

Instead, I ask her if I may hug her.

She giggles like a little girl. I throw my arms around her frail frame and hug her close.

"Now, it's not like I asked you or nothing," she says, still grinning. "It's not like I'm asking for your pity."

"Oh, not at all!" I say. "I've got a couple of boys myself and well, sometimes us moms just need a hug and you're about the most hug-able woman I know, Annie. I hope you let me hug you the next time I visit."

Annie grins wider. "Well, you can come see me anytime!" she says.

But I know what she's saying. She's not confused or forgetful about this-It's her son she's really talking to...