MyDoorsAreOpen
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Thank you, Becky!
Indeed. All anyone ultimately wants is to be accepted.
Indeed. All anyone ultimately wants is to be accepted.
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H&R Moderators: VerbalTruist
I'm moving into a nursing home -- wish me luck and send me flowers
- Thread starter MyDoorsAreOpen
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MyDoorsAreOpen
Bluelight Crew
- Joined
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June 2
After yesterday, it felt almost like a treat to be allowed to sleep until 7:30. As always, I was treated to an enormous breakfast with the usual suspects, minus Armenian Mark, who had recently been discharged. I felt sad to hear this, because I really enjoyed by mealtime conversations with Mark, but I was not surprised to learn he was only a short-term resident. He was definitely the most mentally and physically able of the three amigos, and had a doting wife who was clearly capable of taking care of him at home As much as the nursing home is a true neighborhood, it sees a bit more turnover than other types of neighborhoods do, due to untimely deaths and discharges. The other two guys mentioned that they miss Mark too. This, then, must be the dark flipside to friendships forged between residents; as in a college dormitory, the fact that everyone is constantly under one roof gives the illusion of permanence and ready availability in any friendships forged. In fact, though, no one can say who’ll be next in line to go, and one may never know a fellow resident is leaving until after they’re gone. I imagine in the shuffle of paperwork, consults, and the many other formalities of discharge, saying goodbye to those left behind can easily get lost in the shuffle.
I notice that not all of the residents receive the same breakfast. After awhile, the dietary staff gets a handle on each resident’s peculiar preferences. Rex likes toast and eggs, and nothing else, for example. Apparently eight days was not quite long enough for the dietary staff to get a handle on my peculiar eating habits. So far no one noticed that I never touched the milk provided, for I was consistently served it at every meal. Someone, however, must have noticed that I eat everything else put in front of me, a habit I’ve had since being a small child and getting an earful about starving kids in China. I therefore found myself faced with a rather enormous breakfast, including oatmeal, juice, eggs, toast, Danish, coffee, banana, and fruit salad. The staff must have also figured I’m a healthy young man with a healthy young appetite, and I never complained, because I know that making breakfast the largest meal of the day is good for my metabolism, and also my motivation. Any farmer would say the same.
I was off my walker today, and free to ambulate completely independently – for joy! I’d forgotten that, but the first shift nurse didn’t. She handed me my meds on the way back from breakfast, and reminded me to turn in my walker to physical therapy down the hall. Once again I was up to speed. I was practically skipping as I loped around the halls unhindered by any prosthetic, and people remarked that I was moving a bit fast. I recalled my days working the floors of the nursing home, when I was known to dash and dodge in an attempt to multitask, making the slow-moving residents’ heads spin. For the first time, I just didn’t feel like a resident at all anymore, especially wearing a t-shirt and jeans. This gave me an unfounded feeling of uncertainty about my place in the home, especially when workers and residents I wasn’t acquainted with would give me a look that said, “What’s he doing here?”
I was happy to lose my walker for another reason, though: today was the day my wife was coming to visit me, and take me out for a few hours. It had been too long since I’d seen her, and I just couldn’t wait.
Before that, though, I worked on a speech that the CEO asked me to write for the CNA appreciation banquet on Thursday. I was originally going to be the one delivering it, but then the management realized this would be hours after my discharge, and I already had plans for that evening. So instead I wrote a letter to the CNAs for the CEO to read. I expressed my thanks for all their help, and admitted openly that I used to have their job, and in many ways missed it. I told them that I understood their initial discomfort in providing care for me, but let them know that their professionalism and attention to detail had really made my stay very comfortable. I really wish that all medical students could have the chance to be lowly nursing staff, because I think it would give them a much greater appreciation for the people who ultimately carry out the orders they give, to say nothing of the patients these orders are for.
As I was reading my finished speech to the CEO, she looked up from her desk and told me she’d just seen a young woman walk in, and wondered if it was my wife. Sure enough, when I came out, my “Lisa” was there at the reception desk, signing the logbook, receiving a nametag and visitor’s pass, and getting directions to my room. Having spent so much time around wizened faces, she looked oh so young to my eyes, and it felt like I hadn’t kissed her in years.
First we took a walk around the grounds, including around the llama pen, and I was able to introduce her to many, many workers and residents I’d gotten to know throughout my time at the home. Lisa remarked that I definitely had a way with the elderly, and seemed very much at home in the nursing home setting, and hearing her say this really made my week. Then she came down to my room, and we chatted for a while about this and that. The same institutional room felt so different with my wife in it; I can see exactly why residents in long term care live for the days their loved ones come to see them. Family and friends bring with them quite a lot of the vibe of the outside world, and it really transforms the atmosphere of the home, breaking up the routine of life here.
I had notified the kitchen in advance that I wouldn’t be there for supper, a courtesy that I know the home appreciates when I’m planning on being away. Lisa and I first met with the nurse on duty, to see if I had any evening meds that I needed to take before I left. She gave them to me, and made a note of my anticipated absence. We then visited the front desk, to make my departure official. Lisa signed me out at 16:45, and we were on our way for dinner and a movie.
When Lisa returned me to the home and signed me back in at 19:30, I was struck by how short our time out felt, and I can’t say I was entirely in the mood to go back. At this point, my entire nursing home status definitely felt like a medication whose effect was gradually wearing off. A taste of the outside world, combined with the complete restoration of my freedom of mobility, all so close to my departure time, had me feeling quite restless. My memory flashed back to Christmastime at the first nursing home that employed me, one of the most stressful times for workers there. I recall the residents all coming back from home visits feeling antsy, disoriented, and not their most personable. Popular opinion among the workers had it that this was a result of holiday gluttony, family tensions, and medication noncompliance, but after my experience of being signed out for a family visit, I can’t help but wonder if it might better be explained by a difficult transition back from the old familiar outside world, with its higher levels of stimulation and novelty. I was able to make use of this nervous energy by making phone calls to friends. The parlor room of the nursing home was deserted and all the residents were in bed, and I paced excitedly as I talked on my cell phone, feeling less and less like a nursing home resident by the hour.
After yesterday, it felt almost like a treat to be allowed to sleep until 7:30. As always, I was treated to an enormous breakfast with the usual suspects, minus Armenian Mark, who had recently been discharged. I felt sad to hear this, because I really enjoyed by mealtime conversations with Mark, but I was not surprised to learn he was only a short-term resident. He was definitely the most mentally and physically able of the three amigos, and had a doting wife who was clearly capable of taking care of him at home As much as the nursing home is a true neighborhood, it sees a bit more turnover than other types of neighborhoods do, due to untimely deaths and discharges. The other two guys mentioned that they miss Mark too. This, then, must be the dark flipside to friendships forged between residents; as in a college dormitory, the fact that everyone is constantly under one roof gives the illusion of permanence and ready availability in any friendships forged. In fact, though, no one can say who’ll be next in line to go, and one may never know a fellow resident is leaving until after they’re gone. I imagine in the shuffle of paperwork, consults, and the many other formalities of discharge, saying goodbye to those left behind can easily get lost in the shuffle.
I notice that not all of the residents receive the same breakfast. After awhile, the dietary staff gets a handle on each resident’s peculiar preferences. Rex likes toast and eggs, and nothing else, for example. Apparently eight days was not quite long enough for the dietary staff to get a handle on my peculiar eating habits. So far no one noticed that I never touched the milk provided, for I was consistently served it at every meal. Someone, however, must have noticed that I eat everything else put in front of me, a habit I’ve had since being a small child and getting an earful about starving kids in China. I therefore found myself faced with a rather enormous breakfast, including oatmeal, juice, eggs, toast, Danish, coffee, banana, and fruit salad. The staff must have also figured I’m a healthy young man with a healthy young appetite, and I never complained, because I know that making breakfast the largest meal of the day is good for my metabolism, and also my motivation. Any farmer would say the same.
I was off my walker today, and free to ambulate completely independently – for joy! I’d forgotten that, but the first shift nurse didn’t. She handed me my meds on the way back from breakfast, and reminded me to turn in my walker to physical therapy down the hall. Once again I was up to speed. I was practically skipping as I loped around the halls unhindered by any prosthetic, and people remarked that I was moving a bit fast. I recalled my days working the floors of the nursing home, when I was known to dash and dodge in an attempt to multitask, making the slow-moving residents’ heads spin. For the first time, I just didn’t feel like a resident at all anymore, especially wearing a t-shirt and jeans. This gave me an unfounded feeling of uncertainty about my place in the home, especially when workers and residents I wasn’t acquainted with would give me a look that said, “What’s he doing here?”
I was happy to lose my walker for another reason, though: today was the day my wife was coming to visit me, and take me out for a few hours. It had been too long since I’d seen her, and I just couldn’t wait.
Before that, though, I worked on a speech that the CEO asked me to write for the CNA appreciation banquet on Thursday. I was originally going to be the one delivering it, but then the management realized this would be hours after my discharge, and I already had plans for that evening. So instead I wrote a letter to the CNAs for the CEO to read. I expressed my thanks for all their help, and admitted openly that I used to have their job, and in many ways missed it. I told them that I understood their initial discomfort in providing care for me, but let them know that their professionalism and attention to detail had really made my stay very comfortable. I really wish that all medical students could have the chance to be lowly nursing staff, because I think it would give them a much greater appreciation for the people who ultimately carry out the orders they give, to say nothing of the patients these orders are for.
As I was reading my finished speech to the CEO, she looked up from her desk and told me she’d just seen a young woman walk in, and wondered if it was my wife. Sure enough, when I came out, my “Lisa” was there at the reception desk, signing the logbook, receiving a nametag and visitor’s pass, and getting directions to my room. Having spent so much time around wizened faces, she looked oh so young to my eyes, and it felt like I hadn’t kissed her in years.
First we took a walk around the grounds, including around the llama pen, and I was able to introduce her to many, many workers and residents I’d gotten to know throughout my time at the home. Lisa remarked that I definitely had a way with the elderly, and seemed very much at home in the nursing home setting, and hearing her say this really made my week. Then she came down to my room, and we chatted for a while about this and that. The same institutional room felt so different with my wife in it; I can see exactly why residents in long term care live for the days their loved ones come to see them. Family and friends bring with them quite a lot of the vibe of the outside world, and it really transforms the atmosphere of the home, breaking up the routine of life here.
I had notified the kitchen in advance that I wouldn’t be there for supper, a courtesy that I know the home appreciates when I’m planning on being away. Lisa and I first met with the nurse on duty, to see if I had any evening meds that I needed to take before I left. She gave them to me, and made a note of my anticipated absence. We then visited the front desk, to make my departure official. Lisa signed me out at 16:45, and we were on our way for dinner and a movie.
When Lisa returned me to the home and signed me back in at 19:30, I was struck by how short our time out felt, and I can’t say I was entirely in the mood to go back. At this point, my entire nursing home status definitely felt like a medication whose effect was gradually wearing off. A taste of the outside world, combined with the complete restoration of my freedom of mobility, all so close to my departure time, had me feeling quite restless. My memory flashed back to Christmastime at the first nursing home that employed me, one of the most stressful times for workers there. I recall the residents all coming back from home visits feeling antsy, disoriented, and not their most personable. Popular opinion among the workers had it that this was a result of holiday gluttony, family tensions, and medication noncompliance, but after my experience of being signed out for a family visit, I can’t help but wonder if it might better be explained by a difficult transition back from the old familiar outside world, with its higher levels of stimulation and novelty. I was able to make use of this nervous energy by making phone calls to friends. The parlor room of the nursing home was deserted and all the residents were in bed, and I paced excitedly as I talked on my cell phone, feeling less and less like a nursing home resident by the hour.
MyDoorsAreOpen
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June 3
Nothing significant was on my schedule for this day. Ironically, this was the first morning I thought it would be a good idea to set an alarm to wake up. It’s funny how obsessively organized people can be when they anticipate having nothing to do, sweating trivialities as if to compensate for the lack of actual work required of them.
The morning passed uneventfully, and I saw no CNAs the entire morning in my room. I realized that as my mobility restrictions had faded away slowly, so had the unannounced appearance of aides, there to wait on me. In fact, I had made my own bed for at least the past few days, having come back from breakfast to find it unmade. I don’t know if this was planned, and I didn’t bother to ask since I didn’t mind. But I suspect that since I declined most offers for help, and was now clearly not disabled, the CNAs became thrifty with their effort spent on me. Fair enough, I thought, they’re working hard enough as it is.
Before lunch, the CEO came by, to let me know that a reporter was coming from the head corporate office in Tennessee, and he’d like to interview me and take some photos. I wasted no time getting lunch in my belly, and was glad I did, for “Vic” arrived at my room promptly at 12:30. Although he was as smartly dressed as his three coworkers who visited me the week before, he somehow seemed more genuine in his intentions, partially due the formality of the recorded interview, with questions well prepared, and partially just due to the vibe he radiated. I truly felt like an important and interesting personality being interviewed on Public Radio, as Vic probed me with some rather thoughtful questions about lessons learned from living in a nursing home. It was quite a pleasant experience. Vic followed this up by putting the mike in front of my roommate Joe, and asking him what it was like to live with me. Joe expressed that he’d enjoyed having me as a roommate, was fascinated by the premise of my residency, and would surely miss me after I was gone. Vic and I then traversed the bustling nursing home, stopping many workers and residents I’d spent the last nine days with, for some staged photos. Waivers were signed, and news of my impending departure was tearfully received. This truly felt like closure to a fruitful experience, and although I may not ever read the printed story this becomes, it makes me proud to know that my recent adventure is newsworthy.
The only other major activity that occurred this afternoon was a final and festive visit from the entire team of community college student nurses. Once again I went over the quick and dirty neurological exam, and once again I faked my way through a pre-discharge assessment. But mostly I just wished them well and talked jovially with a few young people around my age, who are joining me in taking the plunge into what I consider the most rewarding sector of the work world. It lasted only an hour, and was superficially businesslike, but when they left, I felt like a party had just finished in my room.
Workers have been coming up to me all day, asking for my final thoughts on my stay, and wishing me goodbye. I tell them all basically the same thing: it was a positive experience, and I have absolutely no regrets, but now it’s definitely time to return to the world I knew, at least for the next 40 years or so. I’ve traveled the world and the fringes of society looking for thrills and adventure. Who would have thought that one of the greatest adventures I’d ever have, would be in a place commonly thought of as sedate and boring.
Nothing significant was on my schedule for this day. Ironically, this was the first morning I thought it would be a good idea to set an alarm to wake up. It’s funny how obsessively organized people can be when they anticipate having nothing to do, sweating trivialities as if to compensate for the lack of actual work required of them.
The morning passed uneventfully, and I saw no CNAs the entire morning in my room. I realized that as my mobility restrictions had faded away slowly, so had the unannounced appearance of aides, there to wait on me. In fact, I had made my own bed for at least the past few days, having come back from breakfast to find it unmade. I don’t know if this was planned, and I didn’t bother to ask since I didn’t mind. But I suspect that since I declined most offers for help, and was now clearly not disabled, the CNAs became thrifty with their effort spent on me. Fair enough, I thought, they’re working hard enough as it is.
Before lunch, the CEO came by, to let me know that a reporter was coming from the head corporate office in Tennessee, and he’d like to interview me and take some photos. I wasted no time getting lunch in my belly, and was glad I did, for “Vic” arrived at my room promptly at 12:30. Although he was as smartly dressed as his three coworkers who visited me the week before, he somehow seemed more genuine in his intentions, partially due the formality of the recorded interview, with questions well prepared, and partially just due to the vibe he radiated. I truly felt like an important and interesting personality being interviewed on Public Radio, as Vic probed me with some rather thoughtful questions about lessons learned from living in a nursing home. It was quite a pleasant experience. Vic followed this up by putting the mike in front of my roommate Joe, and asking him what it was like to live with me. Joe expressed that he’d enjoyed having me as a roommate, was fascinated by the premise of my residency, and would surely miss me after I was gone. Vic and I then traversed the bustling nursing home, stopping many workers and residents I’d spent the last nine days with, for some staged photos. Waivers were signed, and news of my impending departure was tearfully received. This truly felt like closure to a fruitful experience, and although I may not ever read the printed story this becomes, it makes me proud to know that my recent adventure is newsworthy.
The only other major activity that occurred this afternoon was a final and festive visit from the entire team of community college student nurses. Once again I went over the quick and dirty neurological exam, and once again I faked my way through a pre-discharge assessment. But mostly I just wished them well and talked jovially with a few young people around my age, who are joining me in taking the plunge into what I consider the most rewarding sector of the work world. It lasted only an hour, and was superficially businesslike, but when they left, I felt like a party had just finished in my room.
Workers have been coming up to me all day, asking for my final thoughts on my stay, and wishing me goodbye. I tell them all basically the same thing: it was a positive experience, and I have absolutely no regrets, but now it’s definitely time to return to the world I knew, at least for the next 40 years or so. I’ve traveled the world and the fringes of society looking for thrills and adventure. Who would have thought that one of the greatest adventures I’d ever have, would be in a place commonly thought of as sedate and boring.
psychedelic food
Bluelighter
- Joined
- Jan 8, 2009
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How old do you have to be to go to one of those? Id be so down to move out of my parents house and live for free with some chill ass old people. I bet i could have alot of really cool conversations. Nobody would really notice if i came back late at night with giant pupils and a few freinds and they just heard snorting and coughing coming from my room.
Lysis
Bluelighter
Wow MDAO, that's some long posts for a girl who's about to pass out from being tired.
I just wanted to pop into your thread and send you some grats. It's commendable that you're taking care of old people. I have a little soft spot for the elderly, because I think they're the most forgotten in the world. I always have flashes of my sweet gramma, but I'm sure some of them are kinda nasty.
If someone offered me a volunteer job, I'd help out and keep them company. I'm too shy to pursue a job at one. It makes me happy to know that there are people out there who still care about these people
I just wanted to pop into your thread and send you some grats. It's commendable that you're taking care of old people. I have a little soft spot for the elderly, because I think they're the most forgotten in the world. I always have flashes of my sweet gramma, but I'm sure some of them are kinda nasty.
If someone offered me a volunteer job, I'd help out and keep them company. I'm too shy to pursue a job at one. It makes me happy to know that there are people out there who still care about these people
MyDoorsAreOpen
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Thank you, lysis. The elderly are definitely my favorite population to work with professionally. A lot of them are happy just to have someone pay attention to them; the appreciation you get from even the smallest kind deeds is remarkable. That said, old people are, well, people. Not all of them are likable. Some are bitter, some are intolerable, some are just jerks, same as any age group. I just think that since these people have done their duty to society and really paved the way for us young whippersnappers, they deserve some quality of life in their final years, and a good sendoff.
psychedelic food, I know you're kidding, but I'll answer it seriously anyway. Getting admitted to a nursing home is not a matter of age, it's a matter of A) your doctor deeming you unable to properly care for your own health needs, and B) your insurance being willing to cover the cost of live-in care -- it ain't cheap! There was a woman in her 60s living at the nursing home I first worked at. She had drank her brain to shit, and had Korsakoff's Syndrome.
psychedelic food, I know you're kidding, but I'll answer it seriously anyway. Getting admitted to a nursing home is not a matter of age, it's a matter of A) your doctor deeming you unable to properly care for your own health needs, and B) your insurance being willing to cover the cost of live-in care -- it ain't cheap! There was a woman in her 60s living at the nursing home I first worked at. She had drank her brain to shit, and had Korsakoff's Syndrome.
MyDoorsAreOpen
Bluelight Crew
- Joined
- Aug 20, 2003
- Messages
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June 4, and Final Thoughts
My final morning in the nursing home passed remarkably quickly. I felt entirely unencumbered, now without not only my walker, but all my treatments and medications as well. No one came in my room to check on me as I washed, packed my things, and made my own bed for the very last time (more out of concern for making a good final impression, than any practical reason). By this point, I was filled with a strong sense of “the gig is up”, and could sense that my departure, on this beautiful warm Thursday morning, was nigh.
I ate my final breakfast with my two WWII veteran friends, who had apparently forgotten that this was my last day. One of them asked me, “See you at lunch?” when I got up to leave, and it pained me to break it to him that this was likely the last time I’d see either one of them. They tried their best to be old soldiers, hiding any outward shows of dismay. But I could tell in the way both of them gripped my hand to say goodbye, that they would miss me terribly, and had been quite entertained by my presence.
After that, I wandered the nursing home, inside and out, saying goodbye to everyone I could find that I’d gotten to know over the past ten days, residents and staff alike. In was once again filled with the familiar feeling, which I’d felt at other times working at nursing homes, that I was a celebrity guest on Sesame Street, and my cameo was sadly coming to an end. I tried hard not to make my goodbyes overly dramatic or drawn out, for it was a weekday, and I could clearly see that people had things to get done and places to be.
At 10:00, the reporter from Corporate Headquarters who had interviewed me the day before reappeared, as I strolled the grounds by the same llama pen I’d first seen when I’d arrived. He had some final questions for me, about what I had learned and what my final impressions were. This segued seamlessly into my final debriefing in the CEO’s office, which included the director of personnel as well.
The main question on everyone’s mind was this: What would I be taking with me from this experience into my medical practice? To answer this, I referred back to the time I was forbidden from leaving the front door on a beautiful day without an escort, and forced to make do with sitting by a large window. That incident had made an impression on me, and given me a strong taste for what it’s like to have my personal whims and lifestyle choices limited by the orders of a health care practitioner. The doctor and social worker had both told me that one of the chief duties of a nursing home physician is to sign orders, and that some of them did so quite unceremoniously, and without even reading many of them. I decided, based on my own experience, that if I ended up in a position of executive decision making in a long term care facility, I would make every effort to get to know the people for whom I was giving orders. I would keep in mind that every order I signed, even if it was arguably warranted by the patient’s case literature alone, had the potential to have serious ramifications in the life of a human being, who might not have much life left. For example, if I knew a resident well enough to know that being outside in nature was the only thing that brought him any joy, I would think long and hard about signing an order forbidding him leaving the building unsupervised, even if his condition made this potentially unsafe. I might end up signing it anyway, but not without due consideration for the resident as a person.
The debriefing consisted largely of the four of us musing about staff and resident reactions to my presence, which were largely in keeping with my initial perceptions: some initial discomfort, eventual acceptance, and above all, constant curiosity.
The biggest nugget of wisdom we unearthed during that final meeting, however, concerned one of those things that’s always right there under our noses which we seldom think about: food. I remarked that my faculty advisor for this nursing home stay seemed very eager for my comments about the food, and eating arrangements at the nursing home. It was then that the three staff members all concurred on something that should have been obvious to me all along: a nursing home resident’s social life revolves entirely around meals. It’s what they look forward to, what they make small talk about, and in essence, what they live for. No wonder my experience inevitably involved me being put on prescribed diets that were less than palatable, for this clearly has the potential to make or break the quality of life of any real resident.
I told my debriefers of my adventures backpacking, and how even when I ended up stranded in dreary, backwater corners of the Third World, if I truly loved the local food and could look forward to eating, my situation was never that bad. This was typically more noticeable when absent: if I was traveling somewhere where I couldn’t stomach the local fare (Indonesia comes to mind), all the other activities of daily life quickly became a chore, and my morale flagged. I informed everyone present that cooking was one of my favorite hobbies, because one should never underestimate the mood-lifting power of a quality home cooked meal, tailor-made to one’s own tastes. I then remarked that I had, as a very reluctant fan of processed meat, consumed hot dogs and baloney for the first time in years since living at their facility. I was able to abide this knowing that it would be a one-time thing. I really felt bad for any fellow foodies, resigned by their status as long term care residents, to eating such things on a regular basis. The CEO told me that at this corporation’s homes in Florida, fine dining was available for every meal, by resident demand. As those who could afford to retire to Florida tended to be trendsetters in the world of long term care, she told me that this was becoming a common investment for nursing homes elsewhere, as a way to raise resident satisfaction.
My mind raced back to a portly 90-something woman on my first nursing home job. She used to pass the nurse’s station slowly in her wheelchair each morning, throwing up her hands slowly and declaring in her thick Long Island accent, “I can still eat!” I remembered telling my father about this, humorously. But my father, a clergyman with a sharp eye for people’s inner struggles, latched onto this anecdote a bit more seriously, and asked me, with narrowed eyes, “And what do you think she means when she says this?” I was forced to admit that from this resident’s point of view, there was nothing humorous at all about her comment; she was expressing great resignation at her inability to do all the things she once loved to do, with the singular exception of eating. The humor was entirely provided by me, as a way to emotionally distance myself from another’s struggle, and perform my job mechanically. This woman’s death, halfway through my time working there, had followed a brief period when she was not even able to eat anymore. I wondered in retrospect whether this was anything but coincidental. A greater appreciation for the comforting power of good food is definitely one thing I’m taking away from this experience.
More generally, I feel the greatest experiences I had as a nursing home resident were those that did not directly involve health care procedures at all. I was already plenty familiar with nebulizer treatments, crushed pills in applesauce, and awkward physical therapy maneuvers, long before this project commenced. But it was those other aspects of a resident’s daily life that I was only now awakened to: the eating of meals, the sleeping arrangements, the finding of quiet places to sit and write, the toleration of interruption by visitors. What is nursing home life? It’s a pull-string neon light that glares and hums. It’s the window that stays open and makes the room cold, when your roommate’s wife forgot to close it. It’s painters needing to close your door and scrape on it at random times. It’s the nurse at the front desk, with her book of resident faces. It’s the whiteboard on an easel in the main hall, listing the day’s activities. It’s the distinctive stains on the carpets, which you don’t want to know too much about. It’s caffeine as self-medication for boredom, and not seeing the obvious inconsistency in this.
I only hope that many more health care workers who’ll spend their careers working with the elderly in long term care can have the experience I did – to live briefly as one of the residents they’ll be caring for. It pleased me greatly to know that the facility I lived at has instituted such a program for their own nursing staff, and can only hope that others follow suit.
My final morning in the nursing home passed remarkably quickly. I felt entirely unencumbered, now without not only my walker, but all my treatments and medications as well. No one came in my room to check on me as I washed, packed my things, and made my own bed for the very last time (more out of concern for making a good final impression, than any practical reason). By this point, I was filled with a strong sense of “the gig is up”, and could sense that my departure, on this beautiful warm Thursday morning, was nigh.
I ate my final breakfast with my two WWII veteran friends, who had apparently forgotten that this was my last day. One of them asked me, “See you at lunch?” when I got up to leave, and it pained me to break it to him that this was likely the last time I’d see either one of them. They tried their best to be old soldiers, hiding any outward shows of dismay. But I could tell in the way both of them gripped my hand to say goodbye, that they would miss me terribly, and had been quite entertained by my presence.
After that, I wandered the nursing home, inside and out, saying goodbye to everyone I could find that I’d gotten to know over the past ten days, residents and staff alike. In was once again filled with the familiar feeling, which I’d felt at other times working at nursing homes, that I was a celebrity guest on Sesame Street, and my cameo was sadly coming to an end. I tried hard not to make my goodbyes overly dramatic or drawn out, for it was a weekday, and I could clearly see that people had things to get done and places to be.
At 10:00, the reporter from Corporate Headquarters who had interviewed me the day before reappeared, as I strolled the grounds by the same llama pen I’d first seen when I’d arrived. He had some final questions for me, about what I had learned and what my final impressions were. This segued seamlessly into my final debriefing in the CEO’s office, which included the director of personnel as well.
The main question on everyone’s mind was this: What would I be taking with me from this experience into my medical practice? To answer this, I referred back to the time I was forbidden from leaving the front door on a beautiful day without an escort, and forced to make do with sitting by a large window. That incident had made an impression on me, and given me a strong taste for what it’s like to have my personal whims and lifestyle choices limited by the orders of a health care practitioner. The doctor and social worker had both told me that one of the chief duties of a nursing home physician is to sign orders, and that some of them did so quite unceremoniously, and without even reading many of them. I decided, based on my own experience, that if I ended up in a position of executive decision making in a long term care facility, I would make every effort to get to know the people for whom I was giving orders. I would keep in mind that every order I signed, even if it was arguably warranted by the patient’s case literature alone, had the potential to have serious ramifications in the life of a human being, who might not have much life left. For example, if I knew a resident well enough to know that being outside in nature was the only thing that brought him any joy, I would think long and hard about signing an order forbidding him leaving the building unsupervised, even if his condition made this potentially unsafe. I might end up signing it anyway, but not without due consideration for the resident as a person.
The debriefing consisted largely of the four of us musing about staff and resident reactions to my presence, which were largely in keeping with my initial perceptions: some initial discomfort, eventual acceptance, and above all, constant curiosity.
The biggest nugget of wisdom we unearthed during that final meeting, however, concerned one of those things that’s always right there under our noses which we seldom think about: food. I remarked that my faculty advisor for this nursing home stay seemed very eager for my comments about the food, and eating arrangements at the nursing home. It was then that the three staff members all concurred on something that should have been obvious to me all along: a nursing home resident’s social life revolves entirely around meals. It’s what they look forward to, what they make small talk about, and in essence, what they live for. No wonder my experience inevitably involved me being put on prescribed diets that were less than palatable, for this clearly has the potential to make or break the quality of life of any real resident.
I told my debriefers of my adventures backpacking, and how even when I ended up stranded in dreary, backwater corners of the Third World, if I truly loved the local food and could look forward to eating, my situation was never that bad. This was typically more noticeable when absent: if I was traveling somewhere where I couldn’t stomach the local fare (Indonesia comes to mind), all the other activities of daily life quickly became a chore, and my morale flagged. I informed everyone present that cooking was one of my favorite hobbies, because one should never underestimate the mood-lifting power of a quality home cooked meal, tailor-made to one’s own tastes. I then remarked that I had, as a very reluctant fan of processed meat, consumed hot dogs and baloney for the first time in years since living at their facility. I was able to abide this knowing that it would be a one-time thing. I really felt bad for any fellow foodies, resigned by their status as long term care residents, to eating such things on a regular basis. The CEO told me that at this corporation’s homes in Florida, fine dining was available for every meal, by resident demand. As those who could afford to retire to Florida tended to be trendsetters in the world of long term care, she told me that this was becoming a common investment for nursing homes elsewhere, as a way to raise resident satisfaction.
My mind raced back to a portly 90-something woman on my first nursing home job. She used to pass the nurse’s station slowly in her wheelchair each morning, throwing up her hands slowly and declaring in her thick Long Island accent, “I can still eat!” I remembered telling my father about this, humorously. But my father, a clergyman with a sharp eye for people’s inner struggles, latched onto this anecdote a bit more seriously, and asked me, with narrowed eyes, “And what do you think she means when she says this?” I was forced to admit that from this resident’s point of view, there was nothing humorous at all about her comment; she was expressing great resignation at her inability to do all the things she once loved to do, with the singular exception of eating. The humor was entirely provided by me, as a way to emotionally distance myself from another’s struggle, and perform my job mechanically. This woman’s death, halfway through my time working there, had followed a brief period when she was not even able to eat anymore. I wondered in retrospect whether this was anything but coincidental. A greater appreciation for the comforting power of good food is definitely one thing I’m taking away from this experience.
More generally, I feel the greatest experiences I had as a nursing home resident were those that did not directly involve health care procedures at all. I was already plenty familiar with nebulizer treatments, crushed pills in applesauce, and awkward physical therapy maneuvers, long before this project commenced. But it was those other aspects of a resident’s daily life that I was only now awakened to: the eating of meals, the sleeping arrangements, the finding of quiet places to sit and write, the toleration of interruption by visitors. What is nursing home life? It’s a pull-string neon light that glares and hums. It’s the window that stays open and makes the room cold, when your roommate’s wife forgot to close it. It’s painters needing to close your door and scrape on it at random times. It’s the nurse at the front desk, with her book of resident faces. It’s the whiteboard on an easel in the main hall, listing the day’s activities. It’s the distinctive stains on the carpets, which you don’t want to know too much about. It’s caffeine as self-medication for boredom, and not seeing the obvious inconsistency in this.
I only hope that many more health care workers who’ll spend their careers working with the elderly in long term care can have the experience I did – to live briefly as one of the residents they’ll be caring for. It pleased me greatly to know that the facility I lived at has instituted such a program for their own nursing staff, and can only hope that others follow suit.
socko
Bluelighter
Have you read Nelly Bly's "10 Days in a Madmouse?"
MyDoorsAreOpen
Bluelight Crew
- Joined
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^ Can't say as I have.
Though I'll be the first to admit, what I did was not really THAT badass. I'd bow down immediately to those people who volunteer to live in a group home for disturbed youth, or any group living situation that involved physical struggles and altercations on a daily basis. I don't think I could stomach a stint in a group home full of highly manipulative individuals, either. My hat's off to anyone who can work a 9-to-5 job at an institution for severely autistic adults, too.
Even my day on the dementia ward was rather mild -- it was only a day there, and I didn't sleep there, plus this particular facility does not accept Alzheimer's patients with aggression issues, or anyone who needs physical restraints.
Though I'll be the first to admit, what I did was not really THAT badass. I'd bow down immediately to those people who volunteer to live in a group home for disturbed youth, or any group living situation that involved physical struggles and altercations on a daily basis. I don't think I could stomach a stint in a group home full of highly manipulative individuals, either. My hat's off to anyone who can work a 9-to-5 job at an institution for severely autistic adults, too.
Even my day on the dementia ward was rather mild -- it was only a day there, and I didn't sleep there, plus this particular facility does not accept Alzheimer's patients with aggression issues, or anyone who needs physical restraints.