PART III~FINAL

                      

Yes, you will experience shock, sadness, anger, hurt, happiness, joy, and darn near every other emotion you possess during the time the person you love is in a nursing home. All of your emotions will be tapped. Sometimes numerous ones in the course of a single visit.

 

A nursing home is not solely a place for the elderly. That is a misconception. Today, hospitals are sending patients there to recover from various surgeries when they are not quite able yet to return to their homes. I recall one patient who was a doctor himself. His leg had been amputated, and he had no one at home to help him during the recovery and physical therapy. He was about 50 years old. He was an interesting fellow. I used to sit with him in the lounge when Daddy was getting bathed. We discussed all sorts of health situations. He was the one who told me specifically how doctors often assist in suicides of the terminally ill, but they do it in a way that is legal and cannot actually be "pinned" on them. Then there was a patient who was but in his early thirties and suffering from a particularly vicious form of Lou Gehrig's disease. That was a crusher. He had tiny children. He was so very young to have lost his ability to move or speak. To know death was imminent for someone his age was extremely upsetting.

 

There are some disturbing things you will encounter there, and it makes no difference if you are in a topnotch facility or one of the lesser ones. Alzheimer's patients are common. The various stages of it bring about different symptoms, some of which are frightening to visitors or fellow patients. They roam a lot. When they wander, they will go into other patients' rooms. For someone who is trapped in a bed unable to move, it is disconcerting to have a patient come in and start picking up their belongings and perhaps walking out still holding onto those things. Daddy's glasses were taken off the tray table by such a patient. He got them back the next day when they were located in another room. It upset all of us. Enough so that we discussed it with the staff. To deter "surprise" visitors to his room, a bright yellow wide strip of vinyl with Velcro at the ends was put across the entrance to his room (and on which I penned in black magic marker, "POLICE LINE, DO NOT CROSS. Just Kidding! Come on in!"). Regular visitors could easily remove one end and enter, but it did work to keep out the wanderers. You will hear cries for help pour out of some rooms. As you walk down a hall, some may beg you to come into their rooms. Yes, I would go in. How can you NOT? Usually, it was a simple request to please cover them with their blankets or pour them some more water. For God's sake, DO IT...help them. How would you like it if you were the one shivering in that bed?

 

Some patients are notorious strippers no matter where they may be. I do not know why this is the case, but they drop their skirts, pull down their pants, or lift up their shirts. The staff always quickly and kindly told them it was best to keep their garments in position. (And why do I have a feeling I will be one of those stripper patients when my time comes?! :;grin::) Some clutch teddy bears or dolls to them. Others have no clue where they are or even if they exist. They sit back in their wheelchairs with the blankest of expressions on their faces, and you can only wonder what, if anything, they are thinking. They never speak. They never move. Their eyes do not track anything. They are trapped inside themselves. To get those residents out of their rooms, the nurses and aides would often bring them out to the nurse's station. I would go there to ask a question or get something, and there would be a semicircle of those poor souls sitting lifelessly. If I said it to the nurses once, I said it a thousand times, "God should sweep all of these people up and take them directly to Heaven. They have earned the right." Geez, it used to rip me up seeing lives spent incapable of doing ANYTHING.

 

Ah, but there are the moments you beam. When you watch a physical therapy session, and you see a tentative step taken for the first time. Or when speech returns to one who had been silent or unintelligible for a period of time. There are the victories celebrated when a patient recovering from a broken hip gets to leave the facility and return to his home. There are the smiles and giggles when a resident has created a holiday decoration during a craft session and is proud of that accomplishment. The chatter you hear coming from one of the gathering places because the residents are talking about a TV show or sporting event they are viewing. There are the times a patient in the hallway takes your hand and tells you how sweet you are and how you have always been so nice to them. The gratitude visible in the eyes of those who appreciate the smallest of deeds done for them. The sharing of memories with patients whoare strangers, but who just do not seem like strangers after seeing them in the home day after day.

 

There are some things you can do to make your loved one's stay be a better one. Be their advocate. Make sure you are on top of everything that is going on. Do not be an infrequent visitor. Nothing is more disturbing than to learn there are patients who never have visitors, yet they have family living nearby. LISTEN to what you are being told. Let them talk as much as they want. Loneliness is brutal, and a visitor is a very bright spot to days that usually blend one into the other with little change. Do not be a lazy visitor. Help the staff in ways that free them up to tend to the more pressing matters. I knew of a visitor who came to see her mother (sporadically, and she complained constantly about anything and everything), and she actually pushed the call button for an aide to come and LIFT THE BLANKET UP HIGHER ON HER MOTHER'S BODY. Can you imagine? ::shaking my head in disgust:: Find out where the blankets and additional sheets and pillowcases are stored, and get them yourself. There is no reason you cannot grab a blanket if your family member is cold. As long as the staff does not mind you helping yourself, then DO IT. I used to fret when I thought Daddy might be running a fever, but it was not time for the set readings of his blood pressure, temp, etc. So, I would go to the nurse's station and ask to borrow their electronic thermometer. I was never refused, and I would report back to them what his temp was, and they would record it...and also come to give him medication if he did have a fever. Bring music into the room. We had a nice little CD player loaded with his favorite music. Watching television is monotonous, and music is calming. Flowers or plants brighten a room. So do pictures. We hung paintings and had a bulletin board loaded with photographs and cards the grandchildren made for him. One entire door was covered with photos. Bring a bit of home to the patient's new home. Bring your heart and leave some of it there.

 

“To know how to grow old is the master work of wisdom, and one of the most difficult chapters in the great art of living." ~Henri Frederic Amiel 

 

PART II

                        

                                       STAND BY ME~click to hear song

I reread Part I, and I honestly do not think I can stand to chronicle the events that took place while my father was in nursing homes until his passing in 2002. Too many painful recollections. Fortunately, there were also some wonderful ones, not for his health except the times he beat what the doctors felt was "certain impending death." That really had more to do with the type of man he was and his competitive nature and his unwillingness to give up than it did his nursing home experiences. And I will go so far as to say that we, his family, kept him alive with our knowledge and insight into his health conditions. We knew EVERYTHING about him, how certain illnesses effected him and could see them developing before others could, we knew each and every medication he was taking, the side effects of them, we kept his limbs going even when they were rendered useless. I could spot the onset of the slightest fever immediately. A urinary tract infection? Pffft...that was a breeze to detect simply by the way he was feeling. Dehydration? Another easy detection. Pain? He would not admit it, so you read it in his eyes. You CAN SEE physical pain if you look. If you care enough about someone, even the tiniest change in behavior or patterns sets off an alarm, and you have it investigated.

We all weathered the heart attacks, the constant bouts of pneumonia, the UTIs, the shutting down of his kidneys necessitating a permanent catheter, the feeding tube leakages or infections around the site, the petit mal seizures for years. Think it did not kill us to see it happening? To feel helpless to do anything for him except be there for him and try to make sure the nurses and aides and doctors were on top of each and every thing. Did we worry about being pests? Hmmm. Maybe. I did not, though. ::grin:: And I had no problemtaking anyone to task if I felt they were not giving Daddy's health or care enough attention or priority. Daddy was in two nursing homes. The first one was very good until they began to cut back on staff, and with that came an inability to properly tend the patients. We pulled him out of there when that took place and situated him in a brand new facility. We are very, very grateful we did.

So, things to look for in a nursing home? If you walk into a facility, and the scent assaults your nose, GET OUT. If they cannot keep their hallways free of the expected odors, then imagine how the patients' rooms smell. Cleanliness is mandatory. Staph infections run rampant in such places. Staph can kill...especially the weak and elderly.

Visiting hours? Are they set in stone? Most have hours posted, but they allow you to visit during the off hours, too. Sometimes, as in our case, they have a keypad security system. They gave us the code, so the doors would open whenever we visited. I loved that, because I had a tendency to fret if I had visited earlier and saw that he was not faring well. I would return late at nite and just check on his condition. Or maybe just sit with him during the quiet wee hours of the morning. Being a nite owl worked in my favor.

Is the staffing adequate? What is the patient/staff ratio? Just remember, if your loved one pushes that call button, how long do you want the wait time to be for assistance? (God love Daddy...he never once pushed it. Not sure if he really understood its significance, or if he did not want to be a "bother." We wished he utilized it, and we would tell him to push it if he wanted anything. He simply never did.)

Activities for the patients? Do they have a social director?One who plans various outings or activities? Really, that is critical, in my opinion. Whether they be crafts, trips to the zoo or a restaurant, bringing in groups to perform during the holidays...all of those things make the elderly feel like they are a contributing part of society. No matter how small the activity seems to be in your eyes, it is still something to help keep a mind alert or fill the ears of those who can no longer communicate. I will never forget the music and singing at Daddy's nursing home. I will never forget walking in and approaching him from behind as he sat in his wheelchair. His head was moving to the melody, and I slipped my arms around his shoulders and squeezed him. He was beaming. He loved music. Later when he could no longer leave his room, carolers came to him. Sometimes schools will "adopt" a nursing home. The classes or students make cards for the residents. They put on little shows. They come just to say hello. I cannot emphasize enough how important these things are. Children and the elderly are like magnets. They come together, and it is a joy to watch.

What about meals? Is there a dining room? Is there a special one for those who struggle either using their utensils or swallowing? Is an aide in there to assist and keep an eye out for choking? Or are the meals just brought to the patients' rooms and left on a tray table? If your loved one has difficulties, the LAST thing you want is him or her left alone with a tray of food.

Physical therapy, speech therapy? Do they have those therapists in the home? Are they full-time or part-time? Do they hire the employees, or is it an outside agency contracted to work at the nursing home? Is the equipment they have for physical therapy adequate for the needs of your loved one? Do they allow family to watch the sessions?

Financially, you can pretty much expect to pay an exorbitant amount. Most people want a nursing home that is licensed by Medicare. The system rapes the elderly of practically every dime they worked so hard for all their lives before allowing Medicare to cover the costs. Obviously, if the money you have to work with is limited, then it is almost a necessity to be sure you have selected one where Medicare will pick up the slack when money runs out.

Gosh, so many other considerations when selecting the right place. It is very rough on the aged to be shuffled from one place to another. It pays to do your homework and be as certain as possible that where you have chosen will suit him/her to avoid repeated changes. But, I would never EVER leave someone I care about in a place that is not living up to its promises or claims just because I did not want to unsettle my loved one.

Part III will cover what you will see and experience inside a nursing home and ways you can be of help. Some of it is very disturbing, and some is very uplifting.

"Whycan't we build orphanages next to homes for the elderly? If someone were sitting in a rocker, it wouldn't be long before a kid will be in his lap." ~Cloris Leachman

 

 

 

THE RELUCTANT DECISION (PART I)

                      

                             Circle Of Life~click here for music

Sometimes we have no real choice but to do that which we do not want to do. We fight it as long and as hard as we can. Finally, we have to succumb to it. We may never be happy that we had to do it, but we ultimately recognize it was the "right" or best decision.

My family had such an agonizing time when it appeared a nursing home was the logical and safest place for my father to be. Who thinks of a nursing home and eagerly accepts it as a wonderful place to take a loved one? My guess is few, if any. Oh, how we fought it tooth and nail. Put that wonderful, decent, honorable, and much loved man in a nursing home? NO WAY!

We tried so very hard to make it work. After spending almost five months in hospitals and a physical rehab facility, Daddy was finally in his own home, surrounded by all that was familiar, all that he worked long hours to provide for his family. We ordered a hospital bed (extra long) to be placed in the Florida room. His wheelchair was custom made to accomodate his height. How grand that he could be in a room full of windows and skylights to brighten his days. Even though navigating the stairs to reach his bedroom was an impossibility except for occasional trips using the newly-installed stair glider, we loved that he was in a room where nature could be viewed and appreciated by him. We hired full-time nurses, and each of the four of us girls also came daily to assist Mom with Daddy's care. We took classes to learn how to transfer him from the bed to his wheelchair and vice versa. He was a tall man~6' 4" and built well. My mother is all of 5' 2"...and our help was definitely needed.

There were some very frightening times during those two months he spent at home. There were the seizures and the emergency runs to the hospital to halt them. The choking on his meals. The constant need to be sure he was properly hydrated. The oh-so-close calls when he almost fell while we were lifting him. The fevers that came and went. The memory problems. The changes in his overall health on a day-to-day basis. It was impossibly complicated. The brain aneurysm had disrupted so many functions most of us take for granted.

I still laugh, yet also get teary, at one memory that was very scary, but somehow ended up being amusing. Daddy was in bed having taken a nap. I had been called to come over and lift him into his wheelchair, so he could have dinner in the kitchen. I loved visiting with him anyway, and I was darn good at transferring his tall frame from place to place. We chatted for a bit before I lifted him up into a sitting position, holding him upright. His legs were over the side of the bed. I told him I was going to lift him and turn his body until I positioned him in his wheelchair. No problem. Now, the man had some amazing long legs and very large feet. Somehow, my feet and legs (my legs are long, too, but my feet are fairly small) got tangled up with his while I was turning him. I almost dropped him. In a flash, I could feel him slipping from my grip. Within moments, I was sitting on the edge of the bed, and Daddy was sitting ON MY LAP. He looked at me with a startled expression on his face...no doubt matching my equally startled one. Without missing a beat, I said, "So, what do you want for Christmas, little boy?" Well, Daddy laughed hysterically, as did I. It could have been a catastrophe had he dropped to the floor. Instead, it became a moment in time when the two of us had a hearty laugh that resulted in me seeing in his eyes his love for me. Mom entered the room to see what all the ruckus was about and giggled at the scene in front of her. It is a good memory. I have lots of those.

And so, during those two months, there were many ups and downs. Unfortunately, the downs became more frequent, lasted longer, hospital trips were more numerous, his speech began to disappear, eating was an enormous task and often accompanied by choking or a complete loss of appetite. Then came the day when he had a seizure that was the last time he would ever be able to live in his home. He went to the hospital emergency room and was admitted. He was there from mid-November to December 23, 1996. He never really awakened during that time except sporadically. A feeding tube was implanted in his stomach. He could not move any part of his body.

We were told a nursing home was his only option. We fought it. Why couldn't we continue to have nurses at home to tend to him? Why couldn't we keep assisting? His case was so complex with numerous problems and much unpredictability that went along with them. Feeding tubes themselves have perils that go along with the good they serve. He was a tall man who was essentially complete dead weight. Who could lift him? The staff was kind to us when explaining these issues. They pointed out the staggering cost to have the required number of aides and nurses with him every moment of the day. We tried to tell them that did not matter. We would do anything to keep him at home. They nodded their understanding, but continued to tell us the dangers of in-home care for someone in his condition. I think what convinced us of the need for a nursing home was when they discussed how his health would actually be jeopardized by not having the immediate and necessary care when problems would arise should he be at home. We were heartsick.

We began the trek from one nursing home to another searching for one we felt would suit his needs. Not an easy task. Certainly one of the most depressing and heartbreaking duties we had to perform. A decision was reluctantly made. And on December 23, 1996, Daddy was admitted to a nursing home. It was later on that one aide told me she never thought he would live through the nite.

I think I will stop for now. So much needs to be said about nursing homes and assisted living facilities. Most people will not be spared having to be involved with them in some way during their lives. So many memories, fears, triumphs, and concerns reside in them...and in those of us who were or are somehow connected to them.

"No man is so old as to believe he cannot live one more year."  ~Sean O'Casey

CHANGES

                          

I love changes. Big changes. Little changes. This dates back to my youth. I rearranged my bedroom furniture a minimum of once a week, gouging the hardwood floor with every shove of the dressers, desk, and bed. As an adult, I am equally bad feeling a constant need to change the looks of my living room and family room. It gives a freshness to those rooms which extends to me, and I was aware of that even as a youngster.

When a room is pretty much arranged the only possible way it can be, then I bring on the smaller changes. An added painting, a new knick knack, a fresh and different color of paint on the walls, wallpaper, or a wall border. All of those things bring "newness" to a room. I doubt I will ever outgrow the desire for change in this way.

I need change when it comes to restaurants, too. To go to the same one over and over gets stale. Of course, I have my favorites that I will never stop going to unless they should close. BUT, I do not want to go to them every time I dine out. Change is necessary. It is a treat and a pleasure to try a new and different one. If I do not like it, then I will not return.

Clothing styles worn by me are never the same on a daily basis. I have certain outfits I refer to as uniforms, but that is because I can count on them to be appropriate for specific reasons. They are perfect for a particular type of event, or I know I can count on them to be comfortable when comfort is a must. Even then, I change my accessories to give that sense of new. Each day it would be hard for anyone to predict just what will attire this body of mine. Tailored? Casual? Fun? Classy? Dressy? Hip? Hard to tell. And I like it that way.

There is one kind of change I abhor. It upsets me. I avoid it at all costs MOST of the time. That horrid change? A people change. ::shudder:: I become attached to people, be they casual acquaintances or dear friends. They provide a constant that I like and from which I gain a feeling of stability. That is important to me. With all the changes that occur on a daily basis~planned or unplanned changes~it is comforting to know the people will not be a change.

When I lived in apartments, I tried to avoid getting close to any of the other tenants. I was friendly, but I did not want to include them in my world of friendships. Apartment dwellers are transient people. They are going to move on. Why would I want to give them a part of me and then watch them up and leave? Many who moved did not only move to a new complex, they moved to another city. If I had gotten too close to them, I missed them horribly. So, up went my walls. And I remained slightly aloof from most.

Then there are the people changes I initiate. I am the one who dissolves the ties to them. Fortunately, that almost never happens in my real world. I meet new people regularly, and I find I like them and want them to be in at least one of my categories of friends. It takes an awful lot for me to back away from any person I know and like. That "awful lot" means abuse of our friendship. I guess I must select the people in my life pretty darn well, because I cannot recall the last time I dissolved a friendship or even had one the other person terminated with me.

Online, I find I do it more often. Not as often as I probably should. And I give way too many strikes before calling them out. I have thought about why I do not do it when I have had numerous times I was hurt by or angry with the person. I believe my gut instincts do not kick in regarding the quality of an online person's character or expectations as well as they do in my real world. I trust easily (I should probably alter that word to make it past tense), and that is a carryover from my life outside of the realm of cyberland. I honestly do not know of anyone I have trusted in my life that has ever betrayed me. Why would I expect it to be any different on AOL?

Uh, there is my naive thinking (and stupidity) showing. Sweet Lord, people on here are not like they are in my life. The abuses, lies, and downright nasty things they do to each other are incredible. I give chances. Hurt me once, that is one strike. Again, strike two. Yet again, strike three. Are they out? Maybe...maybe not. Every case would be different. I am not a zero-tolerance policy advocate. ::grin:: Some I cut incredible slack and allow them a ton of what I consider "mistakes" and never do cut them loose. Others might be out after only one or two strikes. If that bat they wield does not just miss the ball but proceeds to intentionally smack into my head and drop me to my knees, they are out. Permanently. I do not care if it is their first strike.

It took me a very long time before I became aware that it was necessary for me to not be so gullible online. I kept making excuses for why someone did this or that. It was very wearing on me. I am a people person, and I do not like the thought that a person never had my best interests at heart. I am learning, though! I suspect I will be duped again, but at least I have more of the required bit of skepticism about the intentions of some people. And it was not difficult to sever the ties to some of the folks here I have known. In fact, it was a relief. Those people changes were so easy. It came as a surprise to me when I found I did not miss them even the tiniest bit. But, ugliness in the form of character is something I would never look back over my shoulder and yearn to be around.

I have seen too much ugly here. Now, I just want to be dazzled.

"It takes a lot of courage to release the familiar and seemingly secure to embrace the new. But there is no real security in what is no longer meaningful. There is more security in the adventurous and exciting, for in movement there is life, and in change there is power." ~Alan Cohen

SEPTEMBER ARTSY ENTRY

Judith Heartsong holds a monthly contest, which brings out the creativity of so many people in AOL's journal world. She states the topic for the participants in her journal, and she allows each person to address it in whatever manner best befits him or her. It is delightful to read each of the entries, as well as being a challenge to one's self. For further information about this contest, her link is September's anniversary edition of the Artsy Essay Contest. This is my September entry that asked, "If you could be any animal on earth..."

                                           

            

 

I THINK WHAT???

                    

Who does my thinking? Am I not responsible for it? Are these thoughts not in MY head? Am I unaware of just what it is that is whirling through my mind? It seems to me I am the only possible person on the face of this earth who knows EXACTLY what my thoughts are or could be. I may not share all of them with others, but then that is my right as I see fit.

I have always paid close attention to my thoughts. Perhaps maybe too much so at times. But in doing so, I have gleaned a lot of insight into why I am the person I am. We are each so very unique, and the reasons for it have just as much to do with the way we think as it does our environmental and genetic factors. Being self-analytical can often result in some stunning revelations. At least it can IF you can try to objectively sort your thoughts. Starting out with preconceived notions and being rigid in adhering to them will render the process of self-analyzation moot.

Recently, I had a staggering explanation for a behavior trait that had perplexed me for a long time. It is not a BAD trait at all, but its existence puzzled me, because it had not always been a part of me. I thought I had it figured out, but it never quite fit right. There were still some gaps in my theory. Then one day I was pondering it yet again, and the proverbial light bulb lit up, and I knew I had found the answer. It was amazing. It was so very simple, yet I had not been able to see it up until that moment. I felt a sense of peace descend upon me. I discussed my newfound knowledge with my husband who immediately saw the perfect sense it made. I told a friend about it, too. Again, there was the nodding of the head and the belief that I had surely found THE answer. What a wonderful feeling it can be to better understand ourselves.

I have a very hard time dealing with those people who try to tell me what I think and feel. Have you ever been around such people? I find them to be among the most annoying people in the world. When they tell ME what I was thinking when I did or said something, I get livid. 99 times out of 100, they could not be further from the truth, but they refuse to believe it. And why is that the case? Because they want to be "right" so it suits their own agendas or beliefs. Well, excuse me, but until they have access to my life, my experiences, AND my brain, they have nothing of importance to say about my thoughts. All they have is speculation, assumptions, and most often a narrow-minded way of thinking.

In this world of AOL, it is quite easy to misinterpret words. With it being such a one-dimensional realm, words take on an incredibly integral part of our interactions. The wrong word choices can cause hurt feelings, misunderstandings, and anger. Mature and intelligent adults will instantly ask for clarification if we have been offended during the course of a conversation. Unfortunately, finding the former and the latter is not always an easy task. Pettiness and stupidity reign supreme far too often online. The foolish will dash off to complain to others about the callousness of so-and-so and embellish the story all due to a misunderstood word, sentence, or phrase. If there is already a dislike for that particular person or if the alleged "insult" strikes a very raw nerve, then bring on the "thinking" for that person. That usually follows suit. It goes something like this: "She said such-and-such to so-and-so, and you just KNOW she is thinking that blah, blah, blah." Lovely, isn't it? It then snowballs, and others join in and suddenly the person in question has been branded a certain way, and his or her every thought and feeling and action has been decided by a group of virtual strangers. Who cares if what they believe is totally WRONG? They will never change their minds. Heaven help me if I get to the point where I feel the need to be as judgmental and nasty as those people. It seems to me that it would benefit them greatly if they looked inside themselves and allowed themselves to honestly and objectively analyze the reasons they do such things. They could be in for a rude awakening as a result of what they find.

I try to understand why people do the things they do. I try to wear their shoes. Surprisingly, I can do that quite easily. Given factual information, I am able to explain the whys of their behavior. Makes sense most of the time. Bitter souls who lash out at others often have unhappy lives stemming from their life occurrences. HOWEVER, that does NOT EXCUSE those behaviors. It simply explains them.

To be expected to look the other way and tolerate behavior that is not my definition of decent or kind is far beyond my limits or my desires. Namecalling of the most vicious kind is something I will never accept. I do not care WHO it is doing it and whatever his or her reason may be. It is inexcusable...unless they suffer from Tourette's Syndrome. And, sorry, but I highly doubt the majority of those who get their jollies from belittling others suffer from a disease such as that. Face it, some people are nasty individuals who have absolutely zero self-esteem, and they try to gain some by pulling others down in order to better their own appearance. Pathetic. Help IS available. But, they will never seek it. Why not? Because they do not view themselves honestly. They justify their own actions and condemn those of others. The cliche, "Misery loves company" did not come about because there was no validity to it.

Online, the best I can do is to avoid being around people whose idea of fun is shredding others and seeing to it that I do not get close enough to others to give them the opportunity to try to do my thinking for me.

"Pick your own brain for once, and dare to see what lurks inside."