Wednesday, June 6, 2012


It was the worst one ever. For all the nursing homes I deliver to, that's saying quite a bit.

Usually it's the long hike that gets to me. Sure, this place had one of those, down three halls to the elevator, then up to third floor, and down another long hall to the nurse's station before you can find some person authorized to sign for meds. It wasn't even the getting-trapped-at-the-elevator-because-you-don't-know-the-secret-code trick they use to keep the wanna-be escapees from being successful. I finally figured that one out too, since they used a trick I'd run into before: push both the up and down button at the same time to call the elevator.

No, what got to me was the level of staffing compared to the level of need.

To be fair, it was just after supper, when everybody needs care at once. Everybody was in the halls in their wheelchairs, marginally mobile -meaning they could move a bit here and there, enough to clump and block access to everybody - and vocal about needing help. Presumably staff were busy in individual rooms assisting residents, because there were none in view. The one I did finally find - or thought I did - was sitting at the front desk of the nurses station in her nightie and robe. She smiled cheerily at me - likely the only smile in the whole bunch - but I quickly garnered that she wasn't my "authorized person". Finally a young man appeared and signed off so I could leave.

Now this is a church-sponsored care facility, actually build adjacent to the church sponsoring it. I won't tell you the denomination. If I thought there was any real neglect going on, the kind arising from indifference or lack of caring, it'd be a comment tossed in another direction. What I did see was likely just overwork at the worst time of the day. I'm sure they care. I'm sure they try.

Or at least I want to think so.

But what set me off was the patient who greeted my sight as I got off the elevator on the floor.

She was sitting in her wheelchair, reaching toward the chairs at the windows giving residents and visitors a nice view of outside. Eventually she managed to snag what she was after, one of those velcro-fastened support booties for a bad foot/ankle. As she was wearing one shoe and had one stocking foot, I presumed it was hers. Apparently she had propped her foot up on a chair, and in putting it down again the bootie had slid off.

Another apparent resident was standing next to her, talking to her. She was wanting help, and the other resident was scolding her, not offering her any help, and telling her to stop yelling for help and crying when none came.

Did I mention the yelling for help? She was at the end of the long hallway farthest away from the desk from whence all help came. Loud as she yelled, the bedlam on the desk end of the hallway precluded anybody from hearing here, had they even been there. When not yelling, she was deep in conversation with somebody who was not actually present. Arguing, actually.

Had I felt more sure of my own diagnosis - and immunity from lawsuits - I might have rendered assistance. In the time it took me to finally dispose of my package and return to the elevator, the friend had disappeared, the blue bootie was in her lap clasped in one hand, and she was vainly trying to move her chair towards the other end of the hall. As I watched, she made about 8" of progress.

In a curve.

Not knowing the extent of the reason for the bootie, I didn't try to place it back on her foot. Not knowing if she could keep the foot in question up off the floor, I didn't dare try to push her chair down the hall. There were no foot rests on the chair. As I returned to the elevators, she greeted me like her savior, face lit up in a huge smile and arm outstretched to me. I had to walk by.

It broke my heart.

I knew that she wouldn't be there all that long, and she didn't appear to be in any great pain or needing actual medical assistance, beyond replacing the bootie properly.  When it came time for bed checks later, the staff would of course find her and tend to her, if that's how long it took. If I couldn't leave the floor without a minute's worth of decoding the elevator, she wasn't going anywhere. But she haunted me.

The only thing I actually got out of it was a profound sense of gratitude that neither of my parents had to spend time in a facility like that, neglected, or feeling neglected. Mom went quickly, and Dad spent his last years with us.

Now I had been realizing these last several months how hard that actually was on me. I'm very capable of stuffing my feelings and just going on, taking care of business because that's what people do. That's what's necessary. But they've been popping up lately for me to finally deal with. And I have.

But I've also been feeling somewhat like the wounded party. You know, as if it had all been somehow about me. Sure, there's a bit of a place for that, and it wasn't then. Then it was all about meeting Daddy's needs. So I guess now is when and how it has to be. But it's been a bit of a struggle, coming all at once.

Finally, in that one nursing home visit, I gained the perspective I needed to pull myself out of the wallowing. I was able to see how bad the alternative could have been. It's what Mom saw with her own mother, and why she determined no medical assistance after a certain point. She had a horror of ending up like that. And I was now profoundly grateful that I/we were able to keep my Dad home, with family instead of abandoned, having his needs met as soon as possible after he made them known, having constant attention once he needed it, feeling loved.


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