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Nursing Home Residents Were like Us Once

Where and how will you spend the last days of your life?

That is a question that will pop up in the back of your mind sooner or later, especially if you live in the United States where independence is more valued than family ties. At 32, I am rather young to be asking myself that question, but it's something that happens a lot when you work in health-care.

Somehow I had convinced myself that working in a skilled-care nursing home at night while going to college full-time during the day was a good way to both keep from getting into troubles while funding my own college education (it doesn't hurt that the job would look good on my resume when I apply to medical school after getting my BS degree). It started well enough while I was still fresh enough to endure weeks of less than 20 hours of sleep without falling asleep in class (or during lunch). Working the grave-yard shift (11PM-7AM) meant that the patients/residents were in bed most of the time and I wouldn't have to bother them (and vice versa) much until 5 AM when I had to wake them up and get them ready for the day (how humanely we treat the old nursing home residents, ay? Get up at 5 and wait sitting up in that cold wheelchair of yours for 2 hrs before any breakfast is served).

All blissful ignorance must end at some point, and it dawned on me that those bodies lying in bed to be checked every 2 hrs were actually people who could look at least halfway normal during the day. Moreover, they were just as normal as my colleagues and I were once. In so many decades many of the people I know (and perhaps me also) would be in their place. Very few people I have worked with realized this from the first moment they started working in nursing. Most others learn it on the job, and some never learned it at all and continue treating the patients in their care as bodies that are to be turned and cleaned every few hours to prevent from developing bed sores. Unfortunately, the last type tend to be the ones who stay in nursing the longest, because their lack of empathy prevent them from doing more than what is minimally required, and so never over-extending themselves and burning out from the field.

I was the 2nd type who developed empathy on the job and tried to be humane enough to my charges in small ways like actually talking with them instead of at them, or letting them make some decisions like which dress to wear or whether or not to agree to have their diaper changed voluntarily (hey, when people are roused from sleep every 2 hours, they aren't always sensible). That was taxing when combined with trying to also complete all my chores on time to satisfy my employer and my co-workers. I made it a point to get all the folks assigned to me (usually 11 or more patients) up at a pace that was slow enough for them to not feel rushed to be ready for breakfast, often at the cost of having to clock out at 7AM before returning to the floor on my own time to complete all I was supposed to do.

It was a matter of time before I over-extended. It was horrible... I heard the 'call-light' signal that rings whenever a patient needs assistance going off in my ears everywhere at all hours of the day. It was hard staying awake during classes and retaining my lessons. By the 2nd semester, I couldn't even tell when one day stopped and another began, it was like living in this same never-ending day for the whole year. Absurdly enough, quitting was not an easy thing to do since I felt obligated to those patients. In my self-absorbed state then, I had the impression that others didn't take as good a care of the patients as I did. Not showing up for work then meant subjecting them to people who would treat them worse than I would. Perhaps I was wrong about that, but with such sleep deprivation, I wasn't thinking straight much of the time myself.

Don't believe those beautiful TV ads showing well groomed and happy nursing home patients surrounded by friendly and caring staff. A few places like that exist, perhaps, but they wouldn't be affordable to the majority of us. Living in a nursing home is usually not a pleasant experience. There are some caring nursing staff, to be sure, but they tend to be on the day shift (where the patients are mostly awake and it is easier to see them as another person), and day shift are only half of the staff. Dehumanization of sleeping bodies is a common psychological disease of the night.

I worked in 4 different hospices and skilled-care nursing homes in Missouri during my college years. Abuse of these helpless residents happened everywhere. Abuse isn't always something as blatant as beating or starving someone. Sometimes they are seemingly innocent things like letting an incontinent patient sleep in a bed soaked with his own discharge all night because the nursing staff has better thing to do (like taking the 3rd smoking break of the night) than to bother with someone who will probably soil himself again before the 4AM bed-check comes around.

I consider the lack of action where one is needed is abuse when the well being of another person is on the line. But many people I've worked with can get around that by not being around to notice that an action is needed in the first place. Should I have reported all of them and get them disciplined by management (if that ever happens)? Ideally, perhaps so.... but night-shift was always short. There was never even a single week during the 4 years I did the work that we had 5 nights in a row with full staff coming in to work. And with full staff, I would be charged with caring for 7-15 patients by myself. I have had to cover 25 patients by myself a few times when more than 2 nursing staff called in. It was pure luck for me that none of them went falling and breaking some bones in their room on those nights.

Nursing is an emotionally and physically taxing job and prone to high turn-over rate. And if you can't fill the staff with well qualified people, then you have to fill them with shabbily qualified ones, regardless of what the rules and regulations say. Missouri has a law against hiring people with criminal record for nursing jobs, but nearly all the nursing facilities I worked in hired me on the spot when I went in to fill out application form. The 4th one only waited 2 days. I prefer to work with other people with high work ethics, but when it comes down to either having another set of hands to help or none at all.... One can only do so much before going either completely loony or becoming psychologically harden into indifference.

I have many memories of my nights with those nursing home residents. I doubt that any of them are still alive now, 6 years later. Such is the nature of the place. People come to live in skilled-care nursing home not to get better, really. They are there to spend their final days on earth. More than in other areas of health-care, this is the area where it really doesn't pay to become emotionally attached to your charges. Most of them will only leave the place in a gurney, heading either for a funeral home or an emergency room. Working in these places taught me many lessons (not the least of which is that I'm not really stuff physicians are made of), and made me aware of the inevitability of death in ways that no secondhand experience or classroom lesson can. One does get used to touching a dead body after some practice, but the first one is always unsettling and the feeling sticks with you somewhat.

It's been 6 years since I last worked in a nursing home (medical technologists like me stay in the lab and talk to our test tubes and agar dishes, the phlebotomists are the ones that get to go out collecting blood from real people for testing). Since I have been enjoying the good life away from nursing, I find myself taking things for granted more than I used to. I find it therapeutic to go and visit nursing home residence now and again, especially when I am down and want to feel sorry for myself. The sight of the lonely looking nursing home residents stuck in bed and so out of touch with the world of the living that they don't have much to say puts things in perspective for me in a hurry. Truly, as long as I can get around on my own two feet and don't have to ask others to help me clean myself after a bathroom visit, I really haven't got much cause to complain about. So many are having it worse than I am. While I can walk out the door after a few hours and return to the vibrant world of the living, these people are stuck in their facility for the rest of their days... Often with nothing to look forward to, except for a visit from a few relatives and some old friends who still remember that they are still alive.... or perhaps even by a stranger?

I'd just sit there and keep them company for a while. I don't even mind if they start rambling out about the families that never come and visit or reminiscing of their own 'youthful days' of long ago (mind, some people think they are saying one thing while in reality what comes out of their mouth is really intelligible 'yak, yak' sounds. In which case I can always just go along and nod to let them know I was hearing something).For dissertation writing service visit link.

You won't believe how much better you can make some of the nursing home residents' day by just choosing to spend 10 minutes sitting with them and listening to them yak-yakking as if they are someone worth paying attention to. It would only cost you an hour or two, but they are so disproportionately grateful that it wouldn't seem a fair trade!! Most of these folks don't even mind when I play a Bellini opera on their stereo (though sometimes I wish they wouldn't start singing along... Oh well, that makes me appreciate better the people who can actually sing, anyhow). Who knows, maybe I'll run into some old opera singers there one day... they are people who get old, too, after all.

Really, if you are in a charitable mood and looking for low-investment ways of doing good (aside from donating blood), please consider visiting nursing home/ hospice residents. So little effort is required and so big a difference you can make in those lonely souls' day. You may see nursing staff do it, but really, don't baby-talk with these old folks. They aren't mentally degenerated into babyhood just because they're old (the ones with spina-bifida can usually understand you fine, and the demented ones don't understand baby-talk any more than they do normal talk). Don't ignore them while talking about them with others in their presence as if they can't understand you either. Chances are that they do and it is quite demeaning. If you bring any sweets, better make sure they are safe for diabetics to eat, though... And check the chairs before you sit on them. Most of the time they are clean and innocent enough, but sometimes they aren't.

I'm not a religious person, but I do think goodwill has a way of getting around and returning to its giver. Maybe one day you will find yourself as a nursing home resident, too. Then hopefully someone will come and visit when those you expected to don't.