My Mom was getting older, and she was going through a stage where a rash of her good friends she rgrew up with or knew later in life were starting to pass away. That had to be hard, watching people you knew so well slowly disappear. It was the same deal in a nursing home. Residents often became good friends. It was a community within a community. Residents enjoyed each others company, did activities together and had meals together. Hearing that someone close to you just died, the residents mourned and the unit was unusually quiet for a few days. The staff were more subdued. Who would be next?
Part of my job was to provide support. It could grind you down after a while, the constant illness, death and dying aspect of the job. But then after a period of grief life went on. It was like the residents knew this was inevitable and they dealt with it in their own way.
Not knowing what to expect each day kept the job interesting. What would you see from a new admission: Alzheimers? Stroke? A broken hip? Some families were there all the time to visit, others rarely at all. I felt for all, yet I suppose I had a special place in my heart for the younger residents, those in their 20s or 30s, placed because of an accident or a debilitating disease such as Huntington's or Cerebral Palsy. . I could only imagine what it would be like to be only 35, and for no fault of your own, needing to spend the rest of your life in a place where the general population was mostly in their 80s and 90s. Some of those residents were even younger then I was. That was especially devastating to the parents, unable to provide care at home, forced to seek placement, watching a child slowly waste away. Wasn't it so that children bury parents and not the other way around?
But for thr grace of God that couldv'e been me.
My typical day would be arriving at 8:00 each morning, pushing the block from my house, rain or shine. It was nice to have such freedom and independence and not worry about transportation.
I usually did my charting and paperwork early, before the residents awoke and before the phones started ringing. There would normally be a morning meeting with Mrs. lfgren. and the other department heads at exactly 9:15, then depending on admissions, we would go about our daily duties such as care plan meetings, visiting residents and even more paperwork, always being on alert for emergency situations when a Social Worker was needed.
Often these immediate situations occurred when a resident became violent, threatening suicide or became harmful to staff or other residents. Sometimes a mental health issue or a symptom of Dementia was the cause. I never got in the middle of a resident who was extremely violent- thank God for the nurses and aides, and when bargaining and gentle reassurance didn't work, in order to protect themselves and others, a trip to the hospital was in the cards. But often Andrea and I did help. We knew about body language, tone of voice and how to approach someone who was very confused and agitated. It came with experience, trust and usimg common sense. We tried to teach those skills to the staff through seminars and on the spot training.
There were also less urgent yet important duties too: breaking up roommate arguments, which was an almost daily happening. was big on the agenda. Matching roommates was tough, like putting together a jigsaw puzzle, knowing which personalities would jive together. When it didn't work someone had to move, and that was never easy. Sometimes a resident wanted out and a fresh start in another room and sometimes they would stand their ground. "Why do I have to move? Let her move!"
Generally our rule of thumb was whoever started the ruckus needed to relocate. Often it would be issues such as one person wanting the heat turned up high and the other wanting it cold. Or one was blasting the TV and refused to wear head-phones. The goal was to make everyone happy, and with 144 people to please it was never easy.
We always had to remember this was always a new thing, sharing a room. Chances are many people never shared a room with anyone before, other than a spouse. Now, spending so much time in a room, it was important to share it with someone compatible and not combatable.
Not every issue was stressful or menacing. There was joy and happiness, even in a nursing home. It was always a great day when a resident recovered enough to go home, maybe with services or in-home care. I recall a couple who met at our place, fell in love, married, got their own apartment and lived very well together for the rest of their lives.They were in their 80s when they met.
There were holidays to celebrate and landmark birthdays, especially when a resident turned 100.Often the newspapers or even a Philadelphia television station would cover the big event. There was always a party and decorations, and usually a certificate from a politician was presented to the resident being honored.
Veteran's Day and Memorial Day were big, and we always made it a point to honor out vets in-house and remember those who made the ultimate sacrifice. They were joyous occasions but also tearful at times, as our veterans would remember old war buddies and aspects of the service. Some liked to talk about their experiences and world travel; others preferred not to talk about it at all, as my Dad used to never mention World War II or his place in The Battle of the Bulge.
Anything could happen from day to day. This one particular morning I arrived at work like any other day, and before I could take off my jacket the nurses on second floor called the office. They needed me to come down, right away, even before I had time to start my paperwork.
Thinking it was urgent I wheeled down the hall at a brisk speed. Upon arriving at the nurse's station the gathering of nurses and aides were smiling and laughing. I thought they had all gone off the deep end or maybe were smoking pot. They liked to tease me anyway, since I was a guy ( they rarely saw men in my field), and easy to blush .
It seemed there was a female resident down the hall, around 95 years old, who needed "help." I knew her well and wondered what the big deal was all about.
During breakfast, while the aides were feeding her at bedside, this lady kept mumbling "I need..I need..I need..."
They couldn't figure out what she needed. They offered her everything they could think of; water, a bedpan, potable phone. What did she need?
Finally, as breakfast was ending and the aides were taking her tray away the lady blurted out "I need..sex!"
95! I guess certain desires never go away, even with age. So naturally the nurses called me.
"Go take care of her," they teased.
"They never taught us that at Wets Chester!", I replied.
I wrote something vague in my notes, something like "Resident somewhat agitated this morning. Social worker offered support. Better now."
I generally got along great with the nursing staff. They knew I had their backs too. I learned over the years what special people they truly were. Working in a nursing home can be very emotional, hard work, both physically and mentally draining. It was important to offer support, a friendly, listening ear, knowing what they went through day to day, A pat on the back, acknowledging they did a good job was so important. Often supervisors, caught up in their own work, forgot to offer praise for a job well done. Too many times state surveyors would point out the negatives in a nursing home, which I suppose is their job to do in order to improve care. I found that encouragement also helped to keep moral high as well as rewarding caregivers and pointing out the positives too.
Things like pizza parties or just a special mention during a general staff meeting meant so much. It meant a lot to me. It validated that the hard work you were doing was worthwhile and it kept me motivated to try even harder.
I admired the many doctors, nurses, dietary maintenance and office workers I met during my years working in nursing homes. Unequaled dedication by far. My favorite group of all had to be the aides.
The aides were always the real backbone of our facility. They did the dirty work- cleaning and showering residents, transferring and lifting folks, doing the basic, daily, mundane duties, yet rarely receiving a thank you, paid minimal wages yet their dedication unwavering.
It was always special when the aides got close to the residents they cared for. We weren't allowed to play favorites, but just like anything in life- classmates in school, siblings in a family, co-workers on tthe job- you always liked someone more than someone else. That was life.
It wasn't just a job to many aides. Many baked cookies for their residents they cared for, a few even went out to the movies or home to dinner on rare occasions. I noticed the aides tended to pay a little more attention to those residents who didn't have family, or ( maybe even worse) family who never came to visit.
Someone cared and that's important for anyone to know that someone cares.
The aides laid their hearts on the line each day. When a favorite died it was hard to accept. It was risky, getting emotionally involved with a resident who more likely would pass away sooner than later. Some would vow "never again" when they talked to me for support, but more often than not the next resident who needed a little special TLC was taken into their heart.
Not everyone could do it. It was no sin just to do your duty and not get emotionally involved. I could understand avoiding the heartbreak. For the most part, the aides I worked with over the years were compassionate people who just couldn't help doing that little extra for someone in need.
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