Tag Archives: assisted living facility

The Legend

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Alice

She was one of the more”challenging” residents. I met her eight years ago, when I first entered the weird wild world of Long Term Care as a housekeeper. Whatever preconceived notions I may have held about nursing homes and assisted living facilities were quickly smashed as I moved from room to room, mop in hand.
I had heard rumors about the lady in room 207. She was the only resident who was allowed a pet, a mean little dog that would snap at strangers and bark CONSTANTLY. I was surprised that this was allowed. The caregivers explained that she had worn the administrator down by sheer force of will. She refused to give up her dog and management refused to give up the money that came from her living there. They turned a blind eye until the dog snipped another resident and then, with very little warning, they kicked her and her little dog out.
Fast forward three years: one whistle blowing experience, two owners and three administrators later, I was back in that same facility, this time as a caregiver with much more knowledge and experience in how the system works…there she was! Back again, with all her feistiness but without her dog.
“I remember you!”, she snapped, almost spitting the words at me.
“I remember you too”. I looked through the ADL notes: Refused shower. Refused shower. Refused shower. Two weeks straight of shower refusals.
I had just started working that particular hall…it was the assignment that no one wanted. At first, I was intimidated.  Having worked mainly on the memory care unit, the idea of working with the combination of physical and mental illnesses in this group was daunting. Still, I liked a challenge and seeing a familiar face made it more comfortable. I walked into her room, sat on the edge of her bed and asked her the first question that popped in my head,
“So why do you hate showers?” She looked up in surprise as if the question had never occurred to her. She thought about that for a moment.
“I don’t”, she mumbled. Ok. We’re getting somewhere.
“I just don’t like being told what to do.”…ahhhh. That I understood. So I explained about shower schedules. She could not care less. I cajoled and pleaded and attempted to redirect to no avail. Finally, I settled for bribery. I would buy her a Dr. Pepper. With that, she cheerfully followed me to the bathroom.
She was a force of nature; a fighter who had little use for most people. Over the years, the bond we formed early on over a Dr. Pepper deepened. I knew it was she who pulled the fire alarm during a rain shower, forcing us to evacuate the entire facility when she felt she didn’t get her coffee in a timely manner. I hid my amusement as I firmly explained that this was completely unacceptable, though I never reported her for it. I didn’t have the heart. The time she snuck an entire cup of soap and dumped it in the whirlpool causing a flood of bubbles that spread from the bathroom to the hallway, the times she would “borrow” sodas from her roommate causing veritable riots…she was legendary.
When I left the facility for a job in private care, saying goodbye to her was one of the most painful moments. I told her I loved her, promised to visit and told her to not terrify the new girls. Trust was so hard for her and I knew that she felt abandoned. She told me as much. I made certain to visit as often as I could, but life gets busy. Between my new job, writing, recovery and volunteering, my visits slowed down. There are only so many hours in a day and I kept telling myself I’d visit after New Orleans, after I settle back into work, tomorrow, next week…
I got the call from a friend last week. It was unexpected. She had been sliding downhill slowly but she went into the hospital and died suddenly.
Loss is a part of our job. It isn’t easy but without an acceptance of that fact, it would be impossible for me to continue in this field. My way of coping is to remember each and every one of my folks and the impact that they made on my life. I get attached and that is what works for me. Others set strong boundaries and they are equally effective in this field. There is no one way to cope with the more difficult aspects of our work. I have found it to be an intensely personal and subjective matter. There is no wrong way to find peace in grief. Still, this one hit me hard. I thought we would have more time.
I went to visit the facility shortly afterwards. I had made the decision that any time wasted feeling guilty would be much better spent visiting my former residents. I walked in and greeted everyone and it was like coming home. Residents and staff embraced me and as I walked the halls, I listened. Everyone had a story to share about my friend in room 207. They spoke of her spirit and her fight. Funny, touching stories that spoke to her courage and refusal to simply roll over and play dead. I was filled with a sudden peace and deep gratitude. She may be gone, but it was clear that in this facility her legend will never die.

The Long Goodbye

      photo   ALICE
       I’m calling in sick. I can’t have “the talk” anymore. I just can’t. It’s ripping my heart out. After all, what are they going to do? Fire me?…These were my thoughts as I was lacing up my sneakers and getting ready for work. Even as they floated through my head, I knew the words were a hollow threat. I would not call off. I would not ruin nearly eight years of perfect attendance at work while finishing out my notice. As gut wrenchingly painful as it may be, to cave in because facing this is difficult would be like throwing the game in the last inning. THEY would win. I would lose. And far more importantly, my folks would suffer.
       You can do this, Alice. It’s the right move. After all these years, three owners and five administrators, you know that this facility is never going to change. They will never invest in competent management and because of this, you will always be stuck. Now is the time. Opportunities like this don’t fall on your lap everyday. Take it and run and start moving forward with your life. This has been my mantra, played on repeat, for the week. And it’s true. I know it is. I know that I have to get out of this particular facility. I know that I’m no longer comfortable working under questionable conditions and bosses with very questionable ethics. So, I’m moving on. My resignation letter, worded carefully to not offend so that I may visit my folks without interference from the office, is in.
       I’ve explained the situation to my residents. And explained. And explained. I’m not leaving YOU. I’m just leaving the JOB. I’ll be here to visit at least once a week. It will be different but it will be good! I’ll have time to sit and visit instead of running here and there. You will be fine…over and over again. They are scared and feel like I’m abandoning them. I know this because they tell me and that just shatters me. The average length of employment for a caregiver in this facility is six-eight months and that is being generous. The turnover is ridiculous because the wages are insultingly low and the work conditions are terrible. Because I have been there so long, this is traumatic for them and for me.
       I am letting them down. There is no getting around that. I’m making a choice that is both right and necessary but to deny that it will impact those around me would be dishonest. It is a truth that I can accept and live with, but for the moment it is incredibly difficult and painful. I really can’t discuss it without crying. This decision has turned me into a blubbering mess. I love what I do. I love many of my co-workers and I have been deeply committed to my residents. I resent having to make this choice. I am furious at the administration for not investing and paying a living wage for quality caregivers. I resent the dishonest, inept, incompetent and unethical woman in charge of coordinating care. She has not eased my residents’ stress or discussed with them the upcoming transition. She has not comforted them. She is quite honestly only concerned with how events affect her. Such apathy in this field never fails to boggle my mind.
       A few more days. That’s all I have left there. I will continue to reassure my folks that they will always be a part of my life. After so many years, they are more friends than residents and it will be nice to explore that dynamic. I know that nothing I can say will prove that to them. I will have to show them with action. And I will. Until they see me visit them, I have to accept that emotionally, they are not in a trusting place. Often, the best decisions are the most difficult to make. I know that underneath all of these deeply felt emotions that I am walking through, there is excitement at what’s to come. New opportunities will open up from this very difficult decision. For now, I have to trust the process. After all, life is change and transitions.

Role Reversal

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Alice

“Stop it.” she said, as I adjusted her enormous purple pillow beside her in her wheelchair, making sure she could maneuver her unaffected hand enough to play Word Whomp on her tablet.

“Stop what?” I asked without looking up.

“WORRYING. You’re going to give yourself an ulcer.”  I have cared for this particular resident for more than three years now. I was the first caregiver she met when she arrived at our facility and we became fast friends. Funny, incredibly intelligent, stubborn, and sometimes impatient, she is one of the most remarkable people I have ever had the pleasure to know…she could also read me like a book.

“I’m not worrying,” I said with more certainty than I felt.

“You are so. You always get a wrinkle between your eyebrows and chew on your bottom lip. Spill it,” she said without looking up from her game. Sigh. No time. I had seven more showers to finish, call bells were going off and it was almost time for breakfast. Besides, it wasn’t her job to cheer me up. It was my job to care for her.

“I’ve got to go. I’ll be back to check on you in a little while,” I said as I headed out the door.       “Fine. But you’ll be spending your lunch break with me. You either come back in here or I will find you and ‘accidentally’ run over your foot with my wheelchair.”…she’d done that once before in a fit of anger. I’d always suspected that it wasn’t exactly by mistake, little devil that she could be sometimes.

The morning melted into the early afternoon, blurring by as showers melded into beds that needed to be changed. Between snack time, intervening a feud between residents, and redirecting another one of my folks with a propensity for thievery, I didn’t catch a breath until nearly one o’clock. I decided to take my lunch while the sea was calm.

As I headed down the hall after I clocked out, I felt a nudge on the heel of my left sneaker. I turned around in surprise to see my friend in her power wheelchair. She really is hell on wheels in that thing. I’m lucky I only got nudged.

“Let’s go,” she demanded. There was no room for argument. This was my own fault. About a year ago, I made the mistake of telling her that I consider her and the other residents my boss. In my book, everyone else, including administration, was secondary. It went straight to her head.

“Fine. It’s peaceful in your room and I can still hear the hallway if there’s an emergency.” I perched on the end of her bed as she raised her chair up, elevated her feet and looked at me with a raised eyebrow.

“It’s NOTHING! Honestly. It’s no big deal.” She said nothing. Damn it. She KNEW I was uncomfortable with long awkward silences. Before I knew it, almost as if my mouth had a mind of its own, I found myself pouring my heart out to her; openly discussing my fear that my poor choices in my past would always define me, my frustration that I would never be able to move beyond my current level of effectiveness. I expressed my deep longing to do more to make life better for them and my sincere gratitude that life brought me to this place. My feelings of loneliness and the feeling that I’m always just a little off. A little weird. To my horror, I felt tears on my face. This was no good! I was breaking my own professional boundaries! This was a BIG no-no in the books!

After a moment, she cocked her head in my direction and said, “Well…you ARE a little weird. You are one of the few people I’ve ever met who didn’t see my wheelchair first. From the first day we met, you never assumed I was mentally slow because of how I talk. THAT’S WEIRD! That’s gloriously, wonderfully weird. So yes. You are a weirdo. It’s one of my favorite things about you. Look. I’m a college graduate. I’m an artist. I used to paint before my hand got too bad. Even sold a painting or two. I’ve been to Hawaii before. I am sure as hell bigger than Cerebral Palsy. And YOU are bigger than your mistakes. Hell, we all have a story.”

I took a deep breath and realized, right or wrong, I felt much better after our conversation.

Before I left to clock back in, I gave her a hug and apologized for unloading on her. She looked at me thoughtfully. “No apology necessary. Maybe a thank you for offering such profound wisdom free of charge…Besides, it’s nice to be reminded that I can still be useful,” she said wistfully.

I thought about that for a moment; how I would feel in her shoes. Smart as a whip and capable of much more than most people realized, but minimized to someone who constantly needs care despite the fact that she has so much to offer others. I would go crazy. It’s such a vital part of life to feel useful and of service. I realized then that while setting boundaries is a necessary part of our job, it is just as important to know when to lower our guard and let our residents in. Take away the roles and the walls and we are all just people. She reminded me that life isn’t about the hand we are dealt. It’s about how we play the cards. I gave her a hug before I left her room.

“Thank you for talking me out of my meltdown… And stop running over people with your wheelchair. There are better, albeit less effective, ways to get your points across.”

I sometimes wonder who is taking care of whom.

A Different Point of View

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Alice

Loud voices dragged me kicking and screaming from my sleep; the first solid night’s rest that I’d had in a month. A peaceful sleep is the one thing I’ve got left and they’re hell bent on robbing me of even that.

     My muscles groaned as I rolled over to look at my clock. 7:00 AM. The day people were coming in. I wondered briefly who was on shift before deciding that it didn’t really matter.

“Same shit. Different day. That’s the story of my life these past three years, since I lost my wife. Since I lost my everything.” I thought as I closed my eyes, hoping for twenty more minutes of peace. No such luck.

     “HEYYYYYYY BUDDY!!!! Good morning! Today is going to be AWESOME. You and I are going to hit the ground RUNNING. The world won’t know what HIT it! It’s time to rock and roll!”…Great. It’s the weird one. She must have had a triple espresso today. I squeezed my eyes shut as she opened the blinds, knowing damn well it wasn’t going to fool her.

     “I know you’re awake, pal.” Sigh.

     “It is too damn early for you,” I grumbled. She raised her eyebrow, made sure the door was closed and took out her phone.

       “Maybe. But it’s NEVER too early for Hendrix,” she declared as the first strains of All Along the Watchtower filtered through my ears. Well, I couldn’t argue with her taste in music. I watched as she jumped up on the empty bed (They haven’t paired me with a nut job roommate yet, thank God for small favors) and began to dramatically sing along. Badly. You gotta admire her creativity.

      “Get DOWN, you fool, before you get yourself fired. FINE. Give me twenty minutes to get my bearings and I’ll be up there for breakfast.”

       “Deal!” She leaped down and out the door she went. I try to keep in mind that none of this is her fault. She’s one of the good ones. In another life, she could have been my daughter or my friend, but in this reality, she’s another person telling me what to do, even if she does think it’s for my own good.

       I headed into my cramped bathroom, pulled on my robe and splashed water on my face, hoping to clear away the residual fog from last night’s medication cocktail. I remember when drugs used to be fun. If only they knew the life I used to live. Before I got married. Had kids. Got sick. Lost my wife. Lost my kids. Lost my health. Lost…well, just lost.

         “When did you become an old man?” I asked my reflection. If I squinted my eyes and looked through the wrinkles, I could see remnants of the man I once was. A ghost from the past, hardly relevant in today’s world, where speed is what counts and the old and sick relics are left; carrion for the vultures.   I shook my head and tried to shake that imagery as I headed out the door of my sanctuary into the noisy, overly bright hall.

         “Get your walker!” There she was again, somehow able to see through the enormous stack of towels she was carrying as she ran down the hall.

         “No running in the hall!” I retorted.

         “Fair enough!” She stopped abruptly, tripping over her shoelaces and the stack of towels flew in every direction. I heard her curse under her breath and couldn’t stop myself from laughing. She’s a pain in the ass, but she does make the hall more entertaining.

        “Maybe YOU should get a walker,” I told her. She looked at me ruefully.

        “First point goes to you. Well played, sir,” she said as she picked up the towels. It’s a little game we have. Who can be the biggest smart ass. I usually win. With age comes wisdom.

         “Ah come on, kid. Escort an old man to breakfast. Maybe a cup of that decaf crap you call coffee would do me some good.”

         Breakfast. Rubbery, slightly cold eggs. Grits. Bacon, always underdone. Chaos and noise, everyone demanding everything. Nothing peaceful about it. After breakfast, more meds, then a shower. The same. Every day is the same Goddamn day. I just wanted to escape to my room. I want to lay down and not be bothered.

        We are the invisible people. Congestive heart failure in room 102. Diabetic in 104. COPD, TED hose, two person transfer. We are known by our needs and diagnosis rather than our names and stories. Hello. My name is stage 3 lung cancer. My name is do not resuscitate. My name is dying.

       I laid down and pulled the cheap, rough comforter up to my chin. You would think they would know that we old people are cold natured and offer thicker blankets. I debated pulling the call bell, but I wanted to be alone more than I wanted an extra blanket.   I was in pain. Always in pain. I’d gotten used to it, like an old familiar friend that you never wanted in the first place but after a while, you can’t imagine life without.

       I was awoken from my uneasy rest by a soft, persistent tapping on my door. Jesus, what do they want now?

         “WHAT?!” I shouted. She walked in; the weird one, the annoyingly optimistic one.

         “The new activity lady wants to know if you want to play bingo.”

         “Do I strike you as a bingo player?” I snapped.

          “No. But she insisted that I come and ask anyway. Besides, the winner gets a prize.”

          “Trip to Vegas?”

           “No, a lovely gardening hat with plastic flowers for the ladies and a t-shirt that reads gone fishin’ for the guys,” she paused, “…I didn’t say they were GOOD prizes.”     Something must have cracked in me then. I started laughing. The ABSURDITY of it all; not just the prizes but the very idea that THIS was how I was going to spend the end of my days…in a loony bin being told when to eat and playing bingo for the most ridiculous prizes possible, being visited by my kids maybe one more time before I shuffle off to whatever comes next because it was “too hard” for them to see me like this…it was…it was OBSCENE. Suddenly, to my horror, my laughter turned to tears. I was WEEPING for Godsake. Tears and snot flowed freely down my face as I took deep sobbing breaths and tried to regain control.

     The weird girl handed me a tissue and sat quietly on the empty bed next to me. She let me cry. At no point did she try to calm me or convince me that everything would be fine. She did not minimize my pain. She just sat there and waited. In that moment, I hated and loved her. I hated that she was witnessing my fear and weakness. I hated her for seeing my pain, but I loved her for those very same reasons too; for seeing me in a moment of raw, uncontrollable honesty.

           “I just miss everything so much. I miss my wife. I miss my kids. I miss…myself. I go over it in my head, what could I have done differently. What could I have done better? I don’t want to die alone.” By then I was whispering, afraid that someone else would hear; afraid she would judge me…afraid. After a long moment of silence, she came over tentatively reached for my hand and said,

       “I am so sorry that you’re hurting. I can’t imagine the strength it must take for you to face the day and I’m sorry that your kids are missing the opportunity to see how brave their dad really is. It’s a decision they will come to regret, I imagine. I can’t do much to erase your pain, but I will make you a promise: You will never be alone. I will walk with you step by step; the good days and the bad. You aren’t alone. You’re my friend, whether you like it or not.” She squeezed my hand gently and headed toward the door. There were call bells ringing and she had to go, but I knew she would be back. For the first time, I realized that I took a lot of comfort from that.

         “Hey, kid…thanks”. She smiled back at me.

       “Anytime. Besides, I can’t let you win the smart ass award. I’ve got some catching up to do!” she said as she left the room, quietly closing the door behind her.

     “In your dreams, kid,” I thought, smiling to myself as I slowly drifted back to sleep.

Let’s Call a Spade a Spade

 

Alice

Alice

 

 

Alice

Assisted living facilities. For some, this brings to mind elderly folks who need minimal assistance. Maybe lonely people who are retired or widowed and could use a hand with light housekeeping chores and superficial supervision. To be fair, there is a be very small segment of my facility’s population that fits into that description, which in and of itself is part of the problem.

         The REALITY of it is we have residents with a very wide range of illnesses, levels of care and ages. On my hall, we have twenty-five residents. We have Hoyer lifts, people who are living with both colostomy bags and catheters, residents who need total care, residents who are on hospice and several feeders. We have residents living with severe mental illness, addictions and other ailments that prevent them from living on their own but also make them ineligible for any type of skilled facility. Due to the lack of resources and options for long-term mental healthcare in my state, they are stuck in a sort of limbo. While assisted living facilities are a less than ideal option, it is certainly better than living on the streets. We also have an Alzheimer’s unit.

       All of these folks with this wide variety of physical and mental illnesses are intermingled with varying degrees of success and without an onsite nurse. We have nursing agencies that come in as needed or scheduled. Many of my residents end up in assisted living rather than skilled because, quite frankly, they can afford it more easily and DHHS allows it.

     My assisted living facility is not the exception to the rule. The reality of it is that as the baby boomer generation ages, and the population bulge moves through the Long Term Care system, the difference between a skilled facility and assisted living steadily shrinks. The supply is simply not meeting the demand.

      So facilities like mine have less staff to resident ratios, less pay, but in all reality an equal amount of work. While we may have fewer people with total care needs, we have more with mental health issues. Our training, from the top down, does not meet with the reality.

     These are the facts. One cannot solve a problem by ignoring facts in order to preserve a mental image. It’s the mental image that has to be adjusted so that they encompass the reality.  Those who should know better exacerbate the problem by perpetuating the facade, rather than acknowledging the situation for what it is and taking steps to fix it. New regulations and better education is needed. The first step to solving a problem is recognizing that it exists.

The Unspoken Rant

Alice

Alice

“I thought this would be a productive conversation. I really did.”, I said to myself as I sat across the desk from the fifth administrator that I’ve worked for in seven years. Rookie mistake. I should have known better.
I asked to speak to her because  there is a distinct lack of communication between the office and the floor. What little interaction we have comes in the form of snappy demands, as if we are incapable of comprehending sentences containing words with more than two syllables. It is seriously affecting morale and when morale goes down, so does quality of care.
I wanted to tell her that when a person in authority such as a resident care coordinator speaks negatively of staff members in front of their peers, it breeds dissent. I had hoped to explain that there has never been “light duty” in our facility because there IS no light duty. We don’t have enough staff to allow for such luxuries. The rule has always been that you can come back when a doctor signs off on it. Otherwise, you have one caregiver doing the work of two, while the other is getting paid to sit down and watch. It’s different than in the bigger facilities, where perhaps they have areas that don’t involve lifting, running and transfers. I wanted to point out that this naturally causes resentment for those of us who end up carrying the load when it happens every other week.
I had hoped to discuss the incredible frustration I feel when the powers that be freak out over someone forgetting to put away a package of briefs but don’t blink an eye when every single month, a resident runs out of his colostomy supplies, leaving the staff on the floor scrambling for solutions with no help from the office, or only having small or extra large gloves, or not being informed that we would need to work over until after our shift ends.
I wanted to tell her that the woman who does our inservices is passionate and full of fantastic information and ideas that we aren’t being given the opportunity to utilize.  I had hoped to explain that the uneven application of consequences suck the motivation out of caregivers who feel like the end results are the same regardless of whether or not they give their best.
I thought she should know that it was a bad idea to put a resident who has maintained sobriety after a number of years of being drunk and violent in the same room as an active alcoholic who sneaks in bottles of Canadian Mist any chance he gets, or a resident living with severe mental illness in a room with a resident who doesn’t speak a word of English.
I though she should know that it’s both dismissive and unfair to paint all the caregivers in the facility with one brush; as if we aren’t individuals, each with our own work ethic and points of view.
We choose to stay there, whatever our reasons, knowing that there will be no raises, no bonuses, very little leadership, hell, the shower room doesn’t even have a dip in the floor. The water just pools around so we have to work in wet sneakers. Still, we STAY. Despite the fact that it’s the lowest paying facility in this town, our folks deserve the best possible care and we deserve open and two-sided communication that would benefit everyone; to be talked WITH rather than talked AT.
I WANTED to tell her all of that, but after about two minutes of discussing the need for better communication, I realized I would be wasting my breath.
“I would LOVE to just have to give someone a shower. You have NO idea what it’s like for us in the office!”, she snapped. I sighed, as I left the office, strangling on all that was left unsaid. She’s right. I don’t know what it’s like in the office, but if she thinks that showering people is the basis of what we do, she has no idea what it is to be caregiver and very little interest in learning anything that would make life run more smoothly for all involved. I will never understand why people in authority continually fail to grasp the simple notion that an ounce of prevention is worth a pound of cure.

The Exchange

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Alice

“Ugh!” I groaned as I lowered myself to the floor of Resident who is in no way mentally incapacitated’s room.

      “What’s up?” she asked without raising her eyes from her new tablet. Since discovering a game called “Sweet Tooth”, I’m lucky to get even a mumbled greeting from her. On one hand, I think the game is good for maintaining control of her hand muscle. On the other, she is in full blown addiction mode, calling out every fifteen minutes to get the game back on.

      “I’m stuck on a topic for this week’s post.”

    “With all the crap you have floating around in your head, that’s surprising,” she replied without missing a beat OR looking up from her game. Resident who is in no way mentally incapacitated also has excellent comedic timing.

      I smiled, raised an eyebrow and told her that I could always take my break elsewhere if I was interrupting her mission for world dominance via a video game.

      After uttering what had to be the world’s most dramatic sigh, she put the game on her bed and drove over to me.

       “Ok, ok! Why don’t you go around and ask everyone what they think happens after we die?” she offered after some thought.

      “Interesting, but I don’t like you guys thinking about death. Too morbid. And I’m not about to start a holy war.”

        “You could write about how every man Ms.___ marries ends up dead,” she said nonchalantly.

      “Ok, first, never ever say that to her. It’s very hurtful. Second, isn’t she your best friend?!” I exclaimed.

     “Yeah, but the truth is the truth.”…Resident who is in no way mentally incapacitated lacks a filter. The truth is the truth is a way of life for her.

       After dismissing several more outlandish and completely inappropriate ideas, including a post about her that she suggested I title “The Seventy Year Old Virgin,” I knew what I was going to write about.

         I told her that I was going to write about this exchange; this simple talk during a short break in the day. It was a moment to temporarily set roles aside. It wasn’t a caregiver having a conversation with a resident. It was two friends exchanging ideas. Two equals, on the same playing field. Such rare opportunities are a rich oasis.

        “Good plan. I like it when you write about me. I’m very interesting people,” she said as she adjusted her chair to rest her feet on the bed.

        “I agree.” I got to my feet, restarted her game and was headed back out to the hall when she called out my name.

     “Hey! I would stay away from using ‘rich oasis’ as a description. It’s a little heavy handed.”…sigh. Everyone’s a critic.

The Hole in My Sock

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Alice

    “Breathe, Alice. Just breathe,” I told myself. I could hear my name being shouted. It was Mr.__, waiting not so patiently to be laid down. I knew I had to get back out there, but I had told him ten minutes and I still had five of them left.

         I was in the linen closet. Hiding. Breathing in the subtle scent of cheap detergent and being embraced by the cool comforting darkness.

        It’s safe in the linen closet. The solutions are simple in there. Shadows and worn out towels cannot be disappointed in you. You cannot let a bedspread down. A fitted sheet is in the flat sheet spot? Easy fix. No fear of missing something, no getting sucked into the toxic drama of the wash cloths. Pillow cases don’t die.

        So how did such a ray of freaking sunshine end up cowering under a blanket of her own neurotic fears in a linen closet? Well, it all started with a hole in my sock.

       The first thing I noticed as I was punching the clock was that Mr.___ was already up, dressed and in his wheelchair, a rare and pleasant surprise. As I walked down the hall and greeted my folks, I saw that three of my residents already had their TED hose on. I smiled to myself and made a mental note to say thank you to third shift. It had all the makings for a remarkably smooth day and I gathered my supplies, blissfully unaware of the impending shit storm of inner crazy that was headed my way.

      Because third shift was on top of their game, I was able to knock out two showers before breakfast. It was in the middle of the second shower that I noticed it; the beginning of a hole in the big toe of my left sock. I could barely feel it. A minor inconvenience in an otherwise good start to the shift. I shrugged it off, finished the shower and gathered my folks down to the dining room.

        It was about twenty minutes into breakfast when I noticed it again; my big toe slowly, but with great determination trying to escape the confines of my sock. My sock, which was wet at this point from the showers. They invested all this money on renovations and couldn’t be bothered to find a crew who knew enough to leave a dip in the floor so that gravity pulls the water to the drain. When I mentioned it, they tossed us a squeegee, which did nothing solve the wet sneakers problem. And running around for eight hours in wet sneakers is exactly as gross as it sounds…

  “What is WRONG with you, Alice?! For Godsake, you walk everywhere anyway. You’ve been handling the wet sneaker situation for years. Peppermint oil, hot water soak and lotion. Why are you stressing about it now?” I thought to myself as we finished clearing out the dining room.

      After doing a round and checking the hall, I sat down and adjusted my sock so that I couldn’t feel the hole, willed myself not to wiggle my toes and got back to work. Mrs. __ was a little worried about her friend in the hospital. Mrs.__ is dead set against the idea of using her walker. Mr.__ needs clean sheets. It’s clear they weren’t changed. Honest to God. How hard is it to change a bed?!…all the while, I felt the hole growing; my toe rubbing rebelliously against the top of my still damp sneakers, mocking the other toes for obediently staying in their cotton cage.

       As I went along with my day, I noticed that my thoughts darkened. I didn’t have easy access to my supplies. Every time I get used to one supervisor, they are replaced with another. No benefits. No money. No boyfriend. No 401 K. I found myself worrying about things that ordinarily do not weigh much on my mind. The world’s smallest violin grew louder in my head as the damned hole grew bigger in my sock.

           By the time I found myself in the safe cocoon of the linen closet, I had worked myself into such an inner storm of nerves that my smile wasn’t fooling anyone. I didn’t understand why my emotions spiraled when the day started out with such promise; why I was choking on some weird, undefined panic. Why was I suddenly living in fear of tomorrow, convinced that the world around me would implode because of my endless list of shortcomings? It made NO SENSE!  All over a hole in my sock? It was like drowning in a tea cup.

        So I took a break. I sought refuge and in the safe confines of the linen closet, I quickly began to sort through my shit.  As maddening as they can be, a hole in a sock has never driven someone to the brink of insanity. Clearly, I had some underlying issues going on.  I had five minutes left to get a grip and put it back in perspective.

        I tend to focus on my actions rather than my emotions.  What I do matters more than what I feel. After all, feelings always pass and come what may, the show must go on. I have an incredible amount of gratitude and passion for the life recovery has given me and any sort of self-pity seems like spitting in the face of a second chance that many people don’t get. I do not take this for granted, but there is a thin line between working THROUGH your feelings and STUFFING them down. It took a hole in my sock to realize that I had been doing the latter for quite some time.

      I wrote last week about this job being about perspective more than money. That is true, but it doesn’t mean that I am not affected by financial insecurity. As caregivers, most of us are a paycheck away from homelessness. It’s my normal. The money always seems to work out, but it is a stressful scary reality. I like to minimize that fear, to focus on the positives, but that doesn’t mean it isn’t there.

       I like to write about the beautiful raw, heartbreaking, humorous moments that I share with my folks on the floor and how they bring such depth of meaning to my life. Every bit of that is true. But it is also true that every shift, I face my own mortality. We deal with so much loss.  I love my residents as individuals; as friends and I have days when I’m keenly aware that my very best effort is nowhere near enough to make their quality of life as good as they deserve. Some days, I feel like a failure because of that. Just because I don’t allow myself to sit in that feeling doesn’t mean it doesn’t exist.

       The ability to adapt and persevere, the lessons learned from overcoming challenges, finding meaning in the mundane; all favorite themes of mine. That doesn’t mean that the challenges themselves don’t leave scars.

      Focusing on the positive is a good thing. Focusing on the positive to the point of denying the negative, however, can be dangerous. It’s a tricky balancing act. I forget sometimes to leave room to grieve, to give myself permission to be human, to feel anger or fear, to not be “okay”.

      It’s a subtle, unconscious drive to be superwoman. A need to be the solution because I feel like I was the problem for so very long. Though my intentions are good, the end result is me hiding in a linen closet because my world imploded over a hole in my sock.

       Thankfully, life has a learning curve. Sometimes a mini meltdown in a linen closet just what the doctor (or shrink) ordered to force some much needed reflection. I took one last deep breath and left the safe confines of my “crazy” cave.

       “HEY! What the hell is going ON with you today?” Mr.__ demanded, as I stepped out to the bright fluorescence of the hall.

       “…I have a hole in my sock. It’s been nagging me all day.” I mumbled.

     “You should have said something earlier. You could have borrowed a pair of mine”…Sometimes the toughest challenges we face are those we don’t show and sometimes the simplest solutions are the ones we don’t see.

Fran is Lonely

buddha

 

 

Edison Terrell

I went to sit with Fran for a while, because she’s been unhappy lately. I don’t use words like “declining” around her, but anyone can see she’s going downhill. She knows something is wrong, but can’t put her finger on it. She’s gotten more confused the past few months, a lot weaker, and she didn’t had much self-confidence when I started here; this new development has her putting the brakes on trying at anything, even putting on a shirt. She’ll just fumble with it, groping both arms through the head hole or let it sit on top of her and look pitiful, not making any attempt until you put your foot down.

Fran’s little apartment is divided into a cozy living room/kitchen, a slightly bigger bedroom and a tiny bathroom that barely fits us and her walker. No stove, but there’s a counter and cupboards and drawers with silverware and cups, and a little fridge like you’d see in a dorm room. Coming in through the front door—always unlocked and ajar, because she fears she’ll lose her key—the kitchen is to the right, next to Fran’s electric recliner, a nightstand with a lamp and across from there are two tiny rocking chairs that somehow support my weight, though the arms pinch my girth. A subtle reminder I need to get back on a diet. Or “change my lifestyle” as chronic fat people like me tend to put it. I knocked on the door as I came in, she said she was happy to see me, which I took to mean I could have a seat. I took the chair looking directly at her.

“How you doing, Fran?” I said loudly. She isn’t hard of hearing, but speaking loudly and slowly helps her understand what you’re saying. She talks lower and slower than she used to. Takes time to ruminate on her words. I try hard not to check my watch when I’m around her. She doesn’t get a lot of talking done because we’re all rushed, almost all the time.

“I’m lonely, but I don’t know why,” Fran said finally. “People come in and out, but it’s not the same.”

“Nobody talks to you?”

“Yeah, people talk, but it’s all the same thing. They all their own way of doing things. And they creep up on me with things to do. PT. What you do—not you, but you know. The others. They want me to go watch old movies.” Fran has a perpetually sour look on her face like she was sucking on lemons before you walked in. Her skin is dry all over, no matter how much moisturizer I put on it. The flaking whiteness all over her scalp, her cheeks, and on her chin only adds to the gruesome texture of her face with her mouthed pulled back dryly in a near permanent grimace that forcibly reminds me of a skull.

“You don’t like the old movies?” I ask loudly.

“I saw them all years ago and don’t want to look at them again. That’s us. Old people. Old movies. Old things. Remembering. The sum of our parts; old, old, old; us in a nutshell.”

“Oh,” I said lamely. “I’m sorry to hear that.”

Before I could offer up an alternative, Fran verbally reached into my guts and squeezed them, twisted them. “I’m not used to being dirty,” she moaned. “I’m used to being clean all the time, but they’re not cleaning me as much as I’d like. You’re one of the only ones who does.”

I didn’t know what to say. I started to speak, to tell her she needs to tell someone about this, but she rambled on. I’ve learned sometimes it’s best to just let people talk; they don’t necessarily want advice or solutions as much as someone to grieve to.

“I don’t know what to think or where to go or how to solve anything. I used to know. This is my walker,” she said, rattling its aluminum frame. “My pouch is on it, and those are my pads. But it doesn’t feel right. It doesn’t look like my walker. I wouldn’t know it was if you didn’t give it to me. And you have to take me all the way to the bathroom if I have to go. Nothing is normal anymore. And I don’t know how to get it back to normal.

“My bottom is sore. I shouldn’t say that in front of gentlemen.”

“I know I’m gonna fall. I don’t want to fall again. It’s really bad. It’s bad when that happens. No hospitals. That’s the worst. You don’t get to live in your apartment if you go there too much. All my friends are in Independent Living and I need help with everything. That’s not normal. None of this is normal.”

If I could find words, I don’t know what they’d be. All I could think to do was validate that it’s “normal” at this stage of her life, and some people are at different levels, or some crap I was taught in orientation or class. But I’m twenty-nine. What do I know about any of that? Anything I said would come off as hollow and unhelpful as telling a dying man to cheer up, it gets better. I let the silence stretch on painfully.

Fran croaked that she was thirsty. “There’s a can of ginger ale in the fridge. Take half and we can share it,” she said.

Her fridge was barren but for a few bottles of V8. “There’s only V8 in here, Fran. I’ll have to go and get you one from the kitchen.”

“Please make sure you come back,” she whined. She had turned around in her chair to look at me, fingering the big button on her pendant, not quite pressing it. “I don’t want to be lonely.”

“I’ll be back soon,” I said, stepping out. I had a feeling it was a bad thing to say, and was rewarded for it moments later when someone else hit their pendant. Duty called, and “soon” was almost twenty minutes. I got her ginger ale in the end even though she only vaguely remembered asking for it, and she gulped it down, burping, which she remarked was very unladylike with a little laugh.

Update: Fran moved out of her apartment in assisted living to skilled about two weeks later, skipping right past personal care. Did not pass Go, did not collect her $200. This place would have taken it anyway. She died less than a week after that. I hope she was surrounded by family when it happened. I hope she wasn’t alone. No one told me or I would have been there. She was a huge pain in the final months I knew her, a physical and emotional tax more than a person, but the last few days in her company humanized her again. I’m thankful for that.

I’m sure someone would remark at how wrong it was for losing sight of her humanity. I can only shrug at it, look away. I feel exactly what you’re feeling for me, but it was never a conscious choice… No, I can’t honestly say that. I saw it coming like I’ve seen it so many times before, the moment where acquaintanceship either becomes friendship or sours slowly while you watch in a mix of anxiety and anger. Anxiety because it means a dark spot on your day, anger that swallows you up, pulls you down. Anger at the resident for being such a fuss, so much a dependent pain in the most tender part of the gluteus. The tailbone area for me, that’s the most tender area. She was a pain in my tailbone.

It’s a blind corner that you take with faith or your eyes closed tight. Every time I meet a resident like her I shut my eyes and hope for the best. Sometimes I take a hit. Sometimes I meet residents who are demanding, heavy, angry or mean. And I’d fight against it. I can’t say I did my best because I know I could’ve done a lot better. I could have smiled, forgiven them, rather than taking their meanness into me and holding onto it, hurting myself with it. I guess the more often it happened, the less I fought it, until Fran the human being with wants and needs and a personality was shrunk down to Fran the confused, shrieking harpy who depended on me for everything. Fran, My Future Back Problem. It’s hard to shake off bitterness like that after it has seeped into your skin. I still had some love for her, though, for whatever insane reason I couldn’t put my finger. Maybe because she reminded me so much of myself. A hypochondriac, dependent, whiny, pitifully scared person facing what she’d feared she would face her whole life. Trying to save her from the fear that came on at night when she was all alone—the same kind that creeps up on me when all my distractions are gone—was like saving myself. Working with her put that fear, and all the dependence, the whininess that came with it front and center. It made me take a long hard look at myself. I didn’t like what I saw.

Fran was my zen teacher, in a way, and I hated her like one, for showing me all the ways I was coming up short. I’m only realizing it now as all the confused emotion and mixed up thoughts unwind, smooth out. She was probably one of my very best teachers. 

A Powerful Reminder

photo

 

Alice

We have a new resident. She arrived, along with whispers that she caused havoc at her last facility. It’s true enough that that’s how a lot of folks come into my path, but I tend not to believe anything in this field unless I witness it first hand. Besides, it’s unfair to have to enter a new living environment branded with rumors.

“She will be moving into room 209,” we were informed about thirty minutes before she arrived. My hall partner and I met eyes, and I knew that her incredulous expression mirrored my own. Thirty minutes to explain to a woman living with severe mental illness that, after YEARS of having a room to herself, she was going to have a roommate. Thirty minutes to consolidate a massive hodgepodge into one tiny closet, two bureau drawers and one nightstand.      

I wasn’t sure whether the powers that be were so obtuse that they didn’t realize how difficult this would be for all involved or they simply didn’t care. Either way, it didn’t really matter. The situation was what it was and we had to make the most of it.  We did the best we could to make the room feel a little more in inviting and while she was not onboard with the idea of sharing her room, my resident handled it better than I expected.

The first thing I noticed, when our new resident arrived was that she looked very scared and very sad. The next thing I noticed was that she didn’t speak English. At all. She is from the Middle East. My few years of rusty, hazy Spanish in high school would be of no help at all. Awesome. And by “awesome”, I mean impossible. At least, that’s how I felt until I remembered that I don’t put much stock in the concept of impossibility.

I comforted her as best I could, smiling until my cheeks ached because I know that a smile can say what words cannot. I left that shift determined to come back the next day armed with information to better communicate with my new friend and to put her at ease.

The next morning, my boss pulled me aside to “warn” me that our new resident can be “mean”.  For a moment, I felt a such a deep anger and sadness that I literally had to bite my tongue to keep from shouting,

“SHE IS NOT MEAN, you idiot! She is living with mental illness, thrown into an entirely new environment with   complete strangers from a different culture with no ability to express her needs, feelings or fears. She’s terrified and she feels helpless. WHAT IS WRONG WITH YOU?!”…pause, Alice. She means well, she’s just not the brightest bulb. She lacks insight. Refocus.

As it turns out, kindness and patience is a universal language. Those of us on the floor managed pretty well with a combination of reassurance and charades.  Before the week ended, we had worked out a few hand signals.

Our new resident has turned out to be affectionate and cooperative. When she inevitably would become frustrated, redirection and a comforting hug did wonders to sooth her. And, as it turned out, she DOES know a few words of English. As I was completing my last round, I went in to check on her. She was sleeping and her blanket had fallen to the floor. As I picked it up and tucked it around her, she grabbed my hand and squeezed it, and said in almost a whisper, “Thank you. Love you.” My breath caught in my throat as tears sprang to my eyes.

In that moment, I forgot the lousy wages. I forgot the lack of leadership from the office and caregivers who don’t care, the aching muscles and underlying frustrations. I forgot the broken system, the sometimes broken Alice. I was able to bring this woman one moment of peace. She is able to give my life meaning. In that moment, I remembered with pitch perfect clarity why I choose to do what I do.