Tag Archives: changing jobs in long-term care

The Legend



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 Deadly Illusion of Difference





  I had several ideas floating around my somewhat addled brain for this week’s post. I have started this piece three different times on three different topics. Then I stopped. I stopped because I am broken hearted. I am angry and disillusioned. I am heartsick. Forty-nine people dead. Someone’s son. Someone’s daughter. Someone’s friend. Shot down. Their lives gone in an instant with no acknowledgement that they are a member of the very same species as the killer himself.

      Again, the nation mourns. Again Facebook pictures change and memes calling for unity and peace and prayers in the face of this tragedy are everywhere, quickly followed up with statements of why and how such atrocities continue to occur. It’s the guns! It’s the terrorists! It’s the homophobia! And these statements become angry and fuel the fire as anonymous people spit their one-sided solutions to a complex problem that happens over and over and over again. 

     The more I ponder it, the more certain I become that the root of the problem is simply that we dehumanize anyone who is different from ourselves. It’s in the rhetoric we use. It’s in the angry and dismissive thinking that is based solely in proving that one is right rather than seeking truths. Read the comments on a news story some time. It’s scary. The anger and ad hominem attacks from every side are appalling and anonymity gives people a false sense of courage that apparently leads them to behave like a pack of rabid wolves.

       But Alice, you may be thinking, isn’t this a blog about Long Term Care? How does any of this apply? I have witnessed that same dehumanization on a smaller stage every day in this field. The slow tearing away of the heart and soul of the sick and elderly in the system until all that is left is their diagnosis. They are dismissed. We, as their caregivers, are dismissed. That is how the dangerous flaws and cracks in the very system that is designed to protect them flourish. That is why society never really thinks about that particular demographic until they see some vague story on the news about elder abuse. Only THEN do they rouse themselves from apathy and express outrage but it’s always focused at the incident and never at the system that produced it. They do not see until their hand is forced and then they only see the end result rather than the causes. 

      The more society embraces this insanity, the more of these atrocities we will face. This idea that if people think, look, live, pray, believe or appear differently than you do, then they are not only wrong, but evil, or stupid or somehow less human is going to eventually lead to the destruction of the best of us. When will we realize that it shouldn’t take a tragedy to remind us of our humanity? How many more people have to die before we learn how to truly live?

New Beginnings




This is going to be awesome. That’s the thought I kept repeating to myself as I walked up the drive way to the gigantic and imposing house of my new client. And I did believe that. At least the part of me that wasn’t filled with anxiety believed it.

       This is my second job as a home health caregiver. It comes at the heels of my first gig in home care which led to…well, it led to Long Island for God sakes. And to many many first time experiences, all of which were eye-opening and incredible, but none of which were easy.  So you can understand why my perception of home care was a little askew. I just had no idea what to expect.

         Mainly, I was incredibly grateful that this opportunity came about. I can’t be without work. I’m a CNA. We don’t have financial safety nets. We’re lucky to cover the electric bill. So, this is where I landed and I’m thankfully still on my feet.

        Still, even after all this time, I get nervous when meeting a new resident or client. It’s an awkward dance. There is no graceful way of saying “Hi! It’s nice to meet you! I will be with you in your most vulnerable moments. I hope you like me!” But that’s also my favorite part of the job; the building of a mutual trust and connecting deeply because of it. Some of my most valued moments have arisen due to the unique caregiver/client relationship. You have to learn each other.

       This is going to be awesome. I took a deep breath and knocked on the door. As my new client’s husband showed me around, I noticed a big magnet on the fridge. It read “Well behaved women rarely make history.” I smiled to myself. Oh we are going to get along just fine!

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.

Leap of Faith




You know you have to take this leap, Alice. You KNOW you do, not only for your financial responsibilities but also for your mental and emotional well-being. Sigh. I knew this. And I was excited about the opportunity that practically landed in my lap. Excited, yes. But scared and sad too. After nearly eight years of working with my folks, I am taking another job. Instead of taking care of more than twenty people, I will be caring for one. I’m so accustomed to running and routine that this is a big change for me.

         My ability to get to know and connect with my residents is where my strength lies. I look forward to actually having the time to spend one on one with someone; to get to know her on a deeper dimension than the facilities can provide due to time constraints. I’m excited to put into use much of the training that was a lost cause working in a facility that was often short-staffed. I can actually use music therapy and appropriate forms of redirection. Together, this client and I can plan our day; I can actively encourage her to engage in the development of a routine that suits her rather than trying to get her to follow one that is easiest for me.

       It is a wholly unexplored area of long term care for me and I think there is much that I can learn from the experience. It will be trial and error as we get to know one another and I adjust to the different pace. That is actually a benefit though. This will be a new adventure for us both.

       Ah, but I am not overstating it when I say that it breaks my heart to leave my folks. I know logically that they will be ok. I also know that I’m not actually LEAVING them. The facility is only four miles away and I’m already making plans for fun visits. It will just be a new dynamic to our relationship. We will meet as friends rather than caregiver/residents.

     My difficulty stems from love, but also from my reluctance to let go. My reluctance to trust such a broken and flawed system to care for them properly. It’s MY issue, not theirs. It is true that I need to take this leap. To deny that would be a disservice to myself. It is equally true that taking this position affects more than just myself. To deny that would be a disservice to my residents whom I’ve formed such close bonds with these past several years.

       Change is the one constant in life and I’ve been walking through my fair share of it lately. Though most of these changes have been very positive, it is my nature to cling tightly to the familiar. There is no room for growth in holding on to fear.  Letting go is never easy, but that doesn’t mean it’s not the right move and I look forward to exploring and sharing this new chapter with all of you. I believe this period of one on one caregiving will hone my abilities and help me become more well-rounded, both of which I will be able to use for future endeavors in the world of Long Term Care.

Jumping the Gun




Two weeks. It took every bit of two weeks to adjust to the idea that I could embrace a new opportunity that fell into my lap. An opportunity that I didn’t even know that I wanted.

A few months ago, my frustration at the low wages and dysfunction of my current work environment led me to apply for a position in a new facility. A friend of mine was employed there and she had been encouraging me for months to give it a shot. One day, she hand delivered me the application, I filled it out, dropped it off and promptly forgot about it…until they called to set up an interview.

Suddenly, what was a fleeting notion became very, very real. My first thoughts were about my folks. I’ve been caring for them for nearly 7 years! I BLEW THE WHISTLE in order to save them from terrible owners and cold showers! How can I just ABANDON them?! How can I just walk away from my co-workers; the good ones who trudge forward through the challenges? Can I actually put my own needs for a decent working wage and benefits above their needs for quality care and consistency from a caregiver they trust? It was a maelstrom of conflicting and deeply held thoughts and emotions.

Thanks to the support of friends and family, I slowly came around and warmed up to the idea. Friends said that I’ve EARNED this chance, that I’ve worked very hard and it is an opportunity to love some new people. They said I can visit my folks and it’s time to try something new, to not have to struggle quite so much financially to do what I love.

By interview day, I was equally torn between the excitement of a new opportunity and the heartbreak of leaving my current folks, but I had reached the conclusion that it will always be heartbreaking to move on for me. I am a person who invests my heart fully, but just because it is difficult doesn’t mean it’s not the right choice.

I left the interview elated. They all but showed me in writing that I had the job. I was open and honest, I made eye contact and smiled. I had the perfectly pressured hand shake. I even wore jewelry. I spoke with passion and humor about why I love being a direct care worker. I NAILED it.

The next few days went by in a blur of work and outside commitments. In between activities, I would find myself planning for a life on third shift; my mind leaping ahead, despite my best efforts to not put the cart before the horse. The facility is huge and beautiful. Two more dollars an hour means less Ramen noodles. I was even planning out a visitation schedule so my folks would know that I’m still a part of their lives and what I would put in my written two week notice to my current employers.

So you can imagine my surprise when I got a call saying that they are sorry, but they went in another direction. I was completely dumbfounded. Somehow, I managed to thank them for their time before the wave of crushing disappointment washed over me. That’s when the “what ifs” kicked in, quickly followed by the “whys”. What if I’m no good at this? Why don’t they want me? What if my flaws are all anyone ever sees? Why did they lead me to think I had the job? What if I always have to struggle so much? Don’t they KNOW the emotional roller coaster this has been?

After a few glorious hours of reveling in my own misery and boohooing, I stopped, took a deep breath and reassessed the situation. The whys and what ifs do not matter. It is what it is. I owe myself more than picking myself apart because I didn’t get a job. And no, of course they didn’t know the emotional roller coaster I was on. Even if they did, it is not their responsibility to tip toe around it. Plus, I have a job; a job that I love despite the dysfunction. The pay is pathetic but money follows purpose.

For whatever reason, it’s simply not time for me to leave yet. There is joy that I still get to be there for my folks. I’ve been making it so far and Ramen noodles can actually be tasty if you doctor them up a bit. It was both a humbling and eye opening experience. I know now that when the time comes, I will be able to move on, as difficult as it may be, but part of me is very grateful that the time isn’t today.