Friday, May 29, 2009

Living History

(Part 3 of "Finding a Home in Nursing Homes")

(Photo by Jason Evans)

Though the nursing center is modern and current events are blaring from TVs, I was constantly reminded of the era that shaped the residents. There was a curious duality in the Octogenarians and Nonagenarians wearing Nikes and toting CD players. Those moments when evidence of their vintage broke through are some of my most treasured memories. I'll start with Milly...


Milly was a happy, fun-loving, easy-going woman who raised 8 or 9 children on her farm in rural Pennsylvania. She had suffered a stroke which left her hemiplegic-- with little or no function of her left arm and leg. We could bathe and dress her in bed easily, but she required two aides to help her stand and pivot into her wheelchair.

No one minded the interruption when called to help with the transfer. Because Milly was a joyful soul, with wonderfully contagious laughter. Actually, the stroke damaged her emotion control center, leaving her with emotional lability: inappropriate (often exaggerated) expression of emotion. When Milly laughed, everyone laughed, then Milly would laugh harder and so on. She was known to exclaim that she had peed because she was laughing too hard, which would require a change of her "diaper." So the regular aides knew to get the laughter out before finishing the bathing and dressing routine.

When I first met Milly, two aides were in the process of helping her into her chair and laughter filled the room. Something was said that inspired a great guffaw from Milly, which sent her dentures flying across the room! Naturally this resulted in more laughs and by the time we had her dry and seated, we all were wiping the tears from our faces.

At the start of summer, a young girl who was studying nursing at the local university took a summer job as an aide. Darla was African-american, and from the city. She clearly had the disposition for nursing, and was immediately accepted by the staff. So, at the end of her first day of training, we sent her to answer Milly's call light (Milly was an "easy" resident-- generally happy and not medically complex).

Darla shuffled down the hall and disappeared into Milly's room. Next came an ear-splitting shriek and we saw Darla backing into the hall with a mixture of shock, concern, and resigned amusement on her face as Milly shouted, "Help! She escaped! Send her back on the boat!"

After a moment of confusion (we weren't accustomed to hearing Milly angry or scared), Darla looked at us and we all erupted into laughter. It was a sudden reminder of the generational differences. Milly was scared. Because she had not been exposed to cultural diversity in her quiet, rural life.

By the end of the summer, Milly enjoyed Darla's care, and was sad to say goodbye when fall semester resumed.


Linda S. Socha said...

A lovely heart touching post. These folks are lucky to have you Aine

JaneyV said...

Aine I was reluctant to read these posts because of my own experiences with care homes. My mother died in one at the age of 59 having lived in care for just over a year. She had suffered with cerebral atrophy (cause unknown) and over a period of years we watched a funny, loving, often exasperated (she had 7 children!!) woman become confused, angry, bitter and lose her ability to move and communicate. At first she was in hospice care which was fantastic and very much as you describe here but after many months when her health improved she was transferred to an older unit in a different part of town. It was probably one of the most depressing places I've ever visited and unsurprisingly within a few months of her transfer she died.

It warms my heart to know that there are people like you out there looking after our most vulnerable citizens. Understanding the gaps between the generations and where the sometimes bizarre behavior can come from is so important. I'm so glad that Darla was kind enough to understand Millie's behavior rather than be shocked by it. I remember the hardest thing for us (her family) was watching the fear on Mam's face when care staff came into her room. She was a very modest woman and she found "being poked and prodded" very degrading. She also hated the way some of the staff spoke to her as though she was 5 years old. Yes she couldn't speak, sometimes she drifted away from reality, she was incontinent but she was still a human being deserving of respect. The many Nurses who gave that to her will always have my deepest gratitude.

Thank you for being there for the likes of ELizabeth and Millie.

Sarah Hina said...

I really liked how you demonstrated the familial/friendly bond in the home with Milly before talking about her generational hang-up. The duality is sharp, but not ultimately divisive. We are of our times and geography, but we can grow, too, with personal experience of a shared and common humanity. And with the right people around. :)

I loved the denture story!! And your guys' reactions. :D If only a video camera had been around...but then again, you've preserved it just as vividly, and more lovingly.

A wonderful, heart-warming story, Aine. Thank you for letting us know Milly with you.

Unknown said...

Milly's contagious laughter continues in your post! I laughed right out loud with the denture thing :-D. Also, I could see you standing in the room laughing too. Your stories of those days at the nursing home are wonderful, and I'm glad you are writing them.

Aine said...

Linda~ I'm so glad you are enjoying these. I haven't told these stories (except to Jason), and the passing years are causing them to fade. I hope to keep them vivid in my memory by recording them here.

I was a bit concerned that many would feel uncomfortable and turn away (not read) based on the setting.

Janey~ My heart goes out to you! What a terrible, sad thing for a family to go through. I have seen many different families who all present with different reactions and coping strategies. Jason and I are on the brink of just such an ordeal with his father, so your comment was particularly meaningful to Jason. (Though he is an only child, so we don't have sibilings to share the pain.)

And I am so sad to say that your experience doesn't surprise me. When I started my career, my goal was to change the quality of care in as many nursing homes as possible (an ideal, lofty goal, but certainly noble...) I soon realized that there are so many factors at work that are beyond a single person. Not least of which is the reluctance/fear of young folks to even look at what goes on in homes. And an even greater barrier to improved care is that nursing home care is the lowest valued level of care in the healthcare industry, as well as society in general. I think I'll do a post about this....

Thank you for reading and commenting despite the memories and feelings it brought to the surface for you. And I'm so glad you saw (and more importantly she received care) how it should be done during her time at the hospice. I'm sending you a cyberhug, Janey!

Sarah~ You are so right about the impact of a personal experience. It's often the only way to facilitate change. :)

The denture story is one of my favorites! I'm so glad I could bring it to life for you. I still LOL when I think of it. :D

Catvibe~ I am so happy that I decided to blog about this. As I said to Linda, I was concerned that readers would turn away because of bad personal experiences or preconceived notions about nursing homes.

In many ways it is just like the first year for a new mom-- nobody talks about the hardships. It becomes a black hole in our understanding of the stages of life. In such ways, I believe western culture has really slid backwards. We closet away any aspects of life that are difficult, uncomfortable, or scary. Sometimes I wish I lived in a village where families supported each other in a very open and matter of fact way. We all grow old, let's embrace that reality and preserve dignity and respect the way no other animal on Earth can.

Charles Gramlich said...

I knew a Milly once who seemed quite a bit like this one.

Aniket Thakkar said...

A very touching, heart-warming post again Aine. I loved Milly. :D

Thanks for sharing their immortal memories.

Aniket Thakkar said...

PS: Am glad you decided to post about them too. :)

Deepa Gopal said...

Very touching post Aine! Loved Milly's laughter as I am also one who smiles and laughs all the time even at silly things. My friends tell me that I laugh a lot:)

Do you work there Aine? If so its so sweet of you.

Loved your post very much!

K.Lawson Gilbert said...
This comment has been removed by the author.
K.Lawson Gilbert said...

Aww...what wonderful remembrances! I am sure you had many trying times, as well...but how like you to remember only the happy moments.

Aine said...

Charles~ What a coincidence! Especially given that I've changed all the names in my posts about the nursing homes-- I chose "Milly" randomly.

Aniket~ I'm glad that you're enjoying this series. My hope is that I can de-mystify nursing homes a bit.

deepazartz~ Before having children, I worked as a nurse's aide, and then an Occupational Therapist (my position evolved from staff therapist to clinical supervisor to clinical specialist). In total, I've worked in more than 50 nursing homes. Many of these stories come from my 2-3 years as a nurse's aide, because that's when I became very close to the residents. But I have some great therapy stories to share, too!

Keep smiling and laughing!

Kaye~ :D Yes, very like me! But I am planning on sharing some of the darker moments, too. After all, death is part of the nursing home exoerience. And I have many concerns about the healthcare industry, as I mentioned to Janey (above).

Karen said...

What a delicious slice of life you're serving up here, Aine. If you keep thinking about it, I'll bet the nursing home experience will provide you with stories for years to come!

You never did tell me if you'd read Sara Gruen's Water For Elephants.(?) I recommend it.

Aine said...

Karen~ D'oh! I meant to answer that-- no, I haven't read it yet. But I just finished Jamie Ford's "Hotel on the Corner of Bitter and Sweet" last night. So I think I'll start "Water For Elephants" tonight. Thanks for the reminder!

Deepa Gopal said...

You are too sweet, Aine:)

Margaret said...

Aine, I love the way you're opening up the inside of nursing homes for us to see.

Milly sounds like one unique lady. I laughed out loud at the dentures episode. And poor Daria must have got the shock of her life! But wonderful to see they became close.

Sorry I'm late here, haven't had much time for blogging but glad I didn't miss this...