Thanks for coming by to read my thoughts.
I am remembering today about some of the people I cared for in my job in long term care and how our job relates to their daily living. To me, the job was not a series of tasks, assignments to be completed, or a chore to get finished. It was about starting someone’s day for them, helping them with everything they needed throughout my shift, or helping them end their day, making them comfortable and helping them settle to have a good night. If I was on the night shift it was all about watching over them – as they slept, as they woke, as they needed our assistance to get to the bathroom, to perhaps have a drink or snack…and just make the whole 24 hrs. of their day bearable.
Think about the alternative. Elderly persons living at home have great difficulty trying to negotiate stairs, uneven flooring, opening and closing cupboard drawers, taking lids off jars, cooking, cleaning, just getting the mail from the front door, or putting out the garbage – all these day to day chores that we think nothing about doing…all of a sudden becomes challenging and difficult. It doesn’t happen overnight. It comes on gradually. If the elderly person has family or helpful neighbours living close by, then they can rely on some outside help to continue maintaining their life at home.
Wouldn’t we all like to remain at home all of our days? I certainly would. I am now a senior. I cannot imagine not living on my own. I cannot imagine having to live in a “facility” of any kind, but it is a definite possibility. Not everyone has the luxury of good health into their 90’s or 100’s and not everyone can live at home, cook their own meals, and take care of their own personal needs as they age. The only people who can stay home and enjoy their familiar surroundings, and their personal things, their usual meals, bedtimes, routines…need support and private funds in order to do that. Not to mention there are others in need of facility care and support but because of the long waiting list to get into a facility now, many people end up waiting in a hospital and dying in a hospital.
I can tell you that having worked in a nursing home, and knowing what I do about the setup for residents and the limits that become their boundaries….I am not in a hurry to move in.
Think about it. All of a sudden you become a resident with a room number on your door, and very possibly a room mate that you never met before…luckily your room mate will at least be your same sex, but unluckily your room mate will often be a person with high needs – which means many many interruptions to your own routine, your sleep, your phone calls, your TV programs, etc etc.
Private rooms are available but often come with a waiting period. Not to mention the cost of a private room, which still does not include the cost of telephone and cable TV. All of a sudden your costs go way up and your privacy and quality of life go way down. There is no two ways about it. Facility living is totally different from living at home.
One of the things that I was taught would happen when a new resident came to live in a facility – was that they would be welcomed in, introduced to the facility ,introduced to the RN in charge, then introduced to me, their caregiver on duty – or whoever the caregiver happened to be that day of their move. It is a wonderful idea. It was so neat to think that a new resident would get the tour of the building, learn about the times for meals, their assigned bath day, shown where they could get a haircut, talk to the nurse or the director of care…anything and everything about their new building was on the tour…where to go for nail care in activity dept., where to attend the movie night, get a schedule of events coming up for the month. Nice idea, but it doesn’t really happen.
I have arrived on duty at work and found that a new resident had been admitted and was on my worksheet for the evening. I have gone in to see the resident who was generally disoriented, confused about where they were, where their belongings were, where the bathroom was, wondering why their cable didn’t work yet, or their phone. It is bad enough to move in and start your first night in confusion and anxiety….but not to even have cable working? I can understand the phone but for heaven sake’s can’t the facility pay for cable? Hotel rooms do! You can rent a room for a reasonable price a night and have a great variety of TV viewing, but no, cable doesn’t come with your nursing home room. Another insult to our seniors!!!
Don’t move me on a Monday night when my favorite British comedies come on, or on a Friday night when I am glued to Larry King, or Dateline or perhaps even my nightly routine of Jay Leno! How sad to have to be moved in and wait a day or two or three for cable to be switched on or turned over.
Anyway, back to settling in a new resident. I might be given some sparse information about this new resident, probably that he or she has dentures or a hearing aide, or some chronic condition or other, and I will be told that the person is a one or two person lift or a hoyer lift (mechanical) or I may not even know that. I might be told…we really don’t know about this person’s ability so you give us that information after you have found out yourself! It has happened. Also, we may or may not be told as PSWs whether this person has a communicable or dangerous infection or condition. Sometimes at a later date, a different nurse may share something at report and tell you about the resident and remind you to be cautious about bodily fluids and contamination – and you as the PSW will go “What? No one ever told me that!” Which reminds me….always treat every new resident and every current resident as if they were infectious. You cannot be too careful about your own health and it is important to wear gloves for all personal care and to protect yourself from contact. You are NOT always given the information you need in order to protect yourself. You have to take that into your own hands. Never forget that. If gloves are not always available in your work place then make it a point to carry your own, bring them to work, have them available. Be your own first guard against infection. Sometimes PSWs are treated as if they are “replaceable” and are given information only on a “need to know basis” and even then we are told…it is the resident’s right to privacy to keep some information away from health care workers. Hogwash! We deserve protection too. Not only us but everyone we have at home, our families, our spouses, our personal circle.
Now back to the viewpoint of the new resident.
It is a shock to the system to have your body and your boxes and clothing plopped into an empty side of a room, bare except for a single bed with unattractive spread and flat pillow covered in plastic coating…not to mention the mattress is also coated in a waterproof covering. There is a side table with two or three drawers , and a closet which is too high for most elderly people to reach to even hang their clothing. Someone forgot that seniors shrink a bit with age and then they have issues with how flexible their shoulder joints are…not to mention other joints like knees and hips. It is hard to figure out how you are going to get a whole year’s worth of clothing on this very small and limited rack. Men find it easier as their wardrobe is not as extravagant as the ladies. A jacket, a winter coat, a hat and scarf, a pair of nice shoes, a pair of every day shoes, and boots and a few pairs of slacks and shirts, a couple of sweaters and a jacket and possibly a few other items…but manageable. I have struggled to try and return clothing to one of my ladie’s closets, squeezing everything over in order to get one hanger in with an outfit on it….complete with stockings, jacket and skirt, a blouse, a string of beads hanging over the outfit, everything has to be in its place and all together, because that is how you liked things done at home!
But there is never quite enough room. Try and squeeze in everything you might use every day for the rest of your life into a small room or side of a room and see how you like it. I have experienced what it is like to fit my belongings into a hotel room for a few days, or visiting with family for a few weeks….and it is horrible. You can’t find anything, and you have no where to put anything. You try to stuff it all in the already straining drawers and closet and it overflows. You try to figure out what you can throw out and live without and still it seems you don’t have enough space.
That is just the beginning of the process of getting used to a facility. Now you no longer have control over your routine. You are told when to eat, when to bathe, when to attend an activity or a movie or a tea party. Of course you can say no. Of course you can decline meals. But they won’t be happy to bring you a tray. There are plenty of people who need feeding and every tray that goes out on the floor had better be a sick person. There are not enough staff members to porter trays to residents on the floor just because you don’t feel like attending. So regardless of your mood or desire, meals are at the appointed hour and you had better be there. Otherwise you will get a visit from the charge nurse, or if that doesn’t work, you will get a visit from the Director of Care. They want you at meals because it is your “right to spend time with your peers and have socialization.” This is the attitude of the Ministry as well, if I am not mistaken. Must have all residents in the dining room with nicely appointed tables with the residents names on a card on the table, tablecloth, some seasonal bouquet or table decoration, despite the fact that this lovely “socialization time” is done in accordance with the rules but perhaps the residents are still in need of a personal change, a reposition, or some kind of attention – which we don’t have time for because we are too busy getting them into the dining room in time for a meal that will be served slightly warm by the time it gets to each resident.
Is it just me…or is there something wrong with this picture????
Dearie, (don’t mind if I call you that will you?) Don’t take me to the dining room to “socialize me”. I don’t need it. If I decide to miss a meal and just want a cup of tea, I will go and get it…and I don’t need to be with people all the time. It is enough that I have my space invaded all the time, 24 hrs a day, as staff are always checking on my roommate or making sure I am breathing at night.
Sometimes I just need to be alone! Don’t you get it? Do you get to be alone at home? Well, enjoy it. Your turn is going to come. You will have a tough time getting used to the invasion of space, the invasion of privacy, the fact that you have to wait on someone to come and get you when they have time to give you a bath…whether you want to have it then or not. When you get crotchety because you have waited til your back is sore, and your legs are puffy, and you are just too tired to even care about going for a bath….you will get a staff member who is also stressed to the max and says, if you don’t come now, you will miss your bath and I can’t do it any other time. It is not just one time, it is every time, every week, every bath day…it will never be at “your” convenience.
So, as PSWs going to work every day, I know you probably understand this about your residents and feel their frustration. We are frustrated by lack of time, lack of supplies, lack of staff, but the residents just know that they are waiting for a transfer, waiting to go to the bathroom, waiting to be taken to a meal, or just waiting for everyone to disappear so they can watch their hockey game or soap opera without being asked if they had a bowel movement today, or some other personally invasive question.
Carry on doing what you do best…support and care for our elderly and infirm. Carry on being angels in disguise. Remember that we could be on the other side of the picture, sitting in a chair waiting for help, waiting to eat, waiting to be transferred in or out of bed. Insert a bit of humour in your day and take a deep breath when you feel frustrated, tired, stressed, and know that your residents still need you, regardless of how we interrupt their day. We have a smile, kind hands and compassion for people in need. Congratulations on doing a job that not everyone can do.
Thank you for reading this.
from a PSW who is soon headed for the rocking chair and who may soon be one of your residents 🙂
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