Nursing Homes

There are times when even to live is an act of bravery.     Lucius Annaeus Seneca


Even though I'm the one writing this, it is my mother's story as much as it is mine.  Any anxiety I may have about aging is directly linked to her experience; and I am not alone.  A friend shudders each time she comes away from a visit with her mother, a nursing home resident.  "I hope I can figure out a way to commit suicide before I ever get to that point", she proclaims.  I know how she feels.  We don't want to think about getting old, let alone lying in a nursing home bed.  We don't want to talk about it, and most of us don't even want to hear or read about it. 

It doesn't matter that statistics are in our favor.  Chances are good if we do go to a long term care facility, we will receive therapy, recuperate, and get back home.  But as we watch a parent or elderly friend enter a facility, it's difficult to separate ourselves from the event.  We look on as they trade individuality, privacy, and control over their lives for help they cannot get in another setting.  We've seen the insecurity, loneliness, isolation, and fear that are an integral part of institutional culture.  We've heard residents cry out, "I want to go home.  Will you take me home?"  Resignation and hopelessness are reflected in eyes that once lit up at the thought of a familiar kitchen, bedroom, or workbench.  We wonder if someone with dementia is better off, not knowing where they are.

It has been almost six years since my mother died in the nursing home of a well-respected church-affiliated retirement community.  I owe it to her memory, and to families of other residents, to write about her journey.  As often as our family visited her, she had to take the journey alone.  She was the one eating the baloney sandwich or small piece of fish inside a huge bun.  She was the one trying to maintain her dignity while getting the cool shower, and as she said, 'feeling like a horse being washed down in a stall.'  She was the one who couldn't get to the bathroom by herself and had to depend on a call bell (that didn't always work) to get assistance.  She was the one lying awake in a strange bed in the deepest darkest part of night, suffering from a urinary tract infection and hearing a frustrated aide say, "You have to go again?  You aren't the only patient we have, you know."

Such is the cold, hard truth of nursing home life, in spite of the fact that nursing facilites are filled with compassionate professionals who are doing their best to give good care.  I didn't appreciate this until I walked into one as an employee.  I had been hired as the admissions co-ordinator for a 120-bed facility in Nevada.  Up to that point, and because my career had focused on shoring up the local community-based care system for at-home elders, I viewed nursing homes as dumping grounds for sick, older, and disable adults whose families didn't care or didn't have the time for them. 

As the director of a five-county federal and state-funded area agency on aging in Oregon, I worked with a team of staff members who were trained in Medicaid nursing home rules and regulations.  They were charged with surveying nursing facilities and reporting non-compliance back to the state office on aging.  Our staff meetings didn't focus on the good in those facilities; we talked about bed sores, odors, soiled sheets still on beds, illegal patient restraints, and elder abuse.  I didn't trust nursing homes, and I didn't try to understand life in them, least of all from the employee's or family's vantage point.  I could not see beyond the misery of residents and depressing surroundings, which I blamed on bad administrative practices and poor staffing.

My thinking changed as soon as I admitted my first resident into the health care center in Nevada in the late 90's.  It didn't take long for me to realize that not only had I judged all nursing homes unfairly, but I had dismissed the roles played by loving family members, volunteers, hard-working nurses, dedicated certified nurses aides, and support staff at all levels.

It became clear to me that a pardigm shift had been occurring right before my eyes.  Society began to hold older adults in higher esteem, to consider them a natural resource deserving respect and protection.  More laws were put into place and nursing homes were held even more accountable.  Eldercare became a national priority.

next:  Personalizing Health Care


(c) Sally Z McBain

My Ideal Vacation

Towering trees, mountains, and a lake recently provided my ideal vacation. Nevermind this particular vacation lasted only 2-1/2 days; it was all I needed to forget the phone, internet, violent news, daily responsibilities, and myself.  I came home feeling light as a feather and wanting more.

After several days of preparation and anticipation, we left town on a hot summer Sunday morning, canoe tied securely to the top of the car and a tote full of art supplies squeezed between two suitcases full of clothes for all kinds of weather and coolers with enough food for several days.  We came home with a canoe that never got wet, water color brushes that remained in their case, clothes that never saw the light of day, and food that went right back into the coolers. 

Since I have a tendency to analyze everything under the sun, I've been wondering why and how this break in our normal routines affected me the way it did.  I think it was because nothing else interrupted the flow.  My husband and I have always had a reason for traveling to incredible places: home re-locations, business meetings, or visits with family and friends.  When one travels that way, there are timelines and few opportunities to wander around and really get to know an area.  When we moved back to the Gorge, for instance, we passed the Great Salt Lake, an area I'd like to explore -- but not at 65 miles per hour.  You don't lollygag when you know the moving van is ahead of you.  And when my younger son was in school there, my husband and I couldn't stay long because of our jobs.

We've been all over the country, but rarely - rarely - have we ever just gone somewhere beautiful and restful for the sake of going somewhere beautiful and restful.  This time, thanks to retirement and time on our hands, we did; and it didn't take long to get used to the luxury of sitting on the deck of a lakeside cabin and soaking it all up.  I said to my sweetheart, "This is great. We are getting away from the world and each other - together!"   Our husband-wife personas were left at home and we were content to sit with each other as old buddies inside Nature's best.

Not only are vacations good for a marriage that can get ho-hum or too often emphasize a couple's differences, they're good for the soul -- like a battery, they recharge all the senses.  My husband is happy when he's fishing, which he did in earnest as soon as he unloaded the car.  He looked at the 48 steps from cabin to water and decided casting from the dock into the deep lake would be perfect.  As for feeding my soul, photography took center stage.  We couldn't take a walk without my pausing every few minutes to catch the sunlight through heaven-skimming ponderosa pines, acres and acres occupied by grazing cattle and horses, an osprey's nest and its juvenile occupants learning to fly, or the green-blue lake and summer mountains streaked by thin ribbons of snow.  I was totally relaxed, which is not my normal state; I'm usually up and doing something productive...something that has a tangible outcome (like a hairless carpet).

My mind is just as busy as my body.  Yoga and meditation provide brief, quiet breaks from my daily brain bursts; but this vacation gave me the chance to get away from worrying about our aging dog, coming up with an answer to "What's for dinner tonight?", or thinking about my next Soul Portrait workshop and blog topic.  This vacation reminded me of the value of relaxation and the fun of doing only what I want to do; but it also made me very grateful to have the extra funds to take this trip.  All around us, we see people living hand-to-mouth; in fact, we met a woman who is trying to keep her business afloat.  Single and 65, she is supporting a disabled daughter and working every day; retirement, let alone a vacation, is out of the question.  

The morning we got ready to leave the cabin, I slowly scanned my surroundings, knowing I'd have pictures to remind me of the bliss, but feeling sad.   With fingers wrapped around a last cup of coffee and tears welling up, I said to my husband, "I don't want to leave."  I've never said that before; I've always been anxious to get home.  Yet, even as the words were coming out of my mouth, I started to think about Molly and if she was doing okay at the kennel.  That was another blessing about time away; she doesn't have many more years with us and I swore I'd never complain about her hair again.

"I don't want to leave."  What is inherent in that statement?  Was I content enough to stop the clock for a few more days?  Am I pushing myself too hard at home?  We are retired, for Pete's sake; I can stop trying to prove something to myself any time I want.  Do I feel guilty when I'm not painting, writing, cooking, or knitting?  Is aging gracefully about knowing when priorities need to change, when vacuuming or fixing the perfect meal or having shiny stainless steel appliances is secondary to sitting under a tree with a clear head and a full heart?

                                                                        

Most Oregonians know about Wallowa Lake, just outside the town of Joseph, and  positioned at the foot of the Wallowa Mountains.  Joseph (named after Chief Joseph) is founded on the history of the Nez Perce; it is also a Nature-lover's dream.  In spite of all the summer visitors, it was quiet and serene. Residents of neighboring cabins and year-round homes were my kind of people -- quiet and thoughtful of others and the environment. It was heaven on earth and I can't wait to get back.

                                                                           

(c) Sally Z McBain

                                                                            

                                                                        

Why Write?

I'm just going to write because I cannot help it.   Charlotte Bronte


The more entries I place in this journal, the more I ask myself why I'm doing this...and making it public.  There are several reasons, and perhaps the first is the most critical for my sense of joy and well-being:  Writing offers a protected world where I can express my dreams, emotions, and thoughts.  It's a safe haven for discovery; and with that as my foundation, I integrate layer upon layer of Self.

Writing is one of my centering practices; it calms me and keeps me on my spiritual path.  If I don't write, I tend to get restless.  There are things I need to figure out, relationships I need to sort through, and problems I need to solve.  In her book, Storycatcher, Christina Baldwin says, "I believe the kinds of writing millions of us are doing in our diaries and journals are attempts to heal the split in the human mind and in the human experience."   Writing helps me get to my truth.

My writing is, on first glance, centered on myself; but I've always believed that to know Self is to know the meaning of life...at least a big part of it.  It's all in my writing --the ever-sustaining universal breath, basic needs that connect me with everyone else, and a full range of human emotion.  While it might seem that an over-indulgent ego is what propels me or anyone else to write, quite the opposite is true.  Writing is my way of never forgetting that life isn't just about me; I know I'm a tiny fleck in the scheme of things.  Like Virginia Woolf said, "When you consider things like the stars, our affairs don't seem to matter very much, do they?"   I do a lot of thinking about those stars and everything around and beyond them, especially when I'm deep in an ego-propelled frame of mind.  Writing helps me heal the split, as Baldwin puts it.  It also helps me see life from someone else's perspective.

For most of my adult life, I have struggled with guilt and pain related to my two divorces.  I wanted to know why, to understand my role in those failures.  Today, I have my answers; threads of understanding and acceptance connect much of what I write.  It took many years, but I reached this place by putting my thoughts onto paper with poetry and prose.  Writing inspires me to take a closer look at forgiveness, love, and gratitude.  Granted, it's a lot easier to write about these things than it is to practice them every day, but the act of writing is the inspirational nudge I need to move forward.

The best I have to share with my children is the essence of who I am.  To hide my lessons or dismiss my progress is to deprive them of a basic part of who they are and will become.  Someday, from their unique experiences of me, they will garner insights into one life that contributed to theirs.  Perhaps they will be 60 years old when they feel like reading, just as I was when I reached for my grandfather's diaries.  On those pages, where he wondered if anyone would ever read what he had to say, his adult graddaughter got to cuddle up in his arms again.  I could see the metal head band of his hearing aid reach around and into each ear.  I could taste the candy corn he always put within reach before he read Uncle Wiggly to me.  Most of all, I felt an overwhelming compassion for the physical suffering he endured day after day.  His diaries add to my sense of love, belonging, and personal history.

Finally, having my own blog is one way to reach out to others who experience life similarly. It also offers assurance that these writings will always be accessible to my family.  Just a few weeks ago, a brush fire came dangerously close to the house.  We were ready to evacuate in case the fire spread (which it did not), and had everything together.  I was exhausted and had no energy to grab all my journals; but it was comforting to know that someday, a son or grandchild might just stumble onto my blogs.


(c) Sally Z McBain