Friday, June 13, 2008

Saints Be Praised, Vol. II

Aren't you glad you don't have to fill out your taxes in Roman numerals? Boy, would that get tedious.

The other day I shared a few quick lessons I learned from my time "Among the Owls," serving in the activity department of a nursing home. "What does an activity department do?" you ask? I'll tell you. First of all, we don't do what you may fear: that is, I never had to bathe a resident, or do other intensely personal care. In fact, if you're not an aide, there are close restrictions on what you are and are not allowed to do to help a resident (not patient - resident). For instance, no transferring from wheelchair to bed, or vice versa.

Now, think of what Student Development does at a college, or your student life group. Then translate that into the halls of a nursing home. But combine the activity side of the Student Development department with the responsibility of an RA. Okay, now we're getting close.

Here was "a day in the life": on Mondays I would arrive, sometimes collect newspapers and deliver them to the residents who had subscriptions, if it hadn't already been done. I'd see what paperwork needed done that day/week (nursing homes/ senior care facilities are nothing if not paperwork-laden. High ratings from the state Are Everything, and paperwork backs up everything you do for an entire year). I'd move tables in the cafe to the walls, open the blinds, and put on music. Once a month I'd take around new activity calendars to each room and remove the previous month's. We had the capacity for 109 residents, though that number, of course, varied. And I'd get ready for the day's activities. On Mondays, that was coffee/exercise in the mornings, and Bingo in the afternoons.

In the morning, I announced the day's activities over the intercom, put the coffee on (always decaf), and would begin wheeling residents down to the activity room, where swing, big band, or Gospel played on the cd player. And here was a fine line: in respect of an individual's right to decide, we never took someone who didn't want to go to an activity. On the other hand, the getting ready morning routine for a woman whose body is half paralyzed takes a while for the aides to accomplish. So I'd knock on doors, invite residents to the activity, press their buzzer to let their aide know they wanted to go, and would continue on down the hall. By the time I left the nursing home, I knew dozens of personal preferences for how residents wanted their coffee. I knew who was likely to come, who might come, and who it would be a miracle to get to come. I knew who to check in on several times, as the aides might need "encouragement" to get someone ready on time. I knew that Esther, who loved to walk but had no short term memory, would need me to walk down the hall with her so that she didn't forget where she was going. I knew Evelyn would always say, "you're hands are nice and warm," as I took her hand and walked her to the cafe. I knew that sometimes Mary Grace's catheter tube got stuck in between the wheelchair construction and the wheel - watch out! I knew who needed thickened liquids (did you know some older people have trouble swallowing? Thickener helps it go down without choking or getting aspirated into the lungs). And I knew who was diabetic and needed sweet 'n low instead of sugar.

And then exercises would begin, accompanied by a tape. We stretched. We bent to touch our toes. We "rode our bicycle." We reached out and swam. We did the windshield wiper. All these activities encouraged strength building, and flexibility, and engagement in the outer environment, and interaction with other residents.

Then, one by one, I wheeled residents back to their room, or the tv lounge, or the hallway where they could sit and watch "traffic" - sometimes five, or ten, or fifteen of them, sometimes even twenty. I thought about getting a pedometer. Then Esther would help set up the tables for lunch by helping put tablecloths out, and we'd try to find the centerpieces, but Mattie down the hall kept slowly taking them from the cafe to her windowsill. She loved flowers.

I got out the binder. Everyone had a page. I marked those who turned down invitations "blue," and I marked those who came "yellow." I recorded the liquid intake for those who had coffee (dehydration is a constant battle, especially when you're taking lots of heavy medications) and gave them to the nurses' stations. If I saw a family member in a room, I marked on their chart that they'd had a family visit.

Mail had to be delivered, and read, for most. I sat and announced prayer requests from church bulletins to some folks, read the sermon scripture to others, read notes from grandchildren to some, read cards from friends back home. I propped them on dressers or tacked them to bulletin boards. I held them close to nearsighted eyes to see the blurred, bright images of a Hallmark card. Some knew what I was saying. Some gave no response. I read anyway.

Bingo was disastrous. It was the most stressful day of my week. Bingo was the most popular activity, and residents began lining up outside the dining room door before I even got a chance to get in and set up. And the fights it caused! Broken bracelets, scratched forearms, shouting, swearing. I was frazzled every time. And that's not counting this: "what was that - B?" "No, G, G, G as in GOLF" I shouted. Or this, after every letter, from Mary Grace: BINGO! Or this, from one resident to another - "will you shut up and let us play??" Yes, it was the favorite.

Volunteers came weekly to help corral the chaos. Cards were set out and taped to the tables so that stroke-stiffened arms wouldn't knock them astray. Poker chips were doled out to place on the letters. Trips were made back, forth, back, forth, collecting residents, parking them at their favorite table, with their friends, or at any table, if they didn't have a "regular" spot. Prizes were put out on tables for after Bingo - everyone got three prizes, only two of which could be a stuffed animal and jewelry. The rest were snacks. Thrift stores and church volunteers donated clip on earrings, necklaces, rings, stuffed animals, little boxes of raisins, snack cakes, crackers and cheese, bananas, and more. It was at the rush for the prize tables that things got hairy. That's when fights broke out, if they were going to break out. And there would be a traffic jam of wheelchairs blocking the doorway out.

Mondays I always returned home exhausted. But there was the rest of the week to face.

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