The Nursing Home Experience - 2

What to expect at a long-term-care facility:

Prior to admission I toured the facility and found it to have quite a pleasant atmosphere. The grounds were nicely landscaped and very well kept. First inside were the reception desk and front offices. Then you proceed into the heart of the facility. There is a common dining room for those who are able to use it, a library, activity area, lounges and TV rooms, beauty shop, gift shop, access to a semi-enclosed outdoor patio area for smokers and finally, on each wing, the central nurse’s station and the rooms themselves.

The rooms had a “homey“ feel with durable carpeting on the floor and drapes on the window. There was talk, during our stay, of doing away with the carpeting sometime in the future. That will be a shame if they do but that’s just my opinion. Private rooms can be had but are quite expensive I‘m sure; standard are two-to-a-room. Usually there are several “halls“ or wings with one of them being a “lock-down area“ for patients who tend to wander. The particular room that we occupied had a West-facing window, a private in-room toilet/sink facility, closet space, dressers and side tables for each bed, an under-the-window, wall-mounted, air-conditioner and a small color TV.

I was once again fortunate in that I was offered a choice between two “female beds“; one with a roommate who also had cognitive impairment and the other with a lady who had her mental faculties about her but suffered from COPD, a respiratory condition. I chose the latter, feeling it might be better and I‘m glad that I did. In three months, roommate “Babs“ grew to become very fond of my Dee and acted as yet another set of eyes, ears and helping hands in troubling situations. Occasionally Dee would twist herself around in her bed so that she was near sideways with her legs dangling and her feet touching the floor. Babs would “buzz” the nurses station and soon a nurse or a CNA (certified nurse’s assistant) would come and re-position her.
Since this area did not have “in-the-wall” oxygen at this time, Babs had a portable oxygen-making machine beside her bed. It was a little noisy but not too bad. Besides the 24/7 presence of a RN, there were also a number of assistants on duty around-the-clock.

A physician was on call and would come around once weekly. The hospice nurses and CNAs would also visit 2-3 times a week as well as a hospice Reverend for spiritual counseling and guidance. In that regard the Home also had church services available weekly and of course, in the activities area, regular bingo sessions. The level of care was extraordinary and left nothing to be desired. Showers and/or bed baths were given 2-3 times a week, meds were dispensed routinely each day as prescribed and other special care was given as required; vital signs taken, blood pressure, blood glucose levels, temperature and body weight closely monitored.

Food was prepared on a “likes-doesn‘t like” basis and if the patient is immobile, brought to the room at bedside. Not having her teeth or dentures, Dee’s food was prepared in an easy-to-chew format. If unable to feed themselves they are then hand-fed by a CNA. I was present most days at many of the meal times and fed Dee myself. Sometimes it became very frustrating for me when she was non-responsive and eventually I left the feeding to the professionals and would visit just before or just after meals. Records were maintained in a percentage figure as to how much food was or was not eaten at each meal.

“Wake-up Time” comes early in the nursing home. It’s not unusual to see patients up and about by 4:30 am. Those who are ambulatory are sometimes assisted and encouraged to mingle in the hallway for “socialization.“ Many, however, are far from socializing; more like in a stupor, some slumped over and fallen back to sleep again in their wheel chairs. The main gathering spots would be near the nurse’s station or outside of the main dining room. A coffee cart is available before breakfast and breakfast is served between 7:30 and 8:00 am.

Also around this time, the “Med Nurse” is busy getting ready to administer morning medications. She has a wheeled cart with dozens of drawers holding hundreds of different medications for the patients. A grinding tool is used for some of the solid meds which are usually mixed in a small cup with apple sauce to help make them more palatable. Liquid meds are given in small cups. Med dispensation is very time consuming as you can imagine. In extreme cases, some patients receive up to a dozen different medications. Meticulous records are kept on each patient and occasionally some intense prompting is necessary to get the patient to take and actually swallow the medication. Dementia patients have been known to spit them out. Also performed in the mornings are “vital sign” readings for those that require that. Patiently waiting your turn for your morning meds can sometimes be a time of high anxiety, especially if they are needed pain meds or meds for breathing assistance.

Since Dee had been bedridden for more than three months, one of the high points of our nursing home stay was when “Teesha”, one of the hospice CNAs, gently lifted my Dee up and out of bed, placed her into a special PCV “shower chair”, wheeled her out of the room and down the hall for a real sit-down shower. I was so happy to see that, I can’t tell you how happy I was. Of course, Dee fussed and fumed loudly over the jostling and moving about but once all settled down with drying, body moisturizing and hair brushing you could tell that she was happy as a Lark. Sadly, there were to be only two or three more sit-down showers.

Concluding all that I can recall about the nursing home experience, I can only say that my hat’s off and my extreme gratitude go to the staffs of these facilities. I can’t speak for all nursing homes of course but in my experience at the one we were at, your loved one is truly given the very best in Tender, Loving, Care.

Jay