all in a name

October 26, 2007

It is a delight to watch a five year old burst into peals of loud laughter at the image conjured up by the words of a fairy tale; it can also be an amusing surprise to see the source of that laughter. Carson’s laughter last night over the rhymes of Dr. Seuss was easy to understand, but tonight it caught me a bit off guard. We had settled on the story of “Lazy Jack” from my Child’s Book of fairy Tales, in which little Jack has a series of amusingly confused efforts to heed his mother’s advice. Carson was understandably tickled at the idea of Jack carrying a donkey upside down on his shoulders. But he also literally rolled on the floor when I told how Jack had carried meat home from the butcher by dragging it behind him with a rope–now what Carson laughed so hard about, though, was not the image itself but the word used . . . for some reason, he found the word “mutton” to be the most hilarious thing he had apparently heard in quite some time!

Today I cut Miss Mary’s hair. My intent in going up to her apartment was to have her fill out an application, as she was one of the residents with some mobility issues whom I knew would struggle to come down to sign up for the annual “commodities.” When I got up there, however, she mentioned that she was bothered by the way her hair always fluttered into her eyes. She wanted to get it cut but wondered at the cost of having someone make a house call to do that: or at least that’s what she replied when I asked if she wanted it cut.
So I said that I could actually do it for her, if she wanted, having spent my college years as a bit of a word-of-mouth hairdresser for all my housemates and friends. I started to feel guilty about offering to do something that I am technically not supposed to do [it falls under to social worker-speak term of “direct service” that I am meant to provide help acquiring but not do myself]. But then I thought more about it and realized I did not in fact feel it was wrong for me to do in this case. As it was, Mary had an immediate need that I could provide quite readily, in very little time. She is planning to move out soon, and as she is one of my favorite residents I am anxious to make the most of what time there is left. And frankly–more selfishly, as far as reasons go–there was nothing I would rather have done with a portion of this day.
It was one of those sweet moments in life when time slows to a blessed stand still. Combing the wisps of baby-fine hair as I knelt beside Mary, I marveled at her beauty, and told her as much. As I am always a bit nervous when I cut someone’s hair, I was relieved to see that the result was quite lovely. And I was thrilled at her ready smile when I held up the hand mirror to show her the end result . . .
No, I definitely have no qualms about the non-working time I spent while at work today :-)

lest i forget

October 17, 2007

I was growing increasingly frustrated today as I spoke with Miss Charlotte’s sister today. It began as what I assumed would be a straightforward conversation. After visiting Charlotte for a check-up last week, I had nearly keeled over as I walked in. Her apartment was filthy with a build-up of human waste and insects, and the odor completely overpowering. And she had no idea. She was even soiled herself, yet she spoke with me in a relatively coherent conversation, chattering on in a blissful oblivion to her surroundings.
As we have volunteer student nurses who come periodically, I made sure she had a visit the next day and I spoke with the nurses afterwards. They told me what I suspected they would: that she could not take care of herself any longer. Up to now, Miss Charlotte has been headstrong in her independence, so I was relieved to hear the report that she had also admitted to them that she knew she needed to move out of her own place . . . “It’s definitely time for her to go to a nursing home,” they concluded as the nurses left my office.
The first step in this move is to contact the family, so I made a few phone calls to her relatives and was referred to her main caretaker—her sister. Each day I had left a message for her, since that day, explaining the situation, telling her it was up to her now to make the decision, and asking for her to call me back. But I still had not heard from her today; I was thrilled, then, to hear her answer the phone this time.
My excitement promptly turned into frustration. She almost brushed me off immediately, saying she was tired today and would call me later. Not trusting a return call, and anxious to get something moving, I quickly explained to her my reason for calling [she had told me she did not check her messages so had not gotten any of my prior ones]. My assumption was that she would immediately realize the urgency of the situation and respond accordingly. Instead, she told me that nursing homes “didn’t take care of anyone,” and their food was awful. She said she’d just try to find someone who would come and help Charlotte in her apartment.
I tried to explain to her that the waiting list for in-home care was a year and a half long at this point, and that Charlotte was really needing more than that anyway. She repeated her feeling about nursing homes, citing her bad experience with one in particular, and rushed off the phone. Before she hung up, I convinced her to promise to call me back as soon as she heard back about the in-home care; she clearly was not going to consider a nursing home.

What was so distressing to me was that she was not truly concerned about the needs of her sister; all she cared about was her own idea about nursing homes. Had she had the financial resources to afford top-notch in-home care, that would be one thing. But this was a lady who occasionally came to visit her sister, and who had refused to help financially [when I called to tell her that her sister did not have a mattress—hers being soiled beyond use—she had told me she couldn’t afford one, and couldn’t do anything about it at the time. I had been left to scramble with a hunt at all the donation locations to try to locate a mattress by the time she was ready for bed that evening].
In short, I was left with the unmistakable impression that Miss Charlotte’s sister simply did not care enough to do what needed to be done.
The normal procedure in this case is to let the family make the decision, which means taking the individual to the hospital. The hospital then refers them to a nursing home, so that Medicare has the “official” word to cover the costs.
In this case, I need to decide how long to wait for Charlotte’s sister to respond. If she does not, I’m afraid I will need to have Adult Protective Services intervene, in lieu of Charlotte’s family. It is distressing to think of having the state do what the family should be doing for her. But the alternative is worse: the idea that no one cares enough to make sure that she is not left alone in her increasing senility and infirmity.
I left work today saddened at the lack of care that is so prevalent in this world. And then I reminded myself that I probably need to be faced with such blatant selfishness in order to take care to guard against my own such tendencies. I pray that I can spend a lifetime cultivating a heart that is willing to break over all that is heartbreaking in life as we know it.

Thank you, Hon–You just saved my butt . . . and you know it’s a big butt!
She said it as if it were the most natural thing in the world to tell someone, and I guess I deserved it, having just followed her instructions to help her precarious position in her wheelchair: I braced myself behind her, grasped the elastic waistband of her pants, and hoisted her up to shift her into a better position. My coworker later berated me for attempting such a thing, as the last time she had done it, she had enlisted the aid of a male nurse. Ah well–it seemed to work alright this time!

Once church was over and my laundry finished today, I decided to squeeze in a late afternoon trip to the museum: I hadn’t yet seen the temporary Moser exhibit and am always eager for the chance to take flash my membership card :-)
So while walking downtown I passed a man sitting outside, talking. He sounded just like any weekend leisurer until I realized he was not holding a cell phone [is that a sign of the times, that his lack of a cell phone rather than the fact that he was alone is what struck me as odd?]. I soon recognized him as one of our local not-quite-sane city dwellers, so it wasn’t a terribly surprising sight as far as daily encounters go.
It was, however, an uplifting one. At the time I was rather weary of dealing with landlady issues, as my household is currently in transition. And I was extremely weary of the work issues, Friday being another day of experiencing the vibes of pure hatred I can do nothing about. I cannot tell the residents the truth of the situation, so for all they know, I am a meddling newbie who came in and started a wild rumor about that nice man who stays with his mother. He has now been told he has to leave the building and, if he has any questions, should direct them towards his parole officer . . .
But what I was going to say [when truth broke in with all her matter-of-fact about the ice storm] was that seeing this eccentric man today lifted my spirits unexpectedly. He sat there contentedly talking to his “friend,” while sipping a corona and eating forkfuls of salsa from the jar.
So as I continued on my way I grinned at the refreshing thought that we all have a bit of a “crazy” in us. And, sometimes, I think it is the craziness that keeps us sane.

Feliz Dia, ANNA

October 6, 2007

HAppy birthday! I hope you had a great one- would love to see pics of the party…if you take some!! SO you;re working at a nursing home? How´s your readjustment been to life in the States?
Love susan

. . . what folks who spend their days working with the elderly do when they are gathered together for a nationwide conference: in this particular case, I can vouch for one group who holds serious health care, mental support, and caregiving sessions during the day. But by night, you can find us singing “everybody dance now,” dancing with our heads while our bodies morph into digitally mastered dancing genii. Or at least that’s what three of us did just now–and I have [safely held hostage] a video to prove it :-)