I used to go to nursing homes as a kid to carol at Christmas time or visit with my school class or less often to visit someone specifically, a family acquaintance that was living there.
Truthfully, I hated them. They smelled…odd. Sometimes the patients screamed. They were tied to wheelchairs or beds and would beg me to take them away, saying the staff was trying to kill them. Worst of all, they wanted to touch me…pet me, kiss me, hug me….I don’t know you.
At the time, I did not really understand what was going on and being afraid to ask, it was all the more frightening.
Years later, while still in residency, I had a few experiences that made me reexamine my feelings.
First, I was discussing a patient’s blood pressure medication and I asked her if she needed refills. “Oh, no,” she says,”I get my medication off of the residents.”
Turns out she worked at a nursing home and was taking a patient’s medication. Meds intended for that patient. And I flashed back to the several calls I had received from various nursing homes about patients’ blood pressures being out of control. I asked casually, “So, uh, where do you work?”
“I am not going to tell you!” she said with a laugh. “I don’t want you reporting me.” Guilty. That was totally what I was going to do. Between us, I still got her in trouble.
Another incident was when a 95 year old resident of an assisted living center insisted the staff was taking her belongings. She was in tears and very specific about how it was happening. I was there doing an onsite visit, making rounds. She was not demented. Not at all. So I called her daughter to come sort through her belongings. Sure enough, she was not lying. Jewelry, anything of value, gone. She told me she had told the other staff, the assisted living director, other physicians, no one would listen. They just assumed she was not right in the head and brushed off her accusations. Turns out, other residents had also been stolen from. These staff members would prey only on ones that they could plausibly say would be confabulating … Except they misjudged this woman. And me.
I have never been in a nursing home that was operated well. I am sure they exist, I just haven’t seen them. There ARE sometimes great staff even in the awfulest of places. I have met some of them.
And so, I joke about my plans to stay out of nursing homes by baking bread for my kids every week, but it is a very real fear and not entirely irrational as you see. I wrestle with my own fear when I am recommending that a patient get placed. It probably means nothing to them as they glare at me, seething, that I am so, so sorry I am even discussing taking away their life and freedom and advising that they go to (that place).
So that brings me to decisions about my own family. Soon, I will have to make a decision about my own father as his dementia is advancing rapidly.
Do I pay lots of money to have someone care for him at my house or do I place him in a nursing home? This may seem like it should be an easy decision but truthfully, I hate the man and even as he is losing his mental faculties, the meanness is just getting worse fueled by the fact that he does not have reason and understanding to temper his temper. I can rationalize that this is not really his fault necessarily on an intellectual level, that he should not be held responsible for his behavior now, but emotionally I still remember that he WAS this way when he could completely understand.
I know what I will do in the end. I will keep him from being institutionalized. I have to. He did keep me clothed and fed and provided a roof over my head during my formative years. And I hope my kids will do the same for me, even though they will undoubtedly hate me just as much…because I fear nursing homes so much and because this type of dementia is genetic. I will have it eventually.