Notes from the Nursing Home, Part 1

September 1, 2011

BY KITT WALSH

The men in my family check out early—a combination of overwork and less noble pursuits like smoking and drinking—but the women live forever. So it was that my mother came to live with me and eventually moved to a nursing home up the street. In the eight years she spent there, I learned a lot (making me the go-to person among my friends now that many of them are facing that dread fact that their Mom needs to be in a nursing home.)

Here is Part 1 of some tips I learned along the way. I’ll call them Notes from the Nursing Home:

Get over the guilt: If you really have done all you can or if your mom’s medical condition requires actual skilled nursing care, don’t fret about making the decision that she’d be better off in the nursing home. Keep her as long as you can, talk over the decision with her, and then make the transition from loving adult child at home to loving adult child at the nursing home. If, however, you are going to be one of the absent, uncaring people who dump their mother and never quite find time to visit or call—go ahead and feel guilty.

Make an unscheduled visit: When you are picking which home to send your mom to, only put so much faith in the brochure and tours they offer. Instead, drop by unannounced and walk around. Use your nose more than anything else. If it smells bad, the staff isn’t keeping up with the cleaning of the place (or the residents.)

You’ll never have enough time: Face the fact that you’ll never have enough free time to visit your Mom. You must make the time, and once every Sunday isn’t enough. (Tip: If you pick a facility on the route to your house, work, kid’s school, gym or grocery, you’ll visit more often.) Pick up your kids from school, hit the drive-thru and have an impromptu picnic at your Mom’s bedside. (Smuggle in a single with cheese for your mother, too.) Your kids need to see their grandmother and to see you caring for her. (Remember, they will be caring for you the same way someday.) Drop by for a very early breakfast before work (she’ll be awake) or on your way home to make dinner. Every trip doesn’t have to be a huge whole-family undertaking. Even if it’s just you and a five-minute drive-by, every visit makes her day.

Practice patience: Take time to listen to the details of her new life and the cast of characters that now populate it. She listened to all your teenage angst—now its your turn to repay the favor. Let her complain, gossip or bitch. Bring a pad and paper to write down what she needs or what you need to address for her with the staff. Also realize the pace of the nursing home is slower than your normal hectic life. Have patience with the staff, too, and try not to snap at them (they get enough of that from the residents. A kind word really will work better … usually.)

Get to know everybody: Not just the director of the facility or the head of nursing (though having their full names and after-hours phone numbers—bypassing the closed switchboard—is important.) Meet the caretakers on every shift and remember their names. (Repeat often as staffers are notoriously underpaid and change all the time.)Make sure they all know you and how to get a hold of you, day or night (don’t rely on them all having access to your mother’s records. They won’t.) Bribe them with a dozen donuts, boxes of chocolate at Valentine’s Day, and cash money at Christmas–making sure they know who the largesse is from and be sure to thank them all (and often) for the good care of your mother. Conversely, if something bad happens (my mother got slapped for not turning over quickly enough) pursue the case through all levels of the facility (in writing) and call the cops. I did and that woman never slapped another old lady.

Keep her sharp: There is something called “ICU psychosis” which is a type of dementia brought on by being stuck in one artificially lit room all the time. (My mom, who was bed-ridden, but not senile, kept talking about the upper floors of the single-story nursing home.) If your mom is mobile, take her out to lunch and to family dinners and celebrations (the staff will help you get her in and out of the car) or if not, keep her mind active. Bring her family photos and ask her to tell you the stories she remembers of each, even if you’ve heard them 100 times before. (I had my youngest son go with a tape recorder and interview his grandmother about her life for the archive now known as “The Grammy Tapes.”) Have her help construct a family history tree (remember when she goes, her knowledge goes with her.) Send cards regularly–even if you live down the street–and nag the rest of your family to do so too. (Remember how excited your were to get mail at camp?) Get her an absentee ballot to vote so the election news becomes relevant to her.

Remember the others: Gathered round the nurse’s desk and lining the halls of most nursing homes, you’ll see lots of seniors in wheelchairs, just sitting. Many of them get no visitors at all. Ask the staff who these people are and make a little extra time to stop by their room to hear their stories. Include them in your send-a-card program. Talk to the ones in the hall, learn their names, stop and wish them a good day, offer to summon a nurse for them or help them wheel a little further down the hall. You are at the nursing home anyway. Spread a little love around.

Kitt Walsh owns a web content company, Behind Blogs and freelances as a feature writer, editor and marketing consultant for magazines, newspapers and private clients around the world.