A nursing home is a hospital without the money. Americans worship medicine, and where your heart is there also your money will be.
At St. Joseph’s Hospital, the beds cost $6000 and are, by and large, for the benefit of the staff, not the patient. There was the usual button to call for the nurse, except that there were three of them set in the molded plastic “side rails”—one at waist height and the other two at shoulder height on both sides—and there were buttons to raise and lower the head of the bed, three each, making another six. I mean, heaven forfend that you should actually have to turn over to call the nurse.
There was another button for the nurse to raise the entire bed up to her height. She can push another button and actually shorten and lengthen the bed. Other patient buttons include television with up and down buttons. The patient cannot punch in a number but has to scroll through all one hundred channels. There are buttons for radio and lights but they’re not attached to anything; sometime in the future, when the new building is finished, they are supposed to be connected to things.
The bed has alarms that include one that shrieks if the patient tries to get out of it. This may prevent an addled old lady from breaking a hip but it also can be used on the psychiatry unit to confine a person to a three-foot by six-foot prison. This alarm can be turned on and off by the staff but is out of reach of the patient.
There is another alarm that shrieks if the bed is unplugged; it cannot be turned off. The bed also carries a power pack that enables it to be driven here and there. No longer does an “orderly” arrive with a stretcher to take you for an x-ray; now a “transporter” arrives, unplugs your bed, let’s your roommate listen to the screeching alarm, then takes you in your bed for an MRI.
In the nursing home, there is a narrow bed that probably cost $300 when it was new a decade ago. It has wheels and an air mattress. The control to raise and lower the head and foot of the bed is on a cable that is clipped to the bottom sheet, which slips off and the control falls under the bed during the night. The call bell is on a long cord clipped to the other side of the sheet and also falls on the floor during the night.
There is one thing that is absolutely identical in the hospital and the nursing home. When staff come into a room during the night, they turn on bright lights and talk in loud voices. I have chronic fatigue syndrome and life is misery if I don’t get sound sleep. Yesterday, they assured me that my roommate would sleep all night.
What they did not mention was that the staff would come in two or three times to change her diapers. Why? They make all-night diapers for babies; can’t they make all-night diapers for adults? She most emphatically did not want to be wakened. She would yell “No! No!” at the staff and try to hit them. Then she would scream. Just plain open her mouth and let out several full-volume screams. They don’t do that much in hospitals—the patients still have a modicum of self-control and mental functioning.
So why do they repeatedly change diapers during the night? So the patient’s skin won’t break down into bed sores? How many of these people, if they had the mental competence, would choose bed sores and sleep over screaming in the night? In America in 2012, we measure success on a material basis, even down to bed sores on an old lady’s butt. What if we measured success on the number of smiles and failure on the number of screams?
So it was a bad night. Hot. Really hot. I slept in my t-shirt and undies and was still too hot. Bed controls and call bell out of reach on the floor. Need water. Put my head on the pillow only to discover that there’s some kind of electric thing behind the bed and the vibrations are transmitted through the pillow. How healthy is that?
And, of course, there is St. Joe’s final gift to me—the head cold. My nose runs and I can’t keep the BiPAP mask on. At 5:30 a.m. someone comes in a checks my blood sugar—313. Breakfast is not till 7:30 a.m.—maybe. It depends on where my tray is in the process. This nursing home has 455 beds; the average in New York State is 150. There is no nursing home in this county that is that small.
I ask the aide for the cider I brought in with me. She can’t find it. She walks in carefully carrying two miniscule plastic cups of cranberry juice; in hospital, juice comes in cartons that they can toss at you. It is sunrise and roomie, as promised, is sleeping soundly.
It’s going to be a long day.