I am sitting at breakfast when a voice behind me says, “Hello, Anne.” I turn into the sweeping embrace of Deb, the aide who was my primary on Rehab, the second floor. And this is what it is all about: the relationship between the hands-on care provider and the resident. People kept asking me why I would want to go back to the Iroquois in the face of their hostility and abuse: the frontline workers were nice and we had good relationships. Only the physician and upper administration posed problems so severe that they required the intervention of investigators and judges. In this life, a good aide is more valuable than any physician.
During meals in the dining room they play music that is thoughtfully chosen for the residents, not the staff (as in other places I’ve been). We get Frank Sinatra, Nat King Cole, 60’s pop hits, and Broadway music—Jesus Christ Superstar, West Side Story, South Pacific and My Fair Lady. When I was ten years old my father took the family to see My Fair Lady when it opened in Philadelphia before it went to Broadway. I still have a very clear memory of Rex Harrison, and Julie Andrews—18 years old and just arrived from England.
The coffee is poured and the bread is toasted at 8:00 a.m. The resident does not arrive to drink the coffee until 8:20; the toast is not served until 8:30.
The Law, the Contract and the Notes
Three days ago, we had a seven-person meeting with people from Crouse, the Iroquois, and me and my POA. One person volunteered to take notes.
“Anne will manage her bouts of irritability with PRN doses of oxycodone. . . Agreement was made that the nurse will check in with Anne before meal breaks to see if a PRN dose is required prior to the break to avoid delays.”
These were written notes from a meeting to help us all get on the same page. Expectations on all sides would be spelled out.
When I was admitted to the Iroquois on Friday, the nursing supervisor came to me, called this a “contract” and wanted me to sign it. I understood these to be notes, not a contract. In the hearing, the nursing supervisor made much of what she claimed to be a written agreement with Crouse. She never produced the so-called “written agreement,” which really didn’t matter because the judge wouldn’t have any part of it.
The judge kept repeating, in sixteen different ways, none of them as explicit as this: I don’t give a flying fuck about your agreement—it doesn’t matter. First, you will obey the law. Like I say, the judge didn’t use those words—not even close—but that was the gist of it. The law, as explicated by the NYS Dept. of Health, trumps any and every agreement you may think you have with anybody or everybody.
First, obey the law.
So why is the nursing supervisor trying to turn notes into a contract? They will all fall before the law.
The 160 beds at the Iroquois Nursing Home are all occupied by white people. The kitchen is staffed by black people. The evening and night shift aides and nurses are all Asian or African. Only the aides and nurses working days are white.
English Not Spoken
Try to imagine living with fifty people who don’t speak your language. There are 39 other residents on my floor; not one of them can carry on a conversation of more than two sentences. The aides and nurses who work evenings and weekends all have English as a second language; they do not have conversational English. The English-as-a-first-language people working days don’t have time to talk; they report that they are understaffed.
Do you have any idea how horrific it is for a writer to be trapped with no one with whom to speak?
The aide who comes to my bedside during the night has such severe body odor that it makes me gag. An activist is a person who does something when there is a problem. What do I do about this? Suggestions?
Did you know that the NYS Dept. of Health regulation is that if you ask for pain medication then the nursing home can wait an hour before giving it to you? You want to try that one on your husband who is laying on the couch after doing yard work all day and asks you to get him a couple of aspirin? Yeah, sure, honey—after I bake a cake, put the laundry in and wash the dog.
At 9:30 a.m., the television is turned on in the lounge outside my door. People in wheelchairs are parked four feet in front of it. Yesterday it was tuned to a movie which included a lengthy scene of a woman shouting, gasping and vomiting. The witnesses lacked the physical capacity to move away from it, or to change the channel. There was no aide present to either move the people or change the channel. I think this probably constitutes one of the circles of hell.
The television is shut off around noon for lunch, then it is turned back on and people are set in front of it again at 1:00 p.m. This is supposed to provide stimulation for people lacking alertness. In my room adjacent to the lounge, there is nothing I can do to shut off the sound or change the channel.
Last week at the Resident Council meeting I proposed that the Activities Dept. people provide [what? DVDs?] with Broadway musicals or nature scenes with classical music. These would provide the desired stimulation without being rude, violent or disgusting. The Activities Director received the idea with great enthusiasm.
N.B. Why do you suppose we put abuses and atrocities in television shows and movies that we do not put on Broadway? Do you suppose it has something to do with the direct humanness between actors and audience that does not exist between actors and camera? Is there something so human in stage actors that is says, “Ew-w-w! We won’t go there!” So why do we go there in film?