Table 2 sits in the middle of the left-hand side of the dining room on the Palliative Care Unit of Iroquois Nursing Home. The dining room has six tables, each seating six people. I sit at table two facing the windows and the long view of sky and trees. Behind me there is the kitchen corner that is always staffed by one black woman. She makes toast, coffee and random small other things, and serves the meals that are cooked in the downstairs kitchen and transported upstairs in bins.
Breakfast is purported to be served at 8:00 a.m.
The dietician meets with us from time to time and places our meal orders, which are printed out as menus for each meal and placed beside our table setting. My menu for this breakfast calls for two glasses of orange juice. None have been poured for me or anyone else. In the middle of the table there is a half-gallon pitcher that is half-full of orange juice. The staff is supposed to pour the juice before the residents arrive. You really don’t want little old ladies in wheelchairs trying to reach across a large table to lift a pitcher at arm’s length. But I do it because I still can, and I am very thirsty.
My menu then calls for two coffees, two half-and-half creamers, and a “fruit, apple sliced.” A whole apple sits on top of the menu. Because of my dentures, I have not been able to eat a whole apple in decades. For the last ten years, my aides have peeled and sliced fresh apples.
I call the Iroquois’ aide’s attention to the menu, the apple, and the fact that it is not sliced. He looks at the menu for a very long time, then walks away. His spoken English is very poor and I wonder if he can read printed English at all.
I drink the first glass (thimble-full) of orange juice, gaze morosely out the window and wait for the oxycodone to take effect.
Madeline is two seats away on my left. She is 437 years old and weighs less than the wheelchair in which she is seated. She speaks in such a low voice that I rarely can hear her but we smile and greet each other. We both are friendly people. Madeline asks the aide for coffee but does not get it.
Alice is on Madeline’s left. She is seated at this table because the staff deem her cognitively competent and able to feed herself. Alice is not and cannot. When I arrived she had ugly, bleeding blisters on her face but they have cleared up a good bit by now. She is a pretty lady with soft white hair and an easy smile. My guess is that Alice had a stroke. She also has a handsome, white-haired husband who is kind and loving. I have seen him here once in two and a half weeks.
Alice sits straight across from me and her efforts at self-feeding make me want to vomit. When she lifts a bite of food from the plate, she opens her mouth. As the food gets closer and closer to her mouth, Alice opens her mouth wider and wider, and drops her tongue out farther and farther. A normal person can transfer a bite from plate to mouth in three seconds; I have seen Alice spend six minutes trying and failing to accomplish the task. Her face is smeared with food; food dribbles down her “clothing protector”—bib—and chunks gather on the floor. It is revolting to watch her eat.
A couple days ago, aide Bri sat down and started to feed Alice. Every other table has a “feeder”—a staff person who spoon-feeds patients—but our table does not. As Bri starts to feed her, Alice leans forward eagerly. She is hungry! She wants to eat! She is not just playing with her food and disinterested. Alice quickly consumes everything that is given to her.
At one point Bri gets distracted and sits holding a forkful of food in front of Alice. Alice—eyes on her food—reaches out and nudges Bri’s hand closer to her. Alice wants to eat but they won’t feed her. I mention it to the nurse manager. Nothing changes at table. This morning, Alice is asleep.
Madeline is making motions that she wants her coffee and donut. I ask the aide for coffee for both of us. I get one of the two cups I am supposed to have and Madeline gets none. I drink the second juice. The coffee is served scaldingly hot and has to sit till it cools off.
Seated on Alice’s left is Alfreida, a heavy woman of German origin. On one occasion when I tried to help her, she snapped at me. After watching her for a while, I learned that she does not want help; what she wants is the attention of the young men who work as aides. I cannot give her that, so I leave her alone.
A plate is set down in front of me. The top slice of toast has been burned black. I refuse it and it is not replaced. When I turn over the cheese omelet, it is scorched brown on the underside. Three slices of thin bacon. Madeline still has not gotten her coffee or donut. An aide shakes Alice awake and tells her to eat her breakfast. She immediately goes back to sleep. Alfreida eats her breakfast.
Fran is on Alfrieda’s left, next to me. Fran has some dementia but yesterday we had a fairly lengthy conversation about Broadway tunes that were playing on the sound system. Fran is often mean. The first time I met her, I had marks on my face from the BiPAP mask. Fran responded by yelling, “Nurse, cover her face!” Last night an aide served her something she didn’t want and she hit him. I chastised her, whether it meant anything to her or not.