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Humor in Nursing Homes: Part Two
(For Part One Click Here)
Written by Grace Rudolph, LSW
While researching the effects of humor on health I discovered that Type B people enjoy non-hostile humor while Type A people enjoy hostile humor. Makes sense to me. Think about it. Type A's are the ones suffering from peptic ulcers, hypertension, and colitis. They're the high powered over achievers who are a heartbeat away from coronary care units at any given minute of any given day. Cops and corrections officers are usually prime 'Type A's. An officer working at a prison in Plymouth, a facility that houses very dangerous Federal prisoners, told me that when felons are released he waves goodbye and says, "See yah. We'll leave the porch light on." A Camels-unfiltered- two-pack-a-day habit and hostile humor are his personal self-care tools to offset stress. It seems to work for him but I wouldn't want to be the salesman who sold him an insurance policy.
As long as we're discussing dangerous people and dangerous situations I'll skip the facts and figures on serum cortisol, dopec, and epinephrine levels and get right to difficult, but interesting, families. Social workers who deal with them know that sometimes families under stress turn dangerous. When that happens you either reach for those unfiltered Camels or step back and look at the problem objectively. It's to your advantage to find humor in the situation because if you don't, once the dust has settled, you could find yourself in serious trouble and could segue from a Type B to a Type A in an arrhythmic heartbeat.
I have a tendency to find humor in everything, including battling families. I'm not talking about those wimpy mama-loved-you-best battles, I'm talking Oh-yeah?-I'll-knock-your-lights-out battles.
I once knew a gentle lady named Irene, a resident with a 24/7 blissful smile. Irene had two sons that the staff referred to as Good Son, Bad Son. I really didn't get a handle on this family until the day I tried to set up a discharge meeting. Irene had smiled her way through short-term rehab and her Medicare was running out. The team felt her gains couldn't justify a safe return home. The Bad Son was immediately up in arms since he lived with Irene and thought he'd be out on the street if she were admitted for long-term care. I called to set up a meeting. He hung up on me. I left messages. He never called back. I sent letters. He didn't respond. The team began to pressure me to set the date. Finally I called the Good Son and asked him to contact the Bad Son and ask him to join us. "Sure," the Good Son said. After a very long pause he whispered, "Can I sit near the door?"
My hair lifted away from my scalp. I've been told that this is the phenomenon mountaineers experience when sparks of lightning flash off their ice axes and their hair lifts from their scalps. These signs are the precursor that bolts of lightning are racing in for the kill. "Why do you need to sit near the door?" I asked.
"In case," he said.
"In case what?" I asked.
"Just in case."
"Are you afraid of him?" I asked.
"Should I be afraid of him?" I asked.
Never being one to beat around the bush I asked, "Does he have a gun?"
During another long pause we mulled that one over until the Good Son said, "He's knocked me out a few times."
"Will he punch anyone during the family meeting?"
And then the Good Son came up with a wonderful solution. While his brother was at work he would steal the gun and lock it up. Provided he could sit near the door.
During the meeting I used gentle, very cautious humor and we carried it off without a hitch. Irene settled in for her long-term stay and the last I heard both sons had moved into her house and were living happily every after.
Wait. There's more.
While we were focusing on the Bad Son we should have been focusing on the resident who lived a couple of doors down from Irene.
Ben was a six foot three powerful paranoid schizophrenic. The staff had nicknamed him 'Gentle Ben' because he was a sweet, quiet soul, as long as he was taking his medicine. He didn't have much to say but he smiled a lot and opened doors for little old ladies. What we didn't know and, what Bed did know, was that he had been pocketing his meds in his cheek and spitting them into the toilet as soon as the nurse left the room. If it's true that alligators live in sewers, years from now the alligators around that nursing home will still be doing the Thorazine Shuffle.
On the day Ben's room at the end of the hall was scheduled for a thorough cleaning his furniture was pushed into the hall while the floors dried. The first indication something was amiss was a series of thuds at the end of the hall as Ben began picking up furniture and tossing it into the air; beds, chairs, walkers, commodes, and TVs. If it wasn't nailed down it was air borne. As he methodically lumbered up the hall, a few poor souls quaked in their wheelchairs while the call went out on the overhead page for 'Dr. Armstrong,' to alert every able-bodied male on staff to report for combat duty. Meanwhile staff and visitors rushed around herding residents into rooms, removing everything from the halls, and securing the doors.
Before the first able-bodied male arrived Ben slipped into the TV room. "Great!" someone shouted, "Send the social worker down there to shut the door."
When I inched up to the door and looked inside the room I saw that Irene was watching Days of Our Lives. Ben was upending tables, tossing gig saw puzzles over her head, and throwing chairs against the sliding glass doors that led to the patio. The Beef Trust finally arrived after what seemed like years but was only minutes, and rushed him out of the room to a nurse who sedated him.
I found a chair that wasn't broken and sat down beside Irene. I put my arm around her shoulders and asked how she was doing.
"Not so good," she said.
I put my head against hers. "Is there anything I can do to help?" I asked.
"Sure. Find the clicker and turn up the sound."
Irene was thinking outside the box. We saw danger and thought bodily injury. She saw same-old-same-old and thought home sweet home. Maybe that quote from the bible I keep trying to remember was, "In the midst of danger there is humor."
When I think 'danger' I think 'survey.' Some of my potentially dangerous, but usually funniest, memories involve surveys.
We were in the window for one when a man was admitted to Room 406. He'd only been there a couple of days when he began complaining there were snakes crawling across the walls. After a few times of searching his room and finding nothing, the nurses began searching his chart and found a diagnosis of alcohol abuse. We hooked him up with AA and sent him home.
A couple of months later the State walked in and things were going smoothly until the day they were preparing to exit. I was walking down the hall when a man who had been admitted the day before waved me into his room. He pointed to the wall at the foot of his bed and said, "Snakes." I looked around and I didn't see any snakes.
It wasn't until I got to the nurses station that a bell went off. I called the maintenance man and said, "Do your remember that resident who said he saw snakes?"
"Yeah," he said, "The guy in 406."
"Well," I said, "There's a new guy in there and now he's seeing snakes."
Maintenance men never travel alone. There are always two of them. Usually one's short one and the other's tall. If you're having problems with the floors two show up, rip up the tiles, and lay down new ones. If the roof collapses during a blizzard two show up and build a new one. If a light bulb burns out two show up and screw in a new one.
When they showed up the short one held the ladder while the tall one climbed up and pushed aside a ceiling tile. He almost lost his footing scrambling down the ladder, then grabbed my arm and marched me into the hall. "There's a nest of snakes up there," he whispered
"Hey!" I said, "I'm a social worker. I don't do snakes."
"Where's the State?" he asked.
When I told him they were in the library finishing up he said, "God's on our side."
I wheeled the man from 406 to the TV room and used my feminine wiles to convince him he wanted to watch Brady Bunch videos. Meanwhile the maintenance men packed ice around the nest to slow the snake's metabolism to keep them from slithering into the library.
After the State left a tough looking woman from a nearby pet store came in with a net on a stick and removed the nest.
In my life angst and humor go hand-in-hand. The combination has saved me more times than I care to remember. Especially when I get myself into a situation and something that really isn't a good idea seems like a terrific plan.
For example, one day I was driving to work and began thinking about one of my children who was having a hard time. Money was tight and I was feeling blue because I wasn't in a position to help out. When I stopped at a Cumberland Farms to get gas I noticed a blue and black lottery sign in the window. I'm usually pretty tightfisted when it comes to spending money but throwing caution to the wind I invested a dollar in a quick pick Megabucks ticket.
When I got to work one of the nurses stopped me in the lobby. Clara, a woman who had been a resident since the facility opened, had stroked out during the night and was doing poorly. Her family began gathering at her bedside a little after midnight and were still there at nine a.m.
"I think she's hanging on until they leave," the nurse said. I agreed.
We went down to the room together. The family looked exhausted. Clara looked dead. Her respirations were shallow, few, and far between. Her vacant eyes were half open and one corner of her mouth had begun to droop. The nurse convinced the family to go out for coffee and I promised to sit with Clara until they got back.
After they left I pulled up a chair, sat down and held Clara's cold and mottled hand. I told her I could see she had led a successful life. She was a woman who had passed her love and devotion to her children and now they had taken that gift, were supportive of each other, and would obviously pass the gift on to their own children. "Clara," I said, "That part of you will never die. That part of you will live on through them." Several times I thought she had stopped breathing.
When I sit with dying residents I fill the lulls and silences with thoughts about my own life. That morning I began thinking about my family, my children, and especially about the child who worked so hard to make ends meet. Then, I remembered the lottery ticket. I began to fanaticize. If I won Megabucks I'd buy that child a home. No. I'd buy all my children a home of their own. Then I'd get new tires for the car. Then my husband and I would go away to Aruba for a week. Maybe Key West. Maybe two weeks in Key West. And of course God, You know I'd give a ton of money to charity.
I looked around the quiet room and then rocked back in my chair and glanced into the empty hallway. "Hello?" I said. No one answered. And that's when I got a good idea that seemed like a terrific plan.
I leaned over and said, "Clara? Clara. This afternoon, when you meet God, do me a favor. Ask Him if Grace Rudolph can win Megabucks tonight."
The next morning I picked out a sympathy card for Clara and went up to the unit to close her chart. I was about to take the chart out of the rack when a nurse said, "Where are yah goin' with that?" When I told her I was going to write my final note she said, "Clara rallied last night. Other than a little left-sided paralysis and garbled speech she's fine." She tapped the side of her head and said, "Even her cognition's intact."
I walked down to Clara's room and stood in the doorway until she slowly turned her head on the pillow and looked at me. I could see she was trying to decide if I was the Angel of Death or a bookie.
I gleaned this last piece of humor trivia I gleaned from the American Heritage Dictionary of the English Language where I found several definitions of humor. Two were particularly interesting. The first described humor as, "the ability to perceive, enjoy, or express what is comical or funny: a sense of humor." This was immediately followed by: "Humor. In medieval physiology one of the four fluids of the body, blood, phlegm, choler, and black bile, the dominance of which was thought to determine the character and general health of a man."
Today if you forget everything else you've learned about Type A personalities, T-cells, or endorphins, please remember not to forget:
In the midst of mayhem there is humor.
To contact Grace, you can write her at Gracegannon35@aol.com
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