By Grace Rudolph
When I was a child at St. Angela Merici School, Sister James told our class that when our parents got old we should take care of them. "If you don't," she said, raising a thin, perfectly arched eyebrow and laying on years of guilt, "You'll be like the Eskimos who used to put their elderly, sick parents out on ice floes for the polar bears..." with a shudder she's raise a trembling hand as though warding off the horrible vision of massive white bears lurching around, waiting for tasty 'snacks' to float by on chunks of ice.
I moved on to the upper classes and finally graduated without remembering my multiplication tables but I never forgot that cautionary tale. I promised myself I would always take care of mother...a classical pianist, a poetess...an authority on Russian history who devoured books on philosophy when she wasn't doing the N.Y. Times crossword puzzles. In ink. She loved concerts, theatre, travel and losing herself in novels by Thomas Hardy.
Because she was a self-taught philosopher she gave my sister, two brothers and myself words to live by: 'You get the life you need.'
When mother retired, she spent a season each year with one of us. Her grandchildren looked forward to her arrival because they knew that once she arrived they had an advocate who would rush to their defense when homework wasn't finished on time or they were dating a boyfriend who had been the bane of their parents' existence, and she was always a ready shoulder to cry on when mom said 'no'. She was their Joan of Arc, their Don Quixote, their barrier reef in a hostile world.
But slowly, surely, she began to fail.
One day, while staying at my sister Ruth's, after everyone had gone off to work, she stepped out onto the porch in her slippers and her favorite thin black dotted swiss bathrobe to retrieve the morning paper. The door closed, and locked, behind her. It began to snow. The wind caused drifts on the street and on the porch where she waited for two hours until someone discovered her and got her back inside the warm house.
When she was at my brother Paul's home my sister-in-law was carrying a basket of laundry up the stairs when she noticed mother standing in front of a full-length mirror in the hall. She was obviously distressed. "What is it, mom?" Anne asked, setting down the basket and coming to her side. Mother pointed to her own reflection in the mirror and asked, "Who is that old woman?"
"That's you, mom," Anne said, putting her arm around mom's shoulders
There was a long pause. Then, puzzled, she turned to Anne and said, "How did I get so old so fast?"
By the time she came for her season at my home her medicine regime was very complex. So much so that one morning I saw she was in distress and out of meds. Fortunately, the pharmacy was a five-minute drive from the house but, when I got back home she whispered, "Maybe you'd better call an ambulance." In the short time it took them to arrive she was in full-blown congestive heart failure and trying to hide her terror.
While I was waiting for her to be resuscitated at the hospital I called a friend, "Grace," she said, "she needs more than what all of you can give her. Are you trying to kill her?"
I talked it over with my brothers and sister and we agreed that yes, perhaps a nursing home placement was appropriate. The doctor had suggested it months ago and we finally accepted the reality of the situation. Now the problem was...who would tell mom. We're a close family so we decided to work together and, of course, include mom. We agreed that if we chose someplace semi-public we wouldn't all break down and start discussing polar bears and ice floes. Great minds under great stress come up with creative solutions ... SPRONG! ... a Chinese restaurant.
Well, I showed up with mom and no one else arrived. I forged ahead anyhow and mom, who was obviously very upset, agreed to "give it a try." If a large white bear had shambled into the restaurant and asked to be seated at our table I wouldn't have been the least bit surprised.
A week later she became a resident at a nursing home in Newburyport which was close to my sister's home and we, very quickly, became the family from hell.
We would arrive at the nursing home like a school of piranhas out for blood.
Ruth was in charge of clothing: "Where's my mother's underwear? Where are her socks?"
Leo was in charge of food: "Excuse me, Miss? What's this beige pureed stuff? Can you take it away and bring her something from the food chain?"
Having a background in theatre I was in charge of entertainment: "What's this!! My mother watches PBS, William Buckley, and the evening news in depth. This is General Hospital! It's a soap opera, for crying out loud!" Each time the 'doctor' on General hospital said, "Open your mouth and say, Ahhh," mother and her roommate would open their mouths and say, "ahhh." I was beside myself.
But not as crazed as brother Paul, the brother who lived in North Carolina and was the one who got desperate calls in the middle of the night from mother asking him to rescue her. She confused him with her brother Bill, a lawyer who had died many years ago. She would ask Paul to come up North and start a class action suit to free her and her roommate.
As we watched her decline we were devastated. This brilliant woman who told us 'you get the life you need' forgot who she was, where she was, and who we were. We directed our anger, guilt, denial and frustration at the staff until eventually we came to terms with our grief. In the end I was blessed because mother chose me to be with her when she died.
I eventually went back to college to get my degree in social work. My first field placement was with non-compliant teenage girls. All parents with teenaged girls know what a delightful experience that can be. If I had time or the inclination to clean my oven I would have stuck my head in there and called it a day! The next field placement was mentoring gang member's tough, bullet ridden scary, tattooed guys who looked on me as their surrogate grandmother. One fellow, a Crip, with a voodoo amulet around his neck for protection, took me under his wing and taught me how to cheat at arm wrestling.
Three months after graduation and a round of fruitless job interviews that had destroyed my self-esteem, I finally received a job offer at a nursing home in South Yarmouth. One hundred miles round trip and two daily hair-raising spins around a rotary that rivaled any theme park adventure. That night I told my husband I was going to keep job hunting because working in a nursing home would be as exciting as watching paint dry.
I was wrong.
I suddenly knew I had been living the life I needed for the job I was meant to do.
Suddenly I was dealing with people who were demanding that I find their mother's socks now! Socks. Remember when you're kids were small and they wore white sport socks with thin colored stripes around the cuffs? If you threw eight pair into the washing machine five socks came outand none of them matched? Two weeks later they all showed up in one of the kid's dresser drawers. How they got back there, I don't know. Where were they? I don't know. In laundry limbo? That happens in homes. And nursing homes are homes.
I was suddenly confronted by big scary family members with plates of pureed food who were demanding to know, "What is this stuff?" And while I was out trying to figure out what the heck that 'stuff' was and having post traumatic stress flash backs of feeding my infant son, King, mashed peas another non-compliant family member was back in the room slipping dad Doritos and Baby Ruth candy bars.
Occasionally, I'll go into a resident's room to give them quality one-to-one time but they wave me aside without making eye contact because they're watching a soap opera when they could be watching PBS. Or the news. My head begins to shake a little, then my body begins to tremble and, finally, my left eye begins to twitch. But, I've learned that when you're living in a nursing home TV is your window on the world. Your reality. Have you watched the news lately? Really watched the news? Ha! And you thought The Exorcist was scary!
What's really scary are those calls out of the blue. The ones my brother used to get and relay to us because we were closer to Newburyport and could make that white knuckled drive when mom called him in tears.
There was a wheelchair bound woman in a nursing home where I worked a few years ago, a woman in her late 80's who had a smile that could light up the hearts of everyone she met. Her eyes twinkled without the benefit of cataract lens implants.
One day as I was working in my office she wheeled in to the room and asked if she could use my phone to call her daughter. "Sure," I said. She dug through the enormous ancient pocketbook on her lap until she retrieved a tattered scrap of yellow paper with a faded telephone number penciled across it. I dialed the number, gave her the phone, and went back to my work. Suddenly I became aware that she was sobbing. Broken hearted, gasping sobs. "I wanna come home," she cried, "Tell mama to have daddy come and get me!" Her face glistened with tears and she dabbed at her eyes and nose with a soggy Kleenex. My lower lip began to tremble as I fought back my own tears and rushed to her side. Just as I was about to hug her she hung up the phone, spun her wheelchair around and the room instantly filled with the sunshine of her smile, "Is it time for Bingo?" she asked.
And I knew somewhere a half-mad, disheveled, daughter was tearing her house apart looking for her car keys because, I'd been there. I'd done that.
'You get the life you need.'
I've seen nursing homes from both sides now and I've yet to see a polar bear, or an ice floe, and I have never met an Eskimo.
Over the years I've been working in this field, nursing homes have evolved into rehab centers or healthcare centers. But to me they are still homes because a home is a place where people spend time together, know one another, care about each other, laugh and grieve together and at times face death together. Homes are filled with dogs and kids and visitors. Homes are filled with life.
A few days after I began working as the director of social services at my current nursing home there was a get together to welcome me. The activity room was filled with residents, staff, visitors, and the administrator. No polar bears in sight. One resident, a gracious, elegant woman locked the brakes on her wheel chair and stood up as hands reached out to steady her. In a clear but tremulous voice she made a speech, that ended, "welcome to our home."
I hope Ice Floes, Polar Bears, and Eskimos will give you an insight into the daily frustrations and triumphs of long term care. Look on it as a box of chocolates. Pick and choose what catches your fancy. You don't have to read it from beginning to end. You can spill coffee on it or leave it on a bus. Sister James has long since retired her ruler so your knuckles are safe. In fact, don't look on it as a book at all. Instead, consider it a welcome to my home.
Grace Rudolph is the Director of Social Work at Sippican Nursing and Rehabilitation Center, in Marian, Massachusetts.