Thursday, July 24, 2014

No Thank You

Nursing homes have changed. Despite my good intentions of visiting old friends stacked away in what I pictured as sad institutions, I haven’t made it past the lobby and into a nursing home resident’s room in twenty years. In my mind nursing homes were like the one I worked at in the seventies. A long yellow brick building stretched parallel to the street, three floors and a basement housing the kitchen, dining room, and recreation area. Three nurse’s stations were stacked one on top of the other in the very middle of the building, two long dark halls extending each way from the nurse’s stations.

Small identical rooms on either side of the hall housed two patients each, save for special single rooms near the nurse’s station for the dying. Square floor tiles covered the patient’s room as well. On them were two hospital beds and institutional steel furniture. A narrow table on casters that extended over the bed, a bedside stand with one drawer, built in closets. Those waxed tile floors echoed the clacking of hard leather heels and made the cushioned soles of the nurse’s white shoes squeak. Handrails, seldom used, ran the length of the hall on each side. Rubber tired wheel chairs glided silently by.

Day rooms bright with windows at the end of each hall had a TV. Wheelchairs were parked there or close to the nurse’s station most of the day. Ventilation was poor, it was terribly hot year round, and the smell of urine was pervasive. From time to time a voice was heard from a room down the hall. A tired voice yelling, pleading maybe, or simply trying to find a way to make individual pain something others realized. If you listened closely the faint sound of a radio might break the silence. Time passed slowly in the nursing home where I worked in the seventies, for both the residents and the help.

I was back there this week, geographically anyway, in the block where that nursing home once stood. In its place is a collection of buildings, roof lines, gardens. It’s safe to say the nursing home I worked at is completely gone. When you see the building from the street you don’t see a nursing home. You see a residential complex.

When you go in there’s a fresh smell. The floors are carpeted, soaking up the noise. There are more people than I ever remember in any nursing home, wearing street clothes, offering to help. Old people in wheelchairs are incidental to the activity that seems to be going on in the building.

A woman I met by the front desk gave me a little tour. A vaulted two story atrium sat over the main part of the building where six short halls, each with a nurse’s station, go out like spokes on a wheel. In between the halls is the sports bar (I didn’t see beer signs) with lots of flat screen TV’s on the walls and popcorn available. The smell and sound of it popping filled the area. The Tuscany Room with comfortable couches, like we might have in our own homes, had a library and a door leading outside to the garden activity area. You can get free ice cream anytime in another small room. As we walked by a nurse’s aide was helping a resident fill a cone with soft serve. I was a nurse’s aide. That was never part of the job.

The patient rooms are still small, but decorated better, and each now a single room it appears. The rooms have carpeting, paint, and window treatments that compliment one another. The furniture is wooden and has a homey feel. Each room has a flat screen TV and a fully electric bed that can be raised or lowered, the back or the feet raised, all controlled by the patient. When I think of how I cranked on those old beds, called in especially to do so, my patient thanking me when I was done. Patients were so dependent then on the staff. Here it looks as if the facility encourages free movement and variety, as much as people can still make choices and carry them out.

I used to be part of the settling in process that was going on while I stayed with my friend, showing patients where we kept their clothes, how to use the call button, explaining meals in the dining hall, the routine, how the day was structured. New, since my day, was the aggressive physical therapy component designed to build strength and movement so a patient can go back home. The person I was there with has had surgery and needs help regaining strength and vitality. With any luck only a short stay will be required. At the nursing home in the seventies we never promised that. And it rarely if ever happened.

All that aside, when it came time for me to leave my friend was surrounded by people just met. Each was very nice, but all were strangers. We exchanged a look as I left. I was walking out to my car, driving home, or wherever I wanted. My friend was staying, now a part of the place, and in the hands of others. Night would come and finally the lights would go off. My friend would be alone in that room. Quiet would creep down the nicely carpeted hall. Maybe somewhere a voice, calling out, would break the silence. I imagined how it might feel to be in my friend’s place. I wouldn’t want to be there.

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