When bodies fail, souls still matter
The first thing I noticed about Virginia was her tortured eyes. I had never seen eyes filled with so much despair.
Virginia sat at the same table as my mom during meals at the nursing home. Virginia was so weak and sick she had to be fed soft food and she refused to eat much of it. She was often the last one the aides fed because she was easy to ignore. She rarely made a sound and most of the time sat there dozing. Her hair was thin but still long, sloppily pulled on top of her head. You could see a ghost of the beautiful woman she may have been.
Once in awhile she’d come to life. When the nursing aide tried to feed her a grayish green soup that she herself could not identify, Virginia found the strength to growl “You aren’t putting THAT in my mouth.” That’s when I liked Virginia even more.
My family was there daily to visit my mom over Christmas week. Very few other visitors came, even though it was the holidays and more than 40 patients languished there. I thought of Virginia alone in her room with those sad eyes and went to visit. I found her half naked and shivering. The oxygen she always wore was rolled up in the corner and she was gasping for air.
I ran to find a nurse, who didn’t seem as panicked as I was at my discovery. She and an aide dressed Virginia, put on her oxygen, and wrapped her in a blanket. After voicing my anger to them about finding a patient in such a state, I decided to sit with Virginia for a while and hold her hand. I noticed some pictures of a younger Virginia with a handsome man, kissing at a restaurant at what appeared to be a celebration – a wedding anniversary, perhaps. She had been beautiful and happy. Her eyes held no sadness then – only sparkle and joy. Another picture of the same man, only younger and in a military uniform, also sat at her bedside.
I learned later that Virginia had lived a remarkable life. She loved flying and spent considerable time and money learning to be a pilot. While she wasn’t able to fly in World War II, she instead trained pilots to serve in the war – a job few women enjoyed at the time and which trail blazed the way for other women in aviation. She also joined the American Red Cross and traveled to Europe to assist in the war effort, where she met the handsome man in her pictures – an Englishman whom she married. Together they remained in Germany after the war to help rebuild. She also served as a secretary during the Nuremberg Trials.
Virginia and her husband lived in England, but after his death she returned to the United States, where she cared for her older sister and also volunteered at hospice. She never had children, but did have a niece and a nephew who we were told visited once in awhile. But, as we learned caring for our mother, it is difficult to always be there when you have your own jobs and families to attend to. You want to believe that the people you have entrusted with your loved one’s care are doing their jobs and treating them with dignity. Unfortunately, this isn’t necessarily the case and Virginia was often alone and neglected.
Nursing homes like this one all over the country are full of Virginias. One of the reasons is that most nursing homes are understaffed.
Federal law requires Medicare and Medicaid certified nursing homes to have a registered nurse (RN) director of nursing (DON), an RN on duty at least 8 hours a day, 7 days a week and a licensed nurse (RN or LPN) on duty the rest of the time. However, there are no minimum staffing levels for nurse’s aides, who provide most of the day-to-day care. Instead, nursing homes are required “to provide sufficient staff and services to attain or maintain the highest possible level of physical, mental, and psychosocial well-being of each resident.” But if a nursing home met only the federal nurse staffing requirements described above, a resident would receive only 20 minutes of nurse time per day. (Source: Elderlawanswers.com)
The facility my mother and Virginia were in is no different. The aides were the ones who interacted with my mom the most – but they were often running from room to room just keeping up with emergencies. There was only one nurse at night to keep an eye on more than 40 beds.
Pay is another issue. According to PayScale.Com, the average wage for a nurse’s aide at a nursing home is $10.86 an hour. Most would choose slinging burgers over changing adult diapers for that amount. While some aides were very caring, others had no business caring for anyone. One aide spoke loudly in front of Virginia that she was “tired of her shit” and didn’t want to feed her because she was just dying anyway. I wasn’t there at the time – my niece was – or I would be writing this from jail after choking the aide to death. My niece reported her, though, and the aide was sent home.
Even the good care givers were burned out after trying to make a difference, only to find they couldn’t keep up with all the patients’ needs. You could see the defeat in their eyes. Most of the staff pulled double shifts multiple days in a row because they couldn’t find enough people to work – adding exhaustion to the mix. One aide shared with us that since so many people were calling in ‘sick,’ she worked one 12 hour shift, had six hours off, and then returned to work a full day. Another time, my niece and mom pushed the call button for help and waited over 19 minutes before someone came by to assist. I am glad it wasn’t an emergency. But I wonder how many other residents did have emergencies that went unanswered.
Working at one of these facilities is a soul sucking job. But it’s an important one. Every day I was there, I was sad not only for my mom but for everyone else there. But my spirit was also lifted more than once from the smiles I’d receive from the residents after simply talking to them, squeezing their hand, remembering their name, or giving them coffee or water. One woman was so pleased with herself for finishing a puzzle we had set up for her that she came running to find me, grabbed my hand and pulled me down the hallway to show me her achievement. She was beaming.
We visited my mom daily while we searched for a better place for her. She has dementia and a recent stroke has taken her ability to walk. We were able to be her voice and advocate, making sure she was bathed, fed, given her medication and that precautions were taken to prevent falls. Most importantly, we were able to let her know she was still important and loved. We sang with her, did puzzles, visited and tried to keep her spirits up despite the confusion and pain she was feeling. The time we spent with her was a valuable gift to us.
Others, like Virginia, didn’t have much of that. My niece and I took turns feeding Virginia when we could. She seemed to eat more for us – and that way we didn’t have to worry if she was fed. We would also just talk to her – trying to nourish her soul a little, too. I was even able to get her to smile once when I told her I had seen a picture of a handsome man on her night stand.
Virginia died at the nursing home facility on New Year’s Day. She was 95. I am relieved for her – because the torture in her eyes – which I believe were begging to die – is now gone. But I’m angry and sad she had to die alone, in that place. She was important. She was loved. She mattered. But in the end, I don’t feel she felt that way – or was treated that way.
Maybe the reason I cared about Virginia in such a short time is I saw myself in her. I have no children. Even having children does not guarantee that you won’t outlive those you love – or that you will just simply be forgotten. Any of us could be Virginia.
Some cultures revere their elderly. We have a lot to learn from them. We need to reform the nursing home system. We need to spend time with our seniors and show them they are valued. We need to teach our children that the elderly have much to give. We need to form partnerships between elderly care facilities and schools, volunteer groups, and corporations to provide more resources and awareness. We need to not forget these people. Bodies may fail, but the souls inside still matter.