• author
    • Marla Pugh

      Columnist
    • January 12, 2015 in Columnists

    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.

    RIP Virginia.



    • I spent a lot of time in convalescent hospitals, nursing homes, etc., while caring for my dad for 27 years after he had a completely devastating stroke. I HATED going there. HATED it. But yet, I went, nearly every Sunday. From time to time, I’d think about the other patients as you did Virginia. They all have histories, stories, lives… and the staff often treat them like children. No respect at all. Some would even talk to them like children. And then there were people who no one seemed to visit at all. I’d go on holidays, and you could tell who had family and who didn’t.
      The nursing home always felt like a warehouse for people to me… the place they collect everyone before they pass on. Those places have a one-way door. No on gets out alive.
      Tough times, going through this phase of your life, when your parents become your children. It’s like your world flipping around on its own axis.
      Hang in there….


        • Marla Pugh

        • January 12, 2015 at 12:43 pm
        • Reply

        I hated it too Debra … but I have to admit I also came to love some of the people there. I hope to volunteer at a senior care center here. If I can’t be with my mom every day … maybe I can provide comfort to someone else’s mom.


      • madgew1031Madgew

      • January 12, 2015 at 8:51 am
      • Reply

      My mom died at home after 11 years with caregivers. Thank goodness she had the money to pay for the best people in the world. When it was time we talked to her as best we could with her doctor and decided that she would not want to live like this and we all decided that the pain was too much. We helped her die with dignity. I think sometimes we need to think of ways to help people to die rather than ways to put them away out of sight and mind. I am glad you were there for Virginia and your Mom. After my mom died I made sure my children have the power to voluntarily or involuntarily withdraw food and water when I am no longer able to take care of myself. No nursing care for me. It is not the life I want. Dying with compassion is my choice. Find an advocate who will make your choices known.


        • Marla Pugh

        • January 12, 2015 at 12:40 pm
        • Reply

        I am sorry about the loss of your mom. And you are right, she was lucky to have the resources to have good caregivers and family to advocate for her. You are setting a good example to your own children as well about making sure they have advocates.
        What saddens me is that my mom is also in a position to have good caregivers and has family around to advocate. (Since I wrote this, my mom was moved to an amazing facility.) But so many people don’t have that. And some are even worse off than Virginia. People need to live and to die with dignity. Thanks for reading, and for your comments.


      • Terri Connett

      • January 12, 2015 at 10:37 am
      • Reply

      Marla, this is a beautifully written and familiar story. Your compassion for Virginia helped her find her way home.


        • Marla Pugh

        • January 12, 2015 at 12:41 pm
        • Reply

        Thank you Terri 🙂



    • Very moving story and well written. My retired school-teacher aunt (never married, no children), died in a nursing home and the aides stole from her. So did the so-called “caretaker” of her home; expensive items turned up missing while he was “caring” for the home and maintaining her yard. He also had access to her checkbook and drained her account. I would like to see more stories done about what happens to the elderly in a nursing home. So sad. So very sad.


        • Marla Pugh

        • January 12, 2015 at 12:42 pm
        • Reply

        Thanks Kathy and yes, very sad. I’m so sorry for your aunt and your family. I will keep writing about this topic, for sure 🙂


      • Gil neal

      • January 12, 2015 at 1:39 pm
      • Reply

      Very nice piece, Marla. Was this in Ellensburg?


        • Marla Pugh

        • January 12, 2015 at 3:11 pm
        • Reply

        Yes Gil. My mom’s in a facility in Yakima now though that’s lovely.


          • Marla Pugh

          • January 12, 2015 at 3:11 pm

          And thanks 🙂


      • Paddie

      • January 12, 2015 at 2:25 pm
      • Reply

      Marla, my daughter is a nurse, and has spent many hours during her clinicals in facilities like the one you have described. You nailed it with this. I am so proud to say she is the kind of nurse that went the extra mile to show love, compassion and dignity to those like Virginia that touched her heart as it did yours. With that said I wish there were more like my daughter in the profession, like she said every patient could have been someone she loved. Thank you my friend for an awesome read, xo


        • Marla Pugh

        • January 12, 2015 at 3:12 pm
        • Reply

        I wish there were more like your daughter too, Paddie – but thank god there are people like her. They are angels to these people 🙂


          • Paddie

          • January 12, 2015 at 3:53 pm

          Marla, she would just come home heartbroken some days, but I assured her she made all the the difference, and never change. I am truly blessed and I know every patient she deals with is in the best hands ever. Truly a noble
          Also, it helps she has a great sense of humor. The more contankerous the better, crazy girl loves the challenge



    • In Washington State, we lead the country with our Adult Family Homes! I own one, we give GREAT CARE, and we LOVE our residents and their families, SandersEstatesAFH.com
      No one should be alone and unloved in their elder years!


        • Marla Pugh

        • January 13, 2015 at 2:44 pm
        • Reply

        I agree. No one should be alone and unloved period. There are good places out there too and I’m glad yours is one of them – but many of those good places, like the excellent memory care facility my mom is in now – is not easily affordable or available to everyone. And many others are horrific. The answer is to reform the entire system of nursing homes so people of all social and economic classes are cared for and respected. People also need to contemplate long-term care insurance. Even then, some long term care policies don’t cover facilities like the one my mom is in now, and only cover state facilities, many of which are similar to the one I described in my column.


      • Cheryl Chance, Ellensburg, WA

      • January 13, 2015 at 9:33 am
      • Reply

      Excellent article, Marla. My mom moved West from Michigan to help take care of me in April 2002. Now, the roles are reversed. It is most difficult on me, since I have Fibromyalgia Syndrome, to help my mom care for herself as she has steadily declined in the last five years, both physically and mentally. We live each day, one day at a time, with “catch-as-catch can” moments of memories, patience and love. By writing this article, you brought to the forefront that topic which is always, forever, nagging at the back of people’s mind: “Who will take care of me, and how will I survive, when my time comes when I can no longer take care of myself??” God bless you, Marla, for your insightful story.


        • Marla Pugh

        • January 13, 2015 at 2:46 pm
        • Reply

        Thank you Cheryl. I am thinking of you and your mom … it is never easy, and there is no easy solution. But this is a problem that affects everyone – and hopefully people will start speaking up more about solutions 🙂


      • Jesse Loren

      • January 14, 2015 at 10:57 am
      • Reply

      Virginia sounds like one my aunts. My aunt was a pilot and won awards for her flights. She led a very independent life. After her husband died she continued to travel the world. She made one last trip with her girl friend, who was also a pilot. In their late 70s, my aunts’ friend took time off from flying Doctors Without Borders and they went to Alaska. They spent several weeks flying the small plane to different cities and exploring all of Alaska. On the flight home, just before landing, the gear seized. They circled and tried again, circled and tried again, then the plane exploded in fire. My aunt and her friend died in the plane.

      I wish they knew Virginia. She would have loved those ladies.


        • Marla Pugh

        • January 14, 2015 at 11:16 am
        • Reply

        Wow Jesse … what a great, adventurous lady your aunt was! I wish I had met her, and yes, she and Virginia sound like they would have got along famously! Thanks for sharing your aunt’s story 🙂


      • Kathleen Brotherton

      • January 14, 2015 at 5:32 pm
      • Reply

      I am a Certified Nurses Aide no longer in the field. A good nursing home is the exception not the rule. When I was doing my clinical at a very expensive and reputed to be top knotch home in Fairfield CT I went home and cried everyday. I wanted to pack up all the Gramma’s and Aunties and bring them home with me. RIP Virgina.


        • Marla Pugh

        • January 19, 2015 at 5:11 pm
        • Reply

        Kathleen, I wish there was more people in the care field like you. Thank you for what you did for all those people. Even if you think it wasn’t enough it was more than you realize.


      • David Lacy

      • January 15, 2015 at 11:28 am
      • Reply

      What a comeback column! And on a very important topic too (I appreciate the conversation occurring in the thread).


        • Marla Pugh

        • January 19, 2015 at 5:09 pm
        • Reply

        Thanks David! I’m working on part two!


      • no1fan

      • January 26, 2015 at 8:49 am
      • Reply

      Very nicely written, as always. I miss your writing and am glad to see you have found an outlet for your wonderful hobby!! My grandmother was in a private nursing facility and though my family paid a lot of money in rent for it, my grandma didn’t get the best treatment that she deserved. It’s so sad that these people live tremendous lives and they are reduced to being treated so poorly…but it’s also sad that those who care for them are not treated well either with that low pay.



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