Category: Anecdotes
Posted by Dr. El - January 3, 2011 - Anecdotes
I settled down to talk to Pearl, eager to hear how she was faring in her new room.
“Well, she’s not rummaging through my closet, like Beatrice did. But she told me everybody likes me better than her.” Her voice was strained.
“It makes you uncomfortable.”
“Yes! And she won’t talk to me.”
We debated the pros and cons of her past and current roommates for a while.
“You know,” I said, “this reminds of the time I worked in an office that had cubicles, and my computer faced the computer of a woman who was always making negative comments. I spoke to my supervisor about her, and my supervisor was into the Japanese art of feng shui. Have you ever heard of that?
Pearl shook her head.
“The basic idea is that you arrange furniture in a room to create the best flow of energy.” I shrugged to indicate my skepticism. “She told me to hang a mirror on the wall between me and my cubicle buddy, so that my energy would bounce back to me and her energy would stay on her side of the cubicle wall. It sounded like a bunch of hooey to me, but I gave it a try and it worked! It was like a magic force field. I’m wondering if something like that might help you too.”
She seemed amused.
I spied the photo of her handsome husband, whom I knew she missed terribly. “You see that photo of John?”
“Yes,” she replied, brightening immediately.
“Maybe we could say that his energy is bouncing back to you and shielding you from her negativity.”
“That sounds good.” Pearl looked hopeful, enlisting her husband’s assistance from above.
“Why don’t we see how that goes, and we can always consider changing rooms again if that doesn’t work out.”
“Okay.” Her voice was stronger, and more determined, now that she had two protectors and a path.
I ran into her in the hallway later that week. “Things are much better now,” she told me. “I didn’t think it was going to help, but the magic force field is working.”
Posted by Dr. El - August 17, 2010 - Anecdotes, Common Nursing Home Problems and How Psychologists Can Solve Them, End of life, Transitions in care
“I never say goodbye,” Mr. O’Hara told me, “because that’s what my mother said when she left me as a child. Then she died and I never saw her again.”
At 91, Mr. O’Hara was slim and getting slimmer. He began our next session as usual, discussing the procedures he was receiving from the doctors to save his fingers. “It feels like the knives are still in me.” He grimaced, gently caressing his bad hand with his good one. “They want me to come back in two weeks.”
Mrs. O’Hara appeared in the doorway, wearing her trademark red lipstick and bright suit. We spoke for a while about his health, her health, and their 65-year marriage. She came every day at lunchtime, bearing his favorite foods and spending an hour coaxing him to eat before they headed to the afternoon’s recreational activities.
On the way off the unit, I spoke to the nurse at the front desk. “Mr. O’Hara looks awfully thin lately.”
“Yeah,” she said, “the doctor wants him to go on hospice, but the family refuses.”
Alone with him a few weeks later, I asked Mr. O’Hara if he’d ever discussed dying with his wife.
“Oh no, we never talk about it. That’s a big good-bye.”
“I suppose it is. What do you think happens after people die?”
Mr. O’Hara was silent for a moment. “I’ve been taught that we’ll all meet in Heaven, and I sure hope so. I’d like to see my mother again.”
“That would be some reunion, wouldn’t it?” I glanced at the framed photo on the dresser of a stern-looking woman in a flowered dress. “Can we talk to your wife about this the next time I see her?”
“Yes. I guess that would be all right.”
“Okay then. Take care,” I told him as I left.
Two weeks later, Mrs. O’Hara arrived carrying her home-cooked meal, and I motioned for her to sit down on the bed. “Your husband and I were talking the other day, and he said he thinks we’ll see the people we love after we’ve died. Is that what you believe?”
Mrs. O’Hara didn’t even blink at the question. I was talking about the elephant in the living room.
“Oh yes, I believe that too.”
“That must be a great comfort, to know you’ll see each other when you pass on.”
Mr. O’Hara spoke up. “At 91, there are a lot of people waiting there for me. I’m going to be busy.”
“Well, you’d better make time for me!” Mrs. O’Hara joked, and we all laughed.
A few weeks later, Mr. O’Hara went to the hospital and I stopped at the nursing station to see when they expected him back. “He’s not coming back,” the nurse told me. “His family decided to do hospice at the hospital.”
“Oh,” I said, happy and sad at the same time.
Goodbye, Mr. O’Hara. Goodbye.
Posted by Dr. El - June 1, 2010 - Anecdotes, Customer service, Role of psychologists
When I arrived at Mr. Johnson’s room, he was sitting in the doorway in his wheelchair, frowning at the passersby. He was immaculately dressed, as usual, in a button-down shirt and shorts on this hot summer day, looking much younger than his 90 years.
Lately he’d been frustrated that his memory was interfering with his ability to get things done. Last week I’d tacked onto his bulletin board a calendar we’d created to outline the days and times of his favorite activities.
“How are you?” I asked, settling into the chair across from him.
“Not good.” He shook his head. “My daughter Letty is in the hospital and I can’t reach her. She just had surgery and I’m worried about her.” He spoke in slow, measured words, so that sessions with him, while always fruitful, took on his Caribbean pace.
I could tell his anxiety was high, and not good for any of his medical conditions. “Can we call her?”
“I lost my cell phone. And I dropped the answering machine with her message giving me the phone number and all my messages disappeared.” He sounded close to tears.
“Is there someone else we could call who might have her number at the hospital? Or does she have a cell phone? Let me see your phone book.”
He dug around in the bag on the back of his wheelchair, pulled out a book, and slowly started flipping through the pages. I held out my hand. “May I?” He handed it to me and I saw it was filled with neatly written phone numbers in no particular order.
“Look for her brother, Clifford Johnson. He might know how to reach her.”
I found and dialed the number, and handed him the phone. A brief, pleasant conversation ensued with his daughter-in-law, who then put his son on the phone. After a few minutes Mr. Johnson handed me the phone. “I’m out here in Oregon,” Clifford Johnson told me, “and our sister Annette might have her number, but she’s visiting her daughter in Florida. I’ll give you that number. I appreciate what you’re doing for my father.”
A few minutes later I had Annette on the phone. Mr. Johnson gestured for me to talk to her.
“I don’t have Letty’s number, but I can give you her boyfriend’s cell phone number. They’re in Chicago.” she said. I handed the phone to Mr. Johnson for another brief chat.
Letty’s boyfriend picked up immediately and I explained that her father was worried and wanted to get in touch with her. “Boy, is she going to be glad to hear from him! If there’s anything else I can help you with, please let me know.”
“If we reach Letty,” I told Mr. Johnson, “I’m going to give you the phone and then go.” I dialed the number and a tired voice picked up the line. “Letty?” “Yes?” “I’ve got your father here. He wants to talk to you.” “Oh, good!” Her voice energized immediately. I handed the phone to her dad, touched him good-bye on his shoulder, and left the room.
I was sitting at the nursing station writing up my notes when Mr. Johnson stopped by and fixed me with a long look. “God bless you. I will never forget your kindness.” I almost began to cry at the sincerity in his voice. “I feel so much better now. It’s like a weight has been lifted.” He settled in across from the nursing station. Every so often I’d glance over to find him watching me and smiling.
Posted by Dr. El - April 25, 2010 - Anecdotes, Boomers, Dementia, Role of psychologists, Technology, Tips for gifts, visits
Now that I know I’m not going against State regulations (see Dr. El Goes Undercover with the NYS Department of Health), I’ll confess I love to use my iPhone with the residents. In nursing homes that don’t yet have computer access, the iPhone and other web-enabled mobile devices bring the world right to the residents. (For more on the subject, see Therapeutic Use of the Internet in Nursing Homes.)
Here are some therapeutic interventions I’ve used during my psychology sessions. Please add your experiences in the Comments section.
- When I arrived at the door of his room, Jim was sitting with his head in his hands. He looked up and I saw the worry in his eyes. “What’s up?” I asked him. He said, “I put all my stuff in storage before I got here, but now I can’t remember the name of the place. I’m worried I’m gonna lose my things.” Pulling out my iPhone, I Googled the storage center based on the general location, and handed him the phone number. Relieved, he was able to discuss his other concerns. When I ran into him later in the day, he’d phoned, made arrangements for his belongings, and was now smiling and relaxed.
- “My old doctor gave me different medication,” Ms. Garcia told me. “I never had this problem before.” “Do you have your doctor’s phone number? Maybe your old physician could talk to your doctor here.” “I don’t have the number. But I know her name.” After a quick search and a couple of phone calls, Ms. Garcia was on the phone with the MD she’d had for the last fifteen years. “Hey!!! How you doing??? Listen, can you call my doctor here and tell him about me?” Two days later, the MDs had conversed, the meds had been changed, and the problem was solved.
- Ana’s usually energetic demeanor had faded and my attempts to engage her were met with glum, monosyllabic replies. I switched gears. “Would you like to listen to music? We could play some of your native Romanian songs.” She was unenthusiastic until my YouTube search came up with the Romanian Ballad of Ciprian Porumbescu. Her face lit up and she listened intently, eyes closed, appearing to drink in the music. “He is very famous in my country,” she told me, and when the ballad concluded, she reminisced about her past, revealing more about her youth than she had in our previous three months of psychotherapy.
- Once I worked briefly with a man who was new to the nursing home and appeared lost. Trying to anchor him, I asked if he had any hobbies. “Irish dancing,” he told me. I searched for Irish dance music in YouTube and found a video of some Riverdance-type performers. His eyes brightened and, from his wheelchair, his feet jumped and pranced with remarkable skill. From the knees down, he was a Riverdancer; from his neck up, he was a happy man. After this intervention, I spoke to his children and asked them to bring him a CD player and some Irish music, and also shared the information with his recreation therapist so she could play his music on the unit.
Posted by Dr. El - March 23, 2010 - Anecdotes
I asked nursing home residents, or “people of age,” as one resident cleverly put it, about their reaction to the passage of the health care reform bill. They were unanimously in support of the bill, though a few voiced concern about whether the changes would manifest as intended. Here are some of their comments:
“I think it’s a step up in the right direction.”
“It’s about time.”
“I think it’s a good thing. I’m glad they did it.” Some say it’s like when Medicare went into effect. Would you agree? “Yes, I think so.” Were people nervous about how it was going to be implemented then, too? “Oh, sure, of course they were. But it worked itself out.”
Posted by Dr. El - March 9, 2010 - Anecdotes, Business Strategies, Communication
Okay, so it didn’t involve a disguise, but I did make an anonymous phone call to the New York State Department of Health.
When
I interviewed Mark Kissinger, their Deputy Commissioner of Long Term Care recently, he and Jacqueline Pappalardi, the Director of the Division of Residential Services, were friendly and reasonable. They said the Nursing Home Complaint hotline (888-201-4563) was open, and that in addition to taking complaints, the State was there to help facilities and staff with questions and problems that might arise. So I phoned to see if there could be a collaborative exchange with the DOH via the hotline.
I dialed *67 before the call, so my name and number wouldn’t be visible, and asked them whether or not it was against State regulations to use a cell phone in a nursing home. And guess what? They answered right away and were friendly, reasonable, and knowledgeable!
According to the hotline staff, there are no State regulations against using cell phones, but there may be a facility policy against it. There
is a State regulation about using the camera function in the nursing home. The Health Insurance Portability & Accountability Act (
HIPAA) states that it’s a violation of a resident’s privacy to take a photo of them without their permission. A resident needs to sign a waiver to agree to a photograph by a staff member, and care should be taken to ensure that another resident isn’t in the background of the photo, in violation of their HIPAA rights. I found this to be very helpful information, delivered in a respectful, collegial manner.
Posted by Dr. El - January 19, 2010 - Anecdotes, Communication, Customer service, For Fun
Today’s story, courtesy of Sandra Cherry, LMT (Licensed Massage Therapist), is a humorous reminder to those of us in long term care to be mindful of jargon and the words we choose when speaking with those new to the nursing home.
Today I visited my dad at the nursing home and, as I prepared to leave, I came in contact with a fairly new resident who was somewhat agitated.
Me: Ms. Williams, why are you so upset?
Ms. W: I am so sick of these people in here. They want me to sit in this wheelchair and I keep telling them no. I don’t know how to work that chair and no one has even tried to help me with it. That old aide over there told me she wasn’t going to be helping me up and down that hallway anymore. Well, I’ll just sit here in this chair!
Me: Ms. Williams, they’re supposed to send someone to help you learn how to operate the chair. Are you sure no one has come to help you?
Ms. W: The only person that’s been coming is some boy saying he want to take me to occupational therapy. He comes every day. I look at the clock when he comes to my room. Every day he comes between 10 and 10:30 and every day I tell him no. I don’t know who he is, and why I got to go for some occupational therapy? I ain’t looking for no job. What, they expect me to be doing some work, and I’m here in a nursing home. They must think I’m crazy!
Me: (Trying to contain my laughter) Okay, I’ll ask them to stop sending the occupational therapist to you and send the wheelchair guy down instead.
I explained the confusion to the nurse, who immediately went to Ms. Williams and confirmed that the wheelchair guy would be there on Tuesday to help her with the chair. She appeared quite relieved.
Posted by Dr. El - December 28, 2009 - Anecdotes
Late last year I decided 2009 would be The Year of the Blog. I committed to putting up a weekly post and resolved to wait until the end of the year to decide whether or not to continue into 2010. It turns out I didn’t need to wait long to decide. I love my blog! Thank you to all who have visited, commented, and otherwise encouraged me to continue. I’ve learned a lot and met some great people through my blog this year and I trust next year will bring more of the same. For my final post of 2009, I’ll leave you with a story put up almost a year ago, early in the life of My Better Nursing Home.
The Equalizer
Louise was a petite 79-year old woman who spent her days watching TV and working her needlepoint, anchoring the tapestry frame against her chest with one arm while she slowly pushed the needle through with her good hand. I first met her casually because she was the roommate of another resident I was seeing. I’d say hello and excuse myself as I pulled the curtain for “privacy” while I spoke to her roommate, Cynthia, who was dying of cancer. I wasn’t too sure how much Louise could understand, since her speech was garbled and unintelligible, but we always acknowledged each other when I arrived for my weekly sessions with her roommate. When Cynthia died, I made a point of stopping by to offer my condolences. To my surprise, Louise burst into tears and held up her good hand for me to wait, while she labored over a note she wrote on the back of the recreation calendar. She pushed the paper toward me. I read it out loud.
I was in the room when she died. I was in the room when my father died.
She began to wail, and I murmured reassurances and stayed with her until she became calm.
Louise wasn’t referred to me for treatment, however, until she threw a cup of water at her aide several weeks later. (I’m not allowed to refer patients to myself.)
Louise told me about her life via handwritten notes and the occasional use of the talking computer that verbalized what she painstakingly typed out.
I’ve been a cripple ever since I got polio as a girl. I never had a job.
“Yet you write so well, and your spelling is perfect.”
My mother home-schooled me. My parents insisted on an education.
She told me about her twin sisters, Lina and Lana, now 81 years old.
They doted on me, just like my parents did. She laughed, and took back the scrap of paper to add, They still do.
Once Lana came to the nursing home for rehab and I pushed Louise in her wheelchair to visit with her. The kissing and hugging that ensued caused me to turn away with embarrassment. I felt like I was interrupting a pair of lovers. When I said this to Louise, she giggled.
I took Louise out to sit on the patio, and I introduced her to some of the other residents, but still she sat in her room day after day.
I can’t talk to them. No one understands what I’m saying.
“Why don’t you try using your computer?” I set her up in the hallway and explained to some of her neighbors how the computer worked. She tried this a couple of times, but soon retreated to her television and needlepoint.
“You know, Louise,” I finally said, “you might have been disabled and different from others all your life, but now you’re just like everyone else here. Almost everyone is in a wheelchair. When I first met you, I didn’t know you’d had polio. You looked like you could have had a stroke like Ms. Lopez or Mr. Wilson down the hall. It’s hard to understand them too, and they’re still out there, attending activities.”
She didn’t say much about this, but the next week I found her at a concert in the dining room with the other residents. Soon after, she became a regular at all the recreational activities and her childish rages with staff diminished. She stopped me in the hall one December day after we’d concluded treatment to ask me if I could come by to see her perform as Mary in the 3rd floor’s Nativity play. I managed to stop in the doorway for a while to watch the performance. She caught my eye and beamed a smile.
Posted by Dr. El - October 6, 2009 - Anecdotes, Tips for gifts, visits
I peered into Ms. Alford’s room and saw a visitor sitting in the chair next to her bed, where she was sitting with a stack of photos on her lap. Ms. Alford noticed me and waved me into the room with a broad smile.
“This here’s my son, Willie.”
“And you are?” His worried eyes met mine.
“The psychologist, Dr. Eleanor Barbera. I’ve been seeing your mother since just after she arrived. I’m glad to meet you.”
“Can I talk to you?” He was out of his seat even before I got Ms. Alford’s nod of assent. We stepped into the hallway and spoke in hushed tones. “How’s my mother been doing? She was so depressed the last time she was here.”
“Well, she was very withdrawn and not eating well or working with the staff when she got here a few weeks ago, but she’s doing better now. I only see her once a week and I’m not on the floor all the time, but it seems to me things improved after I took her upstairs to meet with an old coworker of hers who happens to live here too.”
“Really?” He looked at me with pleased surprise.
“I tried to get them to hook up at some activities afterwards, but it can be hard to arrange. Being on different floors can be as difficult to connect as being in different states. But here’s her friend’s name and room number,” I scribbled it on a sticky note, “If you could help them get together, that would be great.”
“I could definitely do that.”
I shifted my gaze to his mother, who was watching from her bed in her house dress, her hair flying in every direction. I waved and she smiled and waved back. “Your mom really needs to get her hair done.”
“I used to cut it for her. I could do that again. It would be a great bonding activity.” His mood was lighter and he sounded excited.
“That would be awesome. I’m sure she’d really appreciate that.”
We headed back into Ms. Alford’s room and the three of us talked for a while before I signaled it was time for me to leave.
“Thank you so much,” Willie Alford said to me, “you’ve given me more than I could have hoped for.”
“I’m glad,” I replied, happy Ms. Alford had a son who so obviously cared about her welfare.
Posted by Dr. El - October 2, 2009 - Anecdotes, Customer service, For Fun, Something Good About Nursing Homes, Volunteering
This positive story about long term care is from the perspective of a nursing home administrator/president. If you’d like to add your own good news, please use the comments box at the bottom of the post, or for a possible featured blog post, send me an email using the Contact Me button on the top right corner of the blog. Enjoy!
“Having been a part of the Long Term Care profession for more than 38 years, I find myself always being defensive. You are right in the fact that most of the good news in nursing homes never gets printed, just those about the bad things. I would love to share a couple of projects we are doing in our facility which have been wonderful for those residents entrusted into our care.
One is a writing class. It started out with residents writing/telling something about their first day at school, or their first car, things of that nature. It was fun to hear them share. We had some assistance from our activity staff and a couple of volunteers. We collected these short stories and printed them into a book and invited their friends and family to come to a reading. Most of the residents read their story. It was a blast to watch a gentleman with Alzheimer’s disease read flawlessly as if he were giving a presentation to the city committee. He never missed a beat. Yet when he had finished and a couple of others shared their story, he asked when his turn would be. To assist in our second book, we asked the our local college if any English majors would be interested in coming and assisting the resident in writing their stories. We were able to have two students come for a semester and would record the story and help the resident in getting it ready for print. We have printed 3 booklets of short stories and each resident and family member receives a copy.
Our second project was a dream of one of our staff members and it’s like the “Make a Wish” program. It’s called “Day Dreams.” We have a dream team made up of staff, who then volunteer their time in helping residents have a wish come true. These dreams can vary from going a local restaurant with their loved ones, to flying model airplanes, to traveling out to their homestead, to riding in a parade in a convertible with the top down. There is no cost to the resident of this experience. We have been able to receive some donations to help cover the costs. We have been able to do over 45 dreams since 2005. These are only a few of those dreams.
I share these with you to encourage others, that being a Caregiver in a Nursing Home is a wonderful profession. It is not for everyone, but most of those caring for others are angels.
Thanks for stating there is a lot of good going on in Nursing Homes.”
Gary M. Riffe, CNHA, Fellow
Administrator/President
Hi-Acres Manor Nursing Center
Jamestown, ND
