Lesson of the Day (Thanks, Syn!): "Enjoy the Funk"

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So, today, I had a tough time being positive. At moments that I had to fight being a real bitch! I'm sure that Dan, the PT, would agree with me. He has to put up with me all day long.

I had posted a note to friends on Facebook this morning:

Needing to look for the positive today,

the negative wants to seep in!!

I spent the day trying to close my ears to the crazy activity outside the rehab department. They moved all the "yellers" to the the two rooms closest to the rehab department. The three former yellers I wrote about last fall aren't really yellers anymore! These are new yellers. Two of them have alcoholic dementia. One is a woman who has lived like a princess, and she's not used to having to wait a bit for service.

See that attitude??

I was beleaguered by the time I got home. After checking email, I found a few lovely replies to my morning post on Facebook. I want to share this one with you (compliments of Syn, thank you, girl!)

 

It gave me a different perspective of feeling this way:

 

"Rather than battle difficult personalities, I have come to accept that some people are just good examples of bad examples. Similarly, I have come to believe that a lot of good may be gained in allowing a funk room to be itself, to run its course. I am a big believer in allowing ourselves to feel what we feel (good or bad) and simply be discerning about how we interpret the feelings. I am not a proponent of forcing our minds to focus on the positive when a helpful lesson may be gained through a bit of stewing about the negative. Sometimes a negative inner voice has an important point to make. In my view, authenticity and quiet discernment trump positivity. So enjoy the funk and the lesson it may be trying to communicate. :)"

 

So, let it run its course.

 

That makes me feel better already.

Unexpected Admiration

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Happy is a WWII vet, long, lean, with usually sad eyes and a gray five-o'clock shadow. He gets around with one foot pushing his high back reclining wheelchair and makes his way from one end of the building to the other several times a day.

He stops in regularly to find out when "he is going to walk again."

I wish I had known him after his stroke; maybe we could have done some good neuromuscular re-education (layman-speak: making his muscle tone normal to retrain movement after a person loses movement in their limbs).

Now, it's been too long;  this lovely place did not have a therapy team in place when he moved here years ago. His knees have contractures, and he can't straighten his legs.

I am in the building late tonight, working on evening ADLs (activities of daily living) which include the residents' regimens for getting ready for bed after dinner.

Happy wheels down Station One and holds out his hand. I take his hand and lean down. He is hard of hearing. He looks up and starts to speak.

Out comes his sweet, soft Southern accent, foreign on the northern California coastline:

"Did you ever see someone

and get a passion for 'em?

There's no law against that,

is there?"

Then, I realize he means me. And I smile back at him,

"No, Happy, there's no law against that."

Saying Goodbye

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Elizabeth had been at "the home" for 2 months, fluctuating between major decline and rallying to get back home with Lloyd. Those two were one of the handful of couples I have met during my career who gazed into each other's eyes after 60 years as if they had just fallen in love.

In fact, Lloyd told his cousin when he was 16, and Elizabeth 14, that he was going to marry that "pretty little thing" who was visiting her grandparents on the coast from her home in Sacramento.

He did, 3 years later. Lloyd is one of the most devoted husbands I have ever met. He visited our facility twice a day for the 2 months Elizabeth was rehabbing.

It became a struggle to make progress. She went into what we in the industry call "failure to thrive."  It means what it says.

Lloyd and I had moments during the last several weeks in which we knew Elizabeth would not return to her former state. My mission evolved from rehabbing her to home to dealing with more basic issues like making sure she did not choke when she ate and positioning her in bed to prevent decubitus ulcers.

We could no longer "skill" her for rehab. That means we had treated every area we could, and there was no longer anything else we could do.

Lloyd planned to take her home last Thursday, December 29. That morning, one of the aides informed me that she had already been assisted to his car. I knew I had to say goodbye.

I ran to the car and rapped on the passenger window. Lloyd was still inside signing her release. Elizabeth was so frail she could not reach to open the door, so I eased the door open and leaned in beside her.

We looked into each other's eyes. We smiled deeply. I told her what it meant to me that I had the privilege to know her. She told me she would never forget me. We hugged, knowing it would be the last time we would see each other. Lloyd's sister sat in the driver's seat and wept.

I left town after Thursday and returned late last night. I was treating a new patient in the gym this morning when one of the aides walked down to inform me that Lloyd was in the building. Elizabeth had passed away Friday morning, the day after she returned home.

Lloyd stopped by the rehab department, and we held each other tight for a moment. We recounted precious moments, like when he brought photos of their life together when they were young, how hard she worked in therapy, how devoted she was as a wife and mother, and how happy she was to return home. "She was so happy to look around all the rooms and see all the things she had collected over the years," he said.

" Lloyd.....you got her home. That was such a gift for her."

He agreed.

I knew it wasn't the time and place to cry, so we said goodbye, and I went back to my treatment and squeezed back tears.

Tonight, though, I figure it's just fine to feel emotional. Elizabeth had held on through so many days just to go home with her husband. She made it! It took everything she had. She barely held on each day so that she could leave this world from her own home. With her loving husband by her side.

Elizabeth and Lloyd touched my life in such a deep and simple way. We had a connection that many people never find in their work.

That is why I work with older people in a skilled nursing facility. It's not a glamorous place, but of all the environments in which I have worked, it is by far the most satisfying.

I get the privilege to share my days with people like Elizabeth and Lloyd.

God bless you, Elizabeth. Rest in peace!



Photo credit: http://wallpaperson.net/photo/nature/rays_from_heaven/22-0-7087

Skilled Nursing Facility Comparison Checklist

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Three weeks ago, I wrote a blog on what to look for if you are interviewing and comparing skilled nursing facilities for a loved one who needs care.

Feel free to use and reproduce this basic checklist; however, please credit the source if you share it.

Skilled Nursing Facility Comparison Checklist Copyright © 2011. Thresa M. Kussman, MOT, OTR http://travelingotr.blogspot.com
Criteria	Name of Facility	Name of Facility	Name of Facility
Five Star Rating	1 (poor) – 5 (excellent)	1 (poor) – 5 (excellent)	1 (poor) – 5 (excellent)
Compare facilities here: www.medicare.gov/NHCompare/Include/DataSection/Questions/ProximitySearch.asp
Deficiencies	□ Staffing □ Hydration □ Weight Loss □ Skin Integrity □ Range of Motion □ Privacy □ Infection Control □ Dietary □ Falls with Injury □ Other	□ Staffing □ Hydration □ Weight Loss □ Skin Integrity □ Range of Motion □ Privacy □ Infection Control □ Dietary □ Falls with Injury □ Other	□ Staffing □ Hydration □ Weight Loss □ Skin Integrity □ Range of Motion □ Privacy □ Infection Control □ Dietary □ Falls with Injury □ Other
First Impressions
Initial call	□ Professional □ Friendly □ Rude □ Other	□ Professional □ Friendly □ Rude □ Other	□ Professional □ Friendly □ Rude □ Other
Was I put on hold?	□ Yes □ No	□ Yes □ No	□ Yes □ No
How long?	□ Under 1 min □ 2-4 minutes □ 5 minutes+	□ Under 1 min □ 2-4 minutes □ 5 minutes+	□ Under 1 min □ 2-4 minutes □ 5 minutes+
Outside of building	□ Clean □ Welcoming □ Contemporary □ Aged □ Dirty □ Unkempt	□ Clean □ Welcoming □ Contemporary □ Aged □ Dirty □ Unkempt	□ Clean □ Welcoming □ Contemporary □ Aged □ Dirty □ Unkempt
Inside of building	□ Calm □ Friendly □ Chaotic □ Stressful □ Odor □ Other	□ Calm □ Friendly □ Chaotic □ Stressful □ Odor □ Other	□ Calm □ Friendly □ Chaotic □ Stressful □ Odor □ Other
Lobby	□ Clean □ Welcoming □ Contemporary □ Aged □ Dirty □ Unkempt	□ Clean □ Welcoming □ Contemporary □ Aged □ Dirty □ Unkempt	□ Clean □ Welcoming □ Contemporary □ Aged □ Dirty □ Unkempt
What did I hear?	□ Music □ Laughter □ Silence □ Buzzers □ Alarms □ Residents □ Overhead pages □ Other	□ Music □ Laughter □ Silence □ Buzzers □ Alarms □ Residents □ Overhead pages □ Other	□ Music □ Laughter □ Silence □ Buzzers □ Alarms □ Residents □ Overhead pages □ Other
Nurses’ Station
Buzzers going off?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Do staff acknowledge me?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Are charts protected from view?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Is it a quiet environment for my loved one?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Residents
Hair combed?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Faces clean? Teeth brushed?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Fingernails trimmed & clean?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Clothing free of food stains?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Wheelchairs clean?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Rooms
Bedroom	□ Private □ One roommate □ Two roommates	□ Private □ One roommate □ Two roommates	□ Private □ One roommate □ Two roommates
Dining Room
Attentive nurse aides?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Age appropriate music?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Showers / Bathrooms
Showers clean?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Bathrooms clean?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Enough turning radius for a wheelchair in bathroom?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Visitor bathroom clean?	□ Yes □ No	□ Yes □ No	□ Yes □ No
Therapy
Rehab	□ Physical □ Occupational □ Speech □ Restorative Nursing Exercise	□ Physical □ Occupational □ Speech □ Restorative Nursing Exercise	□ Physical □ Occupational □ Speech □ Restorative Nursing Exercise
If my loved one is on Medicaid, does facility offer therapy?	□ Yes □ No	□ Yes □ No	□ Yes □ No