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Monday, November 15, 2004

theme week 11- Mildred

The average nurse aid in the United States makes $6.65 an hour caring for elderly patients in a nursing home. According to the University of California, any nurse-aid who is in charge of the bulk of feeding, bathing, and other general care duties should be in charge of only three patients during meals and no more than six between meals. However, in many facilities a nurse-aid is in charge of fifteen patients at a time, or sometimes as many as thirty. Even more grim, the New York State attorney found that 25% of nursing home aids who are prosecuted for abusing residents had some kind of prior record. In a 1994 survey it was found that about 5% of the nurse aids on file with state regulators had a criminal record involving violence or theft. In these over-crowded positions where stress is high and thanks low, perhaps we can sympathize with how things get overlooked. Maybe even we can understand petty abuses of their generally incompetent patients. Understand yes, but accept never.
Walking down the hallway the smell of overheated bodies and antiseptic is overwhelming. It doesn’t quite drown out the underlying odor of urine and sickness though. My head is dizzy by the time we reach Mildred’s room. I wonder if she will remember who I am today.
43% of people who turned 65 in 1990 will enter a nursing home at some time in their life. Only one in eleven of these will spend more than five years in one. The New England Journal of Medicine states that 52% of all women and 33% of men who are now 65 will spend their last years in a nursing home. Those who are 85 and older have only a six percent average chance of dying in their own bed, with the familiar sights and sounds of their lives around them.
I grab a seat in one of the caned chairs. Laura, another teacher who lived with Mildred until she died eleven years ago, made this chair. She was so much fun when we were kids. I feel a mild rush of guilt, knowing that in my secret heart I wish it had been Mildred, not Laura who died. Mildred knows me today, but she can’t remember whether her mother is alive or not. Mom is trying to explain that her mother died a long time ago, before any of us here in the room were born in fact. It doesn’t seem to be having any effect. She can’t hear us anymore, anything you want to communicate must be written down in large letters on one of those white erasable boards.
There are approximately 1,813,665 total beds in nursing homes in the United States of America in 16,995 facilities. There are about 107 beds in the average facility, with an 83% occupancy rate. Seven percent of nursing homes are run by the government, 25% by non-prophet agencies and a staggering 66% by for profit agencies/corporations. On average there are about 53 total direct care staff per facility. Two-thirds of all nursing home residents have no living family, and 70% of all patients are women. The median age at death is about 73.2 years for men and 79.7 for women.
During Mildred’s lifetime teachers could not get married or they would lose their jobs. She shows no particular sorrow at this, we are her family now. She started teaching at eighteen years of age, and is in possession of a lifetime teaching certificate, concepts that would bring horror to the face of any school administrator in the world today. She lived through the introduction of indoor plumbing, the Depression, the civil rights movement, and many other things that seem ancient history to one born in the 1980s like myself. She is a member of MENSA, that group only those in the top two percent of IQ scores may belong to.
Eight years ago my mother finally convinced her that she was unable to live alone. Still lively in her mind, she was upset but agreed that it was time to do something other than just an emergency medical button. In home heath care proved an unimaginable nightmare. People stole from her, others kept trying to force her to change her will, some were completely unreliable about showing up. The last resort was moving her into the nursing home. It wouldn’t be that bad, we all thought. At least she would have someone to talk to during the day.
Now she can’t get out of her wheelchair. She never got the opportunity to go walking, and so now she can’t. She can’t go to the bathroom by herself, can’t bathe herself anymore. Her handwriting, once beautiful cursive is a cramped squiggly line even she can’t read. Her hearing is completely gone, her muscles evaporated. Her lower legs are red and swollen from sitting, with dark angry-looking veins all up and down them. She cannot remember who we are all the time now, nor can she remember for more than a minute or two what the conversation she is having is about. She suffers from paranoia and depression, for which she is medicated heavily.
This once-vibrant woman, so smart and sharp witted she could talk anyone in the room in circles, is now a husk of what she was. Part of it is, of course that she is 93 years old. Anyone is lucky who makes it to that age. However, I am convinced that the sterile environment of the nursing home has eroded that woman whom I love much faster than time itself would have done it. Incompetence, proven over these eight years, mixed with high turnover has been alarming. Mildred is so used to that environment now though that we dare not try to move her to a different facility, nor have we found a reliable source for in-home full time care.
With an aching heart I get up and kiss her papery cheek as we all get ready to leave. She smells a little of talc powder. It’s a good smell, a clean one in this evil soup. Her eyes are tearing, but otherwise flat. I can’t tell if it’s us in particular she grieves or just that she’ll be left alone in this place for the rest of the day. For a second as she hugs my brother Erin I swear I catch a glimpse of the old sparkle that used to liven her eyes, but then it’s gone. Back through the putrid corridor and out into the parking lot. I take a deep breath of the freezing January air. We will be back next week.


****statistics found at http://beoutrageous.com/IYP/death.htm and http://www.efmoody.com/longterm/nursingstatistics.html****

1 Comments:

Blogger johngoldfine said...

Interesting piece to read--I skimmed right over the italicized part, then skipped it completely to get to the human interest, but then, having licked all the frosting went back to the cake, so to speak, and read it carefully. Getting a reader to skip around like that is just right for this assignment, where you hold the personal and the distant ironic 'facts' side by side for a reality check. Very enjoyable piece--I mean,
apart from the part about it being depressing as hell...

November 15, 2004 at 6:34 PM  

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