Homework #30: Illness and Dying - Culminating Experiential Project

            For my entire life I’ve heard the sounds of sirens pulling up across the street, their flashing lights dancing on my walls. Then white beds, three feet high emerge, yellow straps wrapped across the patient’s chest and legs. I had been in to the building once, but not to understand the workings of the nursing home, instead to only to visit and gain what little community service hours I could. Therefore I decided to speak to two patients, questioning them on their own experiences there and their thoughts on dying. 

            The process was actually quite difficult. When I first walked over I had to speak to an administrator on the phone, explaining what I planned to do. She said that it would be easiest if I called her the next morning, after she had a chance to speak with someone about my idea. The next day when I called, she required that a written proposal faxed to her. Eventually I spoke with the social worker of the hospital, who allowed me to speak to two patients of her choice. Deeming it the best I could in this short amount of time, I went.

            While waiting for the social worker to come down and meet me, I read the quote on the wall: “This is not a time for optimism that sees no problems, nor for pessimism that sees no possibilities. It is a time for hope.” Although I found myself agreeing with the statement about optimism and pessimism, I do not believe what these people need is hope. They know they are elderly, their lives more rapidly dwindling. They do not need false hope, instead acceptance. For with acceptance they are able to live out the last of their days fully.

            I had an idea of what I wanted to ask the two patients. The day before we had read the piece about death anxiety. I wanted to learn about their anxiety and suffering. Of course it was a sensitive subject, but I hoped to by the end know if they themselves were afraid to die. But as this was going to be a hard thing to discuss, I decided also to look at the conditions of the nursing home to see if they really felt at home. There are so many sob stories that speak of cruelty done to the elderly and I wanted to find the validity of those stories in this nursing home – not to say that they had already been accused of such a thing. While researching nursing homes, I came across a New York Times article discussing the selection of a nursing home. It states, “More than 60 percent of admissions come from hospitals

. The patient may have broken a hip or had a stroke and now needs rehabilitative care. The hospital is in a hurry to discharge and may move quickly to get the patient moved to an available nursing home bed, regardless of the operator’s quality or reputation.” ¹ Both of my patients spoke of this quick transfer, something that will be discussed later. The article then continued to talk briefly about the relationship between the nurses and patient: “Imagine how much nicer it would be to know the same person will bring your tea each evening and already knows you like sugar in it,” Ms. Benner said. “We know from the evidence out there that a strong relationship between residents and staff consistently leads to better care.” ¹ Quite understandable, I decided to inquire too about the relationship the resident had with the nurses.

            The first woman I was brought to had her son visiting her. He seemed unaware that his mother was being interviewed and a little taken aback when he learned of my presence. Nonetheless we set up on the other side of the room. She sat in a wheel chair hunched over, straining to lift her head to an upright position so she could see me. When I went to shake her hand she offered a claw like hand, barely able to grasp my own. I set up my computer to record the conversation, and set off. I told her she did not have to answer any question she did not want to. She said she had been living there thirteen years. After her open heart surgery the doctor first sent her to a place in the Bronx for two years. She did not want to go to the Bronx because “it was bad back then.” The nine stories of the building amazed her, she repeated it multiple times. Similar to what the NYT article says, she was rushed off somewhere, as they were in a hurry to get her out of the hospital. But as she grew up in Brooklyn, she wanted to return there for her care. Her children had been visiting her in the Bronx but she felt that it was too far for them to travel, hence her move. Her son comes three times a week, her daughter twice a week. The son that lives in Georgia does not visit quite as often, but when he does he stays for about two weeks. Upon asking if their relationship has changed since she came to the nursing home, she said no, they still have a really strong relationship. “We have a party every time they come,” she said, supporting her projection of a good relationship.

            At the very beginning she stated that she loved the nursing home here. When I asked if she had any complaints she replied: “I have no complaints on anybody...I love every one of them.” In the Bronx, she said they never stopped doing anything. Where she is now they do not do too much. “They have trivia almost everyday. Then they have games like throw the ball or the balloon, different things. But the girls work hard. They try to please us. They’re told what to do and they do it to us.” When I asked what her favorite part was, she said she loved everything, she couldn’t decide. I guess the sob story I was looking for wasn’t there, but of course, that’s a good thing.

            We then moved on to medicine. She takes about seven pills, then two Tylenol in the afternoon. “Everything is pills!” Upon asking if she feels like she takes too much medicine, she said no. “It all amounts to something,” she said. She complained about the others who “slow up on everything,” and do not swallow all of their pills at once. She seemed to entirely comply with everything the doctor gave her; to her they could do no wrong. It seems that their generation is fully confident in medicine, that all of this controversy seems to miss them. But then again, who can blame them? They probably see it as their duty, as what is necessary to survive.

            I tried then asking about her religious affiliations, to see if it had altered her experience at all. She replied with a story of the nun who used to live at the nursing home, but she unfortunately had just left for another state. Pointing out the chapel behind us, she described the services they hold on Sundays. I could not help but be a bit disappointed. She did not seem to understand a lot of my questions, and what I was trying to get at. But because of the sensitivity of the subject, I felt that it was not in my place to push.

            When asked what she would be doing if she weren’t sick, she said she had done everything she wanted to do. It was apparent that she had lived a fulfilled life. She went on to describe the big parties they used to have, hanging out right outside of their houses. After hearing this, I asked her if she knew Nietzsche and explained his eternal life. She said that she wouldn’t want to live it again, but I believe she took living it again as changing it. So in terms of the actual idea, yes she would live her life a million times over, because she saw it as perfect.

            I then decided it was time to ask about death. Her only solid reply was, “That’s why I put myself in here...I had to have a woman stay with me in the house. But I said if I go home, I have to go up the stairs, I can’t go up and down the steps, I can’t move around like I’m supposed to move around.  I’ll be like a prisoner upstairs sitting there with a woman. I said go and look for a home and they found this one here.” This surprised me, as we seemed to come to the agreement in class that most people want to die at home. I told her about how a lot of people liked to be at home when they passed, in a place that they felt comfortable in. But she described to me how the nursing home had become her home. She loved it here and it was much better to her than being immobile in her home with a woman she barely knew. “My children come to me,” she said, emphasizing the point that, that was the only reason she might’ve stayed at home. When I asked what she thought about when she was alone she said, “The only time I’m alone is when I go to my bed at night.”

            She is a very sociable person, talking about all the groups she has at the nursing home and the parties she and her friends used to throw. It is clear that she loves her life in the nursing home, contradicting the many stories that one hears. Her relationship with the nurses and doctors was also very strong. She was obviously very found of them as she praised them constantly during her interview. This relationship, just as the NYT article suggests, brought this woman better care and satisfaction.

            After leaving my first interviewee, I walked to the elevator and went up to the fifth floor, where the next resident was already in bed. The elevator doors opened up to white beds on wheels and wheel chairs all holding ghostly white people, with transparent hair. They were all lined up watching the news. Stories of murder flashed across the screen while they all barely seemed to notice that they were watching television. I waited for about 15 minutes, sitting there looking on at all of their faces. One man sat clutching the sides of his chair, staring straight ahead, bug-eyed, the entire time I sat there. The woman to his left sat clutching a baby doll, obviously immersed in her own world. I did feel a bit uncomfortable. The nurses smiled at me, but I was obviously not their main priority. Eventually one came to get me and pointed to a room down the hallway where my next interviewee waited.

            I walked into the room and she immediately yelled at me for not coming at five, like I had said. I patiently explained that I had been there at five, but that the social worker had brought me to somebody else first. Upon realizing that I did not have a chair to sit on, she sent me out to ask a nurse for one, the nurse brought me one and wished me luck with the woman I was about to interview. I braced myself and went back inside the room to start.

            “I am American by naturalization...I am from Antigua,” she said, after asking me why I was there. She had been living at the nursing home eight years, and she had turned 87 the previous Monday. Her family visits twice a week and they talk she said. The nursing home does not clean clothing; therefore her son takes her clothing and washes it for her. In addition he brings her toiletries. When I asked if their relationship had changed, she said that it had gotten better if anything. “I’m here now you know, they know I’m sick and I need every attention.”

            I then asked how she felt about being sick. She said, “Well listen, I am a Christian. First, I believe in God, and he suffered, he died, eh was crucified for me...and therefore, to me, I am suffering...I pray every minute of the day frankly for being here. And I think maybe for a reason, it was an accident I had. I was going to church that Sunday morning.... My son he’s a priest, and he was going to preach that fathers day...I was in front of the car and she was in back of the car...another car came from the other direction...that’s all I remember.”

            She spent four months in the hospital afterwards. When I asked how it was there, she said she barely does know because she was so heavily medicated. “It’s not easy, it is not easy...but with my faith in god, child my faith in God, I can overcome anything.” She said she believes in heaven. “I believe in God, and I know what he’s doing. I know his purpose and I am contented...and that sees me through.” It was obvious to me at this point, that she wanted to discuss further, that it made her feel better. Therefore, I then I asked if she was scared to move on to heaven. She replied, “No let it happen, because I am praying towards. But you know we Christians we are sinners, we come short of God. Therefore we have to pray, father forgive me, forgive me, every second. You know sometimes you worry...I have a fractured hip and arthritis in the shoulders, it is not easy...let nothing disturb you, let nothing frighten you, all things pass.” She spoke of how sometimes she worries, but then God comes and makes everything better. When this happens, she begs for his forgiveness, embarrassed that she ever doubted him. It was a bit inspiring listening to her, especially after the anxiety of  the death lesson. She had none; she was ready to move on. At some points in the conversation, it almost seemed liked she wanted to die, wanted it to be over, so that she could live in heaven with her faith.

            After the depth of that discussion, I decided to ask her about her medicine intake, to lighten up the mood. She does not take any drastic pills, only one for high blood pressure. Her son’s wife is a nurse, so she is able to go home with him occasionally. “I have a good relationship with people...I make friends easily.” The discussion moved towards her life at the nursing home. At the home she passes out pamphlets about her faith, which she sees as her purpose at the nursing home. Because she is such a “people” person, she explained that she did not mind living at the nursing home, especially with the opportunity to still visit with her son. “Because I am here I can get help...I feel comfortable here. You can see that from this room.” I looked around her room, it was decorated with flowers and picture. She pointed out a plaque that said she was named resident of the year. I could see the pride in her face, until she moved back to her rally of God.

            “So my faith my dear child, my faith in God sees me through...I have to wait and to wait and to wait to be looked after because it’s not easy sitting in that chair...but then when I’m waiting, I say my prayers...I pray for everybody...when you go out there and you see these people you wonder, lord...” On her wrist she showed me the bracelet that she wears. It means, she explained, that if she is to have a heart attack, she does not want to be revived. The person is to leave her, and let her die, as she sees it as God’s intention. I asked this woman too then, about Nietzsche’s theory. “Well if it come to the point, but I would be twisted...I live it one time and that would be enough for me...I don’t push my luck with God...I think that’s what he meant it to be...he knows everything from the time we are born...he knows how many hairs are on my head and how long I have to live. So when that time come, I accept it.”

            This woman clearly was not anxious to die but instead embraced it. While to most people death is the enemy, and to Christians too, despite the fact that they believe in heaven, this resident was able to accept it. Religion obviously does play a big role in your suffering at the end of life. She repeated multiple times how she prays to God, asking him for forgiveness when she worries, asking him for help. In some way, she believes she is saved from the pain and suffering of others, because she probably is suffering less than those around her, because she convinces herself otherwise. The first interviewee too, despite the fact that most people would suffer less dying at home, felt that she should instead die in a nursing home. For her, her home was no longer a home with a random nurse living with her as opposed to her children. Instead she chose to come to a community in which she feels she can still function and see her children. This nursing home was the right place for both of them because they were able to make their own home out of it. At the start of their hospitalized career, both of them stayed in places that they were not fond of. Their experiences really support the ideas shared in the NYT article. The hospitals in which they were wanted them out, and they went, but not to places that had an enriching environment for them. But soon enough they found a place where their relationships with the people there blossomed, and they were able to find a place for themselves. As much as we choose to look down upon the care for the elderly, perhaps we need to ask them what they think. For what I have found is, they made their place and enjoy it. They have help when they need it, and for some, God to guide them through it.

           

Works Cited

¹ Konrad, Welacia, Stressful but Vital: Picking a Nursing Home (http://www.nytimes.com/2010/03/20/health/20patient.html?pagewanted=1&_r=2&ref=nursinghomes)