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Nursing Home: Haven or Hell?

by Rose Madeline Mula

Few dilemmas in life are more agonizing than the decision to send a loved one to a nursing home. We have heard all the Dickensian horror stories.  How loathsome those places are;  how destructive to the spirit and the very will to live;  how uncaring, even cruel, the staffs can be.  We vow we will never sentence a beloved spouse, parent -- indeed any relative or friend -- to such an institution.  We will make whatever sacrifice necessary to help them stay in their own homes; and if that is not possible, we will care for them in our home.  Unhappily, however, the sacrifices and problems sometimes become too great.  They overwhelm us.  They demolish our naive vows.  Rightly or wrongly, we reluctantly become convinced that a nursing home is the only solution. 

 For example: 

 Mom has been getting along fairly well since Dad died.  She is no longer able to drive, but you phone her two or three times a day. You arrange for a home health aid to check on her daily.  You visit at least once a week. You do her grocery shopping, take her to the doctor and dentist regularly, help her with housework, and stock her freezer with nutritious home cooked meals for those times when she doesn't feel like cooking.   You wish you had a brother or sister who could share the duties.  Whoa!  Duties?   Where did that come from?  The guilt has begun.  You should not think of these activities as "duties," you feel.  They should be gifts, gladly given, to one who had given so much to you.  But despite this realization, you have to admit (just to yourself, of course) that you are sometimes resentful about the hours you feel are being stolen from your life.  You swallow another dose of guilt. 

Then Mom starts to deteriorate.  She becomes more forgetful.  When you phone her, she can't remember if she ate lunch.  One day when you go to visit, her elbow is bleeding.  She thinks she has fallen, but she can't say how or where.  The following week, her next-door neighbor calls you.  She found Mom wandering around outside in the snow in her nightgown and slippers. Mom could not remember going out.  She didn't know where she was. She didn't know who she was. Your heart lurches.  This is the woman who was so bright you always felt she could have run a multi-million dollar corporation if she had had the same educational opportunities which she and Dad had scrimped to provide for you.  And now she can't remember her own name. 

Obviously, she can no longer live alone; and she would not be much better off with you.  No one would be home all day to care for her.  Both you and your husband work, and you can't quit your job because you need two incomes. And what about evenings, week-ends, vacations?  Can you ask your husband to give up all your social activities?  It wouldn't be fair to him, you tell yourself--not wanting to add that it wouldn't be fair to you either.  More guilt.

Heartbroken, but feeling you now have no choice, you start canvassing nursing homes.  You can barely get past the door of some of them--the cloying, sickening smell;  the bedraggled, blank-eyed residents slumped in wheelchairs, strewn around the so-called "living" room like heaps of discarded deadwood; the harried, hard-eyed aides ignoring feeble pleas for help.  Your Mom is not coming to a hole like this.  You will shoot her, then yourself, before you let that happen.  You make extensive inquiries and learn that apparently not all nursing homes are horrendous.  Then you visit some of the highly recommended ones.  This is more like it.  They are fresh and spruce, attractively furnished.  There is no discernible odor.  The residents are neat and clean.  Some are talking, even laughing, with each other.  And though others are clearly unaware, they are apparently well tended by aides who appear compassionate and caring.  A faint ray of hope brightens your gloom.  Maybe this can work, after all.  The guilt still hovers, but it's no longer all pervasive.

You pick the best of the homes you have investigated and talk to the administrator.  My God!  The cost!  You could fly Mom to Paris on the Concorde and put her up at the Georges Cinq at these rates!  But the Georges Cinq doesn't provide nursing service, and Mom doesn't speak French. (You're trying desperately to hang on to your sense of humor.)  Eventually you work out the financial details.  Mom has enough money to pay the fees for a year or so; and after that, insurances will kick in.  You sign the papers.  The deed is done.  That night your pillow is damp with tears.  You cry harder when you realize that Mom will never be there again to vanquish your night terrors.
 
I did not have to go through this with my own beloved parents.  My mother, who had always done everything quickly, died very efficiently of a sudden heart attack; and my devastated father succumbed to a stroke a few months later.  If only they had lived, I would have gladly taken care of them, I swore.  Of course, that was easy to say not having been put to the test.  However, a short time later Providence zapped me when my elderly widowed Aunt Gerlanda, whom I adored, developed serious heart problems.  Her doctor said she could not be alone since her life depended on getting immediate help if anything happened.  I should have her move in with me, I thought.  Then I thought again.  She would be unattended all day while I was working, which was dangerous enough; and  since she was an Olympic-class worrier, she would literally fret herself to death if I was late getting home. Also, selfishly I knew I could say good-bye to any extended vacations or even overnight trips or evening outings. 

Trying to exorcise visions of my dear Uncle Al, Aunt Gerlanda's adoring husband, looking down from heaven and pointing an accusing finger at me, I passed the buck.  I left the decision to her.  God bless her, though I know it was the hardest thing she ever had to do in a life that was often very difficult, she said she wanted to go to a nursing home.  She realized that coming to live with me would change my life radically, and she could not tolerate that.  But I knew how terrified she was, on many levels, at the alternative she insisted on. 

First, though we've all met clean-freaks, all the others are mere amateurs compared to my Aunt Gerlanda.  She never simply washed a dish, she sterilized it.  After scouring it in a sudsy solution and rinsing it in scalding water, she would buff that plate with an immaculate dishcloth for a solid five minutes.  A speck of dust was an endangered species in her house; and hers were the only floors (including the bathroom tiles) from which one actually could eat with impunity.  In fact, her floors were probably cleaner than the china in a five-star restaurant.  No nursing home, even the finest of the fine, could ever match her standards.  But then neither could my house; and because of her weakened condition, she would not be able to "Gerlandize" it. 

An equally formidable barrier was her fear of strangers.  Aunt Gerlanda was excruciatingly shy with people outside her immediate family.  Born in Italy, she had come to America at the age of sixteen.  Though she soon learned English and spoke it beautifully for the rest of her life, she was extremely self-conscious of her slight accent which was lovely to everyone's ears but hers.  Because of her reserve, she was always uncomfortable with non-relatives.  I knew the thought of living with people she did not know, and to whom she was convinced she could never relate, petrified her.  But her resolve never wavered as we approached her future one step at a time. 

As in the above-mentioned case of the hypothetical Mom, I eventually found a lovely facility a few miles from my home so I could visit often; and after much juggling of figures, we were able to satisfy the financial entry requirements.  Smiling gallantly, she moved in. 

The home, though remarkably clean, was not Gerlanda-sterile, of course.  For that reason, I don't think she lived there completely "happily ever after."  But I believe she came very close, because in that environment my Aunt Gerlanda discovered a new person.  Herself.  She even acquired a new name.  Dubbed "Gerry" by her roommate, it stuck.  Gerry she was to one and all.  And to her great surprise (but certainly not mine), they all loved her.  Everyone pleaded for her to sit at their table in the dining room; all sought her company throughout the day.   Never a complainer, she also soon became the favorite  of all the aides and the two wonderful young women who were the Social Directors.  They involved her in a whole range of activities; and she shone and won prizes in most, including bowling in the downstairs hall.  She had never bowled in her life.  A genteel Italian senora, she would never have previously considered participating in such unladylike behavior. 

When in her own home, she had seldom ventured out.  Now she went on day trips with the group and excursions to local restaurants.  Whenever I went to visit, she'd  be glad to see me but would soon say, "Go home. You're busy.  You have a lot to do."  I know she was being considerate, but I hoped that she was also eager to get back to her activities.  At least I felt she was comfortable enough there to be able to urge me to leave, for whatever reason. 

The highlight of her stay in the nursing home was a Senior Prom organized by the Activities Committee.  The residents were asked to wear their best party clothes, and families were invited.  When I received the invitation, I thought the whole idea was rather condescending, almost a mockery.  I was wrong.  Aunt Gerlanda, who had never been to a dance in her life, anticipated it eagerly.  And when she was elected Prom Queen, she was ecstatic.  I still treasure the pictures I have of her in her gold paper crown, beaming as she danced with the Social Directors.  Could this vivacious, bubbly Gerry be my shy, withdrawn Aunt Gerlanda?

Sadly, she died several months later; but I truly believe that my Aunt Gerlanda enjoyed her last year of life as Gerry, first in the hearts of her new-found friends and Queen of the Senior Prom.

 

Rose Mula was an executive assistant, a public relations specialist, and an operations manager for a New England theater chain before discovering a passion for writing.

Her work has appeared in The Saturday Evening Post, Yankee, Modern Maturity, The Christian Science Monitor, The Reader's Digest, The Philadelphia Inquirer, The Baltimore Sun, and more than a hundred other magazines and newspapers. Actually-thousands of newspapers, since one of her essays, The Stranger in My Mirror (originally titled, The Stranger in My House), was reprinted in Ann Landers' nationally syndicated column in 1999, and after an explanatory exchange with Ms. Landers, an attribution.

Rose's new book, If These Are Laugh Lines I'm Having Way Too Much Fun, is available at bookstores, through online bookstores, and from Pelican Publishing, 800-843-1724. The book was a finalist in USABOOKNEWS.COM's 2006 Best Books Award humor category. Meanwhile, she can reached by e-mail.