Do You Want A Pain Pill?

If I hear that one more time in answer to a call light a patient puts on, I think I shall scream bloody blue murder! Let it be known the call light signal we all have is a little rubber ball we squeeze and a red light goes on behind your bed and out in the hall outside your door. Also, it rings down at the nurses’ station and the CNA or aide comes as soon as she can (or wants to). Honestly speaking, it annoys the hell out of the desk nurses and as soon as someone appears the question immediately asked is, “Do you want a pain pill?”

Some say yes, because they waited so long for any answer. Tylenol is the pain pill of choice, despite the TV warnings to the contrary of a good drug or bad. Actually, the infamous offering is more for the nurse than the patient – give them a Tylenol and shut them up for a few hours or roll their bed over the call light cord and shuts off the squeeze suction of the ball and no light flashes on! One experience I personally had was an aide who put a crimp in my call light cord. When I realized what was done that I couldn’t undo I called for the maintenance man and he clued me in that it was a common practice!

Luckily, I am allergic to most all kinds of meds and I’m  not a bell ringer – so when they rush in and ask the eternal question I say, “No…but if you have a Jack Daniels on the rocks, I’m up for that!” They laugh and proffer a Tylenol 3-PM. (Oh, boy! There’s a nuclear bomb if ever there was one.) “No thanks – do you have a morphine bag and a nose hose, or how about a real quick cyanide pill the WWII soldiers carried in their field jackets?” The poor young aide looked at me with a blank stare – hell, she’s probably never even heard of WWI.

“Uh, so you don’t want a pain pill?” I reply, “No, honey, my pain will be gone once you leave the room.” She hesitates and then gets it. “Oh, Ms. M – you’re so funny!” And so saying, she swishes out of the room. Dear God, I don’t ever remember being that young or dumb. Why would I need a pain pill, you ask? Well, the man next door died and they assume we don’t want to see him leave. Huh? Fortuna Bastard! (Lucky Bastard!)

The Winter of Our Discontent

No matter how optimistic we all try to be, the Straw Flowers dreaded to see the year anew with the number 2013. As if 2012 didn’t have enough craziness, a year ending in 13 couldn’t be good. And sure enough, we are only four months in and so far all hell has broken loose. Turn on the news or scan the internet for a myriad of monsters that can not be dwelled upon or else one can go mad! There was a play and a song, “Stop the world, I want to get off!” That says it all!

Now we go back into Pretty Prison and the long term unit – a.k.a. The Green Mile – and a whole new dimension reshapes the horrors we live with day in and night out. Of late, we have lost quite a few old timers who have served their time and the good gods above have released them. A strange kind of farewell from those of us left behind – it’s not one of sorrow, but of gladness for their release and a shade of jealousy and wonderment as to what day will be our day.

As we Straw Flowers have become accustomed to seeing groups of families crowd the hallways after the fact and a few – a scant few – making a daily appearance. The latest elder Straw Flower has been on the long term unit for a very long while, stricken by multiple strokes and limiting him to a mobile bed-chair. This enables him to be out and around the facility, but he has to be pushed. The bed-chair is long (as he was a tall man), needless to say it is heavy as well and if an aide were to push him, it would be to one place and he would be left there alone. He however, has the good fortune to have either a daughter or grand-daughter who comes every day, dresses him according to the weather change (complete with homemade afghan), and takes him all over the building. She is heard speaking softly to him, as if to encourage the garbled tongue and confused mind back in to action.

Each day I watched the many trips made up and down the hallway and decided she must have been a daughter with whom he lived when he entered the nursing home. Those duties she may have provided were no longer possible, yet she would not leave his daily care to strangers. Their two favorite places were in the sun-room, where as she pushed the bed-chair she would make him aware of another sunny morning, and in the afternoon the promise to take him to the ice cream parlor.

Many of us described her as the most devoted loving daughter ever to be found among us who have grown children – they called her the Saint of Love. God knows, there are too many Straw Flowers who are left bereft by the absence of children who have passed on before us or those who chose to become “absent from location” for any reason. Be all that as it may, I studied this father-daughter duo over the years and while I too, give credit to the loyalty and love of a daughter to her father, my other thought was, “He must have been one hell of a father to this woman to evoke such devotion!”

The hallway is empty today, as he has passed on and it gives me quite a bit of reflection regarding our children and us…how good a parent were we to them and how many of us deserve that love? Straw Flowers should not be too harsh on the voids in their present life. Your children are like “life-time banks”, depending upon your deposits will foretell the amount of withdrawals. Many mothers and fathers here have said to me, “What did I do wrong? They don’t want to come near me since I left home. I couldn’t help what I’ve become. I’m sad!”

It’s hard on our children no matter what the age or stage of their lives and in their eyes you are still what they remember – you’re always Mom or Dad. And herein is the key to your understanding. Think, Straw Flowers, maybe they would rather remember the parent they knew than face the parent you have become! I speak from personal reference on this my own mother’s death day, of when I saw her last also in a nursing home, and the shell of a tortured dementia-stricken woman. That was not my mother! And so, the cycle continues.

One of Those Nights

One of the many things Straw Flowers get used to in Pretty Prison is your clock – it doesn’t mean a damn thing anymore! We all recall being disciplined by the clock at home, at school, at work, in the household you fell heir to the day you said, “I do!” Then shortly thereafter, it was baby’s clock you watched and appointments you had – doctors, dentists, school meetings. You get the idea and will agree that at day’s end you fell gratefully asleep and hoped the “snooze” button would malfunction and you could cop off a few extra minutes. It seemed there were never enough hours to sleep!

Well, kiddie-poos, let me shed the light on the other life you will enter and the long nights ahead when you may lay in your kitty litter box and stare at the ceiling and pray you could close your eyes. It’s told as we age we really need less sleep – i.e., eight hours could become four solid unbroken hours of sleep and maybe a cat nap during the long day ahead. I was born at 2:47 and I’ll be switched if I don’t wake up at 3:00 on my “one of those nights” – wide eyed and bushy tailed, ready to take on the world! Only to find out my world is gone – there is no more of what was! All of us on long term can’t get up and even if we could the territory is very limited. I, however, am very lucky – I grab a notebook and pen and open another blog insight!

Expect to listen to the night sounds…no, not the crickets or the patter of rain. We hear the rumble of the carts, laundry bins, machines to check blood pressure and temps, coughing and night screams for the nurse, someone’s TV left on for company. Then there’s the EMT and ambulance carts to take someone out. For me, tonight is one of those nights.  The dynamics have shifted and two of our own are in the hospital and two more are on the way out to their big cat-naps in the sky. Nurses and aids are running in and out, up and down the hall. They can’t help it – it’s the night shift where everything happens at once and there is never enough help to cover it all. After 23 years of this kind of living, I have gotten used to it and can slip into four hours of sleep regardless, but not tonight for some reason. I only slept two and a half hours and could blame it on age, the hot humid Florida nights, or a rip in the Universe.

Actually, its the lack of all that hustle and bustle I had in my other life that I really miss. For all you youngsters out there, count your busy blessings of your days or nights – they are the most cherished hours of all. And think of us elders who lay awake sweating, itching, and scratching and OMG it’s 4:00 – time for me to get up! But, oh crap, I’ve been up since 2:30. Yes, I do believe I’m back in the spin cycle of my old dryer. No wonder cats take 16 hour naps a day – after all, they have one of those nights every night.

I have friends who tell me they must have eight or more hours of sleep every night, they can’t sleep if there is any noise at all, and some even have separate bedrooms because one or the other snores! Oh, what a rude awakening awaits you. Wait until the nurse throws the ceiling light on or your aide snatches your wet change diaper or the guy across the hall chokes up a yummy duckie and lo, here come the breakfast trays! Oh joy!

There was an old song called, “Enjoy yourself, it’s later than you think…”  Need I say more?

The Age of Recycling

At my present age, I’ve lived through the Age of Aquarius, the Ice Age, the Stone Age, most assuredly the Dinosaur Age – however, this new Age of Recycling, well this is not real! I, as many in the rest of the world do, feel like we have been put in the clothes dryer and somebody turned us on the spin cycle!

As a child growing up in hard times (the ’30s through ’50s), I remember recycling newspapers, tin cans, bottles, and taking them to some unknown depository to be recycled and made into something else – better (?). As times and progress advanced it was learned that even human waste could be recycled and made into a food process. OMG! Is that where Grey’s Poop-On comes from?

If you don’t have enough experience in recycling, just wait until you get to your first nursing home experience, and your first mattress. In my other life, we had plain mattresses our mothers (and then we) reversed weekly – head to foot, then flip over side to side, to preserve it as mattresses were expensive. My parents were married and had the same mattress for 25 years. I was married 20 and only had two. My husband at 180 lbs. and I at 102 lbs. had Posture-Pedics and they were great. My guy was a “sprawler”, edging me inch by inch to the edge each nite. (I then realized the true purpose of those little rope handles on the sides!  Had I not hung on, I would have been on the floor.)

When I entered the nursing home, I was put in a crank handle bed on a mattress with a center hole second only to the north rim of the Grand Canyon! Soon as I bought into a private room on the rehab unit, I received an electric bed and a firm mattress. I had reasons for the switch, as I had cervical lumbar spinal decompression, three hip surgeries over the years, and a neurological condition since birth. I had to get used to a horsehair backboard mattress for stabilization.

Over the 10 year span, at least five mattresses were employed and an air mattress was deployed (commiserate to a WWII life raft!). It ran on an air motor from a 1-10 max comfort level (?), with no allowable sheet to warm the ice cold surface. Though it was different, no one prepared me for the four hurricanes in six weeks and the malfunction of back-up generators, which cut power to the bed. I sunk into rubber up to my earlobes! It was a horrible experience and I screamed bloody-blue hell to get me back to the horsehair back board!

More years passed and again it was time for a change. Two years ago, I was put on a pliable smooth rubber or vinyl mattress – it seemed good except each time I put the electric bed in a sitting position, I slid down to the middle and had to be pulled up several times a day. I began to wonder if I’d ever get a mattress that was comfortable in any position. Finally, my back and the CNAs could take it no longer and my complaint echoed to the powers that be. I was promised a new mattress not once, but three times.

After a hot and heavy care plan meeting with the department heads, out of the fairy dust a boxed new mattress was placed on my bed. This sucker was seven inches thick, with a heavy fabric covering which tore the guts out of me when the aides tried to pull me side to side and up and down. What the hell?, I thought.  I called one of the trusted staff and said, this cannot be the same mattress I’ve had for the past two years – I want my old mattress back! I didn’t want to be dismembered by the new one. The trusted one assured me that if I’d seen the old mattress, well it was so conclave they had to put it in the dumpster – it was no wonder I’d been in pain.

Wait a minute…are you telling me the old mattress was not new when I got it two years ago? Silence. Then…I got a “dead bed” two years ago and now I have the new mattress I should have had then? Suddenly, my head was back in the spin cycle! I was in shock – the trusted one said a quiet yes, affirming that when a patient leaves (willingly or not), their mattress is sanitized by housekeeping and recycled to a new resident’s room. The new resident is unsuspecting that the mattress in question might not be new, until they begin to complain.

This is the ultimate recycling of your life and if your hinder-binder breaks down or any other injury occurs, you can bet your bottom (if it’s still there), “they” will never tell you. Ask questions about what lies beneath your back and butt, hips and legs. You may not need an expensive MRI or a myriad of pain pills – just the proper new equipment.

Just One Perfect Day

Be honest, Straw Flowers, we all go to sleep with one nightly prayer – half of us pray for another day in our wrecked lives with hope something else won’t fall apart, and the other half prays not to wake up at all, knowing full well the Pollyanna crap is not a working tool. However, lately I heard another concept shared from a middle-aged young woman who is preparing for her old age stage of life – and I agree! “Just suppose you speak to and open your mind to the Universe and ask for just one more day – wherein all your ails and brokenness were suddenly gone! Ask yourself, would you really want to give up and die? Or, would you want that new day to explore just as you did before?”

I thought about that possibility of such a “one more perfect day” scenario and albeit an impossible reality, just suppose a call to the Universe did turn fantasy into reality? My answer was: Hell, yes! I’d want that one more day because I’d be back out in the world tearing up the place – learning, working, sharing all my new discoveries with the whole damn world! Oh my, for just one more day…

The answer for all of us elders who want to throw in the towel and throw themselves under a bus, like the song John Lennon wrote in the ’70′s – imagine…really and truly imagine one perfect day that could be your tomorrow, perhaps not in total, but a few new aspects the great Universe had to offer. Opening oneself to others, be it the sage old advice or pearls of wisdom from the mouths of babes, are in fact the echoes of a timelessness we are all offered, and to shut the door of acceptance and sharing them is in itself a death of spirit!

The young woman is wise beyond her years and always has been since her toddler age – who would know better than I, her mother, and now she has become my teacher, helping me over the end years of my life. For those Straw Flowers out there who are weary and beaten down by the winds of personal wars – try, just try, to imagine tomorrow as that possible one more perfect day!

Ignored Breakdowns

Breakdowns within facility infrastructure and staffing is running rampant. As fast as new nursing homes are built, old ones are coming apart. Inspections manifest dangerous or injurious situations to patient residents. The lesser ones are electrical, plumbing, heating and/or AC. The major ones are the bacterial dust (doctor’s term) from exfoliated skin we all share. The walls and ceiling ducts have never (or rarely) been addressed, rooms have never been repainted – so God knows how much “fungus is among us!” I know the staff and visitors all complain of allergic reactions as soon as they enter the building. We all know there is pollen, etc. outside the building but what lurks within?

Personally, in our facility after four back-to-back hurricanes in 2004, we had heavy rain damage in the ceilings, leaving the tiles above us to “dry out.” Those that broke through had flooded rooms with running water. They were replaced, of course, but what of the ones that were left to dry out over time? Surely, mold comes to mind and perhaps much more. However, it is ignored.

We all can recall the horrific condition of our nation’s largest veterans’ hospital, and nursing home facilities so horrific it was a constant expose on television media. Blame games ensue with government cutbacks, and that is a factor. There have been increases in infectious, contagious, and chronic illnesses in facilities – not to mention the constant exposure from the ambulance/EMT and mortician’s gurneys coming and going. The administration blames the corporate umbrellas over them. Corporations look the other way until their investments either fall down on their own or are closed down due to neglect.

Now, if the elders and other facility residents don’t have enough to worry about within the building itself, we all deal with shifting staff breakdowns. Over 22 years, but mostly over the most recent nerve-racking 10 years, the levels of care givers have been a real P.I.A. – back to the blackboard: we have a house doctor, a house supervisor, an RN, an LPN, and CNAs. Back in the day, everybody knew who was who, because they were dependable and showed up for their shifts. Somewhere, for some reason, the sands of time introduced new levels of caregivers – now Straw Flowers have to deal with the P.A. (who only comes every three months on account of Medicare/Medicaid restrictions, unless you code blue and are left waiting for his/her death sign-off.) If none of the trained staff are available during your crisis, you may end up with a “sitter” – a staffer who literally just sits with a patient and cannot leave the room.

Failing structures, falling apart staffing – what’s next? I suppose we can always hope for a good old-fashioned Florida sinkhole!

Realization Coming to Light

Well, Straw Flowers has seen what a crappy year 2013 is turning into and we are only three months old! Beginning with the God-forsaken contentious world-wide weather, down to the Ground Hog Day fiasco (that little bastard predicted an early Spring, followed by blizzards and record-breaking cold fronts!). Then came the expose from Time Magazine and all the TV media about the billion dollar cost scams of the U.S. hospitals to patients. We can all trace back to the cost of a box of tissue as $12.00 – hells bells, my whole head isn’t worth $12.oo, let alone my tender nose! Way back in the 1970′s,  I got an overcharge of $365.00 on a bill for treatments I never had and a two day charge after I had been discharged. It cost my husband $700.00 in lawyers fees to get the hospital to correct the billing! I have many friends and relatives who live in the MRI scans – $8000 to $10,000 a crack for that baby, when in fact it has been disclosed that it costs the hospital only $834.00 to run!

Of late, I’m sure you heard the latest horror in Bakersfield, CA (the sue-me state), of the lady in an ALF dining room who was suffering a heart attack. The facility called 911 and the operator asked if anyone on staff had begun CPR as minutes counted before the ambulance arrived. “No,” came the desensitized answer, “That’s against our policy.” The lady died before she reached the hospital. Which brings to light the further realization that hospitals are “saving institutions,” placing you on all their new machines and ALFs go with, “We stand by and oh well…” policy. Don’t even think about law suits that will take years and tears and OMG so much money!

And then we have the government health care plan promises that are still on the ping-pong tables being batted back and forth. So it seems you can’t win. Personally, I am going with, “Keep it simple, stupid.” Recently I awoke with a huge clot of blood in my right eye. The OMG suggestions from my ring of fire friends and family came in, “Get an MRI – you could have a tumor!” And, “Get a chemo injection in your eye – this could be an oncoming stroke!” And so it went. I waited. Finally, the P.A. in my nursing home looked at it and said it was a blood vessel that had burst. He prescribed Visine four times a day for ten days, and Voila! It worked. A simple procedure and letting nature take its course.

Mistakes, overlooks, carelessness, hurrying, and whatever other categories you wish to apply occur on a daily basis – whatever the name of the office, ALF, hospital, or nursing home. Most of the time the cures are worse than the cause! Let Mother Nature take her course. Oh sure, not every mother is right, but weigh the options and realize everyone who cares for you has a cold eye, a green eye (money), or a blind eye! The good news is, we are all becoming more aware of being duped by the “new normal.” Question, question, question until you feel right. Get copies of every word or diagnosis to remind the next stupid that you’ve been there, done that! Record or document your own personal notes for future references. Diligence is still upon the shoulders of the patients and residents, no matter your health status.