Break It Down. Part I

Ugh. Is it 5am already? I feel like I just went to bed, yet some how 8 hours have already come and gone. I guess I should get up. Get dressed, brush my teeth, basically attempt to look presentable for the day. At 5:20 I leave the house after double, sometimes triple checking that I have everything. … Oh, and there goes the bus. Lovely. Luckily for me the bus I take runs every 10 minutes so it’s not a big deal. It’s pretty cool outside, I can feel fall approaching. Such a warm and friendly season, despite what the actual temperature is.

Crap, I did it again. Thank God for friendly strangers at 6am otherwise I would’ve taken the bus back home again. This isn’t the first time I’ve fallen asleep on the bus. I almost always miss my stop on the way home, which is no biggie as I can just walk home from the bus depot. I take the best naps on the subway. There’s something about the sounds and the motion that just knock me right out. Weirdly enough, I’ve never missed my subway stop. I think I just jinxed it. Before catching my connection to go northbound I stop for a coffee. Coffee is a must. Without coffee my job suffers and the people around me suffer.

It’s still crisp outside but the sun is slowly showing herself. Luckily I have my sun glasses as I’m walking eastbound and the sun in my eyes is blinding. Crap. I just dropped my coffee. What the hell did I trip on?! It’s not my pants… or my shoelaces. How I love Toronto streets. Back up! I forgot my newspaper! I don’t actually enjoy reading the news, but I do like the puzzles. They come in handy when I’m on my break.

What’s my password again? I do this all the time! Maybe I have Alzhiemers… shut up Stef. This stupid machine never recognizes my finger so I have to punch in atleast 3 times. I have time, about 15 minutes worth. I always get to work early because it’s important to get a report from the nightstaff. This is where you find out if any resident’s were sick, in hospital, have had falls, etc. When there’s nothing new to report it’s a good thing. No change – for the most part – is good news. This elevator is slow. It’s weird how I have enormous amounts of patience for my residents but when it comes to an elevator I want to  my hair out.

Ah, this is a nice surprise. I like walking on to my unit and seeing one of my residents already dressed and in the dining room. The nightstaff aren’t required to get them up and dressed, but on occasion we do eachother favours. In this particular case it was because he had soiled himself and the bed linens needed to be changed anyway. Either way, that’s one less person for me to get out of bed, so I like it. I have 9 residents that I am in charge of. 5 of which need my help in the morning, so when one is done for you it helps a lot. There are 3 PSWs on in the morning, and we have 1.5hours to get almost 30 residents out of bed and into the dining room for breakfast. We run a VERY tight ship.

First thing’s first. I have my report, everyone is doing fine, so now we load up our carts. We have towels, we have bed sheets, we have blankets, wash cloths, peri cloths and padding. It’s like your the maid in a hotel, running from room to room to see how the guests are doing. .. Sort of. After I have my linens, I get my diapers. We have different sizes, for different people for what I think are obvious reasons. I also get my creams, my lotions and my soaps. Yep, this is a hotel cart. Next is my dirty linen cart. One bag is for bedding and towels, another is for peri cloths and pads, lastly we have a bag for personal laundry. I take this with me from room to room, up and down the hallways as I provide my morning care.

My first resident is a peach. I’m biased, I think they’re all peaches, but she is specifcially sweet. When you get to know the people you take  care of, it’s much easier to work with them. I try to spend 15 to 20 minutes max with each resident. Sometimes I can do things in less time, other times it takes longer. Every day, eventhough the same, is still different. People’s moods change, sometimes they don’t want to get out of bed for breakfast and that’s fine. The only time we serve in bed is if someone is sick and they cannot come into the dining room. Having everyone on tray service would be next to impossible as there are only 3 PSWs and someone needs to be in the room with the resident while they are eatting.

Alright, we’re done number one. Moving on. As I move on I pop into other rooms to see  if people are ok or if my co workers needs a hand. TEAM WORK IS KEY!!! I cannot stress that enough.

Good grief, what do we have here? You’re not in bed, you’re wandering around in the dark, let me help you. Sometimes residents get disoriented and forget where they are, so you have to remind them. This person in particular is not happy, so I sit them down and we have a chat. What is going on, I ask them.

Imagine this. You’re used to going to the washroom whenever you want. You have control of your urine and bowels. Except for this one day, you let lose without even knowing.  For some reason, you just couldn’t hold it and now you’re soiled. You’re embarassed, you’re scared, you’re ashamed and you don’t want me anywhere near you. Hell, I don’t blame you. But this happens.

I proceed to tell them a story of how I was on my way home from work and I thought I was going to pee myself in the elevator. I may have exagerated a little bit, but I wanted to distract her and make her laugh. MISSION ACCOMPLISHED! After calming her down, we got dressed and I walked her to the dining room. This will be our little secret? I promise.

Almost done, 3 more to go and it’s only 7:45! I love being a head of schedule. Luckily for me, the next 2 I attend to only require a little assistance and not total care.  I encourage anyone who can help themselves to do just that. Not because I don’t want to help, but being independent – at ANY age is extremely important.

It’s 8am. Almost there. One more to go. And the last one is always a little harder. I managed my time, and I knew that the last resident I would attend to would be the most difficult so I gave myself that extra time on purpose. They don’t have dementia so their disposition is very pleasant. My issue with this one person, is that they like to sleep. Waking them up is like pulling something out of quicksand. Get up! .. No, I’m not rude. I gently remove the blankets because this one particular resident enjoys sleeping in a sauna so I know the cool air will wake them. Look at that, I’m right! They’re moving! …. like molases. Relax Stef, you have time. I assist her to the washroom and help her wash and get dressed. Only after I put in her hearing aid does she realize I’m talking to her. Duh.

Is it breakfast yet?

 

 

Let Them Eat Cake

I had the privilege of taking part in someone’s 104th Birthday yesterday. 104. 1.0.4 I’m 27 years old & this person is 77 years older than me. I cannot fathom living to such an age. Imagine the things this person has seen in their life! It’s just mind-boggling. What’s even more impressive is that a part from physical set backs due to plain old age, their over all health is probably more impressive than mine. Easily one of the most charming individuals I’ve ever spent time with. It’s moments like this that add to my confirmation of the fact that I’m in the right place. You need moments like this when you work in long term care, because not all days are cake and birthday parties.

As I’ve said before, working in long term care is difficult. Aside from your residents, there is a whole other group of professionals and non professionals that you have to work with as well: physiotherapists, dietitians, RNs, RPNs, doctors, resident’s families and of course, your partner in crime. PSW.  This isn’t always easy, and like any work environment, there will be days where co workers get on your nerves. However, there are some situations that just… they just make me want to slap people in the face.

Anyone who knows me will tell you that I’m extremely easy to get along with. I’m just a charming individual, what can I say. Unless there’s already an issue at hand, I’m certainly not going to cause one. However, it would seem that there are some people who like to be shit disturbers just for the hell of it. For the most part, I ignore it, but when people start throwing my name into the mix I will stand up for my right. To party. (I couldn’t help it).

Let me preface this by stating what I think is a fairly obvious statement: THIS. IS. A. 24. HOUR. 7. DAY. A. WEEK. 365. DAY. A. YEAR. JOB. When you clock out – or in – at 3pm, your residents do not do the same. If at the start of your shift a resident has soiled themself – you change them. We are dealing with people who are INCONTENENT. They do not go to the bathroom when you say go, they go when they decide, or their body decides that it is time to go. I have read written complaints by other PSWS regarding this. One such comment was directed at me. This is how that conversation went.

PSW: When I started my shift, so and so was wet.
Me: So? Change them.

How much clearer can I get? Unless otherwise specified, my residents are always changed. When an incident occurs which doesn’t allow you to change someone – i.e when my resident tries to punch me – it is documents and the charge nurse is notified. Otherwise, they are changed regularly and if they are wet at the start of your shift well guess what. Deal with it.

You’re not in a world where people go the washroom on their own. You’re in a nursing home now.

“Patience is a virtue, catch it if you can. Seldom found in women, never found in man”.

Thank you for that lovely quote darling resident.

 

Appreciation.

When you work in long term care, you come to appreciate EXTREMELY quickly all the every day things we do that we wouldn’t normally think about:

Going to the bathroom: Pulling down your own pants, pulling them back up, being able to wipe yourself, not having to wear diapers, not having constepation be an issue ALL the time, standing up on your own from the toilet.
I have a resident who asks me EVERY DAY why she can’t do things on her own. What do I tell her? That you’re old, get over it? No. I tell her that sometimes, EVERYONE needs help, that she’s not a lone. Does it help? For a little while, yes, but this isn’t something that will get better with time.

Eatting: Cutting your own food, eatting regular food as opposed to minced or puree, being able to eat when you want, where you want.
There isn’t a lot of variety in long term care. There are set meal times and there are set meals. Your entire life runs on a schedule. You want McDonalds at 11pm? Sure, who’s getting it for you?

Showering: Loofas! Being able to wash your own hair, wash your own privates, wash your OWN BODY. BY YOURSELF. WITH NO SUPERVISION.
Enjoy it while you can.

What I’ve talked about here are your basic ADLS, or Activities of Daily Living. Things we do every day without even thinking about. Getting dressed. Picking out our own clothes. Brushing our hair. Eatting a steak with a steak knfe instead of a spoon.

This is their life. Appreciate yours.

 

Friday I’m In Love

Title curtosy of The Cure.

I’m in love. Again. & it constantly happens in my line of work only it’s a love affair that doesn’t last long. & you know the minute you enter it you’re the only one who’s going to survive and make it through. Your love is 90+ years in age and you know they haven’t got much more to go. They’re hanging on for reasons we don’t know and maybe, just maybe, your love for them keeps them going for a little while. Maybe they don’t have anyone else, and you are the only one who can make them smile.

One of my darlings passed away recently and when I arrived at work on Friday I was informed that someone new had taken up residency in her room. When this happens I get nervous. It’s someone new, I don’t know them at all or their routine. It becomes a new learning curve for both of us. You hope it isn’t someone who requires a mechanical lift, or who has a nasty disposition (curtosy of Mr. Alzhiemers, thank you very much) but you just never know.

The minute I met her I fell. Fell hard. She’s partially blind but other than that she can manage on her own, all she needs is a little guidance. & she talks. A LOT. To herself or to anyone who will listen. I LOVEE that because I love to talk as well – big surprise, right? I told her my name and she said she loved it.

I have a tendency to fall hard in relationships, something which normally doesn’t benefit me at all. I know that in this case I won’t be let down. We have a mutual respect and love for eachother and when it’s time for her to go, it won’t be because she found a blond who’s better than me. It’s just her time. And soon enough, more love will come along.

You Can Rest Now

A few posts back – entitled The Sadness – I wrote about a lady who was slowly on her way out. On Tuesday, August 21st at 6am she finally left. I wasn’t there, but found out about it today.

It’s always hard when someone passes on. Even if you’re not particularily close with them, it’s still a very profound loss that you can’t help but feel. In the case of this angel, I worked very close with her for the last 2 years, so eventhough her passing wasn’t a shock, it was still difficult. I know she’s in a better place & she isn’t suffering anymore, which makes it some what easier. It was difficult to walk into her room and not have her yell at me. Or not here her mumbling to herself. The room was empty, both physically and spiritually.

This is a part of the job that not a lot of people talk about, and I touched on this earlier on. If not for us, taking care of her, talking to her, holding her hand and just being there, she would have died all alone. In my 2 years I have only seen ONE person come to see her. We became her family, and when a family member dies it isn’t easy. Eventhough she couldn’t express it, we have no doubt that she cared about us too.

This isn’t the first time someone I cared for has passed away. I believe I’ve gone through close to 10 at this point. There was one man’s passing that I’ll never forget.

I was assisting a co-worker with bathing a gentleman and during the bed bath his breathing became tense and his skin was slowly turning blue. My co-worker left to get the nurse while I just held his hand, and before they could return he was gone. For some reason, people seem to think that when you’re in a room with a dead body it’s scary. Scary isn’t even close to it. It’s a very profound moment. Even if you didn’t know the individual, to watch them stop breating… it’s just. I don’t know how to describe it. It was sad, I guess that’s the only word I can use. But it was also an experience I won’t forget. We continued to clean him and dress him so that he would be ready for when his family came.

Unfortunately, these days don’t stop coming. All I can do is make their stay as comfortable and happy as possible. And I’ll do anything I can do make sure that happens.

The One Where I Almost Faint. TWICE.

Yep, you read that correctly. Not many things irk me to that extent, but these particular incidents did. I don’t know why they did, as I’ve dealt with and seen a lot worse. For some reason my body wasn’t taking it. Are you ready? Things are about to get pretty detailed and potentially stomach turning.

Urinary Catheterization:
In urinary catheterization (“cathing” for short), a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into a patient’s bladder via the urethra. Catheterization allows the patient’s urine to drain freely from the bladder for collection. It may be used to inject liquids used for treatment or diagnosis of bladder conditions. A clinician, often a nurse, usually performs the procedure, but self-catheterization is also possible. The catheter may be a permanent one (indwelling catheter), or an intermittent catheter removed after each catheterization. – wikipedia.com

SO, in plain english, when urine needs to come out, a tube goes IN and either A) Stays there and urine goes into a bag and the bag is emptied or B) The tube goes in and out.

I’ve seen vomit. Urine. Feces. I’ve gotten all 3, at different times, on my clothes. It doesn’t phase me. But when assisting a nurse with an intermittent catheter, I almost lost my lunch.

It was embarassing! The FIRST time was when I was still in school and doing my co-op. The nurse was inserting into a female and my teacher wanted us to watch to learn. I thought, no problem. What’s the big deal? It’s a tube. It’s a relatively clean procedure. I’m aware of how the female body works. I think. Alright, LET’S DO THIS!

Nope. I was out of that room so fast my classmates didn’t know what hit them. I didn’t actually throw up, but I was pretty close. For someone who has tattoos, piercings and doesn’t get squeemish easily, having an almost faint attack was pretty scary.

Fast forward to work. My nurse asked if I could assist her with a male catheter – another in and out situation. So with a male.. do you want me to explain this or do you get the idea? Yes, the tube goes INSIDE the hole where things normally come out- also called a urethra. Again, very clean procedure, simple. I almost lost it again. And I scared the crap out of my poor nurse as she didn’t know if she should stop to come check on me or continue what she was doing.

Needless to say I survived the ordeal – TWICE – but this is definately something I want to work on.

Surprisingly enough, suppositories don’t bug me at all. Weird, eh?

Sex & The Senior Life

Relax. This isn’t a NSFW-type post, nor is it even remotely pornographic or dirty or what have you. I bring it up because A) You’re interested, just admit it & B) A lot of people don’t think it occurs.

Well, it does.

I’ve gotten asked this question a lot: “Are people who live in retirement or nursing homes allowed to have sex?” And my answer is always: Yes!

First of all: “Allowed”? These people are adults. As long as they are of sound mind and not taking advantage of someone with Alzhiemers or vice versa, than why the heck not? If they have the energy to get up (haha, pun INTENDED!) than why shouldn’t they enjoy themselves?

This type of thing is more related to Retirement homes, as nursing homes are more for people who are dealing with dementia, etc. A lot of people move into retirement NOT because they are incapable of taking care of themselves, but because they’re lonely and want more interaction and company. Maybe their house became too much for them. There are a ton of reasons. A retirement home or a nursing home is someone’s HOME. And like any other home, they can pretty much do as they please.

Another popular question: “Have you ever caught anyone having sex?”
And my answer is no.

Sorry you dirty perverts out there, I have never come across this. I HAVE however almost walked in on a resident watching porn. I could hear sounds of a sexual nature coming through his door, so I just walked away. During my co-op I was cleaning out the garbage of a resident’s room and came across the packaging for a Flesh Light. If you don’t know what that is, feel free to look it up but I’m not explaining it here 🙂

So there you have it. Sex & the senior life. It’s pretty hot.

The Sadness

If there’s one bad thing about working with seniors in a nursing home, it’s that sooner or later, they’re going to die.

Blunt, I know. But it’s the truth and there’s no point trying to hide it. Plain & simple – it sucks.

No one’s died recently, but I’ve been taking care of this one lady since I first started almost 2 years ago and I can tell that she’s slowly on her way out. Her screaming matches with me have turned into mumbles. She doesn’t call me by the wrong name anymore (she never did get the hang of my actual name). She can’t even feed herself. When I first started she was eatting solid food. Now she’s on a puree diet and instead of smiling at me when she takes a bite she throws her spoon of puree chicken at me. Yes, I’ve had a lot of food thrown and spit at me.

It’s almost as if they go back in time and turn into children. The phrase “LEAVE ME ALONE!” and “I DON’T WANT IT!!” are very very popular. I think the only difference is that they welcome naps with open arms.

People have asked me a dozen times if I get attached to people that I work with. Ofcourse I do. I’m human, they’re human, you bond and work extremely close with them. I may be the only person they see on a regular basis besides their family (assuming their family still comes to visit). How do I deal with a death? I don’t know how to answer that. It’s not easy by any means.. it’s almost a relief I guess. Not for me – but for the resident and their family as in most cases they were probably suffering prior.

Another thing I get asked a lot is about the resident’s family and whether or not they have any and if so do they come to visit, etc. Well, it varies. I have some residents who have caregivers and family members come on a daily basis. There are others that come on special occasions or once in a while. Then there the ones where no one comes. Again, the reasons vary. Perhaps they never had children and any family they do have live far away. Perhaps they’ve all died. Or maybe they don’t get a long with anyone. Everyone’s story is different.

As far as holidays go, it is sad and it isn’t sad if relatives don’t come. If a resident has dementia, they have no idea it’s even Christmas, Easter or their Birthday, etc. To them it’s another day, so thankfully they can’t remember anything to miss. If resident’s are cognitive and alone on holidays, then yes, it’s sad. But that’s also where we come in. Someone once said to me PSW = Personal Shit Wiper.

I’m a lot more than that.

On another note, I want to do some updates about some things related to the field that aren’t particularily pleasant. Bodily functions interest me, let’s leave it at that for now 🙂

Another Day

I worked yesterday and nothing out the norm happened. Todd – the gentleman who threatens to throw me out windows & talks of poison – was actually quite pleasant which was odd. Although, he did get very angry at breakfast because not 10 MINUTES after clearing the table he wheeled himself back into the dining room and yelled: “SUPER INTENDENT! SUPER INTENDENT!” because we weren’t serving him. So, we just let him sit there. Again, you can’t talk rationally to a disease that understand the concept of rational thinking and say breakfast was already served. So as long as Todd was safe and just sitting there, we let him be. In 10 minutes he forgot again anyway.

There are some other gentlemen there that are just awesome. Mentally they’re somewhat ok so I can actually have proper conversations with them. Sometimes. Yesterday I was wearing a new blouse to work that was pink and had a flower design on it. This is what happened.

Gentleman 1: I like you’re shirt! It’s so pretty!
Gentleman 2: You just like these (& he procedes to pinch his own nipples).
Gentleman 1: Noooo….
Me:……. Alright that’s enough.
Gentleman 3: Hey Stef, could we have some beer?
Me: Sweetheart, if I had beer I’d sit right here with you boys and drink with you.
All 3 gentlemen: YEAAH!

Seriously. My job is amazing.