Wednesday, November 21, 2007

Giant At the End

Giant At the End

The day before Thanksgiving is our family
anniversary commemorating
the first night Jay and I spent together,
the day we declared as our anniversary
at a common law marriage event in 1978,
the day our first adopted son spent a

whole night in our home, the day Mother died,
and possibly the day our new granddaughter
will be born (we’re waiting while we cook).

I find myself thinking of Mother’s final days
at one of the Episcopal Homes Foundation
villages in Northern California.

It was a complex experience for us,
a deeply personal encounter with The Giant.

There were many wonderful residents
at Spring Lake Village, some
quite brilliant, which made otherwise
relentless meal time extravaganzas
often fascinating.

Mother chose to live there thinking she
would be independent, trusting their promise
to provide life care in exchange for half
of her life savings plus a huge
"maintenance fee" every month.

Like most people in her generation, my
mother rarely caught sight of The Giant,
so vast it was invisible.

The health care center, which won high
ratings from the Sate, was horrific.

After her first heart attack, they worked
relentlessly to force her out of her apartment.
I later discovered, they were clearing
space for an expanded health center.

They didn’t want to invest in capital improvements.
It was easier to "condemn" the health of people
whose space they wanted.

Resident contracts made them forfeit their apartments
if/when they required extended stays at the health facility.
They call this “Life Care.”

I call it conflict of interest.

Whenever they wanted to clear or flip some property,
they simply helped people get sick.

In Mother’s case, they failed to notice she needed
help with her medications, didn’t notice
classic signs of heart failure, miss-diagnosed
swollen feet and coughing as a winter flu.

Before that, they’d failed to notice
six different doctors had prescribed over thirty
different medications.

I arrived once to find my
tea-totaling Mother stoned out
of her flipping mind,
and writhing in pain.

A memo to residents about that time declared,
“Seniors don’t require regular physical examinations.”

Then there was the “golden rod” form they
made everyone sign declining life saving procedures
should one become traumatically ill.

In the health center, they lodged Mother
with a screamer whose poor din
made it impossible for friends and family
to attend her in a meaningful way —
earplugs didn’t help, or a loud Walkman.

Of course residents were all afraid to complain,
with good reason. Mother was twice dropped —
her arms bruised, a nasty cut on one leg.

I returned from another trip to find her
in the "full assistance" dining room,
a constricted trachea had made it difficult
for her to swallow and she had grown weak.

They had lost her glasses and had shoved
both her removable bridge and her night retainer
into her mouth —
at mealtime.

Both hearing aids were gone.

One of our friends, recovering from a sprained ankle,
told me they’d nearly lost Mother the night before –
from coughing. Staff didn’t mention it to me.

They had decided she didn't need antibiotics –

Staff competence ranged in reverse proportion,
for the most part, to salary level
though it was a minimum wage Kenyan refugee,
alternately confused and terrified,
who disregarded Mother's accoutrements
in the dining room, possibly unsure what
they were for, which made my mother
giggle afterwards.

Similarly impressive was the lead doctor,
who fell asleep during our last interview –
the one they called to declare HER incompetent
to live in her apartment.

Residents who found themselves
“moved” to the health center
quickly declined.

Instead of taking the time to help people
walk back and forth to meals or
even to the bathroom,
staff routinely put them in diapers,
changed them every 4 hours,
rolled them around, parked them
by the front desk —
for ease of management.

Elders directed to immobility
grew weak from lack of exercise.

Physical therapy was reserved
for people were going to return to
their apartments.

Many health center residents
found themselves, if they
waited too long to die, hoisted from
chair, to bed, sponge bathed and diapered,
like grandmother and grandfather dolls.

The ones who had it best were attended
by family members constantly.
They got better care, until their mentors
left —

There were programs.

Once -- during a group activity aimed
at perhaps a 3rd grade mentality -- I blurted out --
"These people are old, they are not idiots!"

I knew them. One was a physician.
Several had been teachers, one had been
a physicist. One had walked from Nazi Germany
to Switzerland. One was a famous painter whose
art work graced the walls of the center.

While residents lived independently
there were wonderful programs, trips abroad,
world class concerts, lectures, study groups —
but once people grew sick, weak,
forgetful, helpless —
their quality of life was “managed.”

The purpose of the health center
was to curry people as quickly
and efficiently as possible,
with the help of minimum wage
workers (who may have had papers)
to death, celebrated by lovely
ceremonies at a multi-denominational

Once, before mother was
moved to the health center,
she told me she had attended a service
for a woman who lived there —

“You mean, a woman who used to live
at the health center, right?”

“No,” she said, “She’s still there, but the family
members had to return home so they
held the service yesterday.”

© Susan Bright, 2007

Susan Bright is the author of nineteen books of poetry. She is the editor of Plain View Press which since 1975 has published one-hundred-and-ninety books. Her work as a poet, publisher, activist and educator has taken her all over the United States and abroad. Her most recent book, The Layers of Our Seeing, is a collection of poetry, photographs and essays about peace done in collaboration with photographer Alan Pogue and Middle Eastern journalist, Muna Hamzeh.

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Anonymous Anonymous said...

This was the scariest thing I've read in a while, which is saying something since my life is currently in constant crisis. At lease it's finally got me writing again Susan!

My mom finally had to put my dad in a home when she could no longer physically lift him and bathe him. She visited him every, single day. His home was definitely not as horrible as most, but even with her vigilance, she would discover unexplained bruises.

It's hard to stay cheerful these days.

10:18 AM  
Anonymous Anonymous said...

The amazing thing is that these homes are the top of the line. I suspect local, neighborhood based elder care programs would have to be better -- since people aren't cut off from their community and family when they are at their most vulnerable.

Once I called the ambudsman, who happened to be onsite, and before I could get from mom's apartment to her room at the health center they had asked her if she was alright, and of course, my sweet mother said that she was fine.


10:24 AM  

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