Saturday, January 22, 2005
I first noticed it yesterday.
There is a pall that hangs over a "professional medical day" in this household. I think I noticed it this time because it's been awhile since my mother has gone so long without seeing a doctor, to a lab for a blood and/or urine draw or being in a medical facility for any length of time.
Normally our lab visits up here are quick; there are very few people (sometimes none) waiting to have fluids drawn. Yesterday I wheeled my mother into an almost full waiting room. Despite the number of people it was quiet. Everyone, including my mother, appeared to be steeling themselves against the moment when medicine would be making physical contact with them. My mother, as she always does at this lab, noticed that the aquarium was a "habitat for algae, not for fish". We've been visiting this lab regularly since June of last year and although the aquarium filter burbles ceaselessly, the tank, which stretches the length of one of a diagonal wall that appears to have been installed for this purpose, has never contained fish. When she made her observation a few people in the waiting area chuckled ominously.
One by one the waiting area residents' names were called, each shuffled to the cubicles following someone with a plastic tray containing needles, brightly capped syringes and cups, and, as my mother observed, "...you don't see them again...". A few more chuckles burped from the hunkered, waiting clients. People exit the same way they enter, through the waiting area, but I think everyone is so focused on their individual fates which are about to be determined by their impending harvest that it seems as though a person disappears after a draw.
As usual, the tech, who was lively and talkative, had trouble finding a cooperative vein (my mother's veins, while quite visible, roll with the punches, which is, to me, an optimistic sign...it's the way she does her life) and a second, more experienced tech was solicited. My mother winced several times and her wit turned dry and a touch snide.
I mentioned that it had been awhile since we'd come in. After all the medical attention she received in the fall from hospitals and the skilled nursing facility, I explained, she protested being stuck monthly through the holiday season and I'd agreed. The second tech, an RN, immediately reacted to my mention of the skilled nursing facility. "Don't ever put your mother in one of those places permanently," she said. "I've worked in a couple and the reason I'm no longer working in them is that I couldn't stand participating in the lack of care the residents received."
"Funny you should mention that," I said. "We did our homework, found one of the best in Chandler for her therapy and, still, I was commuting from Prescott every other day just to make sure that she maintained a half-way decent level of hydration, cleanliness and skin care. And don't even talk to me about medication management!"
The RN tech nodded vigorously. "It's upsetting to work in one of those places and it pays almost nothing. That's why the turnover is so high. Most decent people can't take it very long. Understaffing. Lack of attention to the basics. The doctors and administrators treat residents like they're on a factory belt heading toward discharge. The ones who are successfully processed shoot back to their relatives. The ones who aren't shoot into pine boxes. The staff acts like they have nothing to do with the final outcome. Very discouraging. I would never put my mother-in-law into one of those places. That's no way to honor her. My husband and I've decided we'll do what you're doing." Then, she added a curious insight: "I'd put my mother in one. She's a troublemaker and didn't raise me, my aunt did. As far as I'm concerned, she deserves exactly the care she gave: Zero." She stopped palpating my mother's veins for a moment to illustrate a zero with the thumb and forefinger of her right hand. "My mother-in-law, though, raised such a good son, and is the best mother-in-law. When she needs care, she's coming to live with us."
Wow, I thought. I wonder how many people 'end up' in nursing homes as a kind of punishment for past sins against those with whose care they were entrusted. I wonder, in long range, how inevitable it is that, given our society's lack of attention to those ensconced in the tasks of caregiving, making it even harder to give care, our society sets up some ill-prepared, surly citizens to be "bad caregivers" and to earn the neglect of their charges. I know that it is common to believe that intense needs caregiving, particularly of the elderly and infirm, often reaches the point where care within the family is considered too demanding to be avocationally possible. Now I wonder how many people would automatically be better caregivers of all types, able to go the distance, if our society didn't silently agree that giving care is a personal, not a societal, matter.
After our long haul at the lab my mother's spirits were droopy. She slept off the drudgery for almost four hours, during which she shed water as though she'd slept through a night. When she awoke she thought it was early morning of the next day. It may as well have been. We performed a second bath and laundry load. She had to be reminded that the upcoming meal was lunch. Once she reoriented herself she was fine but unusually quiet. "We don't have to go back to the doctor today, do we?" she asked.
"No, not until Monday. Today's Friday."
She sighed. "Well," she said, "let's make it a short visit."
"We will, Mom," I promised. And, I can't see why this won't be possible. Unless I'm completely off base, Monday's appointment should be no more than routine, preceded by a trip to the Valley, which she always finds diverting, and followed by a visit and dinner with friends and dogs. At any rate, if "something" is discovered which appears to be in need of immediate, intensive treatment, as usual, I'm going to approach such treatment with great circumspection. A little bit of medicine is handy; a lot of medicine tends to become an added circumstance from which my mother must recover. Somehow, that just doesn't seem right.
Normally our lab visits up here are quick; there are very few people (sometimes none) waiting to have fluids drawn. Yesterday I wheeled my mother into an almost full waiting room. Despite the number of people it was quiet. Everyone, including my mother, appeared to be steeling themselves against the moment when medicine would be making physical contact with them. My mother, as she always does at this lab, noticed that the aquarium was a "habitat for algae, not for fish". We've been visiting this lab regularly since June of last year and although the aquarium filter burbles ceaselessly, the tank, which stretches the length of one of a diagonal wall that appears to have been installed for this purpose, has never contained fish. When she made her observation a few people in the waiting area chuckled ominously.
One by one the waiting area residents' names were called, each shuffled to the cubicles following someone with a plastic tray containing needles, brightly capped syringes and cups, and, as my mother observed, "...you don't see them again...". A few more chuckles burped from the hunkered, waiting clients. People exit the same way they enter, through the waiting area, but I think everyone is so focused on their individual fates which are about to be determined by their impending harvest that it seems as though a person disappears after a draw.
As usual, the tech, who was lively and talkative, had trouble finding a cooperative vein (my mother's veins, while quite visible, roll with the punches, which is, to me, an optimistic sign...it's the way she does her life) and a second, more experienced tech was solicited. My mother winced several times and her wit turned dry and a touch snide.
I mentioned that it had been awhile since we'd come in. After all the medical attention she received in the fall from hospitals and the skilled nursing facility, I explained, she protested being stuck monthly through the holiday season and I'd agreed. The second tech, an RN, immediately reacted to my mention of the skilled nursing facility. "Don't ever put your mother in one of those places permanently," she said. "I've worked in a couple and the reason I'm no longer working in them is that I couldn't stand participating in the lack of care the residents received."
"Funny you should mention that," I said. "We did our homework, found one of the best in Chandler for her therapy and, still, I was commuting from Prescott every other day just to make sure that she maintained a half-way decent level of hydration, cleanliness and skin care. And don't even talk to me about medication management!"
The RN tech nodded vigorously. "It's upsetting to work in one of those places and it pays almost nothing. That's why the turnover is so high. Most decent people can't take it very long. Understaffing. Lack of attention to the basics. The doctors and administrators treat residents like they're on a factory belt heading toward discharge. The ones who are successfully processed shoot back to their relatives. The ones who aren't shoot into pine boxes. The staff acts like they have nothing to do with the final outcome. Very discouraging. I would never put my mother-in-law into one of those places. That's no way to honor her. My husband and I've decided we'll do what you're doing." Then, she added a curious insight: "I'd put my mother in one. She's a troublemaker and didn't raise me, my aunt did. As far as I'm concerned, she deserves exactly the care she gave: Zero." She stopped palpating my mother's veins for a moment to illustrate a zero with the thumb and forefinger of her right hand. "My mother-in-law, though, raised such a good son, and is the best mother-in-law. When she needs care, she's coming to live with us."
Wow, I thought. I wonder how many people 'end up' in nursing homes as a kind of punishment for past sins against those with whose care they were entrusted. I wonder, in long range, how inevitable it is that, given our society's lack of attention to those ensconced in the tasks of caregiving, making it even harder to give care, our society sets up some ill-prepared, surly citizens to be "bad caregivers" and to earn the neglect of their charges. I know that it is common to believe that intense needs caregiving, particularly of the elderly and infirm, often reaches the point where care within the family is considered too demanding to be avocationally possible. Now I wonder how many people would automatically be better caregivers of all types, able to go the distance, if our society didn't silently agree that giving care is a personal, not a societal, matter.
After our long haul at the lab my mother's spirits were droopy. She slept off the drudgery for almost four hours, during which she shed water as though she'd slept through a night. When she awoke she thought it was early morning of the next day. It may as well have been. We performed a second bath and laundry load. She had to be reminded that the upcoming meal was lunch. Once she reoriented herself she was fine but unusually quiet. "We don't have to go back to the doctor today, do we?" she asked.
"No, not until Monday. Today's Friday."
She sighed. "Well," she said, "let's make it a short visit."
"We will, Mom," I promised. And, I can't see why this won't be possible. Unless I'm completely off base, Monday's appointment should be no more than routine, preceded by a trip to the Valley, which she always finds diverting, and followed by a visit and dinner with friends and dogs. At any rate, if "something" is discovered which appears to be in need of immediate, intensive treatment, as usual, I'm going to approach such treatment with great circumspection. A little bit of medicine is handy; a lot of medicine tends to become an added circumstance from which my mother must recover. Somehow, that just doesn't seem right.
