Skilled Nursing???

Personal Essays

My mother-in-law has been in a skilled nursing facility for about 6 weeks. She broke her leg and we hope she will become strong enough to return to her apartment in an assisted living complex within a week or so. Its important to note that this center has a 5 Star rating which leads me to seriously wonder what kind of criteria is used and what kind of persons are qualified to administer ratings in this industry.

The phrase skilled nursing is one of the cruelest oxymorons perpetrated on the general public. I see people with very few skills, who are grossly under-paid for the jobs they are expected to do. I can’t criticize every employee we have worked with as there are people willing to help and problem solve and I want to extend that credit. The norm, as I see it, is that truly committed folks are sadly in the minority.

Our society needs to develop a healthier outlook on end of life care. I guess we haven’t fully demanded better care for our elderly because we all tend to focus on what we need now as opposed to what we are going to need when we are elderly and helpless. By the time we are elderly and helpless we have no voice to affect change.

More education and higher wages for people who work in skilled nursing are crucial to expectations for progress.  Staff to patient ratio needs to allow for faster response. Staff members need  more support (via more staff on duty) from fellow colleagues to do their jobs efficiently. I fully identify with the plight of staff being spread too thin which, logically, leads to patient neglect.

One of the problems I cannot understand is why the grunge-factor is tolerated in a facility supposedly  dedicated to health and re-habilitation. This place is a lot like motel-quality lodging – you can a tell a mop has been swished around the middle of the floor but the edges are layered with filth. The public restrooms are on par with a gas station’s and the air is contaminated with the odors of every icky bodily function/ the distinct aroma of institutional food. There are no open windows – anywhere. The air feels so stale and heavy, I wonder how much oxygen is even available.

A few weeks ago, my gross-out factor was so high I devised a system for keeping nursing-home germs out of my own home. When I got home, I exited my car and scrubbed my steering wheel and driver’s seat with anti-bacterial wipes. Then I stripped down to my undies outside* and took the contaminated clothing directly to the washing machine.

I was heading to the shower when I remembered that my husband would be visiting his mother after work and his clothing would be equally polluted. I grabbed a sheet of paper from the printer and, with a sharpie, wrote TAKE OFF ALL YOUR CLOTHES HERE. I taped it to the front door and was almost to the shower when I realized the message could easily be misunderstood. I grabbed the sharpie and, parenthetically, added Not for the purposes of sex underneath the instructions.

This method of minimizing the ick factor that comes home with me has somewhat soothed my germ-phobia although, the actual hours I’m there are hugely difficult.  I can almost feel the squalor enveloping me. Knowing my mother-in-law is living  (hopefully temporarily) in this condition is deeply depressing. This is a woman I have known 27 years and the first time I have ever seen her without her hair professionally coiffed, without her make-up perfectly applied and without shoes was the day of her surgery. She is an innately stoic and elegant woman who lives with high standards for her home and personal appearance. Leaving her in place so scuzzy feels criminal.

I can only hope that momentum will develop for the advancement of care for the very elderly. Their must be a public outcry for greater respect and dignity for this segment of our population. The conversation must open and stay open until we can get it right.

*I knew growing a tall hedge in front of my house would be a good idea








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