Friday, March 28, 2014

To Mars and back: My clinical experience in a nursing home


Hey guys!  I'm sorry I've been away and neglecting blogger for so long.  For these past couple months, I've been taking a certified nurse aide (CNA) course and have finished the three longest days I've experienced in a while.

I had 3 days of clinicals at a nursing home and I chose to go on the therapy unit.  I thought it might be slightly less depressing than working on the long term care unit.

One thing I can definitely say is that after finishing those clinicals and then going back to my secretarial-type of job the next day, I feel like a fish thrown onto land for a while and then thrown back into the ocean.  Either that, or being teleported to another world and then teleported back.  It's all been so surreal and I wonder how long I'll be thinking about this.

This experience has really opened my eyes and has me thinking constantly about future senior care.  It's not uncommon that the majority of the population has a very negative association with nursing homes.  Not that I blame them.  I mean, the nursing home I went to was actually VERY nice, being clean, cozy, and spacious; everyone who worked there were amazing people and I wonder how they could handle their job with such grace and enthusiasm.  But even with all of that, I could still feel a depressing aura from a many of the residents.  They wouldn't talk much, would prefer to sleep, and never seemed too enthusiastic about anything.  Many of the residents seemed so helpless and I'm sure that most of them will never again have the independence that so many of us take for granted.

I would wake up at 4am on each of the clinical days (which is so strange for me as I'm a night owl) and get to my clinicals by around 6am. 

In the early hours of the morning, around 6:15-6:30, the CNA's would go around to each of the rooms (consisting of about 11 people total) and wake residents up for breakfast at 7:30.  They would do this early so they could let them slowly awaken and then take them to the bathroom to freshen up (brush teeth, wash face, brush hair, dress) and assist them with toileting.  Yes, this means wiping butt if necessary.

After all of this, the residents would be transported by wheelchair or walker to the shared dining room and served breakfast.  Some of the residents were on a "thick nectar" drink diet which basically means that all their beverages must have the consistency of thick apple sauce.  Even their coffee..  The morning dining room was a very sleepy place.  Sleepy residents dozing was a common sight.

Some of the residents needed 'assistance' with eating so I would either spoon/fork feed them or try to coax them into eating.  I would often be saying, "Would you like more fruit?," "Do you want to try eating more chicken?," "You should eat this, protein is good for you."
Even with all my coaxing, some of the residents just did not want to eat and about 80% of their food would remain on their plate when they were finished.

Mealtime was one of my least favorite activities, mostly for breakfast.  It's just that these people are having to wake up so early and not all of them have an appetite first thing in the morning.  They just wanted to get some damn sleep for all I know.

After breakfast, residents would be taken back to their rooms for... you guessed it!  Toileting.

Some of them would want to go to the main living room to watch TV with others while many just wanted to go back to their rooms.

During this, 'rest' time, I guess that us student CNA's were expected/encouraged to visit resident's rooms to chat.  I didn't really figure this out until the end and instead for most of the time, went around and helped CNA's with toileting residents.

After this break time, there were certain days where there might be a physical therapy class activity which lasted about half an hour.  Residents would gather in a classroom in their wheelchairs, forming a circle and hit a large air balloon across the room to each other.  There were other exercises as well.

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The nursing home I was at had a large glass display with live birds in it.  This was next to the activity room.  It was extremely therapeutic for the residents.  While I was helping a man with walking, the CNA and I would tell him that we're getting closer to the birds and he would get excited and continue walking.

So after all that, it would be around 11am and we would start taking residents back to the dining room for lunch.  By that time, my day would be over.

During my experience there, I was surprised to discover more about myself and what kind of person I am.

My favorite activity was giving showers.  I guess when I think about it, it makes some sense.  The act of bathing and purifying the body has always been something I enjoyed.  I would feel a great sense of accomplishment and happiness from giving residents a shower.

My least favorite activity was again, feeding.  This is mostly because many residents I assisted with feeding didn't have much of an appetite and it made me sad to see them eat so little and with so much food being wasted.

Another surprise for me was how attached I became to the residents over only 3 days.  Before I left on my last day, I went to most of the rooms to say my goodbye's to the residents.  I even had to take a moment to compose myself between a few people because I literally started to get teary eyed.  Now I have a better understanding of why some people are afraid of getting close to residents in nursing homes.  It's just so heartbreaking to have to say goodbye to them.  They just look so helpless laying in bed and not being able to leave.  I think that's what got to me the most.

This gave me flashbacks to when I was a very young child.  When I slept over my grandparents's house, every night, I would make sure to go to their bedroom and say goodnight to them.  I'm actually staring to cry right now because it's a memory that I hold very close to my heart.  Even as a young child, I wanted to live without regrets and always respected and cherished my grandparents as I do my own parents today. 

The nursing home is really like another world.  It's a world where time moves slowly.  It's a world where everything is controlled for the people living there.  Everything from getting dressed to using the bathroom, everything is done for them by workers.  Many of the people living there do not go to the world outside the nursing home walls.  The only connection to the outside world is through the window and the television.  In a way, the nursing home is not unlike a prison, no matter what measures are put in to making it appear like a home.  Residents are not only controlled with activities of daily living (ADL) as they require assistance in almost everything, but they are also restricted by their own physical limitations.  In my opinion, these are the main reasons why some residents and new workers may view the nursing home as being prison-like.  It's a completely different world compared to society on the outside.

I hope you all got something out of reading about my experience in the nursing home.  Perhaps we can all take a moment and think about innovations for future senior care.


lovepirate said...

Your stay at the nursing home must have been a really precious experience. I can only imagine how hard it must be to work there.
My grandmother stays at a nursing home from time to time. She's 92 and usually lives with my parents. But whenever my parents go on a longer vacation, my grandmother also stays at a nursing home. I always try to visit her as often as I can then and I know how depressing it can be to live and stay there. :/
In my opinion for the habitants it's very important to just be "active". Like there's a person they can talk to or for example even play easy games like card games with. I always hate seeing habitants "being parked" in front of the TV all day long. :( But I also understand that there simply isn't enough personnel to do everyone justice. I hope this will improve in future!

MiNapi said...

@lovepirate, It's sweet of your parents to have your grandma stay with them. I've noticed this too. I'm not sure if the residents are always sitting in front of the TV but I do know they usually get breakfast, lunch, and dinner so they're taken away for that. They also have a choice to go where they want in the facility.
Many of them have some form of dementia so a lot of the time, staff say it's recommended that they stick with a routine.
Anyway, I do hope that 'health companions' become more common in the future. It would probably be a rewarding job and help with the mental health of seniors around the world immensely. ^^