Wednesday, 9 May 2012

Male Elderly Long Stay

Use it or lose it
has no place here. 
What better than
to restrain (by indifference)
in chairs upholstered
in the ghosts of those long dead. 

There is no stimulation here;
they sit in regimental rows,
row on row on row,
like some old soldiers
waiting for their final orders,
or some waiting room,
waiting for a doctor
who never shows.

This reinforced apathy
brings atrophy, weakens limbs. 
A fleeting insight
brings panic,
he rises, knees buckle;
he free falls, hits terra firma
with an almighty thud.

This morning
there is only two of us,
short staffing brings many risks. 
Who knows how many
signs and symptoms missed
as we hurriedly stuff thirty men
into waiting clothes,
stack them in the waiting rows,
stuff them full of
cereals and toast. 
(Well as many as we can,
for at 8.30 – finished or not
the breakfast trolley goes.)

They need time,
there is no place for it here. 

There are the wanderers of course
who will not conform;
who wander on their eternal journey
to God knows where.

There is a new admission;
he still has fight in him.
It will not last. 
Soon he will become like them,
his remaining memories
will leach into the chairs.

They need compassion,
there is no place for it here.

As a student nurse, my first ward placement was on female elderly long stay.  I must admit I was naïve – I had this silly notion that my days would be spent sharing tea and sticky buns with confused little old ladies, enjoying their muddled conversations and listening as they reminisced about the good old days.  How wrong I was.

My first shift was that of a morning, there were two qualified staff, a care assistant and two students (including me and we supposedly supernumery) and we had forty patients to assist to rise – that is eight patients each.  We students had no idea who could weightbear, who was mobile, who was aggressive and so on, but this seemed to only bother us and we had to get on with it.

It took me well over an hour to wash and dress and seat my little ladies in their chairs – in fact they did not have their chairs – anyone was good enough.   I was totally exhausted and perspiration was dripping off my forehead.  I remember thinking ‘What the hell am I doing here?  Is this really what I want to do?’ as I realised my silly notion was indeed that – silly.

The majority of the ladies had dementia and were either admitted from the great outside or were ‘long stay’ patients who had spent much of their life in the hospital and had succumbed to dementia as they aged.  A couple were long stay patients who had not demented but reached the ripe old age of sixty and had been transferred as that is how things worked.  They were floor pacers – like caged lions bored out of their minds – both with ‘acquired’ OCD – their rituals their only means of escape from the eternal ennui of ward life.

All the ladies – bar the two floor pacers - were sat row on row on row, there was no stimulation whatsoever – no radio, no record player, no television, not a thing.  Any new admission that rose from her seat was told to sit down and soon learnt that that was her lot and after a few days did just that – sat (and died inside).

My fellow student and me attempted to converse with our patients – but lack of stimulation had had devastating effects – rarely were words spilt from their mouths – they existed in body only.

Male elderly long stay was my fifth placement and it was very much the same bar a few wanderers - not pacers, most of whom were demented and had held onto remnants of their personality.

I saw an awful thing there – it was not direct abuse but that of sheer and utter thoughtlessness, a manifestation of the warder-inmate mentality that still very much prevailed there, and it reinforced my vow to myself that once qualified I would never work in a psychiatric hospital – this vow I had made on female elderly and it is a vow I kept.

Anna :o]

Entered at Open Link Night at dVerse Poets Pub – thanks dVerse!

24 comments:

Brian Miller said...

ugh...hard...the last 2 lines in your poem are the punch to me...they need compassion, but its not here...and that is heart breaking...esp considering their situation...and it just makes me sad and angry a bit you know...to see them fade...

Anonymous said...

Wow Anna, this is so powerful! You've done a tremendous job describing the stages and state of the elderly waiting around. I love the line "their memories leach into the chairs". It's so sad and this really touched me. Well done!!!

Poetry and Icecream said...

Wow Anna, this is so powerful! You've done a tremendous job describing the stages and state of the elderly waiting around. I love the line "their memories leach into the chairs". It's so sad and this really touched me. Well done!!!

Frances Garrood said...

Brilliant! And so true, too. Funnily enough, the novel I'm working on has just such a setting. As a nurse, I've worked in these places. Sheer hell.

Claudia said...

my mom used to work in a home for elderly people and sometimes she took us kids with her...so i knew how tight the schedules are but still she managed to bring a bit light into their day...that's what stayed with me over the year...enjoyed your poem anna

^.^ said...

I worked in psych all my life ... many a time I felt like bolting so bad ... then I thought of the patients that want to bolt so bad but can't ... I love them too much to leave them ... one touch, one word, one song, one more minute ... and stay humble ... stay humble, my friend ... Love, cat.

dodododododododo said...

Repeating myself: publish.

Anonymous said...

Publish, don't worry, you won't earn a penny. Not for money. Publish.

Steve E said...

How sad a commentary on reality of life after 60..for some. Those of us who are 20 years beyond that (79 on 25th this month!) feel so blessed with not PERFECT...but comparatively good health.

We get to ride our scooters from Naples FL to Richmond VA to Charleston SC, to Gatlinburg, TN--you get the picture! It sure beats walking the 'prison' corridor, making the 'rounds'. Or OMG! sitting in row after row after row in a chair. (I'd rather die...well, it IS a death!)

Good poem. Thanks. Have a great career, wherever that is!
PEACE!

Martin said...

A powerful piece. Over the years, we've seen a great deal of rest homes, nursing homes, etc. My wife worked in one for three years. Your words will strike a chord with many.

Dave King said...

I've seen these places. Dante could not have thought, nor have described it in more biting terms than you have. The whole is harrowing enough, but nothing beats:-

to restrain (by indifference)
in chairs upholstered
in the ghosts of those long dead.

and its essential truth. Well spoken

miffy said...

ahh if it could all be fantacy,but its all to true
evoked such memories

Dr Erhumu said...

I'm so moved I don't even know what to say.

Tracy Crenshaw said...

This poem just breaks my heart. I take care of my grandmother full time because I don't want her to end up in that situation. And I also feel for the nurses. I take care of one person and it is overwhelming, I can't imagine taking care of that many people. Beautiful writing.

manicddaily said...

This is quite chilling, but very well done. k.

hyperCRYPTICal said...

Thank you for your welcome comments folks.

Many of the psychiatric hospital in the UK have closed – including the one I trained at – the move being towards care in the community. There are some smaller units now, often part of a general hospital setting.

Of the remaining hospitals and new smaller units – I sincerely hope attitudes have changed, although sometimes I wonder as some of the residents transferred to us from hospital settings come with a label of ‘difficult to place’ and they are not difficult at all, so perhaps warder/inmate mentality still exists there – I don’t know.

I have worked in care homes for the elderly for more than a decade and please be assured that not all care homes are ‘bad’ for indeed if they were, I would be whistleblowing my head off! Of course I realise that some/too many are and I guess the warder/inmate mentality lives on in homes too…

Prior to this I worked in other community settings and for the most part enjoyed every minute of it.

Anna :o]

Student Nurse said...

Wow. Beautifully written (as ever) but so terrifying that there is truth around every corner.

I'm yet to go on my first placement. I don't know where it will be as yet. I'm both excited and nervous.

kaykuala said...

I have my encounter with dementia. My MIL is in such a dilemma. Patience and appreciation of their state of mind is important. Never ever lose your cool! Great write!

Hank

Ursula said...

Sad, sad, sad...
but no easy answers.

Sharp Little Pencil said...

Anna, my friend Carolyn is a music therapist. I was allowed to "trail" her at a high-priced home for mostly Alzheimer's patients. The difference in care when one has money in the bank, well, you know...

I admire your setting boundaries for yourself when it came to long-term care. I was in a psych ward at one point for a week, and it was awful. I had to organize "group walks" up and down the halls to get us up off our asses. And that was mostly young patients.

Great write, but so sad and too real... Amy

hyperCRYPTICal said...

Thank you for your welcome comments - they are very much appreciated.

Anna :o]

Stafford Ray said...

If there really are ghosts, they would be so thick there, the place would glow with them! I do not know if there is a better way to do aged care. If there is we need to talk about it before I too am required to sit, waiting to die, in the row of chairs! Please??

Stafford Ray said...

If there really are ghosts, they would be so thick there, the place would glow with them! I do not know if there is a better way to do aged care. If there is we need to talk about it before I too am required to sit, waiting to die, in the row of chairs! Please??

hyperCRYPTICal said...

Stafford

A care home is far better than the old psyche wards - as long as the emphasis is on the word care.

We have a long way to go in respecting our old folks - they give us so much and we forget them and forget that we too will be old one day...

Anna :o]