By: Jean Johnson for Back1
Part One | Part Two | Part Three | Part Four
“The thing is that the reason I went to the assisted living was to learn and get back on my feet,” Constance Smith said. “Instead the Big Mamoo nurse in charge started telling me what I could and couldn’t do. I mean really, I’m 60 years old, trying to recover from a horrible fall, and the last thing I need is some mean-spirited person to start bossing me around.
| Falls are a big concern in nursing homes, here’s why:|
Each year, a typical 100-bed nursing home reports 100 to 200 falls.
Falls can result in decreased physical functioning, disability, and reduced quality of life.
Physical conditioning and/or rehabilitation using prescribed exercises to improve strength and endurance; physical therapy; gait training; and walking programs.
Modifications to improve mobility and safety such as installing grab bars, adding raised toilet seats, lowering bed heights, and installing handrails in the hallways.
What does not help:
Routine use of restraints does not reduce the risk of falls or fall injuries.
Limiting a patient’s freedom of movement leads to muscle weakness and reduces physical function.
Since new federal regulations took effect in 1990, nursing homes have reduced the use of physical restraints.
“One of the problems is that the place is the land of the blue hairs, all permed and back-combed. I was the youngest there by about 25 years, and the staff was so used to having all these compliant, dependent people that I butted heads with some of them right away. Also, they allow you no sense of privacy and would walk in without knocking even though I called out and said, ‘I’m on the toilet.’ They’d bring the medicine right in. I’d be sitting on the toilet and they’d give you your medicine right there. Extremely degrading and humiliating.”
Frustration mounted so high for Smith that she started smoking again – something she hadn’t done since she fell. She managed to bum a smoke from one of the aides, but even that was a problem because when she stepped outside on her small patio to have a puff and her next door neighbor complained of second hand smoke in the open air.
“I mean this lady is in her eighties at least, and she’s worried about getting cancer?” The incredulity in Smith’s voice rings loud and clear. “And Big Mamoo – she packs a real wallop with a good 300 swaying around on her frame. She informs me that the facility has a strictly enforced no smoking policy, so I must go off the premises to have a cigarette.”
In addition to having to wheel herself out onto the sidewalk by a busy street to smoke, Smith also found the staff overly cautious when it came to her doing things on her own. [See The Night the Music Stopped for similar complaints by Mack Lowell who shared his story of stroke recovery with Heart1.com.]
“I was doing my own laundry, and Big Mamoo jumped me for being up moving about. They just want to have someone with me all the time, and I know it’s because they’re afraid I’ll fall,” said Smith. “I may, but it’s just part of learning. I sure hope I don’t fall in here, though, because what I mainly want is out.”
There’s a silent pause and then Smith tears up. “I never used to be defiant like this. But it just seems as though they want to keep me down so they are doing everything for me, and that’s not what I’m here for. Also, this place costs $115 a day when I thought it was going to be $85, so I need to get better so I can move to Denver into more affordable circumstances. I just don’t know where all the money to handle this is going to come from.”
Smith finally did move out of the assisted living, but not before her morale took a dive. When we spoke with her just before she was released (just as Hurricane Katrina was moving in on New Orleans) she said, “I think reality’s sinking in, and I don’t know – I’m just so overwhelmed with the move and getting myself to the airport and trying to get stuff to Denver. The way I feel right now is that I’ll give this a year and then see where we’re going. I know that’s not a good attitude, but part of it is my left leg is really bothering me.”
Smith also developed two blisters on her right foot so she couldn’t wear her leg brace or participate in therapy. “With not doing therapy, I’m going backwards and my foot isn’t doing well. So it’s just kind of all depressing right now, and I hope tomorrow’s a better day,” she said. “I know it could be worse. I could be one of those 20,000 to 30,000 people waiting in line to get in at the Super Dome because they have no money to get out of New Orleans.”
Smith’s philosophical rationale aside, the fact that her life is undergoing a major revolution is undeniable. “Everything’s changed. My mobility. My finances. And now I’ll be moving clear to Denver away from friends and everything that’s familiar to me.” Although she did not put it in so many words, that Smith feels exceptionally fragile and dependent on a world that she can’t always trust seems to be the case. More, as we will see in Part Five, the human heart has its limits and even though it tries valiantly to rise to the occasion, it can only endure so much at once.
Continued in Part Five