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Tuesday, April 9, 2013

The Other Side of the Mirror

I pulled into the drive-through for a much needed coffee. I was suddenly feeling very tired on this sunny, spring day. Tired and sad. I got my caffeine boost then pulled back onto the highway, jacked up the music and shifted up to sixth gear once at full speed, several notches above the allowable speed. I didn't care if I encountered a speed trap today.

I can't do it; my high speed conclusion.

I had arranged to meet my social worker at the local public health office about a half hour drive north of our home, a scenic highway drive through the countryside. This office is attached to the nursing home serving our area and I was to have a tour of the place.

The social worker had been almost excited when I contacted her about four weeks ago to discuss my options for respite care. Nearly breathlessly she told me about this local nursing home that offers up to two weeks of respite at a time for the laughable cost of $25 per day. That's socialized medicine for you in this wonderful Canadian province of Quebec. All I needed to do was give her a call when I was ready to arrange a visit. Why I didn't arrange it then and there I don't know. I had to think about it, I suppose, wrap my head around the idea.

Two weeks ago I did just that. Today was the day. I walked in; my social worker was waiting for me and greeted me warmly. She ushered me into her office to have a brief chat before going upstairs to see the facility. We talked about my concerns; she filled me in on medication requirements. We discussed strategies for managing the inevitable panic and psychosis and maybe even aggression that would overwhelm my fragile husband if I were to hand over his care for a short- or long-term visit. I put forward my extreme reluctance to do this.

The day before, having been alerted by the social worker, Michael's doctor called to update his medical file in preparation for an immediate visit if I need it. With that completed very little stands in my way of a wild vacation if I so choose. Everyone is working hard to make this happen for me and for that I am very grateful. The fact that I am digging in my heels is not because I am getting no support. I couldn't ask for more.

Our initial chat over, we climbed the stairs to the second floor where a 32 bed facility exists for the region's aged and infirm. I have visited many such places in the years of caring for my parents and Michael's so I have no illusions and very low expectations. I was prepared. A big red button had to be pressed to open the locked security door at the top of the stairs before we could enter.  I walked through to another world, the other side of the Looking Glass.

The first thing that hit me was the familiar smell of every such institution I've entered: feces and urine. The second thing was the inescapable fact that this was nothing more than a hospital with its institutional concrete walls, dull paint, fluorescent lighting, hand rails, nursing station, uniformed staff and, hiding just beneath the fecal smell, the industrial cleansers that might mask but never eliminate that ubiquitous odour. The common area in front of the central nursing station was filled with wheel chairs, white heads nodding sleepily, slippered feet, haphazard clothing and bathrobes, drool. Life was at a standstill. The only sound in this full-to-capacity institution was the quiet, low-volume drone of multiple televisions with a glassy- or droopy-eyed viewer before each set. Only one resident was ambulatory but his face sported a crazy, leering mouth, a blank stare. The newly added gazebo off the cafeteria that offered a calm pastoral view and fresh air was desolate and empty on this sunny, warm spring afternoon.

L. showed me the individual, private rooms whose main attractions are large sunny windows, one side of the building overlooking an elementary school yard and the parking lot, the other a not less attractive back view but with no action. Everyone wants the school view apparently but from what I witnessed, nobody was looking out any windows to the world outside. These rooms were well appointed with built-in drawers and cupboards and were identical in every way except for the brightly coloured blankets and bedspreads on each hospital bed. Some rooms had a picture or two tacked to the walls and every room had the resident's full name typed on a large poster and taped to the door, a memory cue for each resident I assumed.

I was fighting tears while struggling to remain cheerful and positive as I asked all my questions. L. answered them all well or consulted with the nearly unilingually French-speaking head nurse if she didn't have the answer. My biggest concern was ratio of caregiver to patient: approximately 1:5 on a good day. My social worker admitted it wasn't a question often asked which surprised me since most of these people looked like my husband whose needs are great and often keep me very busy. And that's when he's calm and relatively happy. Representing this publicly run facility, she at least didn't try a hard-sell job on me, unlike the for-profit retirement facilities whose slick websites and zealous sales-reps paint a very rosy picture of extreme old age that can lull you into a false sense of calm and well-being. I've detected the body-function smells in most of those places too but they are much prettier and offer fantastic outings even though their caregiver/patient ratios are often worse than their government-run sisters. Bottom line is obviously their main concern.

We shook hands as I departed. I told L. I might be able to manage a night only, at least at first. She agreed that was a good approach and she assured me I could call to talk if I needed to. No pressure, thank God.

But as I pulled onto the highway, my fatigue hit like a boulder. Coffee was definitely in order. When I finally entered my warm home, Michael was seated at the table with tea, cookies and the newspaper spread messily before him. He was gazing out the window calmly and dreamily while my wonderful caregiver buzzed cheerfully around my kitchen, laughter and warmth in her voice. Relief and happiness wrapped around me. 

No, I'm not ready.

*John Tenniel's illustration from Lewis Carroll's Through the Looking-Glass, and What Alice Found There (1871).

1 comment:

  1. Beautifully written. I had no idea it had gotten to this point, though I am sure it's been at this point for quite some time. You are a blessing to Michael. Just be sure you take care of yourself and allow others to help you recharge those batteries!