I am reading yet another article about how we hide away embarrassing or "different" people. The author is, predictably, bemoaning how we remove these people from society. I am taken back fifty years.
When I was in university, I managed to get into a training program as a hospital nursing orderly, in a hospital. The hospital was a federal institution, part of the Department of Veterans Affairs. That was how they came to have a program for nursing orderlies, since they primarily dealt with veterans, who were primarily male, and also veterans from the existing service, and from the RCMP. The hospital, as one would expect when dealing with veterans, had an elderly population, and many wards were dedicated to geriatric care.
Orderlies, in those institutions that had them, were often simply porters. In this hospital we were trained as practical nurses. Practical nurses were not yet licensed, and we performed identical functions. Anything the practical nurses were trained to do, we were expected to do. So, these days, I tend to tell people, and I think reasonably accurately so, that I worked my way through university working as a practical nurse. That was the training we were given, and that was the function we performed.
As noted, there was a very large geriatric population in the hospital. Some were considered to be extended care: this was defined by not being able to get oneself out of bed. If you needed assistance getting out of bed, and getting dressed, you were extended care. Intermediate care meant that you could get yourself up, and dressed. The reasons that these people were in the hospital varied, but were, when I started work at that hospital, basically decided by the Department of Veterans Affairs.
There were acute care beds in the hospital, and eventually, I worked on some of them. But, initially, practical nurses, and nursing orderlies, were needed for the geriatric wards. That was where I got my training, that was where I got my start.
Those of us working on the geriatric wards were quite well aware that we were taking care of old folks. We knew a fair amount about their situation. We knew who had family, and who didn't. We knew who had family come to visit, and who didn't. We knew that these people were here to stay. We got to know them, their personalities, their quirks, their wants, their oddities, and we were their friends. Sometimes we were their family. There was one resident who always called me by his son's name. I don't know if I looked like his son. I never met his son. I always answered cheerily, and he never pursued the issue. I don't know whether he thought that I was his son, or simply derived some comfort and familiarity by calling someone his son's name.
All of us who worked at the hospital realized that we were a poor substitute for family. All of us, myself included, knew that it must be terrible to be stuck here, in our hospital, with us, and not be able to be at home with family. We didn't necessarily know why they couldn't be at home with family, but all the staff felt that it must be much better that way than the way it was.
After I had worked there for a little more than a year, I took a couple of months off, and went traveling in England, Scotland, and Wales. My family came from the British Isles, and my parents had spent some time, when I was a baby, doing an exchange year teaching. So, there was family, and there were family friends. I visited some of them as I was traveling around.
I stayed with one family for a couple of days. This particular family was in our extended family tree. On the third day, as we were finishing breakfast, and I was getting ready to leave, I was asking if I wanted to see Dad.
Not being particularly close to these family relations, I didn't know Dad was still alive. I certainly didn't know that Dad lived in the house. I certainly haven't seen any evidence of Dad in the previous two days. But, certainly, I said, I'd love to see Dad.
We went up to the top of the house. The third story. I hadn't known there *was* a third story. I had thought that perhaps this was attic space. Well, it was a little bit larger than attic space, and certainly had a higher ceiling. It even had a window. Dad was lying in a bed. There wasn't even a chair in the room. So, obviously Dad spent his days in that bed. The window was high in the roof line. Dad couldn't have seen anything out of that window other than sky, clouds, possibly the sun at certain seasons and times of day, and possibly a very nearby bird, albeit very briefly.
In that instant I knew that I had been wrong all the previous year. Being at home was not necessarily a blessing. I'm sure the family loved Dad. I'm sure that they did their best for Dad. But obviously there was very little contact with Dad, other than to bring him meals, and to deal with toilet issues. We certainly did that in the hospital, but we did an awful lot more, and had an awful lot more contact, with each patient, each day, than Dad got.
When I came back to work, every conversation, from then on, turning on what a shame it was that our patients couldn't live at home with their families, I replied that there were worse places to live than in our hospital. That there were worst cases of isolation then in our hospital where the only people who interacted with you were paid to do so. I'm not sure whether that was when I started my retort, to those who were embarrassed that I had to change them, and the entire bed, when they had had a loose bowel movement in the bed, "Don't worry about it: I'm paid to do this. If this didn't happen I wouldn't have a job." I presented it as a joke, and a lot of the old guys got a good giggle out of it.
Some families have the time, money, patience, and skills necessary to care for the elderly. Most do not. Our society does not talk about death, it does not talk about grief, and it does not talk about aging, at least not the extreme aging, where faculties start to become impaired. Therefore, very, very few understand the requirements of the aging, or the disabled, and their wants, and their needs. Even fewer can handle the constant demands, small scale though they may be, with sometimes distasteful bodily processes. To have that combination of time, resources, skills, and character, is vanishingly rare. So, it's not reasonable to expect, as most of our governments, and particularly conservative oriented governments, tend to expect, that families can take care of their elderly right up to the point of death. It's very rare, and it leads to very possibly unpleasant situations. I know that poorly managed care facilities lead to unpleasant situations as well. I don't want to battle about which is the lesser, or greater, of two evils, or unpleasantnesses. But to think that all families are able to care for their elderly as they age into extreme age is to live in a dream world.
At one corner of the property where my house is, a seniors facility is being built. The girls have joked that when I get too old to live on my own, they'll just ship me to that corner of the property. They think they're joking. I am absolutely fine with that, and I'm not joking. Yes, there are situations where staff who should never be working in this field are given charge of the poor and vulnerable. We need to watch out for those situations, and we need to check that they occur as seldom as possible. But I know that the people who work in these facilities are primarily good, decent people, who try their best. They may be hampered by budgets or by uncaring management, but they are trying their best. They are the friends of those whose friends have all died, and they are the surrogate family, for those whose family can no longer, for whatever reason, care for them. I'm quite fine to end my days in their company.
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