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But This Is My Mother!
The Plight of Our Elders in American Nursing Homes
by Cynthia Loucks

From Chapter 12: There IS Somebody Home

The unkindness that some of the aides displayed toward Mama—and that they would behave that way right in front of me—was not only distressing but downright baffling. Throughout her stay at the nursing home, when she wasn't too ill or too sleepy to respond, Mama always had an enthusiastically friendly greeting for one and all. To me it was a reflection of the wonderful graciousness that she managed to retain throughout so much of her ordeal.
One day a young male aide came into Mama's room to attend to her. True to form, Mama called out a cheery "Hi!" when the young man approached her bed. Silence. Seconds passed. Undaunted, Mama said "Hi!" again, with no less warmth or cheer. Her voice and what she said were clear and unmistakable. Still silence. Despite my pounding heart and the fury rising in my throat, I remained calm so as not to make a scene in front of Mama. I said to the young man, "She said 'hi' to you." As though coming out of a trance, he finally uttered a dull, flat "Hello." And without another word, he proceeded to perform his duties in an efficient but perfunctory manner. Mama fell silent.

I winced whenever I watched aides and nurses tend to Mama without speaking to her or speak to her without looking at her. I desperately wanted them to act in a manner that was kind, civil, and respectful. I knew what a difference it would make for Mama if they took a moment to explain what they were going to do and if they made an effort to listen to her, responding as much as possible to what she indicated.
All nursing home residents have psychological, emotional, and social needs regardless of their conditions. They need eye contact and whatever else seems appropriate to foster a feeling of connection and respect for their basic humanity. The lack of such behavior constitutes an assault on the human spirit and is, in many ways, the most painful offense for people to bear. It wounds more deeply than the discomfort and indignity of poor physical care.
Aides frequently scowled and scolded Mama whenever she was difficult, and I rarely heard them compliment her or thank her when she cooperated. This oversight was particularly grievous since she had so little opportunity for positive reinforcement or for being allowed the chance to feel good about herself. Wretched at the sight of how frightened she became whenever lifted from chair to bed or vice versa, I was constantly mystified by the aides' apparent unwillingness to recognize her fright. Her shrieks seemed to annoy them in the way that unpleasant noises are annoying, yet I seldom saw them reassure her or attempt to address the obvious fear that was prompting her protests. I agonized that the staff simply saw her as a helpless old lady who was too confused to know what she meant or to convey what she felt.
I was very pleased one day when Mama was being cared for by two aides who seemed considerate and attentive. I decided to take advantage of the occasion, and I suggested that they take a moment before transferring Mama to ask her whether she was ready to be moved. They agreed to try it. When they first asked her if she was ready, Mama, who apparently grasped the opportunity at hand, told them no. The aides waited patiently and about fifteen seconds later they again asked Mama if she was ready. She said yes, and they were able to move her without her crying out. Mama clearly relished being able to compose herself for a moment as well as feeling she had at least a little control over what was happening to her. But by my next visit, these aides had vanished, and I never saw any others attempt to extend such courtesy.
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