Day 5 - Dad

Dad in 1940s

       Not long ago, I presented a speech dealing with my Dad's experiences living in a nursing home. It was a speech to meet one of the requirements for the Humorously Speaking manual, although the topic was serious and I hoped I would be able to convey the serious message within a humorous context. He had been in the transitional care unit for more than four months when he moved into a long-term-care room where he could get skilled nursing care all the time. The move from the first floor TCU room to his new permanent home was stressful for Dad and therefore for us. While he remained within the same facility, even on the same wing of the same building, the routines on the two floor are quite different, to match their different purposes and resident population. Those in TCU rooms are expected to leave the floor and return to their homes. And that had been Dad's expectation. Those on the second floor have transitioned from home to more permanent care. And the differences were much greater than we had expected.

     One simple difference had to do with meal times. Meals were served earlier on the TCU floor than on the second floor which means Dad followed the previous pattern and often ended up in the dining area too early for meal service. So he had to wait. That just compounded the issue of his limited taste in foods. After waiting longer than he wanted to wait, he would end up being offered a choice between two meals neither of which were to his liking. So food service and options became one of his complaints.

Dad in 2007

      Once Dad learned about the different meal service times, he stopped arriving too early. And since he was able to get himself to and from meals without assistance, he would wait until the last minute to go to the dining room. By that time, it was difficult for him to get his wheelchair up to one of the tables, especially if the open spot was at the far side of the dining area. So food service and options continued as a complaint.

       The biggest difference between the two floors seemed to be the lack of consistent staff providing him assistance. And that is how Dad's loss of independence took the biggest blow. Because the staff changed more often on the second floor, and because many of the residents on that floor had significant needs, Dad didn't feel the staff knew him as well and it seemed to him that the staff sometimes dealt with him and talked past him as if he weren't present. He complained that staff members would come into his room, saying nothing, and then just turn around and go back out. When we asked about it, we learned the staff were just looking to see if Dad needed anything and when it was clear that he didn't, they would go out in order for Dad to have his privacy.

       That issue of giving Dad his privacy led to some other minor issues in his first few months on the second floor. The staff who collected Dad's laundry - both his clothes and the sheets and towels - would come into the room while Dad was at breakfast so that Dad wouldn't be bothered. But that meant that Dad didn't know who had taken his clothes, some of which he wasn't ready to have taken away. And the clothes reappeared while he was out, too. His wallet and checkbook went through the laundry more than once.  Checking the pockets of Dad's pants wasn't part of the staff's routine as everything was loaded into the washing machines together. And small items kept disappearing - his cell phone, a small blanket, a suit, a sweater, and the remote for his TV. Most of them reappeared, but again, while Dad was out of his room so he couldn't ask anyone what had happened. The mystery was finally revealed: anything left on his bed ended up gathered up with the sheets and made their way to the laundry. In the case of the blanket, suit, and sweater, no labels with Dad's name had been affixed to them which delayed their return by weeks. The cell phone never reappeared. Getting Dad to put things into his drawers before going to bed solved the problem.

       The serious purpose for my speech was to emphasize how important we kids learned it was then to be sure we didn't underplay Dad's complaints. He wasn't going crazy, he wasn't forgetting where he put things, and he could still hear plenty, even without his hearing aids. Yet he felt too many around him assumed they knew better than he what was going on and their assumptions were that Dad was just forgetting.

Dolores and Dad

       Well, now things have changed. Dad has been in the same room for more than a year. The staff have gotten to know him pretty well and his independence had grown so that none of the staff had to spend much time helping him. His idiosyncratic food preferences are well-known to everyone. And all the staff members know Dad has a girlfriend, Dolores, who lives in an apartment that is part of the same complex (although she ended up in the hospital during my stay and is now on the TCU floor). But somewhere during the past month, Dad had another stroke. And while previous strokes affected his speech and his balance, offering obvious clues that something had changed, this time only his vision and his short-term memory were affected. These changes are not obvious to the staff members who see him only occasionally during the week. Dad describes his mind as being goofy these days, although because his short-term memory is so poor, each day he thinks this has only been going on for that day. When he understands that his memory has been poor for several days - even now weeks - his eyes tear up as he realizes he is losing memories through the inability to build them. He doesn't know who has visited him in the recent past. He doesn't remember who has called him earlier in the day. And I fear that soon he may feel that no one is calling or visiting him.

       I was able to visit Dad nearly every day for the past two weeks. Each day I would answer his questions about his age, whether he still has a car, who is taking care of his bills, and so on, and I would do so each time he asked me again. After answering about a dozen times that he is 88 years old, I started making a game of it. Instead of telling him his age, I'd ask him when he was born and then tell him it was 2012 and ask that he figure out how old he is. Or I'd ask if he'd believe me if I told him he was 108 (he never would; he knows he isn't that old) or if I told him he was 68 (that never fooled him either; he knows he is older than that) before I told him he was 88.

       I also asked him lots of questions about his childhood and earlier life. Only his short-term memory was affected by the stroke. His long-term memory is in fine shape. He listed the names of his high school graduating class for me one day and then was amazed the next day when I started reciting them to him. How could I know all those names, he would ask. My last day in town was also Dolores' birthday, so I helped Dad pick out a birthday card for her which he signed. Again, he seemed amazed that I knew Dolores' birthdate and he asked me how I knew. I explained that I heard her tell the nurse in the hospital room what her birthdate was. And that meant Dad learned yet again - as if for the first time - that Dolores wasn't well.

       I had to return to California this week, so now I call him each day. Because those conversations are much shorter, I won't likely be faced with his questions about how old he is or what happened to his car. But if he does ask me any questions, I'll answer each as if it were the first time he asked it since I know he'll hear my answer as if it were the first time.