HOW TO VISIT A SOMEONE WHO’S IN A NURSING HOME Part 1

Recently I accompanied my mom to visit two of her good friends in a nursing home, one of whom I wrote about yesterday.

I could tell Mom felt a little awkward. One woman was napping in her chair. “Don’t wake her!” mom exclaimed. (Okay, whispered. Exclaiming would have awakened her fried.) She wanted to leave immediately. Unfortunately, Robin sat on her bed and set off an alarm. Erna awakened, and fortunately, was happy to see us.

At first, with both there was a lot of cheerful chatter. Mostly the old stories told and retold. When the stories ran out, Mom wanted to leave.

I have vivid memories of my dad doing the same, years and years ago. There was an older woman, who grew up in Scotland, who worked for my dad in our family restaurant. She retired; soon after, she was confined to a wheelchair and eventually moved into a nursing home. She had no family here in the U.S. except for her son, who rarely visited her. I remember “making the rounds” every Sunday after church–out to the nursing home in the country to visit Bessie, back to town to visit my grandparents, and then maybe back to the “store” for an ice cream cone.

Bessie adored my father, and was always happy to see us. Dad would chat about ordinary things–the restaurant, our doings and comings and goings. I remember him bringing her flowers from our garden.

But sometimes, especially near the end of our visit, she would cry and beg Dad to get her out of there. As time went on, and she became more frail, this happened more and more, until every parting drew tears.

I remember standing there, embarrassed, wordless, having no idea what to do. I would look at my Dad. What would he do? How would he handle this?

Well, my dad would get embarrassed, too. He would weakly try to reassure her that everything was alright, and we’d all make a fast dash for the door.

In my later years, I pretty much kept up the family tradition. I felt awkward visiting folks in such places, even hospitals. I would agonize over what to bring. Flowers? Candy? Can they have candy?? A book? Maybe they’ve already read it…. I would fill the room with cheerful chatting, clumsily reassure them when things go tearful, and beat a hasty retreat.

I’m still not the soul of compassion, but I try to do better now. Because I know better.

The old rules of how to behave are gone. The circumstances have changed, and so must our patterns.

I try to see what is needed, and what is wanted. I listen. I observe. I touch.

People who have been in such places a long time have different needs. No, I take that back–they have the same needs. But we have to fill them differently.

STOP

Relax and be present.

It’s okay to be with them as they sleep. Sleep is important, yes. Especially near the end of life, deep work takes place during sleep. And it’s still rude to awaken someone suddenly, especially with shaking and loud voices. But perhaps you can sit quietly by them, gently taking their hand. Many times they will sense your presence, and awaken gently. If not, be assured they still sense you on some deep level. Even 20 minutes simply sitting quietly, and holding their hand, can be deeply reassuring.

However, don’t stare at them. Waking up to someone watching you sleep can be icky. Sometimes I just take those moments to think, or daydream. But it’s okay to bring a book if it’s hard to sit quietly.

TOUCH

Taking their hand can seem awkward and forward. When have we ever held hands with our friends, or our family, after we’re five? But people need the touch of human hands, now more than ever. It may be years since someone has hugged them, or stroked their hair, or simply held their hand.

No need to envelop them in a bear hug! I start by nonchalantly taking up their hand and cupping it gently. If someone does not want to be touched, then they will withdraw their hand. But if they welcome it, they will not. They may even clasp your hand tighter.

My friend Bonnie Blandford taught me the “hospice hug“. Instead of our quick little social hugs, it’s simply a longer hug where you let the other person choose when to stop. In fact, if they pull back after a few seconds out of habit, try holding gently for another few seconds. You’ll be surprised how many people will relax and hang on for dear life. I did this with a friend recently who had suffered a dreadful loss. When she realized she could have a long hug, she melted into my arms, and began to sob. Yep, some guys in the group got nervous, and began to make jokes about lesbians. I ignored them all. My friend had lost a new grandchild. She needed a deep hug.

LISTEN

Sometimes people want to be entertained with light chatter and news of the outside world. But sometimes they are scared, or anxious, or lonely. They yearn for richer connection. If they are scared, don’t pooh-pooh their fears. What are they afraid of? What’s making them anxious? You don’t need to fix their problems. But we all appreciate someone who listens to them!

By the way, Erna had trouble speaking and forming words. My mom assumed she was “out of it.” By sitting closer and listening carefully, it became obvious that Erna was actually quite aware and responding appropriately to everything we said. She just needed more time to respond.

STAY

I’m not so nervous about people crying now. I just keep the Kleenix coming until they’re done.

OBSERVE

As they talk with you, listen deeply. Watch “the light”. Note where they are making light of something that actually pains them. Observe the topics that make them light up with joy. For one of Mom’s friends, it was a passing comment about our dogs. She asked, “What kind of dog?” We told her. I asked her if she’d ever had a dog. Her face lit up. “Oh, yes!” She told us several stories, and then got to the one that was painful–the family dog hit by a car, and how terrible it was. The pain, the suffering, the family’s anguish. All these years later, and it was still hard. On impulse, I told her a quick version of the delightful movie, Dean Spanley*. A dog who is killed suddenly, describes it as something he didn’t understand. His former master asks if he suffered. No…no…. There was no pain. It was time to go home. How did he get there? He simply turned towards home, and went there. When asked how he knew where home was, he said, “One just knows. So you turn that way, and go there.” Erna smiled sweetly and sighed.

BE A WITNESS

Tell them about the gifts they’ve given you–the gift of their friendship, their kindnesses, their thoughtfulness. If they were feisty friends, tell them how much you admire their courage to be themselves. Though I didn’t know either woman, I knew my mother treasured their friendships, and said so. To Frannie, who changed her dress on her daughter’s wedding day, I said, “That was such a gift you gave your daughter!”

Ask questions, especially if you don’t know them well. Don’t interrogate–it’s not a fact-finding mission. Just show interest in what they have to say, how they lived their lives, what gives them joy. When they tell you hard things, say, “That must have been hard” and let them tell you more. When they tell you beautiful things, ask them what their favorite part was. Let them tell their stories.

READ

When I do hospice visits, I take books. I take one for me to read to myself and one to read aloud–a book of poetry, or short stories, or novels where individual chapters can stand alone. If the person is religious or spiritual, I’ll bring a book of prayers or blessings. I’ve found that we never lose the desire to be read to, provided the person is up for it. It’s a way to take a break from conversation, a way for them to simply listen, even a way to ease them into sleep. My daughter loves the scene in the movie WIT, where the main character (who is dying) accepts her old teacher’s offer to read to her. John Donne gets voted down, but it turns out the children’s book The Runaway Bunny is beautifully appropriate.

FORGIVE YOURSELF

It’s okay to be thankful it’s not you lying there in the nursing home. They know you feel that way. And it’s okay. You’re not a bad person. Just human. And they know that, too.

There’s more, but I forgot.

This is just quick overview of how to make such visits easier, deeper and fun. I would LOVE to hear your suggestions, too.

How did I get so smart? Listening to my daughter speak of her experiences working in such institutions–nursing homes, assisted living units, rehab wards. And my hospice training, which was rich with insights and practical advice.

*Dean Spanley is my new favorite movie. It starts slow and quiet, fueled by odd and cantankerous British humor, with the most incredibly beautiful and poignant ending. WATCH IT TO THE END!! I fell asleep halfway through the first time I watched it. Fortunately, I made myself watch it again. STAY AWAKE, or watch it twice, and I think you’ll find yourself deeply touched by its message. If you love dogs, you’ll find it triply delightful. But you don’t have to be an animal lover to appreciate its message.

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23 Comments

Filed under art, friendship, hospice, lessons from hospice, life lessons, life with a dog

23 responses to “HOW TO VISIT A SOMEONE WHO’S IN A NURSING HOME Part 1

  1. I can’t stop crying long enough to form an intelligent comment. Margaret Wise Brown—Goodnight Moon was one of my favorites.

  2. Deb Sims

    Luann, as always you have written a deeply moving and beautiful piece about life. And death. But more than that you have reminded us to listen, be present, to hear with our hearts and not our fears and to reach out with all our human-ness to another soul. Thank you for reminding me that it’s ok that I’m not a saint, but I can have saintly moments (yesterday’s blog) and that all each of us really needs is a human touch, a compassionate ear and time to feel and express what is in our hearts.
    Big hugs to you and thank you.
    deb

  3. Dave P

    You have it for me. I couldn’t have said it half as well.
    Other readers, please link to this post, we ‘younger’ readers
    can all learn from this.

    My thanks.

  4. This was such a helpful post, as many of my friends are entering that phase of life where we have someone or know of someone in a nursing home. We may not be prepared for the curve that life throws, but you certainly have given us valuable tips. Thank you so much.
    Kath

  5. Thank you for sharing.. I was too young when my mother and father passed on and not well prepared, and no one to show the way or help me.. Hospital at that time gave no insight. One thing that changed for me,is giving fresh flowers.. One day I took some to my mother in the nursing home and she threw them at me.. She did not want to watch the flowers in the vase die. Take silk flowers they are bright and last forever. From that day onward, I have asked my family never to give me cut flowers. Give me a plant or something I can plant in the yard, or just a pretty card.. Small situations can change one’s whole out look. Wish I had had some guide lines then it would have helped so very much, instead I was in agony at the time, and pretty useless to both of us.. … thank you.

  6. All wonderful and sensitive suggestions, Luann. My most treasured moments with my dad near the end of his life were afternoons spent reading by his bedside as he slept. He seemed to derive comfort from those times as well. My quiet presence led him to feel I was in no rush-though I would race like mad for home once outside the hospital to attend to my preschool children…

  7. All great things to do! Here’s a few more suggestions:
    After checking with the nursing staff to make sure it’s all right, bring fresh produce from the garden or even from the store. If you have a very mellow dog or cat, ask if it’s OK to bring it (a bath for the pet first is nice). Ask if you can bring them takeout from their favorite restaurant. Join them for lunch at the nursing home. If they’re mobile, take them out for lunch, the county fair, downtown parade, fireworks display, Halloween party, Christmas party. Bring your children in to visit. Take them to a local school for one of the children’s events, but be prepared to leave quickly or escort them to a restroom. Play a game with them–cards, dominoes, checkers, chess. Take them outside for a walk if they’re mobile, and by mobile, that includes wheelchairs (be sure to set the brakes, please). Take them clothes shopping, or help them to shop from a catalog. If someone is diabetic, give them a special treat of sugar-free cookies, candy, cake or ice cream. Just be sure to check with the nurses first. Some people have problems with swallowing, on a very restrictive diet, or other concerns, so always be certain to check on dietary restrictions. If you connect with someone well, “adopt” the resident.

    Remember that you can make a big difference by just doing small things. If you’re unsure how to get started, just call the activities director or the administrative director and tell them you’d like to volunteer.

    • These are GREAT, and thank you for contributing. I totally spaced the pet visits, and my daughter is training her dog as a therapy dog! Doh….

      And a small note: The suggestions about taking people out to lunch, etc. are wonderful. But if that’s too much, simply getting them OUTSIDE is wonderful. Many venues now have outdoor sitting areas, courtyards, gazebos, etc. And for your friends who smoke, volunteering to run them outside for a cigarette break is always welcome. (You don’t have to approve of their smoking, just understand that on top of everything else they’re dealing with, not being able to smoke whenever they want can be stressful.)

  8. KJ

    My first job out of college was running a social nutrition program for seniors. It did not take long to figure out that when the chance presented itself it was almost always appropriate to rest a hand on a shoulder, knee, or hand. None of us are touched enough.

    When my husband was dying, he appreciated cards. They were just a nice reminder that someone cared. What they said and the pictures were secondary to the thought.

    • I think most of the people who work with seniors are incredibly wonderful people, and you’ve confirmed that.

      I’m so sorry to hear about your husband. And thank you for the suggestion about cards. It’s easy to put off writing one because it’s hard to know what to say. Your suggestion makes it easier to send one!

  9. Linda

    Thank you, Luann. You are wise. Tough post to read. I lost me father in June. It is so hard to watch someone suffer. We want to fix, we love, we are present, we do everything we can, but in the end we feel so inadequate.

  10. Pingback: HOW TO VISIT SOMEONE IN A NURSING HOME Part 2 | Luann Udell

  11. Linda, I’m so sorry about your father. And yes, it’s never easy to watch our loved ones take that last journey. If you loved, and you were present, and you did all you could, then you did good. Believe me, deep in their hearts, they know that is all we can do.

  12. Dave P

    One more question for Luann and other readers. How do you deal with the frustration and anger when you realise you can do nothing to help ‘pysically’, as the doctors do?

  13. Hello again, Dave, and excellent question!

    Here’s where the “be”, not “do” comes into play. It IS very, very hard not to fix things (although it’s always acceptable to advocate for your loved one.)

    I highly recommend hospice training to anyone who wants to learn more about this stage of life, even if death is not imminent and even if you don’t plan to volunteer. It’s highly educational and informative. And they beat the “do” out of you over and over til you get it. In a nice way, of course! :^)

    Actually, the “be, not do” thing is powerful at ANY stage in life. Just like when people are telling you their troubles, they often don’t want solutions–they just want you to listen. And my favorite story about that is this one: One of my hospice classmates said her daughter came to her one day after school (she was in middle school, a particularly rough time for kids). Her daughter said, “Mom, today was a really awful day. I’m going to tell you about it, and all I want you to say is, “You poor kid!”, okay?”

    Great advice for any age, actually!

  14. One activity I forgot, and if the resident is mobile, take them to their church for a service at the time and day they used to go. It’s a great place for them to connect with their lifelong friends, neighbors and relatives in one place.

  15. Joanne

    I want to share this with everyone of my age that I know. Inspirational and really helpful, too.

  16. Judy Casey

    as I think about the last few with my father in the nursing home…..how many of the techniques I have used… and how many i will try to remember to use…. thanks.

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