HOW TO VISIT SOMEONE IN A NURSING HOME Part 2

I told you I’d forgotten something! More tips on how to make your visits richer.

TALK STRONGER, NOT LOUDER

If the person you’re visiting is hard-of-hearing, try this simple trick: Get closer! Move so you can speak directly into their ear. Often this is all they need, and you may not need to speak any louder.

If you do have to speak louder, go up in increments. I can’t tell you how many times I’ve seen visitors and staff go from normal voice to YELLING. It always startles the client (and me!) so much, they nearly jump out of bed.

SING

Or hum, or bring a CD of their favorite music. This is especially nice if someone is non-verbal. Our brains are hardwired for music (and art, by the way.) If you don’t believe in miracles, test yourself by watching this short clip of an elderly man restored to himself through the power of music.

Don’t be afraid to be silly. One client was only conscious a few minutes each day, and spent most of her time semi-conscious or asleep. I’m not good with remembering lyrics, so I sang the only song I could think of: Come Away With Me, Lucille, in My Merry Oldsmobile. In my defense, I was in a lot of gay ’90’s (that’s 1890’s!) musical revues in high school, and I love the word “automo-bubbling”….

Janey (not her real name) roused, opened one eye and glared at me. “Just how old do you think I am?!” she asked indignantly.

TURN OFF THE TV

I don’t think I need to explain this one. You think the electronic babysitter is just used on kids?!

It’s especially heartbreaking to see how deeply affected clients are by having non-stop soap operas blasting all day. Some of the actually incorporate the dialogue into their dreams and memories. One day a poor gentlemen told me that people were angry at him, and yelling. He’d confused the the evil plots and cruel machinations of a daytime soap with real life.

PICTURES ARE WORTH A THOUSAND WORDS

If you have pictures of you and your friend together, bring ’em! Or ask them about the photographs they have on display. Usually these are ones they cherish and brought with them, or they are important photos their other friends and family have brought. Photos can be powerfully evocative.

NO GUESSING GAMES

Even people with plenty of cognitive aptitude can get confused. Poor eyesight, compromised hearing, being roused from sleep….Have mercy! Good Lord, no one likes it when a stranger turns up at a party and says, “Do you know who I am?” or “Do you remember me?”

Don’t ask them to guess who you are–tell them! “Hello, Frannie, my name is Luann. I’m Mary’s oldest daughter, the one who lives in New Hampshire.” Or, “Hello, Mrs. Brown, I’m Bill Meyers. I was your student when you taught second grade at Houghton Elementary School. I’m the boy who brought a snake for show-and-tell, and it got loose in the classroom!” Trust me, she’ll remember you.

For more great suggestions, visit JazznJewelry’s excellent comment to my previous post.

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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.