T.G.F.M.

It was Friday afternoon at the nursing home. Many of my co-workers had already left for the day. I wasn’t feeling the T.G.I.F. (“Thank God It’s Friday”) hullabaloo people often express on Fridays. It’d been a busy day. I had new patients to admit that day. I was tired, and wanted to be finished for the day, and the week. But, I still had a few tasks to complete before I could head to where I’d find solace that evening, home. 

While walking the halls, and checking on our new patients, I observed that I wasn’t the only one that had my hands full that day. The activity director was trying to get as many residents as she could to participate in an activity. 

I diverted from my route on the hall and decided to help wheel residents to the activity. I approached Margie, a long-term resident, who was sitting in her wheelchair by the nurses’ desk.

“Margie, we’re having a musical presentation. I think you’ll love to see it.”

“A what?”

“A group of college students is here to sing to us. It’s a choir from the Missouri State University. Would you like to go?”

“All right.” She grinned.

I wheeled Margie down the hall.

“Where are we going?” Margie asked just moments after we had decided to attend. 

Margie was one of the most delightful residents in the nursing home. She was a social butterfly, and loved activities, but her short-term memory was becoming more and more diminished. The staff often had to repeat the information to her several times. 

I stopped the wheelchair for a moment, stepping forward, motioning in front of Margie. I knelt, making eye contact with her. I fixed my gaze on her big blue eyes. 

She had an innocent look of a lost child. I smiled and reached for her hand. She smiled back. 

I told her where we were going, again.

“All right.” She grinned. 

As we were approaching our destination, I heard someone calling my name. I stopped again, and looked around. I saw Ronald, a maintenance man, walking down the hall, carrying a telephone in his hand. 

“The new patient in 108 asked for a telephone. I took this to his room, but there’s no tone.”

Even though it was Friday, past 6:30 PM, I engaged my brain in weighing the possible solutions to the phone problem. Phone access was given just as a courtesy, if available, so, most of the rooms had no telephones lines. The maintenance supervisor would have to determine whether this was a technical problem in the existing phone line and report it to the telephone company, or find  another available phone line that he could transfer to that room. With the maintenance supervisor having already left for the evening, and off on weekends, the new resident would either have to wait until Monday, or be moved to a room with a working telephone line. 

I explained to Ronald the alternatives we had, and offered to go and talk with the new resident shortly after I was finished taking Margie to the activity. 

My focus went back to Margie. She was quiet, eagerly observing and listening to my conversation with Ronald. After Ronald had left, she stared at me, her lips curving into a mischievous smile. 

I raised my eyebrow, and grinned with a hint of embarrassment.

“I know, Margie. I’m bossing around!”

“No.” Margie shook her head. She drew closer to me, spending a few seconds searching for the right words she wanted to say. “No, you’re a leader!”

All of the sudden excitement embraced me. Margie had little idea of how gleeful her words sounded to me that Friday evening. 

I kissed Margie on her forehead, and stepped away. I noticed she quickly engaged in talking to some visitors. 

I went home with Margie in my mind. Alzheimer’s may have attenuated her memory, but her innate ability to continue to show love and inspire was in no way diminished. It was totally intact. 

Now my T.G.I.F turned into a T.G.F.M.! (Thank God For Margie—our sweet Margie!)

Happy New Year, Barb!

“What?” I exclaimed in disbelief. “They may put her on a ventilator?”  I clutched the handset and pressed it close to my ear, praying the conversation was just a bad dream.

But it wasn’t.

“The doctor said there’s not much they can do,” my friend Liz related, the tone of her voice revealing her stress. “Barbara’s breathing problems have worsened.”

“But I know she would never want to be on a ventilator, or any life-prolonging machine.”

“My thoughts exactly!”

“I’ll meet you in the hospital in a few minutes.” I hung up, feeling a lump in my throat, never a pleasant feeling. 

My friend Barbara, who I had known for several years, was at the end of life.  In her mid seventies, Barbara was a family friend who had become one of my best friends.  We went out often for dinner, or shopping, or simply a cup of coffee. 

“A colombian supreme coffee!” she would exclaim at the coffee shop, sporting her signature smile. 

I loved being around her.  She was fun, witty, and so full of life, at least prior to being saddled to supplemental oxygen. 

I walked into Barbara’s room in the hospital.  She looked more deteriorated than when I last saw her.  She gasped for air and tried, but couldn’t talk.  The nurse came in and put the BiPAP mask on her for a while.  

I was devastated.  

Memories of Barbara teaching Tai Chi and swimming lessons to other elderly ladies in the subdivision where she lived flooded my mind.  The woman that lay in the bed was not the Barbara I had known for years.    

I held her hand, fighting back tears.  I forced a smile as she gazed upon me.  I felt like a deceiver, knowing Barbara recognized that smile—a sad one—not the cheerful smile we had shared during our dinners, or at the movies.

Over the next few days I continued to visit Barbara.  Family and doctors talked about Hospice.  Barbara was aware of what was the subject of the discussions, and she had expressed she was ready to meet the Lord. 

“I’m glad our paths crossed,” Barbara said, holding my hand. “I love you.”

Tears rolled down my cheeks. “I love you too,” I managed to say, with broken words—and worse, with a broken heart. 

After saying our good-byes, I left the hospital, tearful, my mind swirling with confused thoughts.

This can’t be happening to me.  I shook my head as I realized I was losing my best friend.  My “adoptive Mom,” as some of our friends sometimes teased. 

I turned my worried thoughts into a fervent prayer, longing for comfort in the midst of my despair. 

In the following  days, Barbara’s condition unexpectedly  stabilized, and the hospital Physician decided that she should be sent to a nursing home.  He recommended long-term placement, and Hospice care.    

As the social worker at a nursing home, I wasn’t certain about how I would feel having my best friend as my patient and long-term resident.  I was unsure I’d properly handle the emotional load on top of my professional responsibilities.  Barbara had been so full of energy that I couldn’t bear the thought of watching her die.

Barbara’s family discussed the options for nursing home placement.  I preferred not to take part in that discussion. 

But her family decided she would come to the facility where I worked.  I appreciated the family’s trust, yet I had to warn them about my emotional involvement.  I had to warn my co-workers, as well, since I needed their support in keeping the balance.  

Barbara was admitted as a long-term resident.  Her family helped her to adjust to her room. They moved as many familiar furnishing from her home as possible so her room would be warm and inviting. 

After a few days, I felt happy that Barbara was there.  I visited with her daily, and we often met for lunch. 

“Sometimes I feel so down...so lost,” Barbara said to me one day, softly. “But when I see you around here, it makes me feel better.”  She held my hand. “This has been so hard for me, but you have helped me a lot.”

Her eyes welled with tears.  I hugged her and told her how much I loved her. 

As the weeks passed, Barbara was gradually able to walk more and more throughout the nursing home.  She decided to put a hold on the Hospice consultation, and instead, she wanted to have physical therapy.  Her strength was visibly returning.  Her breathing became less labored.  She started to participate in the facility activities, as much as she could tolerate, and made new friends.  Barbara became a popular resident. 

“She is so sweet.” I heard her nurse commenting. 

Barbara was also known for her good sense of humor.  She delighted the staff with her witty comments. 

Barbara remained faithful to our church and beliefs.  She continued receiving communion, and on the Sundays she felt up to it, I took her to church, and afterwards breakfast at our favorite restaurant.  Barbara loved it, and seemed happy.

“You no longer need  to be in a nursing home,” Barbara’s Physician told her, months later. “You can go back into the community.”

Barbara and I were so excited with the good news.

She had recovered! 

“It’s a miracle!” Our friend, Liz, rejoiced. 

“Yes, it’s a miracle.” I said. “The Lord heard our prayers.”

Barbara moved into a retirement community a year ago. We have continued being best friends, and see each other often.  

I stopped to see Barbara today.  As I walked into her apartment, the aroma of coffee embraced me.  As usual, colombian supreme coffee was being brewed. 

We sat comfortably at the dining table, our coffee cups in front of us.  I sweetened my coffee with sugar.  Barbara used Splenda.  Then we engaged in a non-stop  conversation about books, food, weather, hair styles, the wine and cheese party she’d attended the night before... and finally, on our individual New Year’s eve plans.  We laughed often. We were happy.

“Barb, I’m so glad our paths crossed.” I flashed a genuine smile as I took a small sip of my coffee, glancing over the rim of my cup at Barbara’s face. 

“Yes, my dear. Me too.” Her grin sparkled through the steam rising from my coffee cup. 

“Happy New Year, hun!”

“Happy New Year, Barb!”

Merry Christmas, Lucy

A woman answered the phone.

“Lucy?” I guessed, as she didn’t identify herself. 

“Hi Doris.” 

Yes, it’s Lucy!  

Lucy recognized my voice on the phone, knew it was me from my accent or from my many conversations with her.  I had been the social worker assigned to her father, Mr. Brown, for a year. My residents and some of their family members almost become my extended family.  It’s a good feeling.

“Lucy, I’d like to set up a meeting and discuss the option of Hospice for your Dad. As we recently talked, his condition is worsening every day.”

“Doris, go ahead and do it.” Her voice was gentle but clearly expressed her relief.  “You  know what’s the best for him.”

“Are you sure you don’t want the meeting?”

“There is no need. I will stop by this afternoon to see Dad.”

Lucy carried herself elegantly, was always well-dressed, beautiful inside and out for a confident woman in her mid sixties. While a prideful woman, her candid words left no doubts about her good heart. 

Lucy visited her father about twice a week, unless she was traveling with her husband. Recently retired, the couple would talk about their leisure trips, not to Florida, or California, but to Germany, Paris, Spain, England, India, and even to some countries in South America. 

Lucy sometimes brought pictures of her trips to share with her father, but he had little or nothing to say.  In his nineties, his dementia had advanced to such an extent that he could articulate little verbally and showed even less ability to recognize Lucy. 

Mr. Brown had two sons, but they had been estranged for many years, and wanted nothing to do with him.  No other family members were involved in Mr. Brown’s life.  He was divorced, and the mother of his children had died long ago.  I had been told that Mr. Brown came from another nursing home years before I came to work to the facility. 

The medical records reflected a history of being in the Alzheimer's unit. “Dementia with behavioral disturbances, Psychosis, Alcoholism, Depression” and the list of diagnosis continued. Now Mr. Brown was at the end of his life, and I was glad to see he had a supportive daughter.

Lucy’s husband, Fred, always accompanied her.  He was a man who everyone would refer to as a “nice guy.” A gentleman, down-to-earth man, quiet, most of the time. But he somehow reminded me of a guardian angel—or a body guard, perhaps.  Someone “there” for Lucy, but, not much for Mr. Brown.  

“Doris!”

I heard a familiar voice, one I associated with cheerful feelings.  Turning, I viewed Lucy.  She looked  radiant, not just because she was wearing a hot pink coat, but also because her voice carried words in a tone intended to embrace the listener, as if audible hugs floating from her lips. She flashed a  smile which shone brighter than the Christmas lights that decorated the facility.

“Lucy, you are here early!”

“The hospice nurse called and told me I needed to sign some papers.” 

“Do you have any questions about Mr. Brown’s transition to hospice care?”  I wasn’t quite sure how informed Lucy was about her father’s significant medical decline. 

“I’m ready for Dad to go.”  Her voice became more firm, measured in her tone. “Maybe I should tell you some things about him.  You will understand better.”

I frowned, my confusion evident, I was sure.

“We can go to my office and talk, if you want.”

Lucy nodded.  No words passed between us. If one could ever actually see a lump in another’s throat, this was the time.  Her husband sat by the fireplace, observing us. Lucy signaled to him, to wait there.  He acknowledged, uncomfortably, and looked down. 

Lucy followed me to my office. I spied tears rolling down her cheeks as we sat. 

My heart pounded.  I’d never seen Lucy so vulnerable. 

“What’s going on, Lucy?” I reached for a Kleenex box and set it closer to her. 

“I love my Dad, don’t get me wrong, but my whole life I’ve had to deal with mixed feelings.” 

I nodded, unsure of the meaning of her statement, but remained quiet, letting Lucy continue after she regained her composure. 

“My father is an alcoholic.  I first realized his addition as a little girl.”  Her voice grew a bit stronger, revealing the anger she still harbored. “One day, he was terribly drunk.  He entered my room, and touched me—molested me. I was nine. I panicked—screaming.  My mother and brothers ran in. There was a big fight and that very night we left.  We all went to my grandparent’s house, and stayed there until my mother secured a place for us.”

Lucy paused.  Her eyes filled with tears again.  She clutched, seeming to gasp for air. 

My heart sank.  Now I was the one with a lump in the throat. 

“My mother... she never told my grandparent’s what happened.  She just said he was drinking too much and she couldn’t take it any more.  My brothers kept the secret as well.  The incident was never reported to anyone. None of us ever talked about it. Ever—until I told my husband.  He knows it happened, and that’s why he is always with me when I visit Dad.  I feel more comfortable with Fred around, even though my Dad is now reduced to nothing but still haunting me for a lifetime.”

I searched for empathetic words in my mind while Lucy vented. I could see she needed it, although I was in shock and basically tried to honor the shoulder she needed to lean upon that day.  The person to share such a terrible secret—her father’s unpunished crime.   

Lucy told me she received psychological therapy during her tender and younger years subsequent to the encounter that helped her to move on with her life. She was now a successful Relator, blessed with a happy marriage, and with two children, and several grandchildren. 

“I forgave Dad for what he did—or so I thought.  But now that he is dying, I have tangled feelings, suffocating me.  The thought of his passing will allow me to breathe again.  I feel ashamed of that thought, you know, it’s not a very Christian way to think.”

I expressed my admiration of her courage to share about her emotional pain. Lucy understood what she was feeling was human. She was aware that emotional healing is a continuous process.  

Sharing a shame she should never had to bear, Lucy sighed.  Her lungs were filled with fresh air and good spirit—the spirit of a warrior, I thought. 

She thanked me for taking the time to listening.  I was actually more grateful for her letting me see her inner beauty, and be an inspiration in my life. 

Mr. Brown passed away within a week, a week before Christmas. I wouldn’t see Lucy on Christmas eve bringing presents to her father, I realized.  Instead, Lucy would be with her loving husband, and children and grandchildren. That’s what she had planned after knowing she would no longer needed to come to the nursing home.  

This time would be a different Christmas for Lucy, I presumed.  It would be the beginning of long-waited closure—the end of a gloomy chapter in her life.  

As I walked by the nursing home fireplace on Christmas eve, I thought of Mr. Brown and Lucy.  May his soul rest in peace, I prayed. And merry Christmas, Lucy. Very merry Christmas.

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A Happy Thanksgiving

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“Have I said I love my job? I have... haven’t I?” I asked my fellow worker Frances, fighting tears back.  

Frances gave me a sympathy look. “I know. There's too much going on,” she said, shaking her head. 

“I have to confess, sometimes I don’t love my job.” I took a deep breath. “I’m going out for a break. I need to get a fresh cup of coffee.”

As I walked out of the facility I reflected on the events that had unfolded that week. 

It had been a busy week. November seemed to be a peculiar month in the nursing home. It’s a month in which the resident's seasonal mood changes seem more noticeable. Going from warm temperatures to cloudy and cold days appeared to make some residents more anxious, or more withdrawn.

November is usually the month in which many residents become distressed about being in a nursing home, wanting to be at their own homes for Thanksgiving and for Christmas. Even if they are permanent residents, they still wish they were at home.

Families get anxious too. Guilt-ridden sons, daughters, spouses and siblings seem to channel their frustrations and anger toward the nursing home staff. And ultimately, many of the problems seem to end up in my lap. 

Social Services will help you, I hear often. 

Resolving problems means, for instance, taking care of complaints, meetings with families and residents, assuring that residents return to their home in safe conditions, directing room changes to resolve conflicts between room-mates, or searching for missing eye glasses. 

Those would have been normal challenges during that week, if it hadn’t been for Mr. Goldman’s family. Mr. Goldman’s medical condition was guarded. His family had initially expressed their understanding of his poor prognosis.

“We want to take Dad home once his I.V. treatment is completed,” one of his children had said. 

“We want him comfortable in his own home. We already talked with Hospice," a sibling mentioned.

A simple case. Mr. Goldman’s would be in our facility for just a few days. Then he would return to his home with his family. 

Wrong! 

Mr. Goldman’s family wasn't accepting his end-of-life condition. Their hopes that he would get better started to grow. And so did their stress. Day after day, week after week, Mr. Goldman’s family's demands and complaints multiplied. 

Several family members visited daily, and would stay with him around the clock. I assisted them during meetings, addressed their concerns, helped with legal documents, phone calls, faxes, etc. Nurses dealt with them daily on medical issues. The physician spent a great deal of time talking to them every time he was in the building. 

One day, Mr. Goldman’s oldest daughter came to me with another request. I told her it would be followed up the next day as it had to do with Housekeeping, and the staff had left for the day. 

“I guess it’s getting late for everybody!” She said sarcastically, glancing at her wristwatch.  

I remained quiet, not knowing what to say. It was better that way.

She turned around and, without a further word, walked out of my office. 

The next day, I spoke with Mr. Goldman’s son in the resident's room. I told him that things were being taken care of. He voiced another concern, and stated he would be talking to the physician. 

“That’s fine,” I said, doing my best to remain polite, and hiding my frustration.

On the way to my office, another problem arose, this time involving Mary, a not-so-empathetic co-worker.  Mary had complained to my supervisor about me being late in turning in some paperwork. 

I felt my patience was being tested more than I could handle. 

Call it burnout, compassion fatigue, stress, or any other fancy term—the dreadful feeling is the same. It’s as though all of your energy is being sucked out from you, exposing the skeleton of your physical, mental and moral vulnerability. 

It’s not a pleasant feeling. 

The coffee shop was my refuge, a place of solace. As I savored a frothy cappuccino, I happened to run into my colleague Sarah. 

What a blessing! 

We engaged in a near-therapeutic conversation. Her understanding of the stress involving our jobs as social workers made me feel better. I was ready to return to my office—re-energized and in control of my emotions.

Back in my office, as I was catching up with my paperwork, I heard a man’s voice.

“Excuse me.”  Mr. Goldman’s son was standing at my door. 

What does he want now? I wondered. Thankfully, I was calm, and willing to take on another task.

He walked toward me. 

“I want to let you know we appreciate all you’ve done for my Dad and us.”  His voice carried his sincerity. 

Speechless, I fixed my gazed on him.

He looked me in the eyes, and after a brief pause, he continued speaking.

“And I think you have a tough job,” he nodded, pursing his lips. He extended his hand to me. 

“Thank you,” he said, as we shook hands. 

He turned around, and left my office. I remained puzzled for a few seconds. Suddenly, I felt as though a huge and heavy load had been lifted from my shoulders. A good feeling enveloped me. I smiled for a couple of minutes, replaying the scene in my mind.   

As a social worker I don’t expect for clients and families to thank me. Why should they? Helping them is my job, after all. But those words meant a world to me—that particular day. 

A week from that day, as I was with my family, enjoying our Thanksgiving dinner, I thought of Mr. Goldman. By then, he had already gone home. I thanked the Lord for touching the hearts of his family. 

I thought of my co-worker Mary too as she surprised me one more time. Days after that stressful day, she unexpectedly came to my office to clarify about what happened, and to apologize for the distress caused.  We hugged each other. And I thanked the Lord for people’s kindness.

Unexpected kindness is the most powerful, least costly, and most underrated agent of human change. Kindness that catches us by surprise brings out the best in our natures.

- Bob Kerrey

That was a happy Thanksgiving. I sure had a lot to be thankful for.

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