The Meaning of Care in a Nursing Home

I work part time at an assisted living facility.  Technically, assisted living facilities are not nursing homes.  At the particular home I work for residents must be 75 years of age or older, and they must be able to dress themselves and get to and from the dining hall without help.  If they cannot fulfill these requirements then placing them in a nursing home or hospital is discussed with their families.  However, even though these are technically the rules of the establishment, many of the residents do need help getting dressed and help getting to and from the dining room.  A vast majority of the residents suffer from Alzheimer's, several are blind, and many of them have a very difficult time walking. Residents are generally moved into nursing homes when they become completely unresponsive to care or if they become incredibly ill.  However, sometimes if the resident is not in need of hospitalization and is still marginally functional, if they have been deemed terminally ill then they can choose to go on hospice care in the home. Obviously, these are people who require a lot of care and attention since they are not longer able to take care of themselves.  If they don’t receive this care, if they were to be left alone to their own devices, then they would literally die.  

Now I personally work in the dining hall.  I basically serve food, clean up the space, and get it set for the next meal.  I also go on juice pass once a shift which requires me to go into the residents’ rooms and give them something to drink so that they stay hydrated. I spend a lot of time with these residents.  Meals last anywhere from 60-80 minutes, and that gives you a lot of time to get to know the people you are serving.

When you work at an establishment like this you get used to residents coming and going.  Literally you can be gone for 2 days, and the next time you come back multiple residents could be gone, generally because they become suddenly sick and have to be taken to the hospital where they generally end up remaining.  They tell you when you start to not get attached to anyone.  However, this is incredibly hard.  When you spend 30 or more hours a week with these people you get to know them.  Many of them are perfectly capable of regular interactions, and oftentimes they will talk to you about anything and everything.  There’s about 60 residents in the home and every employee has their favorites.  However, when one of your favorite residents gets sick and either gets moved to a nursing home or dies it’s a really hard experience to go through.  There was one gentleman in particular that was such a sweetheart, and when he went on hospice that was very hard to deal with, which is precisely why they tell you not to get attached.

Clearly these people need to be cared for, but you are not supposed to care about them.  You’re level of caring is supposed to stop at providing them with service.  You need to help them live their lives as comfortably as possible, but you are not supposed to get sentimental, after all it is a job.  However, I think it’s dangerous to think of it as just any other job.  You’re literally helping someone live their lives, it’s not like you’re making coffee or selling clothes.  A certain level of empathy is required.  You have to find a way to care without becoming attached, at the end of the day when you go home you have to let go of the job, but when you’re there in the moment working you need to respect and treat the residents as you would anyone else.  These people deserve care and respect, and you have to provide it to them as best you can.

Similar to the carers in Never Let Me Go, employees at nursing homes and hospice facilities have to care for people whose lives will most likely soon be coming to an end.  They are supposed to provide them with as much comfort and assistance as needed, but they are also supposed to maintain some sort of professional distance.  Obviously in Never Let Me Go, Kathy is actually friends with Ruth and Tommy, and when she has to care for them it is very difficult. Also, there is the added dynamic that one day Kathy will be the one being cared for while she slowly dies, which technically the same dynamic can be found in nursing homes.  All of us are getting older every day, and it’s humbling and actually quite frightening to be confronted with what age can do to a body. All you can really do is attempt to give the individuals the level of care that you would hope to receive if positions were flipped.