Saturday, April 19, 2014

Eating, Being Fed, Dining .... Vast Differences

Mom and our cat had some basics in common -- eating was one of them. They both loved food, had their favorites and enjoyed eating alongside others.

As long as we could, while Mom was in LTC/SNC at her second facility (this opportunity did not exist at the first), we'd stop by and "dine" with her in the cafeteria where we could purchase food and eat with her.

Or, we'd bring homemade meals and sit outside at a picnic table under the trees alongside the waterfall -- admittedly a wonderful and soothing place (donated by the facility Auxiliary).

Yes, there were features to Mom's second facility which, on the surface, provided ambiance and seemed to promote "family" and "friendship". Sadly this appearance did not permeate the facility into daily individualized care as it's supposed to do.

We knew the diagnosis and these times were very limited. We felt guilty because we were both trying to work (with only having one car for transportation) and cope with the challenges left behind by the damages of Julia's Undue Influence and a really sour economy.

My age and having had my own business for so long turned out to be very detrimental factors; settling for minimum wage while trying to maintain a home and all the other life expenses was often stressful and even demoralizing.

Daughter's leaving college to help care for her father as he was struggling and eventually lost his battle to stay with us and her Grandmother's growing physical, emotional and psychological challenges, made getting anything but a minimum wage job impossible and ditto for the horrid economy.

Without a college degree and in a still declining economy back in early 2011 when my husband/her father, passed, and into even now, has presented challenges as rough and difficult as both their illnesses and deaths.

So we treasured those times with Mom visiting and sharing a meal and the other "plus" was the very, very low prices of the food which on our more than limited budget where every penny, nickel and dime counted, there were times when we just sat with Mom and she ate and we went home to find whatever we could but at least we were with her.

Cat, too, loved to eat -- until a few weeks ago. She had her favorites and could be "picky" when offered something she felt wasn't what she wanted. And as time passed, this became more and more apparent.

Now, like Mom, our cat is losing a lot of weight and she's not eating and having more "accidents" as well as more than the usual spit ups (used to be hairballs and now seems to be liquids or solids that don't agree with an ever increasingly difficult to digest internal challenge).

Notice similarities in our cat's approach to food and eating with Mom's and other people who sat in the dining area. They were in this "special area" on the same floor where their rooms were and where many had to be supervised, most didn't have the mental capability to make the choice to be fed in their rooms and none could get "downstairs" by their own power as was definitely necessary. And, some were physical and mental wanderers who needed but did not get more supervision and so being on the main floor with an "outdoor" automatic exit was not in their best interest.

In some videos on YouTube and other places, some self proclaimed "experts" in caring for the elderly and even some recognized experts claim the person who refuses or finds ways not to eat is telling you they want to die with this action.

NOT TRUE.  Watch and listen closely and carefully. Be highly observant and perhaps you'll see what we saw. At Mom's facility, they were greatly understaffed and often took residents into the upstairs dining area as early as 4 PM. These were people who could not get there on their own. Shift change, by the way was at 7 PM -- something to remember.


Dinner was "scheduled" to begin at 5 and last for an hour or so -- at least that was the practice in the main dining area downstairs for those who could remember what time it was and who could get themselves into the elevator and down into the lobby.

Must admit the ladies who manned the front desk were most helpful when residents did make it that far. However, on the floor where they resided, it was a totally different story. If residents received any assistance it was because there were aides on floor duty who cared enough to help and weren't busy tending to someone's personal needs.

Upstairs, people didn't sit down and have dinner served to them. People waited. On more than one night I watched as dinner plates were made up, ONE AT A TIME BY ONE PERSON who was obviously not in any hurry. These were put on trays and delivered to rooms -- one tray by one person and usually there were only a couple of people doing this task.

AFTER ALL THE TRAYS WERE DELIVERED, the singular person began to put together plates for those still waiting in the dining room -- one at a time, of course and no hurry.

Apparently this was "protocol" in the facility because down in the Main Dining Room (funny name since the real majority of people on the two floors using this facility ate in the Dining areas on their residential floors) the same "snail's pace' was followed with only one person plating and serving.

Daughter and I were amazed how slowly one person in the Main Dining area could serve between ten and fifteen people.  First it would be going to one person, asking if they wanted soup or salad and then going back and putting that one order together. Returning to that person with the requested food.

NEXT PERSON; NEXT ONE SERVING. I've watched as the clock ticked off 45 minutes and only the first course was totally served. And, the majority of the time people had to sit, wait their "turn" or "next turn" and stare off into space because some sat at tables by themselves or with people with whom they had no conversation.

Once this round of soup or salad (most dinners did have a first course) was accomplished, it was time for the INDIVIDUAL DINNER SERVICE where the server went to first one person, asked if there was anything being served they didn't want, went to fill the plate checking to see if what they'd "plated" was correct on a "ticket" she/he was given, rechecked the ticket and slowly delivered the plate to the ONE person.


Did I mention the residents were lucky if someone cared enough to at least get them something to drink to at least have something at the table while they waited?  Nothing to eat, though. Several nights we observed some of the residents, who could not feed themselves and even those who could, not getting any food service until after 7 PM yet many had been sitting there with nothing to do since 4 PM.

NEGLECT can cause an individual to not care and to not want to go on.

NEGLECT at every turn from no one answering your call light, making you sit and wait in the bathroom for half and hour or more, "forgetting" you need help getting dressed or changing your outfit that they "forgot" to change when you went to bed in your clothes because you fell asleep in your chair.

NEGLECT masquerading as a resident saying "NO" to an offering and not attempting again to make the offer or adapt the offer to something the resident used to like our could be a part of.

NEGLECT in moving so slowly or in attempting to feed someone who doesn't appreciate the way you turn to talk to someone else and jab at their mouth and shove the food inside and then another and another until the resident says "NO MORE" and so you claim the resident "isn't hungry" or "is refusing to eat".

NEGLECT in ignoring the resident's wish to dine downstairs because you don't have the time or don't want to be bothered with having to roll them down a short hall to the elevator or perhaps "escort" them all the way to their seat.

NEGLECT causes despondency and can lead to delusions and hallucinations as a way of "coping" with an existence that is demeaning, demoralizing and inhumane.

NEGLECT pushes aside Hope for a better tomorrow because tomorrow is just another day of being neglected in one or more ways.

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