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Veterans Administration Donations! Again, for I know. Ready to share new things that are useful. You and your friends.During my active bedside nursing years, I was employed by a long term care premise in an administrative role. In a nutshell, my position as the Mds, or Minimal Data Set Coordinator expensed me with doing regular wide assessments on all of the residents. These assessments very basically were transmitted to the government or more specifically to Cms, the Centers for Medicare and Medicaid Services. This facts translated into payment to the premise for care provided. It also in case,granted a method for capability revising and determinants for areas of revising premise wide as well as for each private resident. This single premise had a capacity for 93 residents and each was viewed as a member of our "family".
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Providing a structured environment for our family to socialize with their respective families, friends and each other was imperative. Our fine Activities Director was tireless as she and her staff organized theme nights, parties, dinner dances, musicals and socials, all representing an era with which our family could resonate. Socialization occurred artlessly as well, during meal time, at therapy and every inherent place in between. As human nature would dictate however, especially in light of diagnoses such as dementia, and side effects like irritability or confusion as a result of assorted disease processes, often times their discussions were heated, their differences in concept on matters ranging from politics to religion to the best way to pluck a chicken shown through, brightly.
This family was colorful and diverse, without exaggeration. Agreeing to family sources, one of our family members used to generate gorgeous and luxurious clothing for workers of "the oldest profession". She also ran the brothel which housed the women whom she dressed. Naturally, she made complete sense to us when we learned of her younger years as she continuously primped herself, wore lovely and festive hats and determined applied her lipstick, before going to bed. A husband and wife couple, both pro singers in their hay day, often led a rambunctious rendering of familiar songs after dinner, accompanied on the piano by one of the primary founders of the Harlem Renaissance. Someone else woman was a school teacher, and despite the fact that she had dementia, persistently scolded the others for not paying attention, for not listening. She often verbally punished the others, using colorful expletives.
Another family member was an marvelous painter Agreeing to her spouse and in her state of confusion at the premise would be found utilizing her own excrement to express herself on her bed sheets. There were World War I and Ii veterans, who shared stories and cried as they reminisced, as well as inventors, homemakers, philanthropists and physicians. Attorneys, welders, grocery clerks and even nurses who remember using glass Iv bottles were a part of the mix. Drug abusers whose habits induced debilitating strokes as well as wealthy individuals who could afford to pay for a hidden room, preachers, secretaries and homeless habitancy with schizophrenia all created an illuminating tapestry. Every single one of them knew the other and as a group, they all created a chemistry which permeated this charming and well appointed structure. While there was much clinical and healing operation behind the scenes, this was their home.
Because of the level of information complex in the estimate process, I was aware of the health of their skin, healing diagnoses, thinking and hydration status, appetite and prescribed diet, familial retain and if they were safe in their immediate surroundings. It was within my scope to know if they were incontinent and what their medication regime entailed. I had to know if they could swallow their medication whole and take it with water, if the staff nurse had to crush it and mix it with applesauce for safe swallowing, what their pain level was, if their cardiovascular status was within normal limits for their admitting analysis and if they had any allergies. I was aware of what their "code" status was, if they or their conservator requested that they be resuscitated in the event that they cease respirations or if their heart stopped beating, and if they even had a representative in the event they were deemed unable to make their own decisions on such matters. The extreme corporal test was performed as scheduled on each and every member of our family, as mandated by the powers that be. As detailed as these evaluations were, the results in black and white crunched into statistics were a poor representation of what truly mattered, what truly defined them. Hindsight, it appears has crystalline vision.
Our family fast trusted our ambience, our philosophy and our staff. They and their loved ones knew they could count on proper and proper care. Everybody counted on us to understand and embrace this stage of their loved one's life, their golden years. Each division functioned as a finely oiled machine, a cohesive theory all for the sake of coordinating the perfect care which we provided.
It is important for the geriatric habitancy to have a sense of structure, yet equally important is the sense of independence which is fostered. Often, family members dropped by my office by self propelling in a wheel chair or if able, ambulated to say hello or to pass some idle time. Daily, I stifled the giggles as these marvelous individuals ineffectively pretended that the butterscotch candies I had in a bowl on my desk were of no interest to them.
On a day which was not unlike countless others prior, I was in the process of completing my assessments, and was in my office entering all of my data into the facility's system, ready to be transmitted for processing. Meanwhile, "The Painter" had propelled herself into my office, rummaging straight through the butterscotch bowl of crinkly cellophane yumminess as she sang "Amazing Grace" while intermittently mentioning that her favorite color was ecru and that she dreamt her husband had perished in a fire. In cautiously walked Marie, an alert, oriented, pleasant and cooperative family member who was admitted to our premise on a short term basis, status post hip change surgery. We all chit-chatted, Marie, myself and our painter friend. Marie admitted to The Painter that she was moved by her gospel voice, and that's truly when the Painter began to weep. In an attempt to comfort our resident artist, it was stated by Marie, "life is what it is, it is as gorgeous as the tapestry of your heart, and your heart will live on forever. You will never be forgotten".
Marie was a fine sewer, a seamstress by vocation. She had come to visit me at my invite to show me the patch work quilt that she was making for her first great granddaughter's impending birth. My face must have exemplified my feelings which depicted deadlines and hunger. Marie winked at me and suggested to The Painter that they go enjoy lunch together. As Marie and the wheelchair she pushed which contained a robust woman humming gospel tunes had rounded the corner, far beyond the corporal limitations which were indicated for which her 2 week old hip procedure, I became grounded.
The familiar rumbling sounds and smells of food carts passed me by which served as two jolting reminders. Firstly, it was my turn on the rotation to aid in the passing of trays and the feeding of the family in the dining room and secondly, all I had ingested since my head raised from her pillow of slumber was remnants of toothpaste and 3 cups of coffee. Frustrated, I entered the last bit of data to complete one assessment, took a deep breath to replenish myself and was about to lock my office when I sensed an emergency. The names of physicians returning calls to staff members echoed over the loud speaker theory and more than one nurse, along with the Director of Nursing as well as the charge nurse ran by. Something was happening, something was shifting.
I ran down the carpeted hallway and followed the rest of the staff into room 104. One of our family members, a retired and revered police chief from the very town in which we were, was found unresponsive and well, cold by one of the nursing assistants who went into his room to aid him to lunch. As the cardiac arrest cart was whirled to Chief's bedside, his primary nurse skirted to the nurse's center to get his chart. There it was, in black and white and signed by him not even 6 months prior. His legal and witnessed check mark and signature indicated the following: "In the event that I have been found to have no pulse or respirations, I invite that there be no chest compressions and no intubation". "I invite no comfort measures or palliative care" also received his acknowledgement. Adjacent to the choice which questioned who to forewarn in case of emergency, in his hand was written, "None". Chief was pronounced dead at 12:12 Pm by his nurse. His doctor was notified at 12:14 Pm.
While the Nursing Director was supporting Chief's primary nurse with his post mortem care, notifying the morgue and monitoring the others assigned to her, I went to the dining room to fulfill my responsibilities and tend to the living. Already, the questions began because the energy was palpably altered. One of Chief's table mates for meals, the Piano Player, began asking questions. "Hey, where is Chief? Is he still at therapy? He is gonna be one sorry sap, he is missing Meatloaf Monday", his chuckle hardly convincing. Due to privacy acts, we were unable to expound what had happened to his friend. Normally however, the truth has a way of making itself known in the most raw of ways.
It was clear that Piano Player was concerned, as evidenced by his lack of appetite. He chose to navigate himself down the hallway in crusade of his companion. As he rounded the corner, he naturally knew. It was Chief in that lousy blue bin, secured shut with an market zipper, a receptacle which was probably used 3 hours earlier for the same reason, just containing a dissimilar life time. Chief was being wheeled to the back door, about to take a ride with no lights or sirens, which would finally lead to his final resting place.
Rumors spread. family members were inquiring about The Chief. The Piano Player was sitting parked in his wheelchair surface of Chief's room and appeared pensive and calm. As I approached him, I sensed such confusion. Not his, but my own. The man who was prolific on the ivory keys was angry and sad, quite aware of his emotions. He had nothing to say to me, nothing to say to any of us. We respected his privacy and at the same time, we made ourselves ready to him. Evening arrived. Shifts changed, reports on the events of the day shared. We only physically left to tend to our personal lives, and 92 family members remained.
Most long term care facilities have resident counsels. This means that one or some family members are chosen by their peers to narrate them in meetings with management about concerns, events and such. Chief had been chosen and it was unanimously decided that The Piano Player would take his friend's place. He did so with reverence and would be sure that Chief's presence here would never be forgotten.
Ms. Darla, the daughter in law of the new representative of the resident counsel stopped by to visit on Thursday, which she has done Normally for the last 3 years. When she walked into her father in law's room and noticed he was not there, his nurse smiled and waved and gestured to the society room, where The Piano Player was doing what soothed him most. When he saw Darla a smile warmed his face, and he prolonged playing. Darla sat with the man who was the only father outline she ever had, and silence was always comfortable in the middle of them. The Piano Player and his "Dar Dar" shared a peck on each cheek and a warm embrace when he began to expound to his lovely daughter in law what had recently occurred.
"Dar, death is lingering heavy, baby. We are all empty here, one day a friend's beating heart is sitting with you having a laugh and eating a meal, next day he's in a bin and out the door. I have this piano to join together the dots of my feelings and make peace. These other folks don't. The ones who can't speak or feed themselves, the ones who don't even know their own damned name, they all know something's different, they all know one of the family is gone, Darla. You can see it in their eyes. We are all so close here, as if it were in the stars that we are all supposed to live and die together. All of us, from dissimilar places and dissimilar worlds, crazy lives and heated opinions, all dissimilar textures and colors, it's cruel for us remaining to not have a way to grieve. Blue bins with heavy zippers, carrying out the heart and soul and remains of us". The Piano Player's voice broke, tears streaming down his face which glimmered with sadness, anger and purpose. He stood from the piano bench, executed a perfect stand-pivot into his wheelchair, and off he went to the operation Director's office. All Dar Dar could see was the back of this marvelous man's chair as he waved goodbye to her on the fly. She smiled straight through her own tears and knew that nothing but good would come of this.
Small groups were organized. It took a month to put it all together, and it would never be fulfilled, in totality. It would always be a perfect reflection of the continuum. As new residents were admitted to the facility, they were also invited to be included. The donated supplies poured in from the society and staff, loved ones and friends. If a family member was bed bound, the scheme was taken to them. If they had no arms, they directed us as to what they wanted theirs to look and feel like. There were embroidered doves and holy crosses, moons, Stars of David and Orthodox symbology. Painted names done by twisted and excruciating arthritic hands, messages of the fragility of life, suns, hand stitched police badges, and a Piano.
Marie had since been discharged to home, yet returned practically daily to bring it all to fruition. She assembled and blocked and steamed and stitched, Normally while listening to The Piano Player doing his fine thing, creating gorgeous music sparkling with harmony and whimsy and wonder, melodies which were the audible representation of the energies of this place, a way to celebrate, a method to encourage one to feel and express.
When she passed, it was quick. She always gave you the sense that this is the way it would be for her. Her body was bathed and mouth care was provided. Her dentures were put in place to enunciate permissible facial and jaw alignment. Despite what procedure dictated, for the ride to her final resting place we located her favorite hat atop her head, over the body bag. She had applied her own lipstick meticulously that day, even though it was not bed time.
Over the loud speaker, it was announced that it was "Time to Serenade". Soft and gorgeous classical music was piped in. If you tuned in to your senses in the truest way, you would smell the roses. The Quilt was delicately draped over The Blue Monster, as Everybody stood in silent reverie. Death was less harsh for the dead and the living it seemed, when you take pieces of family with you.
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