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Shelter From the Storm

By Robert F. Bornstein, PhD and Mary A. Languirand, PhD

For several days before Hurricane Irene hit the east coast, the TV news could focus on little else. Warnings, watches, dire predictions, and advice on proper storm preparation blared from every set, all the time. One of our local nursing homes was designated a reception center for people displaced by wind and flooding, so there was enormous activity as staff set up makeshift bedrooms, stocked the kitchen, organized emergency supplies, and did a thousand things we'd never have thought to do. Most important, a number of kindhearted staff members prepared to leave their own homes and families behind so they could work at the facility for the duration of the storm to ensure the smooth continuation of care for the residents.

The refugees came, the storm struck-not as bad as feared, thank goodness-and life at the facility went on with only minor glitches. They were a little short-staffed, as the suspension of public transportation and flooded roadways left some people unable to travel, but those on site got everything done more or less on schedule, working 16-hour shifts and sleeping on cots. By the day after the storm, everything was pretty much back to business as usual. In view of the devastation in many areas on the east coast (richly documented in the post-storm TV coverage playing on every set), this seemed miraculous, the staff deserving of high praise.

That's not what they got.

Quite the opposite, in fact: All we heard from residents was an endless litany of complaint about the dreadful hardships they had endured. The toast had been cold. An unfamiliar aide had been grouchy, and didn't know the proper getting-up routine. The afternoon activity had been boring, and held in the cramped dining room rather than the more spacious activity room (which was being used as a triage unit). As the day went on and visitors began to appear, most were greeted with withering criticism for not having visited during the storm. There were few questions about property damage sustained or difficulties encountered on the roads, but lots of repetitions of the tale of the toast.

Visitors apologized and fussed over their loved ones. Many took their loved ones' issues to the staff and demanded explanations for the disrupted service. Staff duly apologized.

Something is very wrong with this picture.

We have no problem with society's excusing the elderly from some mundane cares of the real world. They did their part, served their time, and deserve their rest. However, there's something very wrong with permitting-even encouraging-complete denial of outside reality in favor of 24/7 focus on one's immediate experience. People feel whatever they feel; there's nothing to be done about that. But when a hurricane hits and people put aside their own fears to make sure you're taken care of, some respect is in order. You may not be able to speed the restoration of their power lines, but you should care whether their power is on, understand that they may be worried about it, and maybe even ask how their family is faring during a difficult and stressful time.

We do the elderly no favors in sheltering them so completely from the realities of the outside world. There's a big difference between expecting someone to experience a phenomenon in full and giving her an opportunity to acknowledge its existence. "Don't tell Mom" may feel like a caring reaction, but it's also a bit patronizing, don't you think? In the guise of protecting her, perhaps we're also excluding and infantilizing her. Mom might not be able to offer much practical help, but at least she can register empathy and concordance. That helps too.

We are reminded of those situations in which well-meaning families opt not to tell a resident that a loved one has died-particularly when the deceased is the resident's spouse, sibling, or child. It's a surprisingly common occurrence in nursing homes, and is usually justified on the basis of fear that the resident 'won't be able to handle it'. It frees the rest of the family to deal with making necessary arrangements and cope with their own grief, rather than having to focus on the reactions of the resident. However, it also sets up some unusual, awkward interactions in which family members pretend that everything's OK when everything is decidedly not OK. All but the most demented folks will realize that something is wrong-they just won't know what. This actually tends to generate more anxiety-not less-which creates its own problems. In an effort to protect the resident, a situation is set up in which she is denied the natural comfort of shared experience. Better to encourage family members to break the news in 'real time,' so we can work together, putting appropriate supports and assistance in place to help everybody get through the loss as a team.

We're not advocating burdening the elderly with all the gritty details of life's woes (TV news does a fine job of that without additional assistance). But there's something to be said for showing loved ones that you believe that they can handle the truth.

 

Robert Bornstein and Mary Languirand are the authors of When Someone You Love Needs Nursing Home, Assisted Living, or In Home Care, published by Newmarket Press. The second edition, revised and updated, was recently released. Here's the link: http://www.harpercollins.com/books/When-Someone-You-Love-Needs-Nursing-Home-Assisted-Living-or-In-Home-Care/?isbn=9781557048165