Bringing It Home

by Tilda Shalof

  “And not do,” Leala adds, shooting Mallory a knowing look.

  Mallory continues. “We go into some homes that should be condemned. You gag at the stink and feel revolted, but you have to put on your game face and not show your disgust. You have to put your judgements aside and be respectful because that’s their home. It’s their choice. Everyone has a right to live how they wish.”

  Leala describes a man who lives off the beaten path, off the grid entirely, in a 150-year-old old farmhouse. “Animals are running around, feral cats and dogs with missing legs and paws. Dog feces everywhere. There’s a cage of birds with seeds and feathers all over its floor. The windows are dirty; you can’t even see through them. The floor is so rickety, one nurse fell right through. So, I’m seeing this and all I can think is, OMG, OMG. This is the point where I have to compose myself and be a professional. You have to come to terms with the fact that you can’t fix all the problems. You do what you can.”

  They continue on, completing and expanding on each idea, back and forth.

  “There are definitely times when ‘best practice’ goes out the window. I remember one client who had a rash. The doctor prescribed cortisone cream, but the client was rubbing it with banana peels. It didn’t get better, but that’s what he wanted to do. Another guy kept his pills in his fishing tackle box, labelled ‘Bill’s Pills.’ They were all mixed up in different bottles, some expired and without labels. He’d reach in and take whatever he grabbed a hold of. I wanted to get in there, go through all those medications and throw out the expired drugs, and the ones he didn’t need, but he wouldn’t let me. What can you do?” Leala raises her hands, palms up, to show her resignation to a fact that nurses often struggle with: there are some things we can’t fix.

  I’m embarrassed to think of how quick we are to label a patient uncooperative or non-compliant. Even “unmotivated” is a usual and equally damning label we use to describe patients who won’t ambulate or engage in rehab. Once, we complained about our difficulty in getting an “unmotivated” patient to do more activity. But when his wife came in she said, “That’s him. That’s what he does at home – he lies on the couch and watches TV from morning to night. This is his usual level of activity.” Who are we to try to get people to achieve our goals for them?

  “Have you ever been in a situarion that felt dangerous?” I ask them.

  “We always tell the home care workers, ‘If your instinct tells you it’s unsafe, don’t go in, or get out immediately if you’re already there. Never put yourself at risk.’ ” Mallory’s answer reflects VON’s policy, but Leala took matters into her own hands – literally.

  “Once, I had to get a client to hand over his machete and let me confiscate it,” she says casually, like it’s nothing.

  “Wow.” How cool is that?

  In Mallory’s experience, it’s more often the client who is the one in danger. “Once, we suspected a wife was abusing her husband. I was on the phone with her and she was speaking about him nicely, but when she put the phone down I heard her yelling and cursing at him. We went over to investigate. In another case, the husband left his wife alone in bed, lying in a wet diaper all day while he went off with his girlfriend. She was in bed with a broken hip that never healed properly.”

  Leala adds, “We ended up having to admit her to a long-term facility. There was no other way to keep her safe. We’re the eyes and ears, right there on the scene. We take in everything. If something is wrong, we’re the first to know about it.”

  In the afternoon, I meet Mae Quinn, a sprite, trim elder with a deeply lined face and an animated voice who’s a proud VON volunteer. “I’m from Weyburn, Saskatchewan, and I’ve been a VON phone caller and friendly visitor for fifteen years.”

  We sit in the boardroom, but I wish I could see Mae in action, making her calls to folks at home.

  “If I didn’t have this outlet I’d be sitting at home, depressed. When you’re alone, all you do is chew over your problems. Oh, I’m alone, I’m so lonely. If you volunteer, you help others fix their problems and end up fixing your own. I thought I was there to help them, but they’re helping me.” Mae’s husband was in the military and they raised four kids together.

  “Now, I call people who are alone and follow up if they don’t answer. So many people have nobody in their lives. I visit shut-ins and chit-chat with them or play cards.”

  Mae misses her husband terribly. He died a year ago from pulmonary fibrosis caused by exposure to asbestos when he was a soldier during the war.

  “Yes, he could have had surgery, but it was risky and he chose not to have it. He lasted one year. I wanted him to have the surgery, but my friend’s husband spent his last year in the hospital, in constant pain. At least I have good memories, she keeps telling me. You didn’t have to watch your husband suffer.”

  Mid-morning, I meet Don O’Neil, who gives me a hearty two-handed handshake. I accompany him on his rounds delivering meals cooked in the VON kitchen to people in need. He’s a burly, handsome older man who takes anyone in his charge under his protective wing. He wears a dark-green soccer jersey with an Irish logo on it.

  “My ancestors hale from the Emerald Isle,” he says, proudly showing me his Claddagh ring. “If the heart points out, that means you’re available. Heart facing inward means your heart is taken.” (By the way, Don’s faces out. Ladies, take note.)

  “We have some very successful people here in Trenton. There are some people who make life better, others who make it worse.” Don is a retired banker and now a “career volunteer-er.” He says volunteering is not his hobby; he considers it his full-time job.

  “I’m the Godfather of Trenton volunteers. I’ve been president of the Cancer Society, done sports charities. The military is very important here and many are VON volunteers. When one shows up at the door in uniform to deliver a meal, it’s a real source of pride.”

  On the middle finger of his other hand, Don wears a Masonic ring, and just like every other Mason I’ve ever met (including my late father), he won’t reveal the meaning of the secret symbol engraved on it. I wonder if these old-time clubs like Kiwanis, Knights of Columbus, and the Lions are still going strong? Do people these days still have those affiliations? Many young people I know go off to Africa or South America, or other developing or war-torn countries, to offer their services, but I often wonder if the needs right on our doorsteps, even though they’re not as exotic or exciting, would attract them as well?

  We pull into a driveway. “You can sit home and watch TV or get out and do something useful,” Don says. “I don’t like reality TV. I like reality. Yup, as a volunteer, I get a 100 per cent increase in my wage every year.” He shoots me a wink.

  In this house we meet Jerry, who was a golf pro until he had a stroke last year. He now uses a wheelchair and depends entirely on these delivered meals for his nutrition. Don is bringing him a ham sandwich for lunch and beef stew over rice for dinner. On the front door a sign says “No smoking, oxygen in use,” yet the house reeks of smoke and Jerry’s coughing a wet, bronchial cough.

  “We’re not here to judge,” Don reminds me on the down low, as we’re leaving.

  Nancy’s face lights up when she sees us on the doorstep with her meal. In her arms she cradles a chocolate poodle who probably weighs more than she does. He’s definitely better nourished. With her teeny-tiny stick legs and arms, I wonder if Nancy is even sixty pounds. Her hands shake and she’s unsteady on her feet. There is no way she could survive without these meals. She’d be admitted to a hospital with the diagnosis “failure to thrive,” and be put on intravenous hydration and tube feedings. I wonder what’s in her refrigerator right now. The meals Don brings are keeping Nancy alive.

  “For some folks, we’re their only human contact.” Don and I are back in the car, on the way to the next delivery. “Well, I’m supposed to be retired, but I’m so busy, I think I’ll go back to work to get a rest. Volunteering is something I do for myself. Abraham Lincoln said, ‘When I do go
od, I feel good. When I do bad, I feel bad.’ ”

  I’m still thinking about Nancy. I wonder if Don is too because he says, “If we see something not right we report it to the office and they come over to check.” He pulls into the parking lot of a closed-down bar with dusty windows. Don is about to deliver a meal to a tenant in the seedy rooming house above the bar. “Stay in the car for this one,” he says protectively. When he comes back down, he’s sad. “I’ve seen that lady all around town with a child in tow. Bad teeth, ragged clothes. Can’t tell if it’s a girl or a boy. It reeked of marijuana up there. Maybe something worse than marijuana.”

  We drive on. “My wife would have benefitted from some of that. Medicinal marijuana, I mean.” He gives me a sideways glance to check if I disapprove, which I don’t. “She was dying of cancer, but her doctor wouldn’t prescribe it.”

  We stop to deliver a meal to a man who’s more interested in showing me the roses he planted in his garden in memory of his wife (of the same name) than the food delivery.

  “There’s lots of lonely people out here,” Don tells me back in the car. “One lady would push her lifeline just to get the firefighters and police to come. But first, she’d put on lipstick and a spray of perfume.” Don believes that people don’t know how much fun it is to help others. “The best reason to do it is for yourself. Sure, there’s the odd grumpy one, but if you look at their circumstances you can see why they might be like that.”

  What a pleasure it would be to have Don deliver me a warm, cooked meal in an insulated puffy bag, but I’m sure I don’t qualify. Spending time with Don reminds me of how members of a close community can help each other. When my sons were little, we lived in a neighbourhood where I knew most of the people on the street, and the Di Tosto family were the best neighbours anyone could ever have. Time and again we counted on them and they always came through. We had keys to each other’s houses and once, while we were on a family vacation, we called them to check if we’d left the stove on. (We hadn’t.) They taught us how to put on our five-year-old’s hockey gear his first time on the ice and how to take care of our shrubs and bushes (we are hopeless gardeners). I found ways to give back. They called upon me to give their teenage son injections he needed. In fact, I became known as the neighbourhood nurse to many on the street. I loved that role, being consulted by one neighbour over whether or not to take his kid’s sprained ankle to the ER, doing a lice check, and even helping care for someone’s father when he was recovering from a stroke. Unfortunately, we moved and our new ‘hood isn’t nearly as friendly. I often think I’d like to move back there.

  SMILE – Seniors Managing Independent Life Easily – is a program to help keep seniors at home for as long as possible and out of long-term care facilities. They offer help with laundry, shopping, cooking, housekeeping, chores, and errands. I meet two recipients of this program – Edith, a seventy-year-old woman with a child-like, innocent smile who sits on the couch with Patrick, her husband and full-time caregiver. He says he’s reconciled to his role, but I sense weariness in his tired eyes and downcast expression.

  Edith has had to learn to walk and talk again after a brain aneurysm last year. A home care worker comes every day to help her bathe and get dressed, and to give Patrick a break.

  “That’s my time to get groceries, run errands, but sometimes all I do is sit in a bar and read the newspaper. Even if I do nothing, it’s good to get out of the house. I can’t leave her alone for even a moment. She gets confused about where she is and panics. Sometimes, she keeps going to the bathroom because she forgets she just went.”

  “You have a nice husband,” I say to Edith.

  “Yes, I do,” she says excitedly, but then looks at Patrick’s mournful face. “I used to be a good wife, but I’m no good to him anymore.”

  “You’re still good,” he tells her, leaning over to pat her hand.

  “Poor honey,” Edith says, her mood abruptly changing from cheerful to sad. “You don’t have fun anymore, do you? I’ve ruined his life,” she tells me, and starts to cry.

  Patrick puts his arm around her. “No, dear, it’s fine.”

  One thing that makes caring for Edith very difficult for Patrick is his own health problems – migraines, arthritis, and early signs of Parkinson’s disease.

  “At times, it all falls apart, but somehow, we muddle through,” he says.

  “Patrick was an engineer, and was offered a job in Africa. He loves adventure and wanted to go but I didn’t,” Edith says.

  “I’d forgotten all about that,” he says softly.

  Clearly, she’s got the long-term memory and he, the short. Together, they’re a team. The highlight of each month is dinner at the Lion’s Club held at the church.

  “This isn’t how I thought we’d live out our golden years.” Patrick’s voice trails off as he looks out the window.

  My last stop of the day is a community centre where I sit at an oval-shaped table with seniors who have suffered brain injuries or cognitive deterioration and have come here for a day of conversation, light exercise, games, and crafts. The walls are decorated with cheap and cheerful displays of their artwork – collages, drawings, and paintings. In some of the portraits, faces are fragmented and distorted – a reflection of the way they see these images.

  A man with an English accent starts up a conversation with me in halting, slow speech. “I’m Herman, originally from Cornwall, England.”

  “What do you like about coming here?” I ask.

  “The company,” he says, but seems to be thinking about something else he wants to tell me about himself. “I’m the one who laid out the first cloverleaf on a highway in Canada.”

  “You designed it?”

  “No, I laid it out.”

  “So, you built it?”

  “No, I laid it out. I’m a surveyor.”

  Remind me, please. Who’s the cognitively impaired one here?

  Charlotte, the director of the adult day program, shows me wooden nickels they use for a game. “Yes, we’re gambling, but shhhhh. Don’t tell anyone.”

  Around the table, one by one, each person introduces themselves. When Bart says his name, he inexplicably bursts into tears. Charlotte leans over to comfort him.

  Sally, a vivacious woman, speaks next. “I’m from Scotland. A plain, no-nonsense lass am I.”

  “No kidding.” Freda cuts her off. “We know you’re from Scotland. Your accent?”

  “Aye, this lassie loves to be chased by lads in kilts,” Sally agrees.

  Maurice raises his finger, requesting a turn to speak. “I was a supply technician in England during the War. Double-U, Double-U Two.”

  “Oh, he’s been around,” Freda pipes up. “Now, back to me. It was my turn. I’ve been blind since I was ten. I was born with cataracts on the lenses of my eyes. Now they can fix a problem like that. Even when I had three babies in diapers, I cooked and cleaned. I can knit anything that pops to mind. I sewed my girls’ clothes on a sewing machine. Dresses with ruching, puffed sleeves, zippers …”

  Ouch. “How did you keep your fingers out of the way of the needle?”

  “I felt my way along. I had a good sense of where the needle was. My mother taught me, but she died when I was six. My father made axe handles, got a few dollars for each one.”

  This library of human books has it all: history, romance, comedy, tragedy.

  Later, back at the VON office, staff are buzzing with excitement. Up until now, it’s been a secret, but it’s time to make an announcement: Judith Shamian will be starring in an episode of the reality TV show Undercover Boss. She had told me about posing as an entry-level employee, working in a disguise of glasses, a frumpy wig, a dowdy pink sweater, and scuffed running shoes. She looked completely different than her polished chic style and must have played the part so well that no one recognized her. The promo states:

  As baby boomers age, there’s increased demand on homecare services. VON cares for people in their own homes. Once unique, now rival c
ompanies compete for the business. Judith Shamian worries this Canadian institution will be consigned to the history books. She will be in disguise so she can see for herself what’s really going on in the front lines.

  Anticipation is in the air.

  IT’S A BEAUTIFUL DAY IN THE HOSPITAL

  I’VE BEEN ON THIS ASSIGNMENT for two months and so far haven’t faced any emergencies or saved any lives, but even sans adrenaline rush, I’m having a great time. It’s fun being on the road, meeting interesting people, and learning new things. Everyone is so upbeat and positive. Indeed, the world outside the hospital is pleasant. Who knew? But I keep having an uneasy feeling … that what they’re showing me is maybe too pleasant?

  Something is wrong with this picture. There’s a dark side. The ear-worm “It’s a Beautiful Day in the Neighbourhood” plays in my head, more saccharine than sweet. Yes, there’s Audrey, doted upon by friends and caregivers; Ken and Pat coping brilliantly with home dialysis; stalwart Patrick, tenderly caring for Edith – but are they the norm or the exception?

  I happen to know it’s not all rainbows and blue skies out there. I’ve read about elder abuse, burnt-out caregivers, a shortage of home care services and long-term facility beds. Given all of that, why is VON showing me only the sunny side, the success stories?

  Fortunately, I have a few sources to get the inside scoop. Magda, a former ICU nurse, is now a geriatric emergency manager (GEM). She’s agreed to allow me to visit her where she works, in the ER of a big downtown medical centre. (It’s a “bones and groans,” she’d said, meaning a general hospital, and “strictly BBCSs” – bumps, bruises, cuts, and scrapes. “No trauma or anything exciting like that, Tilda, if that’s what you’re looking for.”) But she’ll only meet with me surreptitiously, on a quiet, Sunday morning when no administrators are around. She asks me not to use her real name and looks uneasy about talking with me. I’ve often wondered why nurses are hesitant to speak up. Why are they fearful? Nurses have so much to say but often stay silent. Judith was right about that. Despite her initial hesitation, it doesn’t take Magda long to show her true feelings – which are frustration and outrage. In fact, when I start by asking her about her GEM training, straight out of the gate she explodes with vehemence.