At some point in my career, I had decided to try out facility work. I am normally a caregiver for the mentally disabled. I love this work, because I get to make a real difference in the life of someone who needs help. The idea to try the facility work came up when I couldn't get enough hours for a decent income. Unfortunately, all I could find nearby were facilities for the elderly. Not that the elderly are a bad thing, it was just that I wanted to work with the autistic kids in the area. That was more my specialty. But, life happens and this was where I ended up.
I found that working in a facility for the elderly was entirely different than the individual caregiver work that I had done before. This felt more like herding cattle. At the same time every morning, I would get them up, dress them, feed them, give them medications, whether they wanted to or not. Many would fight it, but state laws required me to be forceful in some cases. This was especially true with those who had developed dementia.
The families of those in the facility would occasionally visit, and during that time we usually just left them alone unless they needed medication. In every facility that I had worked in until now, they were all understaffed, with underpaid workers who struggled to do all of the work in the short period of time that was designated for each chore. Something that really bothers me, is that in a facility that is a 'Resident Assistance' are supposed to only provide 'assistance' in daily activities. This means that anyone who is entirely incapable of even the basic abilities like speaking, or moving their limbs, should not be admitted. They should go to a Nursing Home.
But this is never how it works. The families are so stretched financially, that they go 'shopping' for the best place to put their loved one, for the best price that they can find. So, those who have worse conditions are put into a Resident Assistance facility instead of a Nursing Home where they need to be for the level of care that they need. So the staff are stuck with trying to provide the extra care that we know they need, but are unable to keep up, and sometime legally unable to do so.
In a Resident Assistance facility, the state laws forbid any kind of restraint. This means that we cannot legally restrain anyone for any reason. Now, when we get a resident who is unable to even hold themselves in a chair, or a wheelchair, this means that we are not allowed to put a 'seat belt' into their chair so that they can't fall out. In a Nursing Home, this is legal. Not in a Resident Assistance. So the staff are left with trying to find ways to make sure that this resident doesn't fall out of the chair and break a hip, which could then fall back on them as neglect.
I remember the first facility that I worked in had one of these residents, as well as several others who should have also been in a Nursing Home. I was standing in the dining room trying to feed several people at once. I was standing behind the wheelchair of a resident who could not hold herself up in the chair and kept sliding down. I would have to reach under her arms every 20-25 seconds and physically lift her entire body by myself (this woman was easily twice my weight) to re-position her in the wheelchair so she wouldn't fall on the floor. At the same time, I am looking across the room at another woman who was unable to lift her limbs and feed herself, so she was sitting at the table staring at her food, then looking back at me, and then back at her food.
I felt so horrible for this woman, knowing that I had to choose to either stand behind this one woman and pull her up so she wouldn't fall, or go over to her and help her eat so she wouldn't starve. The other staff were equally stuck with multiple residents, and were unable to help me. So I stood there, lifting and re-lifting this woman in her chair and watching the other woman miss her meal because I couldn't feed her. Legally, this is called neglect. But my choice was either neglect by injury, or neglect by starvation. I would be legally in serious crap for the injury, the starvation I could skirt off without getting in trouble.
Granted, this woman was going downhill pretty fast, but I am 100% certain that I had a few days window to get enough food in her to keep up her energy enough to live for a few months longer, and I chose the safe rout for myself because I would have been in serious legal trouble if I had left the other woman to fall. I am also 100% certain that all of the other staff had to do the same thing, in the exact same situation as me. So, combined I am not sure how much we were actually able to feed her. She gradually weakened, and then died in her sleep.
After I had quit this facility, I had moved on to a different one across the road that had a better limit on the state of the residents, so that they wouldn't be impossible to take care of. There was only one resident that made things difficult, but the facility allowed it because she was a 'private pay' customer. This means that she was paying the facility out of pocket cash in order to live there because they were afraid of the horrors of the nursing homes. This was okay and it didn't bother me much, until she started to decline and her dementia made it hard for her to eat. She had CDIF, which meant that she was quarantined in her room, so we would bring her food to her room.
So one day I brought her breakfast to her room, and set in down on the tray in front of her. She just looked at it, and then looked back to me and started talking to me. I kept trying to re-direct her to the food in front of her, but she couldn't focus long enough to get the food onto the fork and into her mouth. Her dementia had progressed to the point where she couldn't remember to eat the food in front of her. I had other chores to do in a very short time-frame, but I was damn determined not to let the same thing happen to this woman that had happened to the one at the other facility. I sat down and spoon-fed her myself, making sure she ate every bite.
I was written up for neglecting my other duties, and leaving the work to the other caregiver who was forced to pick up the slack, on top of her other normal duties. She was pissed, and had a good reason for it too. It took me an extra 20 minutes to feed this woman, when I was supposed to be helping all of the other residents back to their rooms after their breakfast. This meant that ALL of the other residents were left to the only other caregiver on staff at the time.
After that, every morning I would take her tray to her and feed her a few bites, then go back to the dining room for a resident and take them back to their rooms, and on the way back to the dining room I would stop in her room and feed her a few more bites. This slowed me down significantly, to the point where I was getting complaints from both the staff and the other residents who had to wait for me. But you know what? She recovered enough of her strength back after the period of getting so little to eat, that she was able to recover from the CDIF and her cognition improved enough that she was able to eat by herself again.
Her family was so worried that she wasn't going to make it, that they had all come to visit her to say goodbye. When she suddenly bounced back 2 weeks later, they were all astounded. I remember her daughter was with her one morning as I brought in her breakfast (no longer needing to stay to spoon-feed her) and she had said, "This was the work of God, who saved my mother." I knew that she didn't mean any offense by it, but I couldn't help but think "No, God didn't save her. I did. And with plenty of time, effort, pissed off co-workers, and write-ups."
It was a sudden moment of horror when I realized that the facility was actually encouraging us to allow the residents that we couldn't handle, to die. As I stood in front of the family of the woman I had been determined not to let starve, they showed their grief at the near-death of their loved one, and their gratitude at her pulling through against all odds. They had no idea what actually happened, and they probably never would.
This moment of horror made me quit. I knew I was better off working as a 1-on-1 caregiver for the autistic kids. They aren't cattle. What I do for them is more personal and more appreciated. Anything that I do that produces positive results is accepted, and I get to actually help them, instead of forced to neglect them. I obviously was not fit to work in this kind of environment, and was not able to adhere by the rules. I know that I could have responded differently, better than I had, and I wish I knew what the best way to handle these issues were, but I can't turn back time to try again. These issues were daily, not just the ones that I wrote about here. There were incidences every single day that I was forced to work with, and witness others doing as well, that I had no ability to change. I had tried complaining to the higher ups, but they pretty much just ignored me, or told me to deal with it because that was state law. What else could I do?
