The Real World

Part five

Out Tardis has landed and we find ourselves in 1994. Still on Planet earth. I did set the controls for the heart of the sun but no dice.

It is Easter time and apart from doing the odd paper round I have been unemployed for about nine months. Skint in other words. No benefits, no allowances, no savings. What happened to all that tax I had been paying for years? Not eligible pal. On your bike. It was the worst of times and the worst of times. National was in power, Jim Bolger was PM, Ruth Richardson had the finance portfolio and Jenny Shipley loomed like the wicked witch of the west pointing her stick at Bolger and giving him the shits. In 1997 she rolled him. From that point onwards the coalition with NZ First, created after the electoral reforms of 1996, started it’s downward spiral towards the election of Helen Clark in 1999.

But none of the above meant anything to me in 1994. My mantra was ‘gizza a job…..I can do that”. Finally I knew Yosser’s pain. Your feelings of desperation are directly in proportion to the duration of your unemployment. Well at least I would be able to look actors in the eye and say “I get it”. Not that I would be looking actors or anyone else in the eye. I made a point of avoiding most of my former colleagues in the TV Biz. My close friends were almost entirely removed from that sphere. Lucky for me that I received moral support from those friends. So I was not alone. I had Teresa and I had my mates. But occasionally I felt humiliation and shame because of my position.

However, I have to own up to having some responsibility for my predicament. From this distance I can see that it could all have been handled differently but in those times I was a fairly volatile character with a pretty short fuse.

It was not the first time I had put my own pot on. Too much compromise is not a good thing either. So, there you go.

But soon I was to find myself in a job which knocked most of my narcissism for six.

One day Teresa showed me a job advert for a ‘recreation officer’ at a hospital and care home for elderly folks.

It didn’t look like a good fit for my previous experience but I was desperate to work. I talked myself into it and applied for the job.

My interview wasn’t great but the people who did the interviewing were very kind and considerate.

A few days layer I got a call from the Principal Nurse to say that I had not been successful but it had come down to me and one other applicant but she was a qualified occupational therapist and of course the job went to her.

I then made a bit of a punt and said to the nurse “what if I were to come and work there as a volunteer for two or three days each week? How would that go?” She was quite keen on that idea and so some days later I reported for ‘duty’.

I want to say at the outset that it is my intention to protect the privacy of the patients (or residents as the chief nurse (Matron in old speak) refered to them. The staff also have their right to privacy and the name of the hospital will not be mentioned. I formed a bond there with many residents and staff. That bond exists to this day.

Of course all of those residents have long since passed away. The hospital closed a couple of years after I left and the few surviving residents were transferred to other facilities where they all died within a year or two. Suddenly finding themselves in strange surroundings with carers they did not know just made them give up I suppose. It was a cruel business and the Christian charity which ran the hospital did it because they could no longer afford the level of care which the former head nurse had insisted on. She was a true Christian and had dedicated her life to those old folks. When she left everything went downhill quite quickly with drastic consequences for the residents. The board of that trust betrayed those people (In my opinion). The ‘Christian’ ethos of that board was suddenly found to be wanting in it’s charity. Maybe some board members did demur but in the end it was a painful time for those older folks.

But back to our story.

Most of the hospital staff were Samoan people with a few registered nurses (mostly Palagi) supervising shifts. The kitchen and cleaning staff were all Samoan. Usual story, Pasifika people at the bottom of the heap doing extremely hard physical work for lousy pay. I hate the way our society is stratified in a way which disadvantages those in the lower layers. Today many Pasifika people no longer have to do shit jobs due to their self improvement through education. Their place has been taken by new immigrants and refugees often escaping from appalling conditions and persecution in their own countries. Of course those new chums are exploited, sometimes by their own people sadly. It’s no fun being an immigrant. At times you feel so alienated in your early days because you feel that you are on the ‘outside’ of everything. For someone with brown skin and poor English it must feel overwhelmingly difficult to fit in. I feel sadness for those people. I don’t know what the answer is but each of us can help by showing understanding towards people who are struggling. Fortunately, most New Zealanders still have that innate kindness towards others in difficulty. But what does the future hold with the rise of the political right?

Meanwhile…..back at the hospital I was being initiated into the world of ‘geriatic’ care. I worked three mornings each week and usually finished after the residents had finished lunch. Most required assistance when eating or drinking and all staff helped in that work. I found that aspect of work uncomfortable at first but soon grasped the salient fact that it wasn’t about me but all about the patients and their needs. Object lessons abounded in those first few weeks.

My supervisor was the occupational therapist with whom I had vied with for the job. It soon became obvious that she was a complete professional, highly organised and very dedicated to her work. She was also a very decent person to deal with and never acted ‘the boss’. We became good friends and she was generous in sharing her knowledge. I still feel grateful for her kindness towards me.

We had a fluctuating number of residents. The roll varied between 35…..40. Many had little or no mobility and some suffered from the result of massive strokes and/or severe Parkinsons. Quite a number had developed advanced Alzheimer related dementia. These last were hard to communicate with but they were not left out of the recreational programme just the opposite in fact. The whole existence of the hospital was predicated on compassion for others.

My boss the occ. therapist had devised a programme of activities that was inclusive and everyone could take part or just be there. It was a helluva lot better than leaving people in their rooms with no stimulation at all. We had crossword puzzles from the daily paper(Dominion) which a few residents could participate in at a good level of involvement. I would make a grid on a large blackboard which everyone could see clearly. People who had been immobilised by stroke or Parkinsons could still take part. Their brains were in good working order and they were often really good at solving puzzles. They came from a wide variety of backgrounds. There were Olympic swimmers, mountaineers, lawyers, schoolteachers, Professors of science, musicians, artists, diplomats, shopkeepers, homemakers, chefs, even one big game hunter. None of these people were going to be ‘cured’. The home was a last stop for them except in occasional cases where family would have them transferred to another rest home or hospital.

We also did outside activities using mobility taxi vans. That was hard yakker. But it had a very good effect on the people who could participate. The hospital had a big section out the back which was grassed over and on fine days we could wheel a lot of the residents out there to get some sun and air. Also, those who liked to have a cigarette or a drink could enjoy those things outside under a big canvas gazebo. Can’t imagine that happening today with all the restrictions around nicotine and alcohol. But if you are seriously incapacitated by illness what does it matter if you have a smoke or a drink? That was the Principal Nurse’s opinion and I heartily agreed. Very few of the oldies did smoke/drink but those who did were catered for. Hooray for common sense and compassion!

When I read this back I can see that I am sounding like I had things under control. But the truth is that I was way out of my depth. Nothing had prepared me for the pain and suffering of the residents and their families. The practical business of looking after all the needs of people who are not able to help themselves is quite overwhelming for the uninitiated. For the experienced it is just another day and they are able to get on and do what has to be done and that is to the benefit of the people under their charge. You have to hold your nose, literally, to be of use to the patients. For me it was a big wake up call. But I did learn after a while to forget my own bullshit and get on with what had to be done. The hard work of toileting, bathing and showering and dressing was mostly done by the nursing assistants i.e. the Samoan women working for a pittance. They showed amazing love towards those old people and treated them like family. I cannot say enough in praise of their efforts. My job, such as it was , did not compare even remotely to what they achieved each day. And they were very welcoming to me and accepted me as one of their own. On one day each month they organised a feast of Samoan dishes. I was invited to attend on condition that I wear a Lava Lava and some flowers on my head. I was quite happy to do so. It was lovely and loving. Tight assed Europeans could learn so much from Pasifika.

Each morning after breakfast the patients who were not confined to bed were showered and dressed and wheeled into the living room all spotless in clean clothes and looking forward to some recreational activity from the Recreational Therapist assisted by yours truly. One afternoon each week we had a musical session with the piano played by a lady who was a very good musician. We all sang along to the songs of the thirties and forties which I knew from listening to my mother as she worked around the house. Those music sessions were magic and easily the highlight of the week. The olds were transformed by the music, singing along where they could and keeping time with their hands. I loved it and sang along with gusto. Their truly is a great healing power in music. My outlook was taking a turn for the better. No more bitching about ‘my lot’ and crying into my soup. Bless those oldsters they gave me a great gift.

So the year toddled along with me learning something every day. Towards the end of the year my boss told me that she had applied for a job at The Foundation For The Blind. It was a senior role with national responsibility and as a young careerist she had to go for it. What to do? Well I applied for her position not thinking that I stood a chance of succeeding. But bugger me, the Principal nurse chose me and suddenly I had a JOB with PAY. Hallebloodylujah. And what a difference that made to my life. Teresa was delighted of course. She heartily approved of my move into a foreign field and a whole new bag. Teresa had never really rated my broadcasting career. It seemed to her that the culture of Television was brittle and insincere. It was very common of course for people in that biz to sometimes be at odds with their partners over the merits of what was seen, by people on the outside, as a ‘show off’ business. A tension that never really gets fully resolved. There is a certain amount of truth in the outsider observation but I have mostly only praise for my former colleagues in TV. Anyway I was too busy enjoying my return to the land of the waged. How great to be in the supermarket wine section and be able to raise ones sights to the higher shelves instead of gazing down at the floor and contemplating the cheap plonk. It’s the little things, you know.

And now armed with my whole nine months experience in the caregiver field I entered into my new job with much trepidation and quite a bit of hope. I decided from the start to assist the residents to enjoy life as much as they could without acting like an over enthusiastic PE teacher. My benchmark was simple. How would I like my own elderly mother to be treated in these circumstances? A no brainer really.

I worked at the hospital for about six years from 1994-2000. Bittersweet experience? I guess. But the old tropes wont do when attempting to describe my experiences. My life and outlook were certainly transformed. Again I can’t put a number on it. No Road to Damascus I’m afraid. More of a glacial osmosis seeping into your being. After a couple of years my former life had slipped into the B/G of my consciousness and I started to feel that I would never go back. Just a matter really of making up your mind to live a simpler life and learn to exist on less. It’s very doable. And quite a relief. In a way I guess it was a sort of escape and a hiding away. But there were many compensations. Often a feeling of tranquility and peace as I worked with the olds and gained their confidence. On one occasion there was an intrusion from the past which threw me a bit. It was after morning tea and I was setting up the crossword. The television was on but no one was paying much attention to it. A musical theme suddenly blared out from the TV. It sounded familiar so I looked over at the set. It was playing an episode of ‘THE BLACK STALLION’ a show I had done some direction on. My heart sank a bit. It was one of my episodes. Something I had done about three years previously. My name came up on the screen as director and I felt a great shiver of mixed emotions. I looked around the room. No one was watching. I went over and switched off the box. We carried on with the crossword. Nothing to see there. Now I could feel how much my life had changed. It was nearly all good. No dramas (no puns).

During the next few years I became more proficient in the work and consequently became more useful to the residents. Did the experience change me? I don’t know. Did I learn any profound truths? Don’t think so and if I had learned any such it would be reduntant to attempt an explanation as these matters are by there very nature difficult to put into words. I am reminded of the person who wrote to a great philosopher and said “Since reading your book on humility, I have become so humble you would hardly believe it.”

If you can bear with me perhaps I could mention some observations which flitted through my noddle during my time at the hospital.

Here is a general remark which is mundane but nevertheless true. Everything you might assume about the mental condition of the greatly afflicted elderly is most likely to be inaccurate. Even people who appear to be withdrawn and silent and grievously physically afflicted and have been so for some years, are still very much alive and are listening to you speak and oftimes watching you operate. Most remain silent but you can deduce their true state by the example of those who suddenly come out and make their existence very much felt. Here is one story which I think makes the case. A resident (female) who had been silent for some years but who previously was given to occasionally repeating the arithmetic tables ad nauseam until one of the other residents would yell out “for fucks sake shut up “ much to the amusement of the staff and others, suddenly spoke to me in a clear, rational and knowing tone of voice. I had just recently bought a new pair of shoes which were very comfortable and rather smart looking and I was admiring the footwear and generally feeling good about my purchase. Out of the blue (but actually from my direct left) a voice said “You are looking very pleased with yourself.” That’s a very nice pair of shoes you are wearing.” Of course it was the previously silent woman. I was totally surprised but also happy to hear her talk. “Thank you,” I said. Hoping that she might speak again, but she looked directly at me and only nodded then fell into her usual silent state, head down and eyes closed. (She never spoke again and died about three years later.) I often spoke to her after that but no result. From that time I had a changed view of those who remained silent. How many were listening? So I started to talk to people without being interrogative. I wasn’t trying to get a response. If there was a chance they could hear me it was worth persisting. Who knows? When the lady I talked about above was dying she had been shifted into the ‘quiet room’ and staff members could go and sit with her so that she was not alone. I was sitting by her bed occasionally speaking but mostly being quiet. She was a great fan of Bing Crosby and her family had given us some cassette tapes of Bing Compilations. I swear she was at peace listening to that music. Looking quite serene in fact. But then there was a complete change. She looked like she may have died. I had never been with anyone at the moment of death and I was deeply affected by the change between the two states of life and death. Something that was present just moments before seemed to me to have vanished. I can’t say anything more about it. The nurse arrived after I had rang the bell and confirmed that our friend had died. I had become accustomed to death at the hospital. It was a pretty regular occurence and it was accepted without great fuss but also with respect and regret at the loss of people we had come to know over their final years. It was a part of my job to attend the funerals of our residents and to offer some condolence to their families. I attended lots of services in a wide range of religions and secular beliefs. Got to know a lot of undertakers. Quite humourous people in the main. But not disrespectful about the dead. One guy I often came across at services and memorials was a retired Anglican vicar who more or less said the same thing at every event. He had a script which he gave me a copy of, plus he gave me his card and suggested I gave him a call when their was a funeral in the offing! I didn’t call him you will be glad to know. But that was the 90s in a nutshell I guess. The hustle was in.

I went on a few of courses for people in the care business. The courses were usually held in a rest home or care hospital and I met some other recreation/Activities people. Many were super organised types with clipboards, lists and lots of blue pencils. Busy busy busy. Their systems were necessary for the facilities they worked in which were often quite flash and the residents were mostly compos mentis. The polar opposite to my place where the residents didn’t need organising but rather required someone to be with them every day until that person became a familiar and trusted presence who was their just for them. The principal nurse who agreed with my approach once said to me that my methods were very different but they seemed to work. Ok then, on we go.

Their was quite a lot of literature published on the subject of elderly care and I read up on those bits which related to dementia, Alzheimers, etc.

One publication had put out an article on a process called ‘Validation’ which was new at that time but had already produced good results. It was common then for people to correct an elderly person when they got something wrong when identifying a relative or as was more common completely failing to recognise a close family member.The validation approach was to never correct people but instead carry on as if all was ok. That patients reality is as real to them as your own reality is to you. By contradicting the patient you are throwing doubt on their very existence and causing them to have anxiety and fear about their present situation. They know something is wrong but do not have the mental tools to rationalise what that something is. Much confusion often results with bad outcomes for the elderly person. When you validate someone you simply recognise their reality and personhood. Not too much to ask, is it? None of the above was complete news to me but I could not have couched it in the language of medical researchers. Of course in today’s care environment the validation approach is now mainstream. So if you are visiting a care facility and your elderly relative mistakes you for their father or uncle just go along for the ride.

I once had a longish conversation with a resident who knew me well but on this occasion had shot back to the 1930s and started addressing me as their brother who had had a chemist shop up in Napier which had a flat above the shop which the brother lived in. She asked me if I had managed to sell the shop and was I still living in the flat. I affirmed all that and much more besides. Eventually she became tired but looked content with my story and suddenly went into a peaceful sleep. That same woman told me a story about where she was when the Napier earthquake struck. She was in Willis Street Wellington having just had lunch when someone told her about the quake and her greatest concern was about that same brother whom I had stood in for. The patient could move between realities with ease and appear perfectly rational in both scenarios. A copybook example of validation in practice.

Here is another wee story about something which I had observed in my time at the hospital.

Many of the elderly in care homes are unhappy and quite grumpy at times. Some look tortured and bitter as if they are nursing some painful memory. On the other hand many are peaceful and almost in a state of blissfulness. The split between the two groups is roughly 50/50. I was curious about this so decided to read up on it. Sure enough there was a research paper. The researchers had concluded that those patients who were in some sort of nirvana had resolved all the conflicts in their lives before dementia had taken hold. In other words, they had forgiven the past. The other fifty percent had held on to their grieveances and when dementia struck no longer had the tools to resolve their conflicts. It sounds awfully neat I know but when you see it apparently in operation you can easily concur. Big heads up to us all. I have tried to live as if it were true, not always successfully as I would have liked but the motivation is there and you get better at it as time goes along.

Take it or leave it.

Almost time to say goodbye to the hospital episode.

I was there for about six years and in that time I learned an awful lot about myself through experiences I never dreamt were possible. My previous life seemed to disappear into smoke and my whole pattern of thinking changed. For the better I think. Those residents who could read and talk became friends whom I bonded with and still remember fondly. R.I.P. But the memory of all the residents remains with me. It wasn’t all pain and suffering there was also laughter and fun and good days. On one memorable occasion we took 16 of the residents to Repertory Theatre in Wellington for a special musical show. The performance was put on for the residents by some enlightened person at Rep who issued the invitation. We hired a fleet of wheelchair taxis and the whole staff got mucked in. It was a huge success. Even those residents who were severely incapacitated looked intently at the stage which was bathed in light and colour whilst the performers danced and sang. We were all completely buggered afterwards but it was more than worth it. That night all the residents who took part went to bed very early and slept through the night. A great memory for me.

By the year 2000 the hospital was skint and run down. A few staff were made reduntant including myself. I didn’t mind. I was feeling more than a bit burned out. Too much grief and suffering will do that. I went back afterwards to visit the few remaining residents. About four of them I think were there when I first started. The survivors. Later on they were dispersed to various hospitals where I would visit them usually on a Saturday. Eventually of course they all died and that ended my association with the world of the frail and elderly. Bless them. Hope I have done justice to their memory.