I finished my first clinical rotation at a Nursing Home/ Rehabilitation Facility this week. Just to clarify when I am talking of Rehab here its not substance abuse rehab, its rehab for people with problems of a more physical nature due to the result of stroke, accidents, surgeries etc. This sort of rehab are done in a sub-acute setting. Where the environment is very much like a hospital but there is a lot of interaction with physical therapy, occupational Therapy, speech therapy, dietary intervention etc.
A rather generalize explanation of physical therapy is that it exercise of the below the waist limbs, while occupational therapy is the exercise of the upper body limbs.
So any way coming right to the point. I learnt some very important lessons and this experience made me see my life in a whole new light. The bull-shit quickly gets pushed aside when you are dealing with life at its most vulnerable and fragile every day.
I dealt with people who had dementia at varying stages. Dementia is basically the consistent deterioration of memory. It can occur due to many reasons, Alzheimer is one of the most well-known illness which causes it but there are many others but I wont go into more detail cause this is not a biology lesson. I just want to talk a little bit about what I saw and what I got out of it. As a quick side note, its not necessary that every older person will have dementia it occurs in about 10-15 percent of the population. However, I saw that most people in the advanced stages were not able to do anything for them selves. Makes one appreciate our selves, our independence, the ability to do what we want when we want. Here we keep talking about one bad feature or our weight but if you think about it, what if one day we are not able to move, speak, eat on our own, go to the toilet, scratch an itch. WE are left a prisoner in our own bodies and our own heads full of half finished sentences and foggy memories. It made me appreciate my memories my family more and more and my friends.
Most of these folks old with or without dementia just used to talk of three main things their faith or religion, their parents, their spouses or their kids. That is it, no one talks about their careers which we spend so much energy and time on, no one talks about the big house they lived in or how many expensive things they had, no one talks about the big car and the next big adventure. I saw some kids going the extra mile by coming in to visit with their family member every day and it was mostly children, some spouses also. The children were often but not always the daughter and a lot of times the daughter in laws. When you spoke to them about how their parents had been with them when they were young, the more frequent visitors said they gave them a lot of their time, so this I think was the key the time we spend with our family whether it is our spouse, our parents, our kids. We need to be present in the moment spend it with them. More than the physical presence it has to be a mental engagement. Talk, communicate, play games tell them you love them over and over. Bonding with the kids is all about the care-giving the feeding, the bathing the playing its not just having them in your laps while we work on the computer or watch tv.
On the Rehab unit, it was more a realization of how much we take our body for granted the smallest of things like standing up can become a challenge if just one thing is not working right. So treat your body well, eat healthy, exercise, sleep and have fun.
It was a wonderful experience though, I get this question a lot why Nursing and why a Nursing Assistant who by the way are payed just a little above minimum wage but have to do pretty much all the grunt work on very tight schedules and with limited staff. I can only say it gives me a lot of satisfaction to take care of some one. If I managed to connect with even one person give them some small relief it makes me happy. A lot of times nursing assistants are not being treated with a lot of respect by the patients and by the staff, their work is considered not very fad. But I learnt that the work they do is very important they are ones with the most interaction with the patients and residents, they are the ones keeping the patients clean and fed and they are the first ones to notice if anything is a miss. I had more appreciation for the people around me who are doing the labor oriented tasks. The work a lot of us do not want to deal with and the work a lot of us assume does not require a lot of skill. Yes if you need to take some one and weight them it is not big deal if they are healthy and walk there them selves but if this person is totally paralyzed and really old and fragile the task requires a bit of finesse and skill to ensure the person is not injured by the end of the process.
Most of the Nursing Assistants I worked with or spoke to said that Nurses who were Nursing Assistant are better at handling things and who wont be after taking care of 7-8 patients on one shift where you are the ones ensuring they are clean, hydrated and fed working on tight meal and rehab schedules. An older person and even a patient is like a little child in terms of their needs except they are much bigger and heavier and they are not as complacent and compliant and you cannot scold them into doing things.
So it was a great experience on the whole cant wait to start my next rotation at the hospital.
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