by Tilda Shalof
Alton looks over at Gwyneth, sitting in her throne chair, watching us and listening to our conversation. “Queen Gwyneth,” he says, blowing her a kiss.
“I’m leaving this chair behind,” Gwyneth tells me of the comfy chair she’s sitting in. “I’m only using it now, until I am returned to the Lord.” She has a banana in her hand, holding it like an ice cream cone. Queen Gwyneth, ensconced in her throne, well cared for, at peace, with no regrets, only memories of a full life lived in accordance with her beliefs. She smiles at her banana, peels it slowly, takes a dainty bite, and looks up to give me a wink goodbye. “God bless,” she says, reaching out to clasp my hand.
Ruth is the last to give her endorsement of the Oasis. “I love living here. It’s not a nursing home and you get more help here than you would in a retirement home. We all know each other’s business and check up on one another. We’re family.”
As I drive to my hotel, I think of Audrey – and her opposite. The opposite of Audrey McClenaghan is Joyce Vincent. A year or so ago, I saw a documentary called Dreams of a Life and Joyce’s story has stayed with me ever since. Camera shots of the yellowing newspaper headlines told the story: “Woman Dead in London Bed-Sit for Three Years” and “Skeleton Found on Sofa with Telly Still On.” Only thirty-eight years old when she was found dead in her one-room flat in London, England, Joyce had been full of life, accomplished, and beautiful. In a photograph she looks like a young Whitney Houston. At one time, there were people in Joyce’s life – a former boyfriend, co-workers, sisters, other tenants in the building. Had she withdrawn from them or had they abandoned her? How does someone die – poof! – and no one notices for three years?
The cause of Joyce’s death remains unknown, but foul play has been ruled out. She’d been living in subsidized housing, didn’t drink or do drugs. When the apartment was finally opened, her skeletal remains, intact and upright, were found on the sofa. The TV was still on to the BBC news, an unopened Christmas present lay on the floor beside her, a pile of mail had built up inside the front door, there were dishes from her last meal in the sink, the window was open, curtains flapping in the breeze, insects and cobwebs had taken over, and there was a thick layer of dust everywhere. It’s one of the saddest stories I’ve ever heard.
By the time I make it to my hotel it’s ten o’clock, and I’m beat. Hungry, too. I’m tempted to indulge and order that room service I was fantasizing about, however, on VON’s tab, I can’t bring myself to do it. I’d feel like the Canadian member of Parliament who was outted for staying at a ritzy hotel and spending sixteen dollars of taxpayers’ money on a glass of orange juice, and was forced to resign in shame. I pick up the phone and order extra-spicy chicken wings and a Coke. With my coat over my nightgown I go down in the elevator to the restaurant to pay for it myself and bring it back to my room. Self-service is always best.
1:00 A. M., NOTE TO SELF
No more chicken wings!
(At least, not after midnight.)
SMILE
SOBER-WASTED. That describes the state I’m in this morning. After a restless night, I woke up queasy, still recovering from my late-night wing fest. It’s seven o’clock and somehow I’ve managed to drag myself to the local community centre where I’m now busting a move on the gymnasium floor with Gladys, Delphine, Millie, Harvey, and Werner. Twistin’ and jiving, we’re moving to the beat with Ken, our SMART instructor, who’s not too hard on the eyes. For Seniors Maintaining Active Roles Together, you have to be fifty-five-plus to qualify. I’m not quite there yet, but they let me in.
“I hope I can keep up,” I joke.
“Don’t worry, dear, just go at your own pace,” Millie says in all seriousness.
We grapevine and do-si-do to Harry Belafonte’s “Day-O” and the Bee Gees’ “Stayin’ Alive.” Last time I heard that song I was working in the ICU, caring for a patient whose condition was deteriorating. The song came on the bedside radio my patient’s wife had put on earlier that morning. The unfortunate irony was that her husband was struggling to do that very thing. The wife and I glanced at each other, acknowledging the truth of those words. Come to think of it, “Stayin’ Alive” is also the tune we play in our head while performing CPR on a patient during a cardiac arrest. The beat of that song’s tempo helps us pace our chest compressions.
I’m in yoga pants and a plain black T-shirt. Wisely, I decided just before leaving my hotel room to change out of my colourful “No More War” T-shirt, emblazoned with a huge peace sign. I didn’t think it would be welcomed here, in Trenton, a military town and home to the headquarters of Canada’s largest air force base. Here, you see khaki camouflage and military personnel everywhere you go.
Trenton is also a down-home sort of place, with local eateries like Granny’s Kitchen and Momma’s Diner. A vintage sign says “Kentucky Fried Chicken,” not KFC, the acronym now used, no doubt to mask the mention of grease. Downtown Trenton has one main drag, with businesses like Scrapbook and Smiles, a Dollarama, and a diner boasting the “Best Caesar Salad of the Season.”
After exercise class it’s time to visit the foot clinic.
Feet, it turns out, are a big deal. Who knew? In the ICU we don’t pay attention to feet unless they’re impressive: black with necrosis, red from inflammation, green with pus, or about to fall off for one reason or another. I’ve seen some gnarly feet in my day – mottled and dripping, scaly and lizard-like, even mummified, shrivelled, and flaky as parchment. Don’t get me started.
Wally is Nurse Janet’s first client. He settles into the chair, puts his feet up, and is pleased to have the attention of a “reporter” like me.
“If you’ve got a foot fetish, this is the place to be,” says Wally, a jovial, burly, healthy-looking gentleman in his seventies, here for his six-month foot checkup. While Janet examines his feet, Wally doesn’t waste a moment and launches straight into his life’s story. “I’m a retired cop and I’ve been on a twenty-six-year vacation from liquor. I’ve taken a permanent holiday from the stuff.” He makes abstinence sound delightful. “For years, my beat was downtown Toronto. I patrolled those mean streets for years and survived to tell the tale. Once I got in a brawl with an Asian prostitute who kicked me and knocked the cartilage out of my knee. She was all hopped up on drugs, along with another hooker – a black chick – and their Gino pimp.”
What the relevance of the ethnic background of these characters is, I don’t get a chance to ask, because Janet wants to tell me about her work and the standards maintained in this clinic. “We use sterile instruments that have been autoclaved. That’s gold standard. Others may use antiseptic, but it doesn’t kill everything.”
“ ‘Put your lawn mower up for sale,’ my doc told me,” interjects Wally. “If that’s what a heart attack is, I’ll have one every day. A twinge of indigestion, was all. Now, I take it easy.”
Janet digs in between Wally’s toes, gets under the nails. “How do you manage to wash your feet?” she asks him.
“I nailed a face cloth to a stick and use it to get down in between my toes,” he says with a grin. Janet recommends a fungal spray, which will be easier for him to use.
“Wally has normal, healthy feet,” she pronounces. “Beautiful feet.”
“It must be from walking on sandy beaches. I’m a snowbird.” Wally is one of those retired Canadians who escape to Florida for a certain number of winter days, careful not to overstay their sojourn and jeopardize their coveted health coverage.
Janet shows me her equipment. “We use heavy nippers. No grinding tools because they aerosolize any nail fungus that’s present.”
Discretely, I move my coffee cup out of the trajectory of any flying fungi.
Another client waiting for Janet’s magic hands motions me over. “I want to tell my story, too. Don’t forget about me. I don’t want to get left out. And please use my real name – Fred Carson, by the way.”
No concerns about “privacy” here, I see.
“It’s Betty’s turn,” Janet tells h
im. “You’re next, Fred.”
“So pipe down, Fred, and take a number,” Wally calls out from the sidelines.
Betty takes up her position in the feet seat, moving slowly and cautiously. She’s a plump woman in her sixties who looks worried.
While Nurse Janet works on her feet, Betty talks to me. “Janet always tells me I have to be more careful, take better care of myself. I’m a diabetic and have almost no feeling in my feet. Once, Janet pulled out a pin that was stuck in my toe. I didn’t even know it was there. Didn’t feel a thing. Trimming my nails is impossible because I can’t bend down.”
(Now that I think of it, there was a memorable “foot” incident in the ICU. I can still hear the surgeon bellowing, “Will someone wash this woman’s feet?” The patient’s nurse informed him about the provenance of the deep grooves and dark striations in her patient’s feet. “This woman is from India and has worked barefoot all her life in the rice fields. Her feet are not dirty.” Not the least bit chastened, the surgeon stormed off.)
Nurse Janet remains focused on the foot at hand, Betty’s.
“People think all we do is a leisurely pedicure, but professional foot care saves legs and is a lot cheaper than admitting them to a hospital for an amputation. Many elderly can’t even reach their feet.”
“It’s quite a feat!” Wally quips from the peanut gallery.
(I guess he’s staying to hang out, like in an old-school barber shop.)
“You can tell a lot about a person’s health by examining their feet.”
“Oh, the agony of da-feat.”
(Guess who?)
“Once, I noted a client had foot drop and other neurological changes in just one of his feet,” Janet recalls. “I was concerned, so I alerted his physician, and good thing I did because it turned out the man had a spinal tumour. He had surgery and is all right now.”
“That’s impressive detective work,” I say.
“Make sure to use my real name. Wally Smitherman. I’ve got fungus on my left toe and my big toes are gouty. Tell the world. I don’t give a hoot about privacy.”
“I’m not sure your story will make the cut, Wally,” I tease him. “My readers need more excitement than your healthy feet.”
He looks bemused while I return my attention to Janet, who’s talking radial pulses and pedal nerve innervations.
“Don’t forget about me,” he warns.
“How could we?” I assure him.
“I don’t paint my nails. The reporter can quote me on that, also,” he tells Janet.
“Duly noted, Wally,” she says, then explains to me that clients pay a small fee for this service.
“Believe me, it’s worth it,” says Wally. “I wish I got paid for every bad guy I caught.”
“We have a travelling clinic and do home visits for people who can’t make it here.”
“I’ll miss you, Janet, when I’m in Florida.”
Fred has been waiting patiently and, finally, it’s his turn. He wants us to hear his whole story, not just about his feet.
“I did three tours in Germany during the war in the air force. I didn’t want to sit in the slit tranches and couldn’t swim, so the air force was for me.”
“Veterans are covered to receive this service and it’s free for those who can’t afford to pay,” Janet explains.
Fred uses his cane to slide his socks off. He can’t reach his feet either.
Janet palpates his ankles. “Your ankles are swollen. Are you on a fluid pill?”
“Only a baby aspirin every second day.”
Janet listens to his chest and hears bilateral crackles so she calls the doctor. Based on her findings, he orders a diuretic over the phone and a follow-up visit to his office tomorrow.
“Merry Christmas,” Wally calls out as he gets ready to leave.
“It’s only September,” Betty says.
“Every day is a holiday when you’re retired.”
“I love feet,” Janet says, going over to give Wally a goodbye hug. “And the people attached to them.”
Deborah is a manager of the home care workers. She outlines their role, which is to prepare light meals, assist with personal care like bathing, showering, and dressing, and to help clients with their meds.
“They administer meds?” I ask. “Is that safe?”
“They are only allowed to cue them to take their meds, but if there’s a concern or a change in the clients’ health, they will call a nurse. Home care workers have different levels of education. It’s difficult to find good ones. Let’s face it: Who wants to work hard, deal with yucky things, cope with demanding, fussy people? Some are young and too good-hearted. If they see there’s not enough food or clothes, they want to buy them, but they have to learn to set limits.”
Deborah introduces me to Kendra Phillips, a home care worker who is on disability due to a work-related injury. After talking with Kendra for a few minutes, I get the feeling she’s someone who struggles with those boundaries Deborah mentioned. In her twenties, with a short pixie cut and a sad face, she’s been on long-term disability for the past few months. “I was helping a senior in the bathroom and he started to fall. We’re not supposed to catch them, just guide them down to the floor, but he had cancer and was fighting a big battle, so I caught him. Immediately, I felt something tear in my shoulder.”
“I can see you’re in pain. What happened to the patient?”
“He passed away a few days later.”
With her good arm, Kendra repositions the injured one, and winces from a sudden nerve spasm. “I feel guilty being off and not being there for my clients.” Her eyes tear up. “I love my job but I have no idea when I’ll be able to work again. My husband was an abusive control freak. I’m better off on my own, but I’m scared because if I can’t work I have no idea how I’m going to support my two kids.”
She doesn’t move much or turn her neck. I’m an accurate detector of malingerers and embellishers, and I don’t hear a ding, ding, ding around Kendra. Her pain is real and severe.
“VON has given me office work to do, like filing with my left hand, answering the phone.” She stops to dab at her eyes. “Forgive me …”
“You’re in pain.” She nods, grateful that I recognize her suffering.
“I went back to work too soon and re-injured it. The thing is, I love my job. I love caring for seniors, especially ones with Alzheimer’s or dementia. There’s this one lady who has beautiful skin and it kills me that I’m not there to put her cream on her.”
She tells me about another patient, one who had a big impact on her.
“She was a creature of habit and I learned those habits. At first she was difficult and cranky, but I didn’t ask to be removed from the case. Eventually she told me, ‘You are like one of my daughters.’ But that made the daughters jealous. ‘Mom’s all yours,’ they’d say to me. ‘She only wants you anyway.’ My client had these bad panic attacks and I was the only one who could talk her down. ‘Take deep breaths,’ I’d tell her. ‘I’m here with you.’ The day she had a stroke, I was there with her. She had told me many times she didn’t want to be resuscitated in the event of something like that, but I didn’t know how to make her comfortable. So, I called the ambulance. I told them she was a DNR and they listened to me. I kept telling her, ‘stay with me, help is on the way.’ When she died the daughters didn’t let me come to the funeral. That hurt.”
Kendra prides herself on her personalized care. “For one client, I used to always pick up her favourite treat – a walnut crunch doughnut and double-double coffee from Timmie’s. I like to get to know their likes and dislikes. When I first meet a new client, I ask, ‘What do you prefer I call you?’ I took care of a Hélène who wanted her name pronounced the Quebecois way and got angry when anyone said Helen, the English way. People my age are used to speedy communication, so I make sure to slow down when I speak to seniors.”
Next, I meet Mallory Freeburn and Leala Pardy, nurses who teach home care workers like Kendra. M
allory is mellow and sweet with frosted blond hair and Leala is tall and wears all-black; she has an edgy, rocker-girl vibe. They operate as a tag team and seem like they’re longtime BFFs, but they’ve worked together for only a year. They speak in a rally of sound bytes and I sit back and listen to their verbal volleyball.
“You have to become what they need you to become,” Leala starts off.
“But at the same time, encourage independence,” Mallory joins in.
“It’s challenging and not everyone is capable of it, but that’s what’s required.”
“In the hospital, if you spend time with a patient, you’ll get behind in your work and the other nurses will think you’re lazy.”
“Yeah,” says Mallory. “I worked in a hospital and it was a bad experience. I’ll never go back.”
“I don’t like hospitals, not one bit,” Leala agrees. “The white rooms, white coats. It’s stressful for staff, patients, family, and sooo political. They say you’re part of a team, but as a nurse, I never felt it. In home care, you really are part of a team.”
“Tell her what happened to you, Mal,” Leala says. “Wait’ll you hear this,” she says to me.
“It was traumatic. I worked in a hospital dialysis unit and was under the microscope because I am a practical nurse and they were all registered nurses. They bullied me because they felt I might take their job and replace them. It even made the local newspaper. Eventually, I stood up to them. Now, I don’t tolerate bullying in any way, shape, or form.”
Leala smiles at Mallory and gets back to describing their job, teaching home care workers. “We teach them tact and diplomacy, because sometimes you go into a client’s home and they’re in a bad mood or uncooperative. They’ll say they don’t want a bath, but the smell tells you they need one,” Leala says.
“Some ask to be taken to the liquor store or to buy lottery tickets or cigarettes,” Mallory adds. “Some can be abusive, even request sexual favours. We teach the workers to be clear about what they are there to do.”
