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July 16, 2009
MetroWest CARES, the Committee Addressing Resources for Eldercare Services, is coordinated by United Jewish Communities with support from the Healthcare Foundation of New Jersey; CARES brings together professionals and lay leaders from MetroWest agencies that provide services to older adults. Each month, a MetroWest CARES agency presents an educational column on an eldercare issue; this month’s article is presented by Dr. Joshua D. Schor, MD, medical director for Daughters of Israel in West Orange, and is excerpted from his book, The Nursing Home Guide: A Doctor Reveals What You Need To Know About Long-Term Care.
Several years ago, I read a newspaper story that has stuck with me for a long time. It concerned an elderly Arizona gentleman who had been a felon for much of his life. For some years he had gone straight but owing to desperate finances, very bad health, and perhaps an unflagging criminal bent, he held up a convenience store from his wheelchair at age 92. His getaway was none too swift and as he exited the handicapped ramp the police apprehended him. He was soon convicted and a wise judge deliberated on the sentence. The judge observed that the man was not a flight risk and that he badly needed care. The judge offered him a choice between seven-10 years in prison or admission to a local nursing home. The felon responded that he’d rather take his chances in prison because he’d never get out of a nursing home alive.
We have probably all thought about having to put a parent, an uncle, an aunt, or someone dear to us in a nursing home — and like the felon, would prefer just about any other option. Some of us have promised not to put a father or mother in a nursing home. Because I specialize in this field, I know that almost everyone sees long term care as a last resort. Many of us have made promises that we cannot keep. It can break our hearts to have to put someone we love, and who more than likely raised us and sacrificed for us, into a nursing home.
I have learned to place myself in the shoes of my residents whenever I can. One of my favorite residents was a gentleman named Eddie who was 104 when first we met. He had been a tailor and still threaded a needle with ease. I had just been introduced as the new doctor on the unit. He recently had prostate problems and had been to a urologist (a man’s best friend, my cousin the urologist tells me) who had ordered some lab tests. Sensing he might get more information from me than from the last doctor, he swept up to me like a middle linebacker. I checked with the lab and the results were not ready. I told Eddie there was nothing to report but every half-hour he approached me while I was working to ask again. I then made the mistake of saying something like, “Eddie, what’s the rush? You’ve lived 104 years. What difference would a day or two make?” Eddie grabbed me by the lapel of my bright white lab coat and said, “Doc, you don’t understand. I’m 104. Every minute counts.”
I’ve done many other things in medicine, from working in emergency rooms to reviewing insurance applications but I’ve never done anything as fulfilling as the work I perform as medical director of Daughters of Israel, a 300-bed skilled nursing facility. At Daughters, I’ve witnessed some moving and beautiful moments. There’s plenty of good to be said about nursing homes. As a society, we’re quick to blame external factors when things go wrong. There are also times when stuff happens, people age, the good times end, and friends abandon friends. The comedian Robert Klein has a routine on aging and what a bust Florida is. I paraphrase, “What’s so great about Florida for the elderly? I took my parents down there. They were 65… great health…played cards. Now I have to bring them up north again thirty years later. And look at them, old, wrinkled, like ghosts! What the hell good did Florida do for them anyway?” Too often we expect miracles and are disappointed. Sometimes, we have the ability to learn more and do better and we miss the chance. Please consider this an offering to help you not miss that chance. Even if you couldn’t keep your promise —Thanksgiving dinner or not — make the most of what lies ahead.
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