Just So Much Sex: 6 Realities Of Working In A Nursing Home
Hello, future old person!
You probably try not to think of yourself that way, but the fact of the matter is that, unless your family has some sort of Highlander gene or your hobby is ramping school buses, you're going to get old. And while none of us like to think or talk about it, there's a good chance you'll spend your final days in a nursing home.
To find out what we have to look forward to, we spoke to Luc Belanger, who spent a decade of his youth living at his mother's family-run nursing home, and "James," who worked in the secure lockup section of a New Zealand rest home, housing patients with dementia and Alzheimer's. They told us about how ...
There Is Sex -- So Much Sex
Most nursing homes rent you a single room with an adjoining toilet (if you're lucky), so kinky sex dungeons that reek of talcum and communist paranoia are pretty much out of the question, but that doesn't prevent residents from getting their rocks off. And homes don't usually put locks on doors in case of emergencies, so staff members are absolutely going to see it happening. "My mother once walked in on a man motorboating another resident's breasts," says Luc. "What do you do when you walk in on that? Break up their fun? Supply the comical engine noises? Start a slow clap? My mother's response was to freeze in place like a cartoon character, then slowly back out of the room."
"You should see the speed I can hit when the dentures are out."
Oh, and then there's the masturbation. "One resident would routinely masturbate onto the floor of his room, then make fun of the staff while they cleaned it up. Another was nicknamed 'Horny Smurf' because he used a blue cream on his hands for his arthritis, and one day an employee saw him through his window fighting a bout of hand to gland combat with his blue cream smeared all over his face."
"I've fought through two wars and three marriages. I wanna get weird, I'm gettin' weird."
But wrinkly old sex is a real problem, for several reasons. One, since residents don't have to worry about getting pregnant, they also tend not to worry about practicing safe sex. As a result, rates of STDs in nursing homes are going through the roof. And then there's the issue of consent.
For instance, our other source, James, worked in a secure lockup -- meaning everyone there is mentally incompetent (and in any couple, one party is even less competent than the other). Caretakers can't allow sexual contact at all in those cases ... which means constantly having to break in and interrupt the act. James once saw an old married man casually spending time with a female who wasn't his wife -- the two would hold hands and eat meals together, and even the guy's wife didn't mind much, because it was all so very sweet and innocent. Until, that is, the staff found him in his new girlfriend's bed, naked and erect.
In case anyone has yet to catch on: If he's both being sweet and has a penis, this is always the end game.
After they took the guy back to his room and explained that this was not allowed, the man self-righteously insisted he was "always careful about wearing rubbers when playing out of bounds." The guy begged the staff not to tell his wife, and promised he wouldn't do it again (that promise would last all of a week). He then promptly asked to be left alone so he could "relieve some tension."
On occasion, residents might also come on to caregivers. One old woman, Emily, thought she was still a twenty-something running her own B&B and that James was her old bookkeeper, whom she called "Jimmy." As it turned out, Jimmy had also been her "gentleman friend." She'd repeatedly try to kiss James and put her hands down his pants. He humored her, to an extent -- he let her peck him on the cheek, but if she tried to go down south, he reminded her that they were "keeping things hidden."
"Oh, I know a place you can hide it."
Emily wouldn't trust the rest of the staff (all women) with James. Once, she slapped a nurse and said, "That bitch stole my leather panties and didn't even bother to give them back. I'd kick her out on the street, but that little girl of hers wouldn't survive, stupid tart."
Dementia Patients Are Like Werewolves
Residents who are mildly demented (yes, that's the official term) are relatively normal for most of the day. They enjoy all the activities that one typically assumes the elderly do: knitting, scowling, walking up and down pathways complaining about their various aches. But when the sun sets, they go nuts. They scream or cry. They have no idea what's happening. They demand to be taken to their rooms (even if they are in their rooms) or start trying to get their cows out for milking ("Sometimes, that's not a euphemism," clarifies James; the patients actually hallucinate cows). The symptoms are collectively called "sundowning."
Sometimes the best you can do is keep them comfortable and try desperately not to get milked.
There's no one reason why residents sundown. "Much like the rest of elder care," says James, "it's almost impossible to pinpoint the reason someone is breaking. All we can do is treat the symptoms." But if you want to see things get really bad, watch how they react at sundown ... during a full moon.
We're not joking. Once a month, patients suddenly become much more agitated and symptomatic. And it's always the three nights of the full moon. "Shit goes crazy during those nights," says James. The whole lockup fills with howls, so the staff knows the moon's cycle without needing to check the sky or a calendar. It's hard to explain scientifically, but more than a few independent sources (including controlled studies) back up the observation.
It's possible that they're legitimate werewolves living here who've been hit by elderly hair loss.
It might have something to do with the moon disrupting sleep. And then there's the wacky theory that the Moon is pulling at the water in the human body the same way its gravity grabs the oceans. This could cause issues with the hypothalamus (the weird seahorsey-looking part of your brain), which affects the pineal gland, which dovetails rather nicely into symptoms for sundowning. And if you think their erratic behavior is just a matter of confused old people hilariously shouting at invisible cattle ...
Violence Is Shockingly Common
Earlier, James treated the sexual advances of a confused old woman as an amusing anecdote -- but only because she didn't pose a physical threat to him. But if a person suffering from dementia gets confused about their surroundings, all bets are off. Maybe they mistake you for an old lover, or maybe they mistake you for a human-shaped monster who has come to eat their liver. In a moment, they can be transformed into ticking dirty bombs filled with hip-bone shards and casual racism. Once, James repeatedly asked a patient to lower his voice, and the guy snapped. He attacked and got so violent that he smashed a window before other staff could restrain him.
"One resident at the home where I grew up," recalls Luc, "was still relatively young, but she was too mentally far gone to take care of herself. On a good day, you could have a secondhand-smoke-filled (but pleasant!) chat with her about her childhood spent singing in a choir. On a bad day, we'd have to call paramedics to come get her because she'd think we were alien invaders coming to murder her (that is not, in any way, hyperbole). And you'd be amazed how strong a tiny elderly lady can be when Predator is real and she's starring in it -- one night when she got violent, it took four paramedics to wrestle her into the ambulance and take her to a special center with higher security."
Though I suppose it's encouraging to know that Nana's still healthy enough to throw a haymaker if need be.
Once a resident snaps and starts thinking his cane is Mjolnir, the home requests a re-evaluation. Then it's all crossed fingers and hoping he doesn't simply get shuffled to another home with low security or, God forbid, sends a fellow resident to that great big nursing home in the sky.
This is one reason why there are residents who get over-prescribed antipsychotic meds. It's called chemical restraint, and it's illegal as all hell -- but then, so is using a home as a thinly-veiled front for an elderly Hunger Games, and we all know we're anxiously awaiting the next season of that on TLC. Luc told us about his firsthand experience with chemical restraint: "When we first took over the home, most of the residents were low security risk cases that were kept sedated under mountains of pills, because if they sit around staring straight through Matlock all day, all you have to do is dust them off every now and then."
When dusting the elderly, make sure not to spray Endust in their eyes. To avoid doing
that, try treating them with a shred of human fucking decency in the first place.
Rest Homes Function By Lying To Patients
Residents with Alzheimer's often have no idea what's going on, even if you provide them with all the evidence in the world. "Did we use this to our advantage?" says James. "You bet your arse we did." He told some residents that they were on vacation -- believable, because a rest home looks exactly like a five-star resort to people with the mental capacity of children (it's the crisp white nylon smocks, mostly).
Nothing says "dream vacation" like some bleach and a good starching.
Remember Emily, the resident who thought she was still in her youth and running a B&B? James thought he had to respond like this was a serious dementia episode, but as time went by, it made his job easier. She thought he was very hands-on in management -- doing the laundry, fixing meals, entertainment -- and he could get her to calm down if she was having an episode and convince her to take medication with minimal effort.
Still, some patients get fed up of their "vacation" and want to return to their families. For them, the rest home erected a fake bus stop. It had a paved area and its own gate, so it looked convincing -- they even got a few of the residents to help construct and paint it. "The fake bus stop was a godsend," says James. One resident in particular would regularly get worked up, storm into her room, and return with a small bag packed. She'd sit at the bus stop -- hat just so, with her bag sitting on her lap, looking around expectantly while muttering old lady swears under her breath.
Eventually you get used to constantly being called a carpetbagger.
After about five minutes or so, she'd make her way back inside and ask when the bus was going to come. "Oh? About 30 minutes," James would say. "But I've just put the kettle on, so how about some tea?" Old people love the fuck out of tea, and on the rare occasion when that wouldn't draw them back in, he's say, "Come inside and wait. It's about to rain." Once back in, they'd forget that they wanted to leave.
The Residents Often Get Treated Like Shit
Elderspeak is when young people talk to old people as if they're kindergartners. ("Oh, that's great, sweetie! You cleaned your whole plate! I'm so proud!") And boy oh boy do seniors hate that shit. Probably because -- and we're just spitballing here -- they're the precise opposite of kindergartners. It seems like a small annoyance, but in a nursing home it conveys that staff aren't thinking of the residents as adults. That lack of respect can in turn lead to residents being treated like furniture that's taking up too much space, or worse, being smacked around and yelled at when the boss isn't looking.
Luc never witnessed outright abuse, but saw plenty of staff who seemingly shared an extremely limited pool of fucks to give amongst themselves. "Most governments mandate that staff bathe the residents at least once a week, which is usually exactly what they get. But when you have staff members who view residents as something less than people, you get situations like sticking a safety chair in a tub and giving residents a quick wipe-down rather than letting them take an real bath. And believe me, you do not want to know what happens to ancient junk when it doesn't get a good soaking."
Glade won't be packaging that scent any time soon.
And when allowed to go on indefinitely -- which it most certainly can if no one complains or launches an investigation -- this can snowball into the situation that Luc's family encountered when they first moved into their nursing home: "We found out the previous owner was the only staff member. The home was a 'converted' (as in, 'left pretty much intact') hotel from the '60s ... When we removed the carpeting, we found an inch of dust underneath. We found old dentures left so long on a bathroom shelf that they were fused to it ... It was like this for over a decade before we moved in, and my mother spent years and several hundred thousand dollars bringing the place up to code. The previous owner, on the other hand, was content maintaining a filthy warehouse full of elderly zombies."
And then there's all the relatives, caretakers, and nursing home staff who flat-out steal from residents -- be it cash, valuables, or even really petty stuff like shampoo and soap.
"I'm going to need these Depends. The Dodgers got a double header, and no way in hell I'm waiting for the bathroom line."
Oh, and pills:
"After we noticed some pill count discrepancies," says Luc, "and one employee started shaking like she was sitting on a washing machine during the spin cycle, we caught her stealing pyschs to take with booze." Yeah, medication theft means that you, your grandma or the government foot the bill for a sneaky staff member who wants to get high off their ass, while your dear grandma spends the night in immense pain because she got a Tic Tac in place of her hydrocodone.
At least she can take comfort knowing her sacrifice made late night cartoons marginally more enjoyable for an abusive jackass.
And Then Everyone Dies
Most people hope that at the end, they pass away painlessly in their sleep (the rest hope they suffer an orgasm-induced stroke while in the middle of an orgy on board Prince's private jet). In the real world, it rarely happens that way -- not even in a nursing home, where people go to live out what they know full well will be their final years.
The biggest cause of death in American nursing homes is tickers winding down, but Luc saw everything from suicides, to death by complications from broken bones, to residents found clutching at bottles of nitroglycerin after heart attacks. If you live in a nursing home, an everyday part of your life is seeing others die -- and unfortunately, "peacefully in his sleep" is about as common a cause as it is on Game of Thrones.
Though on the plus side, beheadings are a lot less frequent.
For instance, even if your heart quietly stops in the middle of the night, God forbid you don't have a DNR agreement signed. If you're not aware, DNR means "do not resuscitate," which you'd think would sometimes be self-evident, but the joke's on you, motherfucker. As Luc says, "My mother once found a resident cold and dead in her bed after she missed breakfast. When the paramedics came, as per protocol they tore her nightgown open, broke her ribs performing CPR, and defibrillated her the entire way to the hospital, where a doctor finally declared her officially dead. She was 103 years old."
And in case you don't have an overwhelming urge to go hug your grandparents yet:
"Another resident was a Canadian World War II veteran who was captured by the Japanese army in Hong Kong. He had to get around on crutches, and would drink away his memories of being caged up in a POW camp at the bar across the street . Last time I saw him, he was behind a police barrier, under a tarp -- he got run over by a sleepy truck driver while shambling back to the home after one of his bouts of chasing Hirohito and Hitler out of his nightmares."
Not even a life of dealing with the inevitable fully prepares you for sudden, death-via-folk-song passings.
When patients approached death at James's New Zealand facility, they were often put on the "Liverpool pathway." This practice (now being phased out due to overuse) feeds patients drugs that ease their pain as they actively die. One patient on the Liverpool pathway, Shirlee, had been a florist and avid gardener -- James lost count of the times her pockets would be full of flowers, roots, and dirt from the garden outside the facility. Then she had a tumble while walking, hit her head, and started declining rather rapidly. In the end, she wouldn't talk too much except to say "oh, I love you, I do" while shuffling around the unit. Shirlee lasted five days. They had to turn her every few hours so she wouldn't develop bedsores, but she'd be staring in one direction for about two hours at a time. Looking at a blank green wall while you're dying is a bit depressing, so James cut out some flowers from magazines and stuck them to the walls so she would have something comforting to look at.
If you're getting the sneaking sense that it's time to get a box of tissues ready, we'd go with that instinct.
The belief is that hearing is the last sense to go while dying. So James spent one lunch break with Shirlee reading from a newspaper and generally commenting on whatever was in it while holding her hand. Physical touch can be a powerful thing, plus it lets someone not fully conscious know you're there. "As I was reading," says James, "I felt her fingers squeeze my hand. And as I looked up from the paper, she had turned her head. Her eyes, unfocused, gazed over to me, and she corked out a 'oh, I do' before letting out a sigh, her mouth resting into a smile."
Patients on the pathway are pretty tanked with morphine, but he got the impression that, right at the end, she knew she was dying and was okay with it.
One patient spent five years in the non-lockup portion of the ward before his dementia symptoms popped up, and he was moved to James's wing. He moaned that all his friends were dead, his son didn't come to see him, and he had no one to take him out to the pub. So James got permission to sneak the man a six-pack and drank it with him, while chatting and watching cricket on TV.
He was pretty stable all the way through his stay, until his heart attack. One of the staff went in to his room one morning, and he was dead. James wasn't working the day he died, so a few days later, he found the man's room all packed up. When he asked one of the other staff what had happened, she answered, "Oh yeah, right, sorry -- I thought you knew. Can you give me a hand with Beryl?" So he turned to Beryl. "My first personal experience with death," says James, "and I got to mull it over while washing someone's arse."
For more insiders' perspectives, check out 5 Horrifying Things That Happen When You Go Missing and 6 Things You Learn When Your Penis / Vagina Doesn't Work .
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