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Bucket Lists

Ever since Morgan Freeman and Jack Nicholson got together and made that movie The Bucket List it seems like most everyone has used the phrase when talking about things to get done in life before we die.  I know I'm guilty of doing so, and because I'm kind of OCD-ish I speak of things on my bucket list categorically.  Like, I have a restaurant bucket list, a travel bucket list, and a professional bucket list.  I'm sure there are others, but you get the point. There's even a website, www.bucketlist.org, to help you track the 10,000 things you should do before you die.  Really.

Morgan, can you believe how our movie title has become a bit cliche?
This summer I ventured into a new professional territory when I took a part-time consulting job with a company that contracts psychologists with skilled nursing and assisted living facilities.  They were looking for someone to cover for another psychologist going on maternity leave.  Prior to taking on this new role of geropsychologist, I'd only worked with a handful of people over the age of 65 and none were in need of assisted living, let alone skilled care.  My training was minimal and more of an orientation to the 5 sites I'd be traveling to.  I received a crash course in Medicare rules and went on my way.  Now, 3 months have passed and this week is my last and I've been mulling over my experience.


First, there's a wide range of quality in terms of the facilities out there.  Nobody thinks that a nursing home is a happy place, but some are really, really nice (and have the price tags to prove it) with private rooms and dining rooms that rival a cruise ship.  Some are old, with crowded rooms of 3 or 4 residents, with food you wouldn't feed your cat, and cater more to the seriously mentally ill than the elderly.  The staff is primarily non-White, caring for primarily white residents, at least in the Chicago suburbs where I was going.  Hours are long and difficult, salaries are offensively low, thus turnover is high and the residents notice when their favorite aide is no longer there.  There's actually an academic article published in 1994 in the journal Gerontologist called "Nursing Home Aides:  Saints or Monsters?"  Like all things in life, it's not that dichotomous and most operated somewhere in the middle.

Many places put the residents with greater needs on different floors, so being moved to that floor becomes a fear for those who live in the more independent areas. One of the nicer places I covered was run by nuns, one of which gets around on a motorized scooter.  Psychological services are valued differently, and most of the residents who I met had never seen a therapist in their younger years. I'm a good 40-50 years younger than them, so what the hell do I know compared to them?

I've met so many people in the past 3 months.  The vast majority were somebody's grandparent, often great-grandparent.  I saw a WWII veteran who survived Pearl Harbor; a 90 year old woman who could yodel; a former marine who ran marathons until he was 80; an endearing, tiny 92 year old woman who contracted pneumonia in July - and beat it.  Issues ranged from the existential to almost high school-like with cliques and interpersonal fighting.  Some residents were almost too far into their dementia to help, so my role was more supportive and perhaps helped pass the time and gave them someone to talk to, even though they wouldn't remember who I was at the next visit.  Others were dealing with substance abuse, domestic violence, or being in the caregiver role to their spouse of 60 years.


Interacting with the residents of these facilities brings about such a mix of emotions.  It's hard to see them sitting along the hallways in their wheelchairs, staring off into space, unable to move until a staff member comes by to push them back to their room.  Some are incredibly lonely, either having very little family or family who visits very little.  One image that makes my  heart sink is that of women with baby dolls who they hold in their laps and coddle like it was their own child. Other residents have wonderful stories to tell about their lives, and are able to maintain a positive outlook.  The staff tries to keep up with the demands of basic care while offering activities to keep residents busy.  A whole lot of bingo goes on, here.  One place had a residential government, complete with an election for each position from President to Secretary where residents made posters and hung them from the walls.  Some really get into the activities, while others scoffed at the idea of arts and crafts.

I never asked any of them about their bucket lists and how many items had been crossed off.  And if you asked me before this summer if I'd ever thought working with the elderly was on my bucket list, I'd honestly have to say no, it wasn't.  But now that I'm reaching for my pen to check it off, I'm happy to say it was.

Best,
Dr. T

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