Saturday, January 30, 2010

Bits N Pieces and Brave New World

Edie and Flo. 1912

In my story about my own grandmother, Looking for Mrs. Peel, which I posted on this Flo in the City website, (about a girl coming of age in the 1910 era, based on the letters of http://www.tighsolas.ca/)
I have a chapter called Bits N Pieces. That's a song by the Dave Clarke Five. My older brother had their album in the sixties, but I included the song in my story (when I had the choice of a gazillion iconic tunes) because I believe that with the modern media, or just modernity, our reality is in bits n pieces, like an Eisenstein montage of sound and image.

As an essayist, I try to take these bits and pieces and make sense of them, find a pattern.

For instance, today I am listening to Saturday Live on BBC Four, a great program, and that show features a man discussing robots and artificial intelligence.

Yesterday, I listened to a few episodes of Brave New World on BBC 7, a book I studied in grade nine and which I loved - I won the literature prize at school that year because of my essay on Huxley's book.

And the other day, I heard someone, somewhere, discuss the danger of drones in war.... (the US is now using them) creating a comfort zone for the aggressor which might lead to eternal wars (Star Trek had an episode on that I believe. No doubt Twilight Zone did too.)

OK. So now I have to find a way to join these ideas with Tighsolas and modern life (as I am experiencing it.)

Well, the idea that connects all this came from that Saturday Live guest, who informed the host (or presenter as they call them in England) that the Japanese were hard at work creating robots for childcare and eldercare.

"Surely that is a dangerous thing?" said Fi Glover, the SL host.
"I agree," said the guest.

(As if war-drones are NOT dangerous, I thought.)

Then the guest explained that in Japan they have the same ominous demographics as we do in the West, with the population aging and not enough replacements, but they don't have immigrant workers to pick up the slack.

Touché guest!

We, in the west, push our elders off on low paid over worked professional caregivers. I know because I did just that!

My mother who was quite autonomous until age 88, when she discovered she had bone cancer and only weeks or months to live. She spent her final days in an old age home, albeit a beautiful and expensive one.

As she was in sharp decline, I visited every day and took care of her, as did all her friends and relatives. I must say, the other residents were not so lucky. They had relatively few visitors. I think the nicer the home, the less likely the person is to get visitors, but that's my opinion. Sure, on the outside everything looked charming. The facility was brand new and picture perfect (like a store catalogue).The residents were all nicely dressed and coifed, for one. There were fresh cookies out on the counter and a capuccino machine, too. But the truth wasn't all it seemed.

Since I visited every day, and got close to the workers, I learned, the hard way, that these beautiful places are money-making establishments functioning with skeleton crews of well-meaning, often dedicated, but overworked employees, almost all of whom are part time a la Macdonald's.

(Digression: Two decades ago I listened to a man who owned many Macdonald's franchises brag about the benefits of hiring only part-time workers. They work harder. The problem is, old people aren't hamburgers.)

Even the nurses, who were the ones charged with giving my mother her mix of pain killing opiates and morphine substitutes, and making her final days bearable, were part-time and when called upon, they cleaned the tables in the dining room.

The one doctor they had on staff was hardly ever there from what I saw.
My mother claimed she never saw him, although I didn't know what to believe as she was on drugs. I certainly never met with him.

When he went on vacation for three weeks (and my mother was in agony, tears rolling down her face) I had to hire a 'doctor on wheels' who worked outside the Medicare system and I had to pay her cash. (She followed me in her car to the banking machine down the road for her money.) She didn't do much, I tell you. She just upped my mom's dosage a tad.

Despite the 6,ooo- 8,000 dollar a month bill at this home, my mother was not well taken care of in her final days, with respect to her condition. The place was simply not set up for palliative care.

They were stingy with the pain killers, and killing pain is the point of palliative care. Pain management was my No. 1 concern when I interviewed the Director there (under great stress as my mother was in dire need of 24 hour care, immediately, and she needed some major painkillers) but they failed, despite my vigilance. (I had to hound them weekly, then daily, for two months, always to get them to up the dosage. "If my mother says she is in pain, SHE IS IN PAIN, I said.My mother was stoical in that regard. For two months she rode a roller coast of no pain, tolerable pain, intolerable pain, weeping from pain, a three day or four day cycle and her moods fluctuated as much. I never knew what to expect.)


In my mother's case, the entire medical system let her down, as she refused radiation treatment, her spine was turning to mush and she couldn't get to the hospital except on a stretcher, so her cancer doctor dropped her, just like that, and advised me to find a pain specialist for her (on my own, off the street) "Pain management isn't my specialty," he said. "Find a social worker." I had no time for any of that. Her G.P's nurse tried to help me as much she could.

Anyway, how do I relate this to Tighsolas. Easy. In 1912, Margaret Nicholson is feuding with her sister and brother in law about the care of her aged mother, who dies that year. They didn't have old age homes in that day and age. The kids took care of their parents, but it was no easier, as the Nicholson letters reveal. Indeed, there was such a need for an old age home that the town Tycoon, Mrs. Wales, left money in 1917 for the building of a home for the elderly. Norman Nicholson was an executor of that will.
(It is likely Margaret's trials with her mother inspired Mr. Wales.)

The Wales Home still exists up in Richmond, beautifully seated up on a hill. Inside, the once graceful furnishings are faded and old fashioned. (The place seems as if it was last redecorated in the 50's). I know, because I visited a few years ago to see Baby Montgomery, who was about 95.

And, unlike my Mom's Residence, some of the guests were lined up in wheelchairs at the nursing station, in their nightgowns or sweats, and their hair was not neatly coifed.

My mother's home prefered to install the inactive in comfy chairs in the salon, in best Sunday dress with jewellry and makeup, where they slept away the time.

But with what I now know, so what? Appearances aren't everything, not when it comes to Seniors Residences.

How did I finally come to understand that my mother's pain was mismanaged. Because 1) a friend of a friend had a husband diagnosed with a similar condition at the same time. He was nursed at home by his wife, who regulated the medication as per his pain level, and she had a doctor at all times at the end of the phone to consult (as well as a great many friends taking care of her other household duties).The man died two days after my mother, but had no pain the entire time. And, still, it wasn't easy.

2) I had my hair done by woman who had spent her summer in much the same way as me, by her mother's bedside in a small hospital out west. The first thing the doctor said to her when she arrived, "Pain management is the most important thing." This was a palliative care unit and a terrific one from what the hairdresser said. And, still, it wasn't easy.

Now my mother in law had a similar bad time at the end. She too refused treatment (her spine had degenerated due to osteoporosis) and was sent home, where her bed had to be put in the living room, and she was screaming in pain with only her husband (and my husband as back up) taking care of her. But at the very very end, she went to hospital, where they managed her pain killers very well, from what I saw first hand, as I was there when she died.

We're lucky if we can get out of life with just a few weeks of agony. I know that. But, still, it shouldn't be a 'crap shoot' as a friend called it, with one person getting good treatment and another rotten treatment, with one person paying a fortune and another getting it for free.

Disclaimer: I'm sure there are plenty of great Residences out there, but my advice for anyone choosing a Residence, don't get carried away by the superficial touches. And don't just visit briefly (These places tend to give whirlwind tours, I know, I took a lot of these tours earlier on, when researching an autonomous Residence for my mom).

Hang around and talk with the workers and residents, not just the sales person. As for palliative care, make triply sure the facility is equipped for this very special form of care. A doctor must be available all the time and nurses should be full time with at least one registered nurse. As for palliative care facilities, there are wonderful ones in my area, but they are too few beds.