I wrote this paper for a class in 2011
On
Convivium -
Aging
Well in Long Term Care
I had an opportunity to interview a fabulous subject for
my paper. I chose her for several reasons. She is already in long term care,
and except for her change to long term care, she enjoys the same kind of travel
she did when I first met her. She is a good conversationalist, and is a
pleasant person to have on my van. I admire her for her ability to adapt to her
aging. We spent a pleasant half hour reminiscing on the many experiences she
has had in long term care, and she shared some of the frustrations she has been
through.
I met Margaret Hall almost nine years ago, when I first
started driving the handivan. She was an active lady then, and still keeps her
schedule of going places, no matter what her situation is. I have been
impressed by her tenacity to maintain her independence in spite of her having
been out of her home for seven and a half years, first in The Seasons, then in
Lancaster Manor, and finally, when she moved to “The Martin House”, the first
Tabitha Green House. When she moved
there, I asked her what she thought, and her first statement addressed
Lancaster Manor’s refusal to let her use a sit-stand device for transfer,
insisting on her using a Hoyer lift which was not always available. Of course,
Tabitha allows her to use the device.
I wanted to focus on her experiences with long term care,
since she maintained her schedule of going to meetings and luncheons, as well
as numerous volunteer activities. I have picked her up from regular volunteer
visits to the City-County Building, Kiwanis meetings, lunches and celebrations
with friends, and lunches and coffee at various restaurants and bookstores
around town. She is part of a retired librarians group, as well as a
wheelchair-users support group.
The first question I asked her was what she thought was
great about living in Nebraska’s first Green House. She says Tabitha follows a
philosophy of Protect, Defend and Nurture.
For Margaret, the primary plus of the Green House is the privacy and
consistency of staff. Having a private room and a private bath are so much
nicer than traditional nursing care. She says the smaller size of the Green
House beats even the Assisted Living experience. There are very few
difficulties. She says trying to have a conversation at the large “family
dining style” table is difficult, because she has trouble seeing another
speaker when there are flowers in the middle of the table. Voices are also
sometimes difficult to hear. She would like to have the convivium work better.
In spite of the difficulties, Margaret would not trade
the Green House. She loves it there. I did ask her when she mentioned the
consistency of staff what happens when a staff is on vacation or away, how she
deals with the substitutes. She says that even though they are trained in the
Shabazzim (the Arabic word used for the universally trained Nurses Aides)
techniques, some of them still tend to bring their “big facility” experience
with them.
My second question dealt with the similarities of
Tabitha’s Green House to other Long Term Care Facilities. She stated that freedom is somewhat restricted
in all the facilities, and for her the restriction isn’t necessarily in the
philosophy of the facility, but in some of the staff not understanding that
getting on the van and going places is an essential part of her daily life. She
said they occasionally claim they are too busy to help her get ready to meet
the handivan. She was in a wheelchair
when she lived at home, and has experienced problems with her eyesight. She
feels the cooking is still somewhat institutional, but expects that will change
when the new houses are built. She is excited about the future prospects of
Tabitha’s Green House projects.
I asked her if she missed anything about traditional long
term care. I would have been surprised if there were anything. She did seem to think
about the question, and then said, “No.”
I then asked her if she missed anything about being
young.
What she most misses about being young is the same thing she
feels everyone misses. Youth affords the ability to do things without being
encumbered by limited means and mobility. She used this comment as a leap to the
subject of “freedom of activity,” and discussed how they (as a house) got an
opportunity to think about how they wanted to present the Green House at
Tabitha with a DVD. There was a national contest at the convention, and they were
able as a house to come up with ideas to share with the attendees. They came up
with a “Simple Pleasures” idea. She showed me the PowerPoint presentation pages
about simple pleasures that won national accolades for the DVD. One woman
wanted to go to a volleyball game. The PowerPoint printout reads: We believe people are unique and that not
everyone likes bingo. She told me one woman wanted to walk out and get the
mail, and that they all went together to a nursery to get plants for their
garden. Margaret says her simple pleasure is to do as she has always done,
visiting with friends and enjoying her volunteer activities and meetings. It’s
the little things that mean the most. She was able to go to Kansas City with a
delegation from Tabitha, and she got to meet Dr. Thomas, the leading
geriatrician who conceived of the ideas for the Eden Alternative and Green
Houses.
The final question I asked her was what she enjoyed most
about being an elder. She said being a part of something bigger than herself,
where she can pave the way for other elders, means a lot to her. She says that
the ability to speak out comes from being older, and not so fearful of what
others might think. She still feels the sting if people don’t like what she has
to say, or do.
She says that not everyone is able to speak out. If she
can help lead people in the people-centered viewpoint, she can help others who
cannot say when they need that extra special touch.
I talked with her today, January 29th, to read
the draft of this paper for her, and she added a few things. She says her
eyesight is getting worse, and she’s trying to get assistance to place things
where she can find them. She told me of a conference call interview with a
reporter who is doing a story about the difference between cottage living for
elders and traditional long term care facilities. She said, “When the reporter
heard the residents of the Martin House are allowed to have Hot Toddies she
seemed incredulous that anyone would take the time to make Hot Toddies in long
term care.” They sit around the smaller round table to enjoy their evening
toddy, and the convivium is much better! We also discussed Dr. Thomas’ use of
the word convivium, from which we get our English word conviviality, and we
decided that Dr. Thomas liked the word because doctors are so surrounded with
Latin terms. I looked it up, and it turns out the word in Latin means “living
together.” I like this word and it should become a common term as a noun. She
wants a copy of this paper after I turn it in. When I give it to her, I’ll ask
her for permission to post it on my blog. One of her major concerns for today
is; in all the health care reform conversations, that funding will stop for the
person-centered care movement. “We need people to advocate for such care as this,”
she said. I promised her I would continue to do so.
This interview gave me a wonderful sense of the joie de
vivre (French for “hearty enjoyment of life”) that Margaret Hall expresses, and
how she has managed to maintain the social activities that are so important to
her. I hope, if I ever end up in Long Term Care, I remember Margaret, and the
example she is setting for me.
Sources:
Personal
Interview: Margaret Hall, January 6, 2011 at: The Martin House, 508 S. 47th
Street, Lincoln Nebraska.
