|5/14/2013 9:27:00 AM|
Long term care residents face death constantly
MOUNT ANGEL — On his bedpost at Providence Benedictine Nursing Center here, Dan Hurliman hangs a red cap. It was a gift from the kindly one-legged neighbor who lived down the hall. The man often wandered into Hurliman's room to chat, take a nap or just sit and stare quietly.
|Learning about grief|
|Symptoms of grief|
• under eating
• sensitivity to noise
Suggestions for comforting grief
• Share a meal with a friend.
• Go outside every day.
• Listen to music that brings joy or tears.
• Visit family or friends or have them visit you.
• Write daily.
• Grieve with your children.
• Watch the sunset.
• Buy fresh flowers.
The seven stages of grief
• Shock and denial
• Pain and guilt
• Anger and bargaining
• Depression, reflection and loneliness
• The upward turn
• Reconstruction and working through
• Acceptance and hope
— Source: Mary's Woods pastoral care
Since his friend died, Hurliman has kept the hat as a memorial.
Residents of nursing homes and assisted living centers face the death more than most. At Providence Benedictine, for example, there is on average a death every five days.
Hurliman, 54, was injured in 1979 in a car accident on the Oregon Coast. Now in a wheelchair, he hopes to spend the rest of his life at this 98-bed nursing center. He knows he will see many friends die.
"I bring it to the Lord in prayer, or ask Mary's intercession," says Hurliman, whose walls are filled with images of Jesus, Padre Pio and Mary.
A month ago, death came for the woman who sat by his side for four years each day at Mass. Unable to speak because of a stroke, she would motion and grunt to her caretakers until they wheeled her next to him. No place else would do.
Hurliman's response to death and the indignities of age has been to become a kind of local holy man, distributing rosaries, blessed water and sacred pictures to neighbors and staff in distress.
"I guess you could call me a prayer warrior," he says.
After a death at Providence Benedictine, staff often set up a small shrine outside the room. It includes a photo, a candle and some items special to the one who has died — angel statues, a fishing hat, a can of a favored soft drink.
"We do it for our grieving and so residents know they won't be forgotten," says Dana McBrien, pastoral care director at the nursing center. The facility hosts memorial services twice per year and remember residents who have died.
Memorial services are common at Catholic long term care centers. During one memorial at Maryville Nursing Home in Beaverton, residents played a song on the kazoos the deceased had given them as gifts. Mary's Woods in Lake Oswego on May 23 holds its annual memorial service for those who have died over the past year.
Elders in long term care are grieving many things to begin with: loss of homes, loss of mobility, loss of vitality. Add constant death and the pressure grows.
After a death in Mount Angel, one man grew agitated, which was out of character. After a talk, McBrien learned that he feared he would be the next to die. Another man, a former mortician, found it difficult to handle deaths, since it revived difficult experiences, especially the time he had to prepare the body of a good friend. McBrien and staff are treating the situation as post-traumatic stress.
Earlier this month at Mary's Woods, established by the Holy Names Sisters, residents gathered for a retreat on grieving.
"We are surrounded by death and loss, more so than if we weren't living in this community," said Susan Foy, on the Mary's Woods pastoral care staff. Near the start of the day, residents gasped when they heard that one of their peers had died the night before. Everyone took a moment of silence and many daubed wet eyes.
"Death is something you never get over. You get through death," said Mary George-Whittle, head of pastoral care at Mary's Woods. "Awareness is key."
During the retreat, residents prayed over a large bowl of water that represented their tears. At the end of the day, retreat-goers used the water to irrigate small pots planted with Forget-Me-Not flower seeds. The lesson? Tears help sustain the memories of lost friends.
"You make friends you never knew you could at this stage of life, but you are also with a lot of people at the end of life," George-Whittle told the group.
She says grief is an "unstable" journey. Someone who has lost a friend may wake up in the morning and feel over it, but then something will spark a memory and the agony will return.
"You move in and out of pain and loss," she says. "You can't go around them. You have to go through them."
Experts say grief can last from a year to about four years and can cause all sorts of symptoms, including confusion, insomnia, overeating, under-eating, weakness, tension and sensitivity to noise.
"Residents take on a community feeling," says Derrick Landis, administrator of Assumption Village in North Portland. "They really form strong bonds. They eat meals together. When someone passes away, it's something the residents care about."
Many look to faith for understanding. "I've lost several really good friends," says Helen Dishman, an 84-year-old resident of Maryville who has lost 10 roommates in four years. "I felt really bad the first couple of days. Then you realize death is coming for us all. You get used to it." Faith has helped her keep going, she says. Maryville has daily Mass where worshipers pray for those who have died.
Gertie Webb, an 83-year-old resident of Maryville, got a call recently and still has not recovered. It was one of her best friends, a girl she had known since age 5. The woman called to say goodbye because death was imminent.
"That hit me like a ton of bricks," Webb says. She can endure, she explains, because of the three Fs: faith, family and friends.
Ted Tann, 99, chokes up when he discusses losing his table buddy at Maryville. The men, both veterans of World War II, shared meals for years. "He was a really great guy," says Tann.
"It becomes like a little neighborhood. If you stay long enough you get to know people," says Sister Josephine Pelster, a Sister of St. Mary of Oregon who is chaplain at Maryville.
Some residents say they don't want another roommate because repeated loss is too painful. "It raises the issue of their own death," Sister Josephine says.
Luann Smith, a 90-year-old resident of Maryville, says when she first moved into assisted living, she made a group of close friends. Within three months, most of them were dead.
"That was just earthshaking," she says. "After that, I knew you don't make long term friends here. You make acquaintances." Smith handles death by praying the rosary for the souls.
"We all know we are on our last steps here," she concludes. "We don't have any plans to buy new curtains for our houses."
It's unclear whether residents with dementia are aware when someone dies. Sister Josephine, a longtime nurse at Maryville, says they do sense increased anxiety and sadness that emerges in others after a death. That often makes them afraid they won't get what they need and so they will become demanding or agitated.
Some elders say it makes no sense to dwell on the inevitable.
"I don't think much about death," says Pauline Ames, a 94-year-old who sits in a Providence Benedictine hallway and greets passersby. "I think about life and living. I might as well. It's all I know."
Her eyes do fill with tears when she recalls the recent death of a neighbor, a friendly man everyone loved. "I liked him very much," says Ames, who shakes off the sadness by waving to someone. Then she recalls a roommate who died and weeps again. Ames quickly restores equilibrium, saying that despite the occasional sadness, she is glad to be cared for in such a lovely place.
"Dying is part of living," says Father Brendan Fleming, a retired 86-year-old priest who lives at Maryville and lost a roommate not long ago. "It's the last thing. When you are younger you have more regrets. The older you get, it does not effect you so much."
Virginia Dockrell, who has lived at Mary's Woods for three years, found a good friend there. Then the friend died.
"That wasn't supposed to happen," Dockrell says. "But it's just one of those things. You have to move on. Life here is good."
Some elders cope with death by withdrawing, says Sister Josephine.
"There is a level of stoicism," says Landis of Assumption Village. "But I have spoken with residents when someone passes away. Some feel they are not that far behind. That is a difficult reality."