We always knew the day would come when dad would have to move to nursing care.
From the outset his dementia has been a sliding scale of needs and competencies. Like anyone else he had his good days and bad days. The residential home accommodated him for as long as they could – but they were not equipped and did not have the staff to deal with more advanced needs.
And so, we moved him into a nursing home to live for the next, and last stage of his life. This was his last home.
For those of us who can no longer live in our own homes, nursing care may be our only option – if we are lucky enough to find one. The sad thing is that a room will only become available once someone else dies. It is a one-way revolving door of people who enter, but who only rarely return home.
For residents of nursing homes the bigger world largely disappears.
As we get older the body becomes the focus of needs; psychological, functional, physical. Getting up and going to bed become the big events of the day: a sign that one day is over, and the next begins and where every day blends into the next.
In residential care people are more able to move around, engage and interact with others. There are more activities which means greater participation and engagement in the social life of the community.
In nursing care, due to their personal health needs, people are quieter and more inclined to stay in their own room. There is not the same level of fun, or spirit. For socially-minded people like my father, it would take time to adjust to the different vibe.
In a body-centred world, when mobility is compromised, food is everything. It provides a world of treats and delights; hot and cold, sweet and savoury. Tastes that are subtle, sweet, textured, flavourful and omni-sensory.
Eating adds variety and focus to the day. Porridge in the morning, a big meal at lunch time and at tea, punctuated with drinks of tea, juice with biscuits, buns and scones: sustenance combines with pleasure.
Nursing homes cater for people who have different levels of swallow: thickened drinks, puréed foods and softened/mashed meals. It is not fine dining. It is not cordon bleu, but they try to make it tasty; that is, real food of different consistencies – enhanced by ketchup or HP sauce.
When he moved into his room we were allowed to re-arrange the furniture to suit his needs. His pictures went up on the wall: the same pictures from his own home, and from his last home, in a different room.
Perhaps this was more for our benefit. We felt it was a way of connecting him to ‘home’, and to us, and to his life before. His belongings at this stage reduced down to a few personal bits and pieces – and clothes.
My father died in a lovely, bright and airy room. It overlooked a garden of beautiful mature trees and caught the light of the evening sun.
He liked to listen to music on the radio.
Those last few weeks were about keeping him comfortable. He had his family around him and we knew we could spend as long as we liked with him. In a hospital he would have been bothered by noise, other people, movement and constant activity. We would have been restricted by formal visiting times and parking.
But here it was quiet, and calm. He was comfortable and cared for.
As his health deteriorated we knew he wouldn’t have to go through the trauma of being moved to hospital, to end up in a trolley in casualty, and needlessly distressed. In nursing care they have the right levels of staffing, know-how and experience. There is nothing that they haven’t seen before. As professionals in care they step up to deal with every situation that is part of the body’s slow, but natural, decline.
With special equipment and facilities to make people as comfortable as possible, clean sheets, pleasant surroundings and cheerful staff; this is not a sad environment. It is an environment that is geared up for humans at a stage of life where they need specific help to see them through their last days.
And now someone else is in dad’s room.
Someone else with needs that means they cannot live where they lived before.
The care home world never stops, 24/7, 365 days a year. And just as we used to visit dad here another family has taken our place. This bed… this room… this space that was, for a short time, the focus of his life – and ours. It is now someone else’s world; it is where they live, it is their home.