Caring on Stolen Time: A Nursing Home Diary

I work in a place of death. People come here to die, and my co-workers and I care for them as they make their journeys. Sometimes these transitions take years or months. Other times, they take weeks or some short days. I count the time in shifts, in scheduled state visits, in the sham monthly meetings I never attend, in the announcements of the “Employee of the Month” (code word for best ass-kisser of the month), in the yearly pay increment of 20 cents per hour, and in the number of times I get called into the Human Resources office.

The nursing home residents also have their own rhythms. Their time is tracked by scheduled hospital visits; by the times when loved ones drop by to share a meal, to announce the arrival of a new grandchild, or to wait anxiously at their bedsides for heart-wrenching moments to pass. Their time is measured by transitions from processed food to pureed food, textures that match their increasing susceptibility to dysphagia. Their transitions are also measured by the changes from underwear to pull-ups and then to diapers. Even more than the loss of mobility, the use of diapers is often the most dreaded adaptation. For many people, lack of control over urinary functions and timing is the definitive mark of the loss of independence.