Wednesday, July 24, 2013

24 July 2013

I was mistaken

When I first entered nursing care, I thought the program and the people would be doing their best to care for my needs. I find now that that's partially true. That is to say there is care for my needs - to a point. As long as my needs do not require more costs then has been budgeted by some administrator given too little money to facilitate my care. Basically it is an oxymoron of a situation. It is the best care for the least money, which in effect is not good care at all. The least money trumps every time.

I am constantly running into examples of how limiting this extra force can be. Many of the hands-on people who administer the actual physical care are trained well enough so as to be able to do the job. But often their attitude towards doing this job, working for this administration, and ability to show care and consideration for their residents under their care shows itself to be extremely lacking. Now, this is not an outright condemnation. There are several individuals who shine through the circumstances in which we meet. These people are gems. I wish there was some way that I could encourage them further. If only I was sought after for my opinion about some of the people who have contact with me, I'd put my $.02 in. Sadly, the value of my opinion is so lowly held that it is not sought out, or considered 2¢ worth. This is too bad. Who better than the resident who receives the care are able to rank the quality of said care? Admittedly, I have seen some short-term residents who are here for their recovery from surgeries or other short term care needs. Many of these people are not far removed enough from their previous lives to render an untainted free of past longing, type of evaluation. I have seen more people able to bitch, complain and make life miserable for the CENA help than anybody else. I have heard from these people more fowl language, cursing and swearing, obstinate behavior all directed at the very wrong people who are just trying to help them. This is not appropriate, I realize that these people are not happy and the CENA staff are the 1st to be available for them to vocalize in the extreme. But their unhappiness is aimed at the wrong people.

The first thing to remember is that there are appropriate people to answer for one's concerns.

For example, I happen to have celiac disease. This means I don't eat anything made from wheat or containing gluten. Now I would think that if somebody were making a wage in the kitchen that they might understand what this means, or at least the dietitian who was employed by this facility overseeing the meals being prepared in said kitchen. For the most part the kitchen crew has done well by me regarding this requirement. When they advertise some sort of breaded fish for a meal, I am served something else. In general they do a pretty good job of serving me a meal sans gluten. However, not every trial has been successful. On one occasion the desert was an apple cobbler. I examined the cobbler portion and wasn't too sure exactly what it was made of. Some of those flecks looked suspiciously like oats.

Now, as a long-term celiac (over 45 years now) I have learned how to be suspicious and read and gained a lot of information. If one were to consult books on the matter, oats do not contain any gluten to speak of. However in practical sense it is advised not to eat oats as they are often processed on the same machinery that processes wheat, which has a lot of gluten. There is such a thing called cross-contamination and the oats can carry gluten although it is externally acquired.

Back to the cobbler

I cautiously ate the cobbler. Within 4 to 5 hours I was beginning to experience the intestinal distress for which I am familiar from eating gluten contaminated food. All night long and the next day I had a very rumbly stomach, un-ease to the point of threatening a loose bowel accompanied by great eruptions of noxious gas. Okay, I got fooled. The trust of the professional staff turned to understand them according to the behavior they showed, they failed.

Two days later there was another dessert that was the same Apple cobbler, only this time the crumble topping was much thicker, adhered together much more strongly in my suspicions of a similar batch of the same desert from previously grew too large for me to ignore. It deftly took the spoon and peeled off the crumble topping, which came up in huge tile like sections, leaving cooked apples naked and thus edible.

Count one for my side of the division. This is just one example of how an eye must be kept on these rascals.

There are times when the public menu posted in the hall way of the day's meals never matches up with what I'm served. I assume in many cases this is due to the fact that fish is prepared breaded and is therefore not served to me. But events like yesterday really have me confused.

I am able to eat potatoes if they have not been adulterated with anything, as potatoes are basically a simple starch and contain no gluten. Yesterday for breakfast there were to be served some form of hash brown like potatoes (which I really like). My breakfast tray held nothing that could be mistaken for some form of fried potatoes. The lunch menu also stated that there would be baked potato wedges with spices. What appeared on my lunch tray was the ubiquitous lump of white stuff (most commonly known as instant mashed potatoes). It's not often that I feel gypped or is it the meals here deprive me (that's because they really do) but I really like hash browns and potatoes that had some caramelizing process applied to them. Here were 2 occasions that they publicly said what they were going to do and nothing even close was produced. Are these people not to be trusted on any level?

Today's lunch was some form of breaded fish, according to the CENA who brought my lunch, at least that's what all the other lunch trays that she was delivering had on them. My lunch looked like pieces of fried bread with a small piece of cheese hidden within them. Euphemistically called a grilled cheese sandwich. (Make no doubt the bread products but they serve me here are gluten-free and specifically made for celiac individuals like myself) how can I tell? Since the flour combination that is used for in baking gluten-free bread really misses the activation of gluten to hold the baked ingredients together, it often collapses on itself, much as a fallen soufflé might look.) The CENA thought this not to be right, there wasn't enough protein in this meal. She volunteered to call up the kitchen and ask/order up another grilled cheese sandwich for me. I indicated that if they were going to make another sandwich from scratch, could they slip in the middle along with the cheese a slice of meat and make a grilled ham and cheese sandwich?

They did! Which surprised me.

A couple of days ago one of the former residents here, came back for a visit along with her husband. They brought along a plastic bag with some of the produce from their garden this summer. There were 2 peppers, 3 cucumbers 2 jalapeno peppers and a tomato. I thanked them profusely and set the bag aside. After they had left one of the CENAs asked me what I was going to do with them? I replied wouldn't it be nice if I could send them down to the kitchen and have them make a really nice salad? She said that was a great idea and that she would call the kitchen and speak with the dietitian and asked if it could be done. That was last I ever heard of the project.

Two days later I have received no visit or comment from the kitchen. This morning I took out the vegetables and laid them out on the table that often holds my meals in order to take a photograph of these soon to be in the trash vegetables. Imagine my surprise when everything was there except the ripe, red tomato. Where did it go? How did the exit bag? Did somebody surreptitiously while I was sleeping liberate the tomato? I have been in this room ever since I received those vegetables, and nobody has touched or inquired as to what's in the bag. It's pretty hard to mistake a round, red, ripe tomato amongst all the green things that were in there.

One of the other CENAs mentioned sagely, that the kitchen might not want to have anything from outside, in their kitchen due to cross-contamination. While the argument does have some merit, I only had to laugh because according to the Apple cobbler incident, (mentioned above), the kitchen is more than capable cross contaminating on their own, they don't need any help from me.

The kitchen is run by a third-party company. Contracted by the facility owners to provide their food concerns. We had a meeting with them when they first came to the facility to take over the operations. They told us from here on things would be different. No more mystery meat, the protein product that is ground up so fine that one can ever tell what sort of meat it was to begin with. Then the ground meat product is formed into many different shapes. With this kind of ingredient the kitchen can put numerous products in and around this meat product and call the same meat different end results. For example when formed into “riblet” form it can be served with a tangy barbecue sauce and referred to as ribs, sort of the way Macdonald's does with ribs. When molded into round balls about the size of a quarter's diameter they can be served over noodles with marinara sauce and called spaghetti and meatballs. Or they can be served with a white sauce and various flavorings and referred to as beef stroganoff. Mystery meat is indeed a wondrous food ingredient. My concern, and that of many residents, is, “what is this crap?”

The new food service company indicated that there would be no more mystery meat. From now on we would have slices of real beef, slices of real turkey breast, ham, real (miniature sized) chicken breast and lots more fish. I've heard of tilapia, but I've never had it before, same for skia, but I have now. They're okay, I wouldn't cross town to get one at a restaurant, mind you. And those slices of beef – there are all brown all the way through. No redmeat excapes the kitchen's attention from here on out. Everything is cooked to well done, regaedless of flavor and texture loss – State law we were told.

The food service industry removed all snacks (which really meant crackers, which I couldn't eat) and they did away with the soda pop that we had available, ostensibly as it was not good for us. Well I can kind of agree with this as the soda pop that was available was all artificially sweetened soda, This way  we wouldn't drink so much as to ruin our teeth and incur even greater costs due to dental work. So I suppose from Medicaid's point of view that's a plus. In lieu of the soda pop, we were told with great fanfare that we get of all the water we wanted. Only 2 problems here. 1) the ice machines on both floors are always needing repair, meaning there is not always ice available. 2) the water that's available is city water, long known for its chemical additives and terrible taste. When I lived in Jackson before our house had its own well. The only time I experienced “city water” was when I went to visit my grandmother's house, in town. In the 40+ years that I've been gone from the city of Jackson, they have done nothing to improve the taste of that water. Now it is the only liquid of choice that I am able to utilize.

Of course if I had somebody who would bring in soda pop, fruit juice, iced tea mix, or any other liquid from the outside I would be free to be able to have that. However, I have no one on the outside, including my brother who lives 10 min. away, who would even bother to consider doing such a thing. So in another fact I am the downstream recipient of governmental largess as expressed through this facility, paid for by Medicaid, which insists on making me institutionally poverty-stricken, and provided for by a food preparation company that won the bid by being the cheapest operator available. Yay me! Things could be worse, although I would hate to consider such a possibility.

I try to look on the bright side, but it's awfully thin. When I lived on my own I used to get raw honey straight from the apiarist, excellent gluten-free bread already baked, frozen,and  delivered to my local health food store. I could order grain fed beef for not much more than my local grocery, frozen and shipped right to my door, on a weekly basis. I used to can and freeze all sorts of fruits and vegetables. I made my own ice cream and sherbet and have begun cooking using the sous vide method, I had begun dehydrating food and making fruit leathers. All of that is just memories and history now. Nobody here understands what I'm talking about when i mention these things.  They think they know how to cook. As far as I can tell what they know is blasphemy towards food.

The new food service company says that they will make soup from scratch, rather than open a can. That may be so but the only type of soup that I have seen is tomato, in spite of the publicly posted menu offering vegetable soup on one occasion and green pea soup on several others. Surprisingly, everything comes disguised as tomato soup. What the food does have In a lack of imagination and style of preparation it certainly adds to it in monotony and blandness. Both of which I've seen entirely too much of.

You may have seen in one of my earlier posts some pictures of several my meals, especially showing the ubiquitous hemisphere of white stuff. That, has not ceased. Several of my later pictures also feature the same loathed entrĂ©e. This new food service company indicates that we will no longer have over easy eggs, why? Because, we were told, in a condescending tone, that if the yoke is not cooked solid it may contain salmonella. Then the statement was backed up by that comment - state law. Which I find extremely cowardly and fallacious as I have seen restaurant advertisements featuring breakfast 24 hours day picturing lush, shiny over easy eggs whose yoke has not been molested by heat or scrambling, which this food service company delights in doing to eggs every morning. Oh well, at least they've gotten away from the previous company's penchant for serving “scrambled eggs”, which always looked suspiciously similar to dehydrated eggs, and have as much flavor too.

We may come to love each other, but I doubt it. To do so I would have to be reduced even further than I am now so that what they offer will look good to me. Those days may come, you never know, in the meantime I will celebrate in memory of good beef cooked rare or medium rare, chicken from the behind parts bearing dark meat and not everybody's favorite tasteless breast meat, or potatoes that have met with a skillet to dance through the oil wearing a dusting spices, or real whole fruit other than bananas, like oranges, apples, pears and maybe a rare peach or two. Living inside of a can does nothing for perfectly good fruit. Occasionally we get half a cup of fresh fruit usually consisting of 2 or 3 chunks of cantaloupe or honeydew melon occasionally a grape and a couple of sections of an orange that have been deprived of rind and neighboring sections. This is nanny food. I look forward to having some real food.
The usual breakfast under the new food service
(notice the overcooked fried eggs, the new over easy)
Old style Mystery Meatball (naked) along with the ubiquitous white stuff

Scene of the Crime - Topping scraped off the Apple Cobbler

A shot of the "Homemade" soup; Tomato, vegetable and Green pea
(surprisingly they have all looked and tasted like this tasty selection, amazing how they do that)

My fresh vegetable gifts (sans tomato)
I bet they would have tasted wonderful

A grilled cheese (only) on an MSU luncheon plate (spinach and white stuff)
Another protein laden lunch, beans and one (1) Tube steak

Another high volume lunch. This time the Tube Steak is split down the middle
Makes it look bigger that way. Eat hearty, now!

First Political statement putting glob of white stuff to good use

Although not large by any standard, this is the largest salad yet
Will wonders never cease?

Although the oil reflects the flash making the meal to appear greasy
this is actually one of the better breakfasts served.
Two new fried eggs, two pieces of toast, two fingers of sausage

An edition of the more commonly served salad.
Chunks of lettuce cut from a head of iceberg, half slices of cucumber and  half slices of tomato
and all the 7/16 of an ounce salad dressing that you can never hope to apply to the entire salad.

A Tuna fish salad Sandwich
(which I decided to eat with a spoon, scraping the tuna off the bread and leaving the slices to survive on their own)
There is so much about presentation to making food appealing, for some reason this does not approach that.

Advancing the form of political comment using the ubiquitous white stuff
This one is titled Planting Trees 
Last of the over easy fried eggs
(mourning is ongoing)

A rare delightful lunch featuring a tube steak, fresh frozen peas, and chunks of fried potato

A somewhat decent lunch (with the ever present white stuff overseeing the the steaks dressed
in celebratory regalia)

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