Wednesday, August 21, 2013

21 August 2013

Eh, What's Up Doc??

Another day of twists and turns. If it isn't the administration moving people around for what ever reason, its the equipment deciding to act just as strangely for its own set of whatever reasons.

This morning breakfast was preceded by the CENA assigned to my care that breakfast will probably be a little late this morning, both the front elevator and the service elevator weren't working. The elevator repair people have been notified. They have to come from Detroit. They were the same folks who have been here for the last few months installing the replacement service elevator. The story is that most times when it was used sparks would fly inside of the car, then it would cease half way between floors. For the entire time the elevator company was dismantling the old service elevator and assembling the new one everything had to use the main elevator in the lobby.

Lunch was always interesting. The elevator was heavily used by second floor residents,most of whom used the dayroom on the first floor as there was not enough eating space on the second floor. Most of those residents are either chair users, or spend their out of bed time in what looks like an industrial designed chaise lounge on wheels. The occupant can't move it very well except by pushing it backwards with their toes. For each resident coming down to eat, there is a CENA driving from behind.

The elevator traffic can get pretty hectic. The elevator doors open to disgorge usually two residents in wheeled devices pushed by attendant CENAs. The CENAs park the residents just outside of the elevator in the lobby then race up the locked stair well next to the second floor (everything that resembles a door is locked with a numeric key pad around here) to collect more residents. The elevator has automatically returned to the second floor where other residents have been gathered by other CENAs who have remained to collect residents for the next freight down stairs.

Meanwhile more CENA staff are in the day room/ dining room retrieving wheeled residents from the lobby an placing parking them in seating that has been determined by experience. No one has kept track of the experience in a written form like a placement map, instead it tends to be haphazardly performed depending on who is working that day and what they may recall from the past. Two certain individuals are not placed next to each other because they can't (or won't ) get along. Such placements are guaranteed to elicit certainly verbal incidents, possibly physical alterations that could result in injury – ever watch a hockey fight on the ice? Or most interestingly a food fight that envelopes the whole dining room. No body wants that.

Then there are the quiet people who just sit in their chair patiently, giving the appearance that the world is just flowing by them, not giving any impression that anything is cooking inside that head of theirs. Suddenly the meek, mild non-imposing resident might use their spoon like a ten year old might improvise cutlery as a makeshift catapult and next thing you know instant mashed potatoes are flying through the air. The strange thing to observe is the launcher of the reconstituted tubers shows no emotional response to their transgression. The flying starch lands on someone's territory and a corresponding flagrant assault on public nicety ensues, a chain reaction erupts and the mealtime repast has gained an afternoon repercussion.

Of course the post mealtime exodus is just as involved, only in reverse. The mood coming ot of thr dining room is as dripping with emotion as the atmosphere was with food previously. Some of these minds may be somewhat thread bare and worn in places, but you would be impressed at the grudges that can be held and resurrected at any time.

I try to stay away from the elevator and the dining room around meal time.

Its not just the elevators that have decided to have a work action to get some attention. In order to lift some residents from their beds and replace them there are two mechanical devices that come into play. One is a Hoyer lifting device, used for lifting very large people and or those without enough mucsle tone to get themselves out of bed (and back in). It operates with a full sheetlike sling that is placed under the resident, then the corners are hooked into a metal hook arrangement that is electrically motivated to lift the load gently. Once sufficiently clear the whole device is on wheels so it an its load can be moved to where the person can be set down.

Usually the sling is left under the resident after they have been sited in their particular wheelchair. The resident spends the entire time while in the chair sitting on the sling until they are to be removed from the wheelchair. Yesterday it was announced that no longer would the slings be allowed to remain under the resident during the day. There was an immediate howl of protest from those residents who utilize such equipment. The reasons given were that some people somewhere (unstated as to where) have gradually slipped forward and have been found to be slowly slipping out of their wheelchairs. Then as a quick addition it was added that other people (visitors) don't know what the distinctive fabric of the sling is peeking out from under the resident, so ita partly a privacy issue for the resident. A wild discussion broke out among the residents, many of whom use these Hoyer slings. One gentleman said that whoever is making up these rules has never spent enough time with those who need to use a Hoyer lift. Once the person is in the wheelchair how is the sling going to be removed?

Answer, the person bends forward in their chair while 2 CENAs pull the sling down the back of them and then rock them from side to side while in the chair gradually pulling the sling out from under the person.

Ghastly!! To which the gentleman who asked the question responded, “What if the resident can't lean forward?” the answer was we'll just have to work it out. A woman who is very large, so large that her extra wide wheelchair can go on the elevator only all by itself, there is no room for another resident in their chair, asked if being seen with a Hoyer sling under her while in the wheelchair was so embarrassing what were they going to do about her great girth erect a tent around her where ever she goes? I can just imagine telling someone that their chore for the day is to get the fat lady out of bed and into her wheelchair and then wrestle the sling from under her when you are done, or how about trying to get the sling back under her when she wants/needs to get out of the chair, like for a restroom trip. I have seen this woman crying, screaming to the heavens while waiting for the elevator (its slow) to come fetch her to make a trip upstairs to use the restroom. I can just imagine adding the fitting of a Hoyer sling under her while still in the chair in order to lift her to relieve a bladder.

I am not too sure who thought this thing out. Or if they just considered from their own point of view.

Sometimes I am driven to inquire what did they think was going to happen? When I went to the University in May of this year to have a follow up MRI before my appointment with the Neurologist in June, I called to confirm my MRI visit with the Radiology department. I cautioned them that I could no longer walk into the MRI tube this time as I could no longer stand or walk I use a wheelchair. They assured me that was no problem, that they could get me out of the wheelchair and onto the gurney device that rolled into the magnetic tube. When I got there what they planned on doing was to get a pair of 150 pound guys on either side of me and lift from under my shoulders to clear me out of the chair and then just like the movies drag me, feet uselessly dangling behind me to the non ferrous rack device to roll me into the tube. I looked at them and laughed, this is all you've got? Yep, that is what they had planned. After trying mightily for three tremendoustry’s, they about pulled my arms out of the sockets and could barely lift me about an inch out of the seat. They needed to practically stand me all the way up before I would be able to clear the wheels and the arm rests of the chair. Now they were really stumped, their big idea, the scrawny muscle men weren't going to work, now what … I asked if they had access to a Hoyer lift? Someone actually knew what that was and before the eager crowd was able to regroup and manage to try once again trying to lift and inadvertently tear off body parts An old dusty antique looking device was produced to hoist me up and out of the chair. The multitude eagerly stuffed and threaded the sling behind my back and under my rear end and legs. The sling was not evenly distributed but with extra hands holding me in the sling I was lifted up, over and laid out ready to glide into the magic tube.

After I had been examined and recorded for posterity I was removed from the tube and reinserted in my chair, which was out of reach of stray magnetic fields in the other room. The second time withn the Hoyer sling was much more pleasant to experience.

Whenever some great new idea comes down on us from the heights of administration or those in charge, I recall the experience being made ready for the MRI. To those who are only familiar with the ways of disability from the position on the outside as helpers, who have never really stopped to hear or consider how it is from the other point of view, how the one with the disability experiences what so many do, please consider a second deeper thought.

Yesterday in our residents council meeting it was announced that there was going to be a picnic outside on Friday behind the building on the grassy hillside. A big tent is going to be erected so we won't have to be out in the sun all the time, I am assured that it will have open sides so the breeze can blow through. Hamburgers and hot dogs are going to be cooked. The area is behind the building and up a slight hill, slight to a vertical person, one who doesn't use wheels to get around. Oh thats okay, we were told the facility plans on having CENAs push you up the hill. I hope that they will be available to help break us as we descend afterwards too.

This evening when I mentioned this Friday afternoon plan to some CENAS working with me, they had never heard of this and instantly said that they were both glad that they weren't scheduled to work that day. One said that if she was scheduled to work that she just wouldn't come in that day. Makes one feel real good to know that even the littlest activity the administration comes up with generates such overwhelming support from the line workers I can't help but wonder if the elevators both breaking down, the minor equipment breakdowns that constantly happen and some of the less thought out schemes that have occurred around here, haven't help to turn the CENA staff just a little sour on some of the ideas about the running this place.

Sometimes those who administer those who look after us need to stop and consider the consequences of their edicts. Often surviving through a great idea provides a different perspective than just hatching one up.

My particular favorite lifting device
The Easy Stand
(easier on the body than a Hoyer)

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