The elderly have wisdom of great value to all, but few listen. Their story is worth being heard. If things don’t change, we will all share their experience. This first-person narrative is the result of years of interviews and the extensive experience of a Registered Nurse specializing in Geriatrics. We invite you to live a day in the life of a 90 year old.
By: Danielle Ruiz, RN
“’Morning, Sugar. Got some good news. We’re awake again today,” I say to the air. My wife and I haven’t shared a bed in 12 years, and she was moved to an entirely different building about a year ago. Still, I like to start the day talking to her. I glance around my blindingly-black room and see a blurry red glow a few feet away. It makes me laugh. How I’m supposed to know what time it is when I obviously can’t see the clock without my glasses? It doesn’t matter. I always wake up at 5:30.
I’m exhausted already. I woke up to try and use the toilet at least 5 times last night, but my mind is wide awake and there’s no point trying to go back to sleep. I’ve gotten up at this time since I could walk and there’s no changing me now. I fumble around for the call-pendant around my neck.
“Ha. It’s stuck in my armpit. They’re so worried I’ll choke on a short cord that I can’t even reach it,” I think. After who knows how long, I manage to untangle myself from my sheets, my pajamas, and finally my pendant. I take a couple minutes to get my breath back. It’s March, but I’m still fighting the residuals of that cold I had in January.
“Ok,” I mutter as I press my call-pendant, “let’s spin the wheel and see who I get”. I’m hoping I’ve delayed enough that it’s 6 by now and the night shift has traded in for the morning gals.
A beam of light enters my room as the aide opens the door. “What do you need.”
Ah. Night shift. “’Morning kiddo, I’ve got to get up to the commode.”
“Can you hold it 2 minutes? I’m in the middle of a report.”
“Um. Sure hon.”
The door closes and it’s dark again. Alright, let’s waste some time. I don’t want to call too early and annoy the aide, but I don’t want to wait too long, wet myself, and annoy her anyways. I feel around for my glasses so I can keep track of the time, but I just knock whatever is on my table onto the floor.
I start reminiscing about the past… the heavy blankets now laying obediently over my chest remind me of the weight of my gear. There always were plenty of fires in our district back in the day. I think about the boys, all of us working together to save lives, save homes, save each other. We were some team. Remember the time I went back in 3 times for those kids, one under each arm? Yeah, I remember that. I wonder if they remember. Remember the time that little girl wouldn’t stop crying because some feral kitten was stuck in the storm drain and I saved the day? Yeah, I remember that. Remember the time the fire spread too fast and we couldn’t even go in to try? Remember when I had to go in afterwards and count who had been in there? Yeah. I remember that.
Please let their report be over.
I press the call-pendant again. I must be the only one calling because she comes pretty quick. “Hon, I’ve really got to go now.”
She starts pulling down the sheets. “Ohhhkay. Um, it looks like it’s a little late for the commode.”
I hear the snap of her gloves and the lights flood on, like a slap to my eyeballs. “I’m sorry, kiddo; I tried to hold it as long as I could.”
That’ll be the last I hear from her until she’s done. I feel bad, I feel dirty, I feel helpless. I feel a little… vindicated. I told her I had to go. Now I see the machine in action. In less time than it took me to get my pendant in the first place, she’s got my pants off, and is rolling me back and forth, pushing new sheets up under me.
“Oh! Those wipes are cold!” I gasp, apparently to no one who’s listening. This is one time I’m grateful I can hardly feel anything ‘down there’ anymore. I can practically see my scrotum jumping away from her hands. She's too hurried to be gentle. My penance now is to lie in bed naked; it’s ‘not her job’ to find new clothes.
“Hon, could you give me my glasses so I can keep an eye on the time?”
“Where are they?”
“I’m not sure, sorry. I can’t see them.”
“Ok, well, I don’t see them either. Someone will be in to get you up at 7.” And with that, the lights go out and the door is solidly shut.
I’m wide awake, so I go back to reminiscing. I estimate that I probably live a quarter of each day in the past. It’s fun. Those were the good days, when Sugar and I were building our little life together. I’m deep in thought about how I could have improved the deck I built for our house when I was in my 40’s, when the door opens again.
“Good morning Mr. Howie!”
I smile, I know that voice. “’Morning Val, how did the kids treat you last night?”
“Oh, you know, they didn’t sleep and neither did I. You’ve been there!”
We chat as she gets me ready and the time goes by quickly. I only get a bed bath today, but she makes sure I’m covered so I don’t get too chilled. I’m shivering anyways, I suppose because I don’t have any meat on my bones anymore. Maybe it’s that slow thyroid. Maybe it’s just that I’ve lost all my hair, everywhere. ‘The “why” doesn’t matter, you’re just cold’, my goosebumps tell me. Val rubs thick lotion the texture of butter all over me.
“You’ll be greasy all day, but at least the itches won’t be so bad!” says Val, cheerily. “I don’t want to see your skin getting so dry that it tears again. That was no good. Do you want to try number 2?”
She puts my hearing aids in, my glasses and my orthopedic shoes on so I can walk to the commode without harming the toes I can’t feel. It’s just 1 ½ steps from my bed, basically a stand-and-turn deal. We get up a little fast, so I’m lightheaded for a few moments. My heart thunks distantly, trying to reach my head. I reassure my heart; ‘take your time, mornings are hard for everybody.’
Val hands me the hairbrush and I get the sides. I give the brush back to her to fix the rest. Years of lifting hoses and humans, climbing ladders, and crawling under the smoke have left my arms to hang from my arthritic shoulders. I can hear the bones grinding against each other like hearing myself eat a mouthful of peanuts. And boy, can I feel it.
I’ve always brushed my teeth before breakfast, but I know better than to ask for that anymore. Val’s a sweetheart, but she still gets to make the rules and ‘it just doesn’t make sense to brush them when you’re about to eat’.
“Ok, Mr. Howie, I’m going to give you some privacy and you just push that button when you’re done, ok? No getting up on your own, deal?”
She leaves the door open, I guess for my safety. I know I’ve got a blanket over me, but everyone knows what I’m doing as they walk by. These old pipes are rusty, you know, and it takes a lot of patience and concentration to get things moving. It’s already stressful enough. I think it’s been a few days and I do not have time for an enema. And like heck am I getting manually dis-impacted again! I practice the slow breathing my Sugar taught me when she got into yoga in the ‘80’s. It takes a lot of effort since my twisting spine doesn’t leave a lot of room for my lungs, and I’m still coughing from that cold. I’m just getting relaxed when the nurse walks in.
“11 pills for your 8 o’clock, Howard,” she says, scanning my wristband. I’m like a box of cereal in the grocery store checkout line. I wonder if I’m Shredded Wheat or Cocoa Puffs.
I hold out my hand for the pills, multicolored like a deconstructed rainbow in capsule and tablet form.
“What are these for?” I ask.
“Same as always. Thyroid, blood pressure, arrhythmia, diuretic, cholesterol, prostate, vitamins, depression. A couple extra today for constipation,” she rattles off.
“I haven’t had breakfast yet. Should I wait? I thought I was supposed to eat with some of these.”
“It’s fine. You’ll eat soon.”
I take the pills. There’s no arguing with this nurse. It’s just her and one other nurse on this floor. There’s what, 60 people living here? If I don’t take them now she’ll just say I refused them and that will be that. She only has 2 minutes an hour for each person. She must never pee.
I swirl the water she’s given me… she hasn’t added any thickener to it at all. ‘Ok’, I think, bracing myself, ‘swallow hard. You don’t want to go breathing your pills in.’ I cough and choke a little since my throat muscles have gotten too weak over the years to manage water in its purest form. But I get them down. I press my call-pendant after she leaves.
“Hey Val, I’d better quit trying for some action here. I just got my pills so I think I’d better eat something.”
“Sounds good, Mr. Howie.”
I glance at the hall clock as I pass by with my walker. 9:00 already! I’m way behind today. If I want to get to see my Sugar at all, I’d better hurry up. I quicken my pace, stretching and straining my joints and ligaments and muscles and mind to work better together. My lungs are burning, and I can feel my blood pressure going up despite my pills. I see my heartbeat pulse crimson in my eyes, and can even feel a headache nagging behind all my usual pains. But I’m still just shuffling along, hardly lifting my feet off the floor. It doesn’t help that I can’t really feel them anymore. ‘I won’t be long on my own feet’, I think. ‘I can feel the wheelchair chasing me.’
I get to the cafeteria and glance at the faces around me. You can’t even see who they were. Their wrinkles and expressions are like a mudslide smothering the town that used to thrive. The men’s threadbare scalps, the women’s thin perms are our uniform, unifying and anonymizing us all. There’s nothing to mar the predictable sea of ‘old’. Well, there’s Jim. He’s still got a twinkle.
We sit and eat together, our toast and scrambled eggs cut into small geometric shapes. I watch Jim fight for every bite. It’s like his hands wait to tremor the worst right in front of his lips.
He laughs when he sees me staring. “See, I’ve almost got this hypnotism thing worked out. You’re getting sleepyyy”, he says, holding his spoon to twitch back and forth in front of my eyes.
I chuckle, “is it nap time already?”
We chat back and forth. Jim brings up the most recent resident who has ‘moved on’. Stacy was his neighbor so he took it pretty hard. You’d think after watching all our friends and family leave us one by one, we’d have gotten used to it. But it’s like playing Russian Roulette your whole life. Each person who dies is like a bullet slipping one slot closer to you. Jim thinks Stacy got a better bargain than some of the others living here. Our kids tell us that the fees just went up since the nursing home gets such good ratings. Some of us might be getting moved to a facility that still takes our Medicare or Medicaid. It doesn’t matter that there are so many rumors and reports of neglect and abuse, of breaking laws at those homes. Somebody has to take care of us and they’re only going to do that if they can make money off of us.
My Sugar and I tried to take care of each other as long as we could, but even I could see we just couldn’t make it work anymore. Our son, Tom, had us come stay with him for about a month and then we were off to the nursing home. I could have stayed there with him, but I just couldn’t get used to the idea of not being able to see my Sugar every day. I guess it’s a good thing we both moved, because I started falling and have been getting sick with colds and urinary tract infections a lot more now. Every time, it feels like I’ve aged a decade. And not like aging from 20 to 30, either. Every time I get sick, I can feel how probable it would be for it to be the last time. I guess feeling 90 equates to the feeling of dying any minute.
It’s ok, though. If my years have taught me anything, it’s that there’s always a little good with the bad, there’s always some joy in each day. I just try to find that little bit, and if I can’t, I think back on the good times we’ve had. As long as my Sugar keeps going, I’m not going anywhere else.
It’s been a rather introspective breakfast, and I’m completely full. Actually, I wasn’t hungry to begin with. I don’t really get hungry anymore, and my mouth is so dry it hurts to eat sometimes. I think about the last thing I smelled… maybe the perfume that my daughter-in-law wears? I think it’s citrus-y. I think about the last thing I tasted… that tomato sauce on last week’s spaghetti was decent, but it gave me the runs.
Oh, I think I have to go number 2.
I frantically press my call-pendant, and Jim does the same in solidarity. “Hey! Hey!” I call out, trying to get someone’s attention. I start to get up, I’ve got to go!
“Howard, you cannot get up on your own. It’s not safe,” an aide tells me.
“Well, Bud, I’m about to split my pants. I gotta go!”
His eyes widen. He knows it always takes me a few days of storing up to finally get going. This is a mess he does not want anywhere but the toilet. He rushes me up, which is fine by me. Before I know it, we’re in the bathroom, pants down. I sit down and release, my toes skimming the ground from the high seat. There’s no time to put a liner on the toilet seat, or to give me privacy. The aide can barely put on gloves and definitely is not going to waste time washing his hands, but at least he turns away. I’m sure that’s for my benefit, right? I muse over the pros of using the toilet at 90: I can’t really smell anything, can’t hear myself passing gas, can’t feel if something’s splashing on me. The seat hurts my tailbone but once I get going I don’t have to sit for very long. The best part is that I did it on my own. I imagine thousands of my past selves, applauding my success. It’s the little things.
The aide is a good kid. He helps me stand up and lets me wipe myself the first couple of times. He finishes up with a wet wipe, warning me of the cold, and pulls my pants up, holding them so I can fumble with the button to fasten them. I know that he could do it faster, but it’s important to me to try for myself. I can tell he’s debating whether to ignore what just happened, comfort me, or congratulate me, poor kid. I grin as he flushes the toilet behind me. “What? You want to get rid of my masterpiece? As rarely as I get to go, I was going to save some and frame it for my son!” He bursts out laughing, relieved he didn’t have to break the silence.
“You have a minute to walk me to physical therapy?” I ask.
“Yeah, Howard, no problem. You headed to see your wife today?”
“Of course! Every day. Our son’s coming today, too. I have to get this out of the way by lunchtime.”
We make a little small talk on the way to the elevator down to PT. The kid is dating and thinks she’s ‘The One’. We talk about the ‘secrets’ to a good marriage, happy kids, loving life. The usual.
Therapy takes about an hour. I waste a quarter of it trying to pee. We practice walking, sitting, standing, we do a few exercises with light weights and elastic bands, we do a little stretching. It’s not much but it keeps me vertical, out of that wheelchair, and as independent as possible. This hour of effort keeps me free enough and strong enough to see my Sugar. By the time it’s over, I’m exhausted and my shoulders, hips, back, knees… every joint I have is aching and every muscle I have is fatigued. ‘It would probably be better to do this before bedtime’, I think, ‘but this is the time they have and the time I have.’ I squeeze some artificial saliva in my mouth for the dryness, always worse after exercising. It’s 11:00 already. By the time I get back to my room it will be 11:30. Tom, our son, is coming after lunch, at 2. I calculate that I have enough time to take a quick nap.
When I get back to my room, Val finds me. Oh, right, we never brushed my teeth. I take my nap and repeat the meal ritual for lunch, downing another 4 pills and maybe half a glass of some supplement shake. I keep losing weight, so they’ve been trying to get me to eat more. I must drink as many protein shakes as an Olympian. I grin, picturing a “Got Ensure?” ad, complete with a liquid mustache and me flexing my little biceps. I know I’ve got to keep up my strength for my Sugar, but it just makes me nauseated to keep forcing the food down. It’s a little easier to eat on days like today, when I’ve done number 2. They keep pushing glasses of water on me, too. It drives me crazy. Between the water pill and my prostate, it feels like all I do is pee. Besides, the thickened water is disgusting, like drinking cold, tasteless potato soup, and it fills me up so I have even less of an appetite. They say staying hydrated will help me think clearer and have more energy, but what’s the point of energy if I spend it all walking back and forth to the toilet?
I digress. It’s almost time for my son to get here, and it’ll take me a half hour to shuttle and walk to my Sugar’s building where we meet.
Our son beat me to the building, and I wave to him as I shuffle up. He looks upset, standing next to his Mom. “How’s my little family today?” I ask.
My son looks down at my wife, worried. “Maybe this isn’t the best day for a visit”, he murmurs.
My Sugar is crying, not making any sound. “No, no”, I reassure him. “This happens sometimes. The doc says she’s just got her feelings and responses all mixed up. She’s probably just happy to see you. Maybe she recognizes you! It’s a treat to see her beautiful eyes open. They’re as green as ever, aren’t they?”
My son looks uncertain and uncomfortable as I stoop to kiss my wife. I make sure I wait for her to look into my eyes when I ask her: “Hey Sugar, how’s the love of my life?” I tell her that Tom is here to visit and that she looks like a cutie today. After a few minutes her tears dry up. “See? It always passes pretty quick.”
“Has this been happening a lot?” asks Tom, looking around, “Are they taking care of her? It always smells so bad here.”
“She seems ok. It’s hard to know, and she can’t tell us. And she wouldn’t probably remember even if she could.” I understand his concern. This is why I’m here by her side every day; I’m never completely certain that they’re treating her well. And they couldn’t possibly love her like I do.
She’s so thin now. Her eyes are closed almost all the time, and as poor as my hearing is, I can still tell her breathing isn’t normal. But it’s hard to tell what is the result of her disease, and what might be a lack of care. I’m just grateful that they’re taking care of her since I can’t, and that our son cares so much. It must be scary for him to see us like this; our little man is already almost 70. I know it was hard for him to decide to move us to a nursing home, but it really was the only choice. I try to help him see the big picture. I don’t want him feeling guilty when all is said and done. Between my falls and infections, and her bouts with pneumonia and bedsores, I’m sure we’ve had more time together here than we would have on our own. We talk for a good long time. We talk about our son’s life now, his hopes for the future, the past we’ve shared together, as we try to feed my Sugar some pureed lunch while she’s awake.
I drop the spoon and my son looks at me with a little smile. “Want me to take over, Dad? You look kind of wiped out.”
I’ve been nodding off while we’ve been talking. I chuckle wryly, “Yeah, I’m pretty beat! Guess my own story was boring me to sleep.”
He takes the spoon, and I watch while he feeds his mom like she used to do for him. There’s the same look of love, and the same joy when a mouthful goes down. I half expect him to start making airplane noises as he brings the spoon in for a landing. She hasn’t nearly finished the food that’s supposed to be required for her to stay alive when the aide comes up.
“I’m sorry, her visiting hours are over. It’s time for her to rest.” I don’t want to leave her, but it seems reasonable enough. My Sugar has been fast asleep for a while already.
We kiss her goodnight, and get up to leave.
“Dad, do you want to use the bathroom?”
I look down, confused at his sudden question, to see that I’ve already used it, apparently. I feel a little ashamed; I always lose track of time when I’m with my Sugar. I usually have a pair of disposable underwear on during the day. It must have slipped Val’s mind when we were getting ready this morning. “Well, no use crying over spilt… milk”, I exaggerate a wink for effect. I don’t want Tom to feel any more uncomfortable. Poor guy already had to tell me, and sit next to me smelling like urine for who knows how long.
“This isn’t my first rodeo. I have an extra set of everything in the seat of my walker,” I tell him.
He helps me to the bathroom and I’m mostly able to get changed myself. He rides the shuttle back with me, like nothing even happened, carrying my soiled clothes in a trash bag on his lap. He’s a good son. He stays with me for dinner, enjoying the brown-on-brown Salisbury steak about as little as I do. The nursing home has a therapy dog come in, and we pet him a little. We talk some more, and I really get into recounting a history of all the dogs we’ve had over the years, but I can see I’m losing his interest. You know, we conversed differently in my generation. And the years have only compounded that change. My mind works differently now. As kids, we rush through stories, we don’t have time to recount the details, tell illustrations, hide stories within stories. At my age, I’ve had all the time in the world to figure out the best way to talk, it just takes a little more attention and a little more time. But that’s all right, Tom isn’t far behind. He’ll learn that skill with experience and age.
Before I know it, 7:00 has rolled around. Val must be pulling a double shift because she’s still here to help me get ready for bed. Tom says goodbye; he’ll be back to visit next week with his wife and her citrus-y perfume. I take another round of pills and Val and I perform the morning ritual in reverse. She takes extra care in flossing the teeth I have remaining, setting my dental bridges in their cleaning solution, my hearing aids in their case, my glasses on the nightstand.
I’ve been really having a hard time getting to sleep lately. The dryness in my eyes scratched my corneas a couple of weeks ago, so I’m getting eye drops before bedtime. I have to time my ‘only as needed’ pain medications just right. Of course, they’re needed every day and far more than I can get them. My shoulders and everything else hurt so much more at night. I don’t know if it’s the bed, or the position, or the lack of movement, or just that I’m not distracted enough, but it keeps me from sleeping. Those pills don’t help my constipation any, and they make me more lightheaded when I stand, but I do have to sleep a little. I lay in bed as long as I can, hoping to wait until 11:30, because then the medicine will last me until I wake up the next morning. I stretch the time by pressing my call-pendant to pee whenever I feel like I need to. That way I can ask the aide what time it is, since I can’t see my clock. I give up at 11:00, and ask for the pill early because I’m starting to get cramps in my back. I don’t want to let that go too far. As the pill starts to take effect, the pain fades away and I can feel myself finally easing into sleep. I settle deeper into my pillow and close my eyes on the day.
“Goodnight, Sugar,” I whisper. “Save a kiss for me when we wake up."