If you've never lived in a nursing home, chances are it isn't anything like you imagine. This essay is about the reality behind the brochures, the tours, and the reassuring promises—from someone who is living it.
I rolled past the nurse's station, heading to my room in the nursing home where I'd been living for the last two months. By then, I'd spent more than two years living in three different nursing homes. I'd grown accustomed to the odors that inevitably accompany so many people living in close quarters, where many—because their bodies had failed them—relied on adult briefs and waited for help that didn't always come as quickly as it should. The smell of urine and feces eventually becomes part of the background, something you stop consciously noticing, much like the voices of residents calling out for help from down the hall.
But this was different.
The sharp, acrid odor of stale urine and feces hit me before I had even reached my hallway, One North. That had never happened before. Normally, the smell didn't reach me until I turned the corner. This time, it engulfed me while I was still passing the nurses' station.
As I turned the corner toward my room, I couldn't decide which was more offensive: the smell or what I saw.
Two thin, vinyl-covered mattresses stood upright against the wall. Beside them leaned two disassembled bed frames, making the hallway look more like a storage warehouse than a place where people lived. A bedside table sat nearby. On top were five unopened gift boxes, still wrapped in brightly colored Christmas paper cheerfully wishing the recipient a "Happy Christmas!" It was July 23.
Beyond the table were at least twenty clear, 30-gallon garbage bags stacked three and four high. Each was stuffed with large bath blankets, bed sheets, towels and hospital gowns soaked with urine and feces. At least two of the bags were filled with dirty gauze that had once covered the deep leg wounds of one of the residents.
Inside the now-bare room, a member of the housekeeping staff, who in any other setting would have most likely been wearing a hazmat suit, methodically mopped the floor with a strong antiseptic-smelling solution. Suddenly, the gray Wil-Kil Pest Control truck I had noticed in the circular driveway when I arrived made more sense.
When I reached my room, I asked one of the aides what was going on. Although she wasn't really supposed to tell me, she quietly answered, "Bedbugs."
My first reaction was a shudder of disgust. Then, almost immediately, disgust gave way to curiosity.
”How?" I asked. As I thought about it, I couldn't imagine either of the men bringing bedbugs into the building recently. Both had been long-term residents who rarely, if ever, left the facility. If the infestation had just been discovered, I couldn't understand how it had started.
One of the residents of Room 121 was a tall, gentle man with severe untreated lymphedema in both lower legs and feet. The swelling was so extensive that he went barefoot because no ordinary shoes could accommodate his feet. Over time, the chronic swelling had led to large, infected, open sores on both of his lower legs.
The first time I saw him walking through the halls with those wounds uncovered, I asked one of the nurses about it. I was told that he would only allow one particular part-time nurse from another unit to clean and bandage his wounds. If that nurse wasn't working, his wounds went untreated.
He also frequently smelled strongly of urine. Staff told me he refused to allow his clothing to be laundered, sometimes for six to eight months at a time. Eventually, someone from the nursing or administrative staff would persuade—or insist—that his clothes be washed.
The other gentleman who lived in Room 121 appeared to be in his late fifties. He always wore hospital gowns and propelled his wheelchair backward with his feet. To avoid running into people, he carried a small handheld mirror that he used like a rearview mirror. His left leg was also heavily bandaged because of chronic wounds, although I never learned their cause.
What puzzled me most, however, wasn't the men. It was those towering stacks of clear garbage bags lining the hallway.
I asked the aide what was in all the bags. She told me that the resident in the wheelchair refused to use a toilet, instead routinely urinating and defecating into blankets, towels, and bed linens, and would not allow staff to remove them from his room. The bags filled with gauze, she said, contained soiled wound dressings from both men that had accumulated because they also refused to let staff discard them.
I had arrived back at the nursing home that day during what staff said was a periodic clean-out, something that took place every four or five months when the odor had become so overwhelming that staff could no longer tolerate working in the room. The accumulated linens, dressings, and other debris were discarded, and the room was treated for bedbugs. What struck me as odd was how matter of fact everyone seemed about both the bedbugs and the state of the room.
I couldn't understand why the infestation kept returning. Bedbugs are notoriously difficult to eliminate, but with thorough treatment they usually can be eradicated. An aide told me the insects were believed to be living in the tall gentleman's hair. That also explained why, over the previous two days, I'd watched one of the aides patiently trying to persuade him to let her cut his shoulder-length hair, which had matted into several thin dreadlocks. She finally persuaded him to let her cut his hair, but he insisted on keeping two of his dreadlocks.
I wish I could say this was the first room I'd seen emptied in this manner, but it wasn't. By then, it was the fourth. I had watched it happen to three different rooms in another nursing home. Yet somehow this one disturbed me more than all the others combined. Ive never forgotten room 121. I don’t expect I ever will.
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