I spend a lot of time in institutions. Hospitals. Skilled nursing facilities. Rehabilitation facilities. Assisted living facilities. All institutions made necessary and profitable by the large wave of aging folks known as the Baby Boomers.
Few people want to be clients in these places. And if news reports and other anecdotal sources are accurate, few people want to work in these places. At least at the lowest level of care providers. Anyone from the janitors to the non-credentialed employees who assist with moving patients, changing them, cleaning them, feeding them, even delivering pills to them.
It isn’t glamorous work. The halls echo with the moans and shouts and cries of the lonely, the confused, the needful. It takes a special kind of person to work in these places, regardless of what our society may think of them. To a culture obsessed with glamour and youth and power and prestige these are low places filled with low people.
When I first met her nearly three years ago she was fairly mobile. Walking with difficulty. Living with her sister. She became a member, dependent on her sister to take her to church, which didn’t always work out. A year later or so, I received a note from a friend of hers out of state indicating she wouldn’t be coming to church any more but would like Communion at home. I contacted her, confirmed this, and began regular visitations. I learned she suffered from a rare degenerative neurological condition. So rare, a major research university in the north of California requested her brain and spinal column after her death, and would handle all the necessary costs for those issues. It was a waiting game at this point.
She moved to a hospice house and I continued to see her regularly. She outlived her prognosis, and her Medicare coverage for that facility, so earlier this year she moved to a new facility. Not a house but an institution. Over these few years she became wheelchair bound. Then bed-bound. The condition slowly paralyzes her. First it was just the left side of her body. Now she can only move her head ever so slightly to the left and right. Her eyes are always active. Her mind is keen and she’s always looking and listening to everything around her. Speech grows more and more difficult.. Thankfully, she has no pain.
But she’s in an institution, and institutions are large, impersonal places. It’s easy to get lost in the shuffle. It’s easy to be on the neglected end of a system that employs the bare minimum number of staff to provide adequate care for all of the patients and clients. But adequate care is not necessary personal. Not necessarily timely. And for someone now immobilized, that can be terrifying.
She has a wonderful personality. A faith as strong as any I’ve ever witnessed. She’s ready to go, but God apparently isn’t ready for her yet. We talk about this often, which sometimes elicits loud wails and tears, which come more easily as a result of her condition. When the research university called to check in on her last week, they asked her sister – who spends hours every day with her – whether she was afraid or not. Good grief, no. She’s not afraid! She knows what lies ahead.
In the meantime, until God is ready to bring her home, she becomes a joy to everyone who meets her. Staff pop in to say hi to her, knowing she’s almost always smiling. She’s a rare source of sunshine in a place often filled with clouds of confusion and despair.
But with shift changes every day, and with changes in institutional ownership that further affect who stays and who goes and who is hired on, friends are rare and special things in an institution like this. An institution that tries to do well and by and large does, but still operates within the broken confines of a sinful creation.
But friends can ease that brokenness. They can attend to her quickly when she needs them. They remember she needs her food pureed now because swallowing is becoming more difficult. They are as close to clockwork as is possible in a place like this with the hoyer lift, an amazing device that enables a single elderly caregiver to hoist this woman from her bed and deposit her in a wheelchair, and visa versa, almost every day for a few moments of cherished fresh air and sunshine and a cigarette outside. Friends help ensure she doesn’t sit alone in her wheelchair for hours on end because nobody remembered to return her to bed. Friends remember to bring her pills on time.
Friends make things bearable. Little touches of God’s grace for a woman who has lost everything but her mind. Who is kept awake most nights by her insomniac roommate. Whose family is all the way across the country and isn’t able to get out to see her very often. Friends offer a smile, a bit of humanity in a place that can be very dehumanizing. Friends help her sister rest easier, knowing she is taken care of for the other 20 hours a day she can’t be at her side.
It’s not a glamorous place or glamorous work but it so vital and necessary, and when it’s done with a little bit of care and love, with a smile, it means the world to the one receiving it. Who can’t do anything but smile back and try to speak her gratitude, try to share a bit of the love of Christ with whomever is with her at the moment. Who prays and worries when her friends aren’t on shift when they should be, and rejoices for and with them when she learns it was just a cold and not a layoff.
Friends in low places are beautiful things. Pity they aren’t the heroes of our days. Pity they aren’t the ones feted and followed by the Instagram crowds. Pity that sex tapes and obscenity are more revered and respected than honest, difficult, sometimes very unpleasant work. But thanks be to God for those people who do this work anyways. I hope they know how special they can be when the become not just an employee of an institution, but a cherished friend of the patients because of a little love and care and extra effort.