Working in senior care isn’t for everyone. It isn’t even for most. But for those rare few who find their passion in this multifaceted industry, the sense of job and life satisfaction are limitless. So too, however, can be the pervasive sense of loss and hopelessness. Poopy Fingers: One Person’s Account of Working in the Delightfully Strange World of Assisted Living, follows the author’s experiences as he fumbles through, and then stumbles upon his own passion for working with, and for, this often undervalued and ignored demographic.
Poopy Fingers also explores the varying stages of life familiar to so many of us. With tenderness, compassion, and humor, the author describes with raw, and often painful honesty, his experiences with the residents and their families who are all trying to navigate the challenges that arise in our later years. Poopy Fingers is a true celebration of the circle of life, and a reminder that more often than not, we don’t pick our passions in life, they pick us, nor do we necessarily get to plan out the direction our life takes. Often we just have to strap in and try to enjoy the ride.
The bag of pee strapped to his ankle was what most people noticed first about Ariel S. For a man shrinking at an alarming rate—he had most recently measured in at 4 foot 11—his clothing, for some inexplicable reason, was shrinking faster than he was. The result being that, instead of shrinking, Ariel thought that he was in fact growing. Each morning when the care staff dressed him, he marveled at his latest apparent growth spurt. Each pair of pants barely reached down to his ankles. His belt buckle, pants button, and zipper were always disengaged. The only thing that kept people from seeing the other end of the urine bag, which was attached to his penis by a catheter, was the pair of faded red suspenders that had been with Ariel nearly every day of his adult life.
“Am I going through some sort of a growth spurt?” he would ask. “Is this normal? Is something wrong with me? How tall will I get?”
The care staff, on the other hand, wondered how small he and his clothing would become. Whether one day he would need to go naked—as he both refused to buy new clothes nor to wear anything that he had not brought with him to Gleeful Meadows Assisted Living—or whether they would come to his room to wake him one morning and he would not be there, having grown too small for his neutrons and protons to hold him together at all.
Ariel was not without his charm. The only problem was that most people had a very difficult time discovering it, as it required actually spending time with him. People were usually repelled or repulsed long before that time of discovery arrived. Ariel was on “behavior watch,” as dictated by the nursing director. The most recent of his indiscretions, which were always verbal and never physical, was to tell his caregiver during his shower session that she needed to clean his penis twice. The first cleaning being for the normal wear and tear of daily living, and the second cleaning was for what he had fantasized using it for.
~
On the sidewalk in front of a donut shop, Ariel laid his arms over the front of his walker. He looked again for a place to sit. The curbs were all too low for him to lower himself onto. He had tried to rest upon the bumper of a parked car, which had then started to make a piercing high-pitched noise.
He could see clearly perhaps five feet in front of himself. Beyond that, the parking lot turned into a blur, mixed with the sky and horizon into a blended abstract. His glasses hung around his neck via a piece of string, so naturally he assumed that he had forgotten them at home. Wherever home might be. He could never remember. He wasn’t crazy, or at least he didn’t think he was. After all, he knew his own name and his social security number—well, most of it, anyway.
As with most of the residents who called Gleeful Meadows their home, I had learned some of Ariel’s earlier life and experiences over hot chocolate or coffee. Ariel had worked every day of his life from his fifteenth birthday until his eighty-eighth. On that day, he had said that he was tired. He stopped getting out of bed for meals, stopped grooming himself, and stopped taking pleasure in those things which used to give him pleasure. In truth, nobody knew what those things were, but it was evident that, whatever they had been, they were no longer doing their job. So, Ariel’s son did what most people would do in his situation—found a place where his father would be cared for and would not be allowed to starve or wallow in his own filth.
“Yeah, it’s really nice that he gets to live out his golden years in this cushy place with me footing the bill,” Ariel’s son had said to me. “He didn’t pay for a goddamn thing while I was growing up. He was a lousy father. He never hit us, but he never hugged us either. Barely saw him. The man was never there.”
I hear that he was too busy earning a living putting food on the table, I thought to myself.
~
I pulled the bus to a stop in front of Safeway, once again employing a liberal use of unlawful parking spaces, which I felt were made slightly less unlawful by the handicap decal that rested on my dashboard.
I entered the coffee shop at the front of the store and saw my group waiting for me with their assorted purchases. A potted plant in the lap of one wheelchair-bound resident caught my eye. Potting soil already covered the front of her blouse, culminating in small mounds around the base of the pot on her skirt, as well as a dark trail ground into the floor that marked her path. I also looked with disdain at the full grocery cart next to another resident, knowing that I was the one who would have to carry her purchases into the bus, secure them, then later carry them off to her room, storing them in her cupboards and icebox. Gleeful Meadows Assisted Living, where I worked as the activities director, provided three meals a day, as well as snacks. Why anyone wouldn’t take advantage of that—considering that they were already paying for it—was beyond me. I was even taking advantage of it and had already gained ten pounds since I began working there.
I took a headcount. “Adeline, where’s Iris?” I asked.
“How would I know?”
“You said you’d keep her with you.”
“She wanted to look at the candy bars.”
“I told you she needed to be watched. You said okay.”
“After she veered down aisle six, she was out of my hands. Does it look like I need another candy bar?” She flashed a grin that revealed her three remaining teeth, one of which was so decayed and porous that it took on the color of her most recent meal. At the moment, it was a light shade of blue. Adeline was a heavy-set woman who never wore anything other than a cream-colored knit sweater and matching pair of sweatpants that were so tightly wrapped around her meaty thighs that I wondered if, years earlier, she had just given up trying to take them off. Her gray hair was in ringlets and sported two plastic barrettes, the kind a little girl would wear.
“Everyone wait here,” I said. I ran to the candy aisle and saw Iris midway down the aisle with her hands filled with chocolate bars. I rushed to her.
“Iris, you had me worried.”
“How could I worry you?” She tugged on her yellow mullet and adjusted her enormous glasses.
“Our friends are waiting for us at the front.”
“Which friends?”
“You’ll see.”
“I’ve got to go to the little girl’s room,” she said.
“Supermarket restrooms are dirty. Can you wait until we get home?”
“I suppose. Who’s going to pay for all this?” I looked at all the candy she had.
“We’ve got candy at home.” That was a half truth. The full truth was that we did, in fact, have plenty of candy back at the community, but Iris was not allowed to have any. Her daughter was convinced that she was getting a little too round and, therefore, wanted us to restrict her sweets intake. I did my best to look in the other direction when such intake was taking place. My personal point of view was that, if a woman going on ninety wanted to end her days in a chocolate bliss overdose, well then, who am I to stand in the way of such a delightful exit?
However, buying her what she now held would be a blatant a disregard of her family’s wishes, and besides, we were running short on time. I was new at the job, but I had already discovered that the world of assisted living revolved around the punctual start and stop of daily activities. Our “trip to Safeway” was nearing its finishing point, and “cooking with Kevin” (that’s me) needed to begin promptly in twenty minutes. If it didn’t, no doubt a phone call would be made to the ombudsman by one of the eighty-six residents describing the “flagrant disregard for scheduled activities—not to mention the walls which haven’t been painted in over two years, and the soup was served lukewarm two weeks ago, and would it kill Gleeful Meadows to serve prawns instead of shrimp, and I think that they didn’t pass out the mail until after dinner time last Monday, which is clearly a violation of our civil rights, and I also noticed a trace of mildew in my shower which could be a biohazard issue that the state authorities might have to look into.”
I did not want to be the cause, or even appear to be the cause, of one of those phone calls again.
“Has anyone seen Ariel?” I asked once back at the coffee shop area with Iris.
“Who?”
“Red hat with his name on it. Sits next to you at dinner.”
“Never heard of him.”
“I don’t like him. He’s rude,” someone else said.
“It’s definitely rude of him to be late.”
I led the group outside. “I’m going to have you all wait on the bus while I look for him.” I checked my watch and opened the doors to the bus. The able-bodied residents began filing on as I went around to the back to operate the wheelchair lift. After I had loaded and secured my one current passenger with a wheelchair, I walked back around the front of the bus to see Adeline struggling to pull herself up the stair rail.
“I’ve got the lift ready for you,” I said.
“I want to try the stairs.”
“Are you sure? Didn’t you take a tumble a couple of weeks ago?”
“That was different. I was rushing then because I really had to use the toilet.”
“You’re sure you want to do this?”
“Absolutely.”
In our line of work, we try to encourage as much independence as possible. The physical and psychological benefits are obvious. The pitfalls are obvious only to those of us who have walked these paths on repeated occasions. Even though I was relatively new at my post, certain experiences made me a hardened veteran, and I knew from those experiences that I was heading face-first into one of the job’s pitfalls.
As Adeline gripped the base of the railing leading up into the bus, I positioned myself behind her with my arms ready to support her weight in the event that her legs could not. She began to pull herself upward. The sound of aged exertion was the warning I was waiting for. I turned my head away from the pitfall—preferring to encounter it ear first.
Three…two…one…
The sound of the fart was wet, though luckily most of the sound, and much of its aromatic value, were absorbed by Adeline’s adult diaper. She moved forward into the bus, and I followed, holding my breath.
There are side effects of aging that one can’t describe without seeming to be making light of them. Laughing at the humors of aging is not the same as making jokes about them. Prior to coming to work with seniors, I would have turned my nose up at such a description if I had read it. Looking back, I learned more life lessons than I can remember in my year of working amongst the aged, and one of them was taught to me by a resident who had sneezed and inadvertently peed herself. “If we don’t laugh, we cry. So, we might as well do both at once.” I try to remember that always.
“Are we going to miss bingo?” someone asked.
“Bingo’s tomorrow,” someone else replied.
“Can’t we play it today?”
“Then what will we do tomorrow?”
Once everyone was locked securely inside the bus, I ran back inside Safeway and searched the aisles, though I did not find Ariel.
I stood on the curb with my hands on my hips. A bus full of seniors looked down at me, some probably wondering how they could help, others wondering if we would be home in time for dinner, and still others wondering why I looked so familiar.
I boarded the bus and then drove the length of the strip mall, glancing at the pedestrians, hoping that one of them would match the description of my quarry. None did. When I reached the far end of the final shop, I turned left so that I could make a loop of the parking lot, allowing me to come back around for another pass. Taking the long route would be quicker and less taxing than making a three-point turn. In this bus, a three-point turn more readily offered the driver the prospect of finding himself wedged impossibly between opposite curbs, as well as marring the already scuffed paint job with love-taps from a variety of objects that all lay concealed by the design of the bus, which had more blind spots than sides.
To my knowledge, I had never met anyone suffering from Alzheimer’s disease before coming to work at Gleeful Meadows. About fifty percent of our residents had a diagnosis of Alzheimer’s, and an additional thirty percent suffered from some form of dementia resulting from other illnesses. This is a population that can take some getting used to. Some people never get used to it. Industry statistics say that the average yearly turnover rate for staff in assisted living is a hundred and thirty-three percent. Of course, there are many wonderful people who find their passion in a lifelong career in this beautiful industry, but there are many, many more who try it and then run screaming. In one year, I saw two executive directors, three business managers, four receptionists, four care staff managers, three marketing directors, and four activity directors pass through Gleeful Meadows. This list doesn’t include the plethora of support staff working under those directors who I saw come and go, and go and go.
Bottom line, it’s an industry that quickly weeds out those who don’t truly have a passion for it. Working with Alzheimer’s can be scary and sad. It can also be incredibly fun and funny. Once again, there is nothing wrong with allowing ourselves to see the humor in sickness. Anyone who works in a stressful industry will tell you that the only way to cope is to laugh. Ask a family member of an individual suffering from Alzheimer’s, and, more often than not, they will tell you that it’s not just okay to laugh—it’s necessary.
As I drove, I considered employing the assistance of the minds and eyes that sat behind me. Even though the majority of them suffered from at least mild dementia, they tended to be more aware of their surroundings than one might readily believe or even hope. However, with that said, the collected effect of their voices and experiences tended more readily to follow the mob rule phenomenon of breaking down the collective to its lowest common denominator rather than being elevated by a meeting of the minds and a “more heads are better than one” outcome.
“Where are we going?”
“We’re lost.”
“We’re not lost, somebody else is.”
“I think we’re all here.”
“Are we going shopping?”
“Did you take a head count?”
“We’re not going shopping, we just came from there.”
“Who’s paying for this?”
“Kevin, are you going to get fired?”
“My kids never got lost, because I never let them out on their own.”
“Whose kid is lost?”
“Somebody lost their kid?”
“What kind of a parent would lose their kid?”
“My kids never got lost, because I never let them out on their own.”
“Aren’t we going the wrong way? The shopping center is back there.”
“I think we lost somebody.”
“Are we going out for lunch? I didn’t bring my wallet.”
“My kids just dumped me off here and left me. They made it seem like we was going on a little get-away. They said, ‘Isn’t this a nice place?’ Then I noticed it was all my things in the room. I said, ‘What’s going on here?’ They said, ‘This is your new home.’
“My kids never got lost, because I never let them out on their own.”
And on and on it went as I drove.
I checked my watch. How long could I search before I needed to call my boss to tell him that “one of the eggs has fallen from the basket?” A call certainly worse than “one of the eggs has cracked and is now leaking all over the bus” (quite common, indeed), but not as bad as “Sir, one of the eggs is dead.”
It was now time to take the search to the street—store by store by store. I was scared and beginning to panic and not thinking straight.
I thumbed my cell phone in my pocket, delaying my shame coming to light.
I entered Target, and for the first time in my life, was overwhelmed by its immensity. Where once I reveled in the “hell yeah” attitude of having every possible shape, size, color, and brand of every product I could imagine available to me under one roof, I now cursed at the nooks, crannies, aisles, doorways, hallways, innies and outies, and stock galore that possibly stood between me and Ariel. Assuming that he was even in here and not at Buster’s Cameras, Toro’s Teriyaki, or a thousand other stores in between.
There are several things that one must keep in mind when hunting down a missing senior, a list I made up while I walked to the customer service counter.
1. Remove your name tag.
2. Lock the others in the bus. I’m not exactly sure of the legal implications of this step, but I feared the possibility of losing another resident much more than I did that of a spontaneous bus explosion.
3. Never have a store employee announce the individual’s name over the loudspeaker. The reason for this is two-fold.
a. You want to keep this as clandestine as possible.
b. A lost senior is not like a lost child. They will not bound up to the customer service station upon hearing their name. There’s a good chance that their hearing aids are not even on and, therefore, they will not hear the aforementioned announcement, which could leave you standing there for a very long, fruitless, and wasted amount of time. Furthermore, seniors do not bound.
No matter how nervous you might be, never show it. Pretend like everything is cool. Store clerks can smell fear. How else do they get you to pay too much or buy some stupid crap you don’t need?
“I’m looking for an elderly man in a red ball cap,” I said.
The staffer, a girl of perhaps sixteen, glanced down at my chest, and I realized I had neglected to employ the first step on my list. “What’s Gleeful Meadows?” she asked. “Sounds like a funeral home.”
I wondered for a moment if I had neglected to also lock the doors of the bus, and an image of aimlessly wandering seniors being clipped down by cars in the parking lot, entertained itself upon my psyche for the briefest of moments. The girl turned to an older, plumper version of herself at the far end of the counter, who was scanning returned items with a tool that looked like a magic wand. “This guy’s lost his grandfather.” She turned back to me and shrugged. “A lot of people pass this counter. It’s a busy place.”
“It would have taken him considerable time to pass this counter. I mean, he moves really, really slow. You would have had plenty of opportunity to notice him.”
She took hold of a microphone. “What’s his name?” she asked me.
“He won’t hear you if you call him with that.”
“So, what do you want me to do?”
I left the counter shaking my head. Crap. I’d have to run through the entire store. Ten minutes later I was sweaty and still hadn’t found Ariel. I began to worry that he had gotten hurt. Lost was one thing. Lost can be fixed with found. But hurt, on the other hand. If he had fallen…or…. A worse thought came to mind. Not death, but what if someone had decided he looked like an easy mark for a scam? Losing his life savings to someone’s unscrupulousness could have happened many times over by now in the time since I had last seen him.
I had seen this sort of thing before. The first time was even before I began working with seniors. I had been in line at a bank and had overheard as the teller described to a woman and her elderly mother how the old woman’s bank account had been drained by a young companion of hers whom she had trusted, whom she had thought was her only friend in the world. For some time, the old woman couldn’t seem to grasp what had happened, but when understanding, and then shame, came to her, she said that she wished she could just die.
Could that sort of thing be happening to Ariel right now? I admitted to myself that it was unlikely, as most of our residents had long since relinquished control of their finances to their children. But this wasn’t always the case, and even when it was, the circumstances were often less than ideal. We’ll come back to that later.
Back on the bus, I took a moment to gather my thoughts. My store-to-store search had turned up nothing. I was no longer just afraid for myself and getting in trouble. I was now deeply afraid for Ariel and the trouble that he was no doubt already in.
“I’m out of options,” I said.
“You act as though you’ve never lost anyone before,” someone said.
“Just glad it wasn’t me,” someone else said.
“Who’s lost?”
I drove slowly back toward the entrance of Safeway. Beyond that was the entrance to the parking lot, a line I did not want to cross, perhaps ever again. I withdrew my cell phone and pressed the speed dial for Gleeful Meadows.
A car behind us began to honk its horn. I looked in my side mirror and saw the car (I never was very good at specific vehicular identification) swerving left and right. “What’s his problem?” I asked. The phone rang.
“What a jackass,” someone said behind me in the bus. Assuming he wanted to get past me, I rolled down my window and waved him through. He did not pass, but merely kept honking and swerving side to side.
“Did you run someone over?” one of my seniors asked.
The call was picked up on the second ring. “Good afternoon, Gleeful Meadows,” a charming female voice said.
“Hey, it’s me. I need to talk to Paul.”
“What’s wrong?”
“I lost Ariel.”
“Oh no. Hold on, I’ll put you through to him. Good luck.” I was put on hold.
The car behind us continued to swerve and honk. “That young man’s parents should have taught him to be more respectful of people,” someone said.
“My kids never got lost, because I never let them out on their own.”
Shut up, shut up, shut up, I thought.
I again waved the person to pass, but the honking continued.
The on-hold music coming in over my cell phone stopped. “This is Paul.”
“Ariel’s in the car,” someone shouted. “Stop the bus, Ariel’s in the car.”
I held the phone away from my face. “What was that?” I yelled back.
“He stole a car?” someone else asked.
“No, he’s in the passenger seat.”
“Hello?” I heard Paul’s voice say. I pressed the end call button and put the phone back in my pocket.
I pulled the bus to a stop and got out. The driver of the car did the same. I could see Ariel sitting in the front passenger seat, now fumbling with the door.
“Thank God,” I said. “Where did you find him?”
“Wandering in the parking lot,” the man said. He walked around the car and opened the door. I rushed to his side to help Ariel to his feet. The Samaritan removed Ariel’s walker from the back seat. As soon as Ariel was free from the car, he threw his arms around me and pressed his face into my chest. At first, I thought he had lost his balance, but then I realized that this was an action he had intended. As deliberate as it was reflexive. Ariel needed to be comforted, needed to be held and reassured that everything was alright. His body shook violently with sobs of both fear and relief.
As Ariel cried in my arms, the smell of his aftershave reminded me of something. Two days prior, I had had a disagreement with our head nurse regarding Ariel’s appearance when he leaves the facility on outings such as this one. Typically, his ensemble included a white dress shirt, blazer, and bathrobe all covered in various articles of mouth-missed food. Once I had seen the thick, gooey innards of a blueberry pie resting precariously on the inside edge of his open shirt. I had mentioned this to him, and before I could reach forward and rescue the blueberry mash, Ariel patted his shirt down, smooshing the bluey-gooey goodness into his shirt, and causing most of it to fall back down in between his inner and outer shirts.
The nurse had argued that, with concern for the marketable image of the facility, we should require Ariel be clothed cleanly and smartly before leaving the property on outings. I had felt in my gut that this was not fair, though I had a difficult time, as is often the case, articulating my feelings in a coherent, non-stammering fashion. I knew I was right, though I didn’t know exactly how or why.
Presently, as I stood on the sidewalk with Ariel in my arms, and the Samaritan next to us, the thesis of my argument at once became clear to me. We should be vigilant about the appearance of our residents when they leave the property, not because their appearance is a reflection upon us, but because their appearance is a reflection upon themselves. It was not the endgame of the nurse’s argument that I had found so objectionable, but merely the reason behind it. Ariel’s dignity was of chief importance, not our marketability. He should be shaved, showered, combed, in clean and fresh clothing, because that is what’s best for him, and if that’s what also happens to be best for our facility, well, then, that was just a bonus. I knew that the reality of the world also dictated that, if Ariel had been lost in the parking lot, looking as disheveled as he usually did, he would most likely still be there, and I would be on the phone right now explaining to Paul that I had lost one of my precious cargo. Appearance is everything.
~
Back at Gleeful Meadows, as the residents filed from the bus, Dorothea gave me a hug. “Thank you so much for taking us to the store, Kevin.”
Cora, off the bus right behind her, complained, “Hey, how come I didn’t get to go to the store? No one told me you were going.”
“I’m so sorry, Cora. I don’t know what I was thinking. I’ll make a special point of making sure you’re on the bus the next time we go.” That moment, right there, was my job. Making them happy. Sometimes it required fixing them a cup of tea. Sometimes it required taking them to the store. Other times it required filling in the gaps of their memories that their illnesses had left behind. Lies filled the holes just as easily as the memories that had slipped away from them. I was here to help create new memories, no matter how fleeting they might be.
That evening, before I left work for the day, I paid a visit to Ariel’s room. After a moment’s hesitation, I knocked on the door. I waited a beat, and then entered the room. Ariel was sitting on his bed in his robe, his head in his hands. The room was lit by a small nightlight plugged into a wall socket. He looked up at me and smiled. “Hey, it’s the Jewish kid,” he said.
“I was thinking the same about you.”
“What can I help you with?” he asked.
“Can I come in?”
“Does it look like I’ve got much else going on?”
“No date tonight?”
“I thought I’d give the ladies a break.”
“I’m sure they appreciate it.” I sat next to him on the bed. “Are you okay?” I asked.
“I’m in perfect health. As long as you don’t count the eight or ten things wrong with me.”
“No, I mean about today.”
Ariel looked at me for a long moment before he spoke. During the silence, his eyes reddened and filled with tears. “Getting old isn’t all bad. Though it’s true you spend a lot of time thinking about the past. Wishing you could do some things over again. Or wishing you could undo some things completely.
“Today was the first time that I had ever noticed my memory isn’t what it used to be. When I was in that parking lot, I couldn’t remember the name of this goddamn place, or the phone number, let alone what store we were supposed to meet at. Christ, I’ve spent so much time wishing I were young again. Today, I finally got my wish, and it wasn’t what I had hoped for.”
“What do you mean?”
“You ever get lost as a kid?”
“Sure.”
“That’s what I was today. A lost kid. That feeling all over again. Right back like it was yesterday. The world too damn big and me too damn small to understand a thing.” He lowered his head back into his hands.
It’s been said that we never stop learning, as long as we’re above ground. That day, I learned that everything I cherish in my life, I take for granted: health, family, independence, and a feeling of self-worth. I saw how quickly, or even slowly and surreptitiously, those things can be stripped from a person.
Another thing I would learn that day was that my wife was pregnant. I was going to be a father.
“I suppose, after today, you’re not in a huge rush to get back out to the store with me,” I said to Ariel.
“Are you kidding? I’m ready to go again right now,” he said.
“So soon?”
Ariel smiled. “At my age, you can’t plan any further ahead than that.”