THE DECUBITIS ULCER A.K.A. PRESSURE ULCER OR PRESSURE SORE OR BEDSORE

The decubitis ulcer is a scourge I wouldn't wish on anyone.

With the exception of a few minutes each day, Vivie lay in her bed or sat in her wheelchair. But her skin was fine until the day she pointed to her bottom and told me it was gooshie. Click HERE for that part of the story.

Bedsores can occur because of an inability to change positions, along with poor nutrition, irritation to the skin because of urine and feces, and the simple reality of being elderly. An old person's skin is fragile. 

Over the next few months, the two red spots on Vivie's bottom became sores. They gradually deepened, wept, and turned yellow and ugly. I showed them to a night nurse, who said, No diapers when she's in bed. Air needs to get to those.

Every two hours, I turned her from one side to the other to keep her off of her bottom. I don't know what happened on the nights I worked in another area or wasn't there. During the day, she should have been helped up from her wheelchair to change her position. I doubt if that happened.

A friend who worked during the day, someone who was a good GNA and worked hard, told me that by the time they got everyone out of bed, it was time for the GNAs to take their lunch breaks, and then they served lunch to the patients and fed those who couldn't eat on their own. After lunch, the GNAs answered call bells and did what they could.

We never had enough staff to do everything that should have been done. People who could have been helped from their wheelchairs to the toilet sat in urine for hours. One patient who only needed to be reminded to use the toilet wasn't reminded. She was soaked almost all the time. Patients who were in bed during the day didn't get bedpans. A patient once told me she'd asked for a bedpan during the morning and a GNA said, I don't have time to do that. Just pee in your diaper. 

Then she lay in the urine the rest of the day.

Someone who worked at night had a terrible idea. She put a patient on a bedpan and didn't remove it so the bed wouldn't get wet. The patient was on the bedpan for about eight hours.

That patient ended up with a black, necrotic ring of flesh on her bottom.

If patients still had teeth, their teeth hardly ever got brushed. If they didn't have teeth, their dentures often weren't cleaned and their gums weren't swabbed.

During the busiest hours––getting people up, mealtimes, and putting people to bed––we should have had twice as many GNAs as we had.

Some GNAs were lazy and could have done more, but more staff would have helped no matter what, unless two people who were lazy worked together. In that case, they seemed to encourage each other to slack off.

When I left the nursing home, Vivie had spent about a year with bedsores. I saw many that were worse than hers, but what happened to Vivie was of special concern to me because I was the one who cleaned her up after she had diarrhea. I saw the progression of the sores.

Vivie never complained about her bedores. She seemed unaware of them, and for that I'm grateful. Bedsores are usually painful, especially when the patient can't avoid the pressure on them.

Several months after I moved away, I returned for a brief visit. Vivie had died. When Bernadette the activities lady planned her summer vacation, she let Vivie know she'd be gone for a couple of weeks. Vivie said, I won't be here when you get back.

And she wasn't.

ODDS AND ENDS

 Gentle Readers . . . and Maxwell,

Time to catch up on events good and bad.

Here's the worst: Carol's 21-year-old great-granddaughter had COVID and is blind in one eye with diminished sight in the other. Eye problems often come with the virulent virus. I hope it's reversible. 

This is better: During my occasional trips to grocery stores or the pharmacy, I see more people wearing masks. Do they now respect the severity of COVID? Have they become more respectful since Joe Biden was inaugurated? Whatever the reason, I'm glad of it. Even one person without a mask is too many. Do you see more folks wearing masks?

We finally have a break from the rain. The waters of Lake Junebug have receded in favor of a muck of mud. Miss Penelope Muddy Paws made a mess of my bed. I washed my sheets and quilt. While they were off the bed, she muddied the mattress pad, so it ended up in the washer, too.

I delight in sunshine, low humidity, and temps in the 70s. I'm trying to clean up the load of leaves in my front yard and have made a little progress. I gave my car a bit of a wash today and added power steering fluid. The car moans and cries and is difficult to turn. If the fluid doesn't do the trick, then something is seriously wrong with the power steering *sigh*

I've been cleaning and decluttering a lot inside the house, too. Many of my clothes are much too large, so I try two or three things on each day. If they don't fit, they go in the Goodwill pile. I'm also rearranging some furniture. An old chest of drawers went to the curb today. If someone doesn't take it, then it's for the garbage men. It's falling apart and too crappy to donate.

The great weather brings growth and blossoms––and allergies. An OTC antihistamine keeps sinus headaches at bay, but sometimes I sneeze so many times and so loudly that it startles Franklin and Penelope. 

Franklin and I take advantage of the good weather with long walks, and Wednesday night he accompanied me to Lowe's, where dogs are welcome. He is a polite shopper.

The man who attacked me is still locked up and has not yet been arraigned. It gets pushed from one week to the next. I'm confident he'll plead guilty and be sentenced to prison. This time of waiting will most likely be considered part of his time served.

I was finally able to get an appointment with a maxillofacial surgeon but decided to cancel because the staff member with whom I spoke was rude rude rude. Furthermore, the surgeon is associated with a hospital I don't like. I called an advocate with my insurance company who found other surgeons for me. I called one. Although I have to wait a little longer, this surgeon is associated with my preferred hospital and the person I talked to was polite and friendly.

I've renewed my love of baking––something I enjoyed when my children were young. I started with the banana bread when I forgot the chocolate chips, then made cinnamon bread, and last night I moved on to peanut butter cookies with chocolate chips. More bananas are softening for the next batch of bread, and I swear this time I'll remember the chocolate chips. I give away some of what I bake because it's too much for me to eat.  The young man next door doesn't seem to mind when I knock on his door and hand him baked goods.

My birthday was Tuesday. I'm old enough to know better but not old enough to get the vaccine. My network of doctors/hospitals sent me an email that says they'll contact me when it's my turn. I'm confident they will follow through. While I wait, I'll get my second shingles vaccination. I had a lot of side effects from the first shot.

I still have lots to do in and around the house. It's time to make my taxes a priority. I've never waited until April 14 to do them, but I do procrastinate because it gives me a headache even when I get a refund.

I'll try to finish Vivie's story soon. I'm not sure how much more I should write about the nursing home, though. I have some happy stories, but more sad ones. I also don't like it that I'm coming off as a saint. I worked very hard when I was there, but I cut corners at times when I was overwhelmed or didn't have the strength to do something. 

Okay! I think that's it. I wish you sunshine, warmth, homemade bread and cookies and cakes, and everything else that's good.

Infinities of love,

Janie Junebug

THE BIRTH OF A BEDSORE

One afternoon I arrived at work and discovered inspectors from the state bustling around to see what we were up to. They made random observations, usually once a year.

I walked past them down the hall toward Vivie's room. I greeted her and she pointed toward her bottom and said, It's gooshie.

Gooshie? I took her into the bathroom, where I discovered she'd had diarrhea. I cleaned her up, replaced her "diaper," and saw that her bottom was red.

When we left the bathroom, Bernadette from activities accosted me. What's going on? she demanded.

I needed to get Vivie cleaned up, I said, and wondered where the conversation was headed.

That happened this morning, Bernadette said. We had a hymn sing. Vivie was there and the odor was so bad I had to keep spraying air freshener. When we finished, I told the nurse at the desk that she needed to be cleaned up. The nurse said it would be taken care of and it wasn't done. She's been sitting in that mess for hours. You should take that diaper and open it up right in those inspectors' faces.

I am not doing that, I told her. I would be fired, and I'd deserve it. (I wouldn't have been fired for showing the diaper to the inspectors, but the Director of Nursing would have found some other way to get rid of me for such a betrayal.)

But I did take the plastic bag with the diaper in it to the nurses station, where I saw the Director of Nursing, Lynn. I told her––quietly––what had happened and then tossed the plastic bag into a bin in the Soiled Utility Room, where trash gathered in one bin and soiled linens went in another.

Lynne sent Donna, the night supervisor, to talk to me and fill out a report. I was glad I had flatly refused Bernadette's demand and followed the chain of command, but giving Donna the information was the easy part. Vivie's trouble was just beginning because of her red bottom and someone's failure to provide necessary care.

LAUGHTER WITH VIVIE

For an introduction to Vivie, click HERE.

The nursing home didn't have a volunteer organization. Occasionally a church group came in for a hymn sing, or a local music group sang or played instruments. "Fuzzy Buddies" participants visited with therapy dogs and placid cats willing to be hugged. A pastor from the area conducted a church service once a month. Patients adored these visits. Although they loved many of the workers they saw everyday, new faces were special and fun.

The entertainment the residents enjoyed the most, however, was the time some of our nursing home chain's employees from another city came to put on a show they performed regularly. They dressed as country music singers and lip-synched to popular records. Our patients clapped in time to the music, if they could, and we saw many smiles that day.

The woman who portrayed Dolly Parton had plenty of make-up, a big blonde wig, and a large chest. 

After the entertainment, the performers walked around, talking to the residents and joking with them.

Vivie pointed to "Dolly Parton's" boobs. "Th-those are r-really something," she giggled.

Dolly reached in her blouse and took out two balloons, which she presented to Vivie, who put them in the front of her housecoat. As I wheeled Vivie back to her room, she laughed and stuck out her chest and made the most of what she suddenly had.

We found Bobby in Vivie's room, where he had left a pitcher of fresh water. Bobby was a senior in high school who worked part time as a hospitality aide. He was a nice kid who was always pleasant and even tempered. He also happened to be pretty darn cute.

As he left the room and we walked in, his eyes nearly popped out of his head when he saw the chest of Vivie's housecoat.

After he was gone, Vivie unsnapped the top of her housecoat and called out, "Oh, Baaaaaahhhhhby! Bobby, why don't you come back for another look?"

Vivie wiggled and simpered as I laughed.

Fortunately, Bobby did not return. I don't think he would have known what to do if he had!

That day, I saw how happy Vivie could be.

But a few months later on Christmas Day, I saw how unhappy Vivie could be.

I smelled liquor as I approached Vivie's room. A scruffy man and woman––clearly inebriated––sat with her. They'd poured large cups of beer for Vivie and for themselves. 

I walked in; they departed. Vivie's face wore a frozen mask of disgust. 

"Do you want me to pour these out?" 

"Yes. That was my son and his wife." 

I never saw them again, and Vivie never mentioned them.

I had learned that the woman and little girl who put Vivie to bed every evening had lived in an apartment Vivie owned. They were devoted to their former landlady, and arrived at 7 p.m. sharp.

Every evening. Every 7 p.m., that little girl ran in to hug Vivie, who always smiled. 

Families can be made of our parents, our children, our siblings.

They can also be made of a landlady and her renters.

VIVIE I LOVED

This is one of my nursing home stories. I'll tell it in multiple parts because it's a bit long. Logically, my prologue would be followed by how I came to work at a nursing home, my training, and all that, and maybe I'll write about that. But for now I'm posting reruns and adding to them a bit. I think I'll tell most of my stories by focusing on certain patients––with names changed, of course.

How I adored Vivie! Our love affair began when I was still a hospitality aide, emptying the laundry bins for the GNAs, one of whom I would soon be.*

One of my most important evening tasks, and one that was required by law, was offering an evening snack to the patients. I didn't get a lot of takers since most of the old folks ate supper and then headed straight to bed.

But I asked anyway: "Would you like some juice? Would you like some ice cream? How about a sandwich?"

Faith, who was an old hand at the hospitality aide business and who trained me, told me not to ask Vivie if she wanted a snack. "She never wants anything," Faith told me.

But disobedient soul that I am, I asked Vivie anyway. Faith was right. Vivie always shook her head and waved me away.

But with persistence I had a Vivie breakthrough. Each evening a woman and her young daughter, about five years old, came in to put Vivie to bed.

One night during October the little girl wore her Halloween costume, complete with crown and gown.

"Your Highness," I cried, as I entered Vivie's room, "I didn't realize you are a princess."

Then I curtsied.

The little girl giggled. Vivie giggled. After that, Vivie smiled when she saw me, though she continued to wave me away at snack time.

One night I got to Vivie's room with my snack cart to find Vivie already in bed. She wore a fresh snap-up-the-front smock. A hairnet perched on her dark hair to keep her permed, dyed curls in place.

"Would you like a snack?" I inquired as usual.

"Why do you ask me?" Vivie spluttered. "You know I never want anything."

"I ask because I love you," I said.

"Oh, oh!" Vivie responded, making her usual spluttering noises as she searched for the right words. "Oh, I just love you."

I hugged her and kissed her cheek.

I knew I had a new friend.

*GNA stands for Geriatric Nursing Assistant.

A POEM FOR THE DAY AFTER VALENTINE'S DAY

 Arachne's Song

I spin my web around and round,

Its silken threads securely bound.

Athena's gift, not meant as a blessing,

Has helped me to better my sweet caressing.

I use my punishment extremely well

To pull you into a delicate cell.

My weaving more wondrous than ever before

Mystifies men, so they call me whore.

Use whatever name you like,

I'll take off your head with a single bite.

But first my poison your struggling ends,

Numbness sets in, then to Hades you wend.

My pleasure leads to your deadly sleep,

Revenge for Leda, Philomela, and all who weep.

Come, Hermes, now ferry this one away,

I have performed my task for one more day.

Tomorrow I'll spin around and round

To bind another who'll never be found.

My web I'll spin to seize his heart,

And then my loving I'll impart.

SO WE'VE HAD A LITTLE RAIN

Gentle Readers . . . and Maxwell,

So many of you have cold and snow or cold and ice. It's been raining here, on and off for days and days and days . . . 

Yes, we have poor drainage here at The Little House On The Swamp. It's a swamp. My son bought a pump that works well, but I have no idea how to hook it up. I'll go out to the garage to examine it on a nicer day. If I wade out to look at it today, I'll only get frustrated.

We deal with the rain as best we can.

Penelope hides from it in my closet.

Franklin prefers my bathroom:

I decided it was a good day to bake banana bread, which I've wanted to do for a while so I could add chocolate chips to the batter as Mitchell's beloved San Geraldo does. Everything San Geraldo makes looks yummy.

I started some music and soon enjoyed the sound of Jack's nasally whine. Meg whacked the drums. 

Got out the mixer and all the ingredients (I thought).

Smooshed the bananas till they were dead and dumped in everything else (I thought).

Sat down to write this post while the bread baked and suddenly realized I forgot to put in the chocolate chips. When I went to Costco last week I bought a gigantic bag of chocolate chips. They remained unmolested.

I switched the music to Alanis.

Took the bread out of the oven and dolloped it with butter.

Decided everything would be okay.

Now I have a reason to bake again––and soon!

Infinities of love,

Janie Junebug

MOVIE WEEKEND: KISS ME KATE

 Gentle Readers . . . and Maxwell,

Recently when I felt a bit down, I watched a classic movie––Kiss Me Kate (1953; I recorded it from Turner Classic Movies; also available on some streaming services for $2.99 to $3.99). 

Kiss Me Kate features a musical within a musical. Howard Keel and Kathryn Grayson perform as Fred and Lilli––two divorced, battling actors––but also as Petruchio and Katherine in a musical based on The Taming of

The Shrew.

Lilli: Do you really think *I* could play the shrew?
Fred: You'd make a perfect shrew!

Ann Miller plays Fred's new "girlfriend," Lois, to whom he gives the part of Bianca. 

While I appreciate Keel's rich baritone and Grayson's sweet coloratura soprano, it was Ann Miller's dancing that had me tapping my toes. 

Here, Miller and company perform From This Moment On, which includes Bob Fosse's first on-film choreography danced by Fosse and Carol Haney. 

Kiss Me Kate was originally filmed in 3D. That's why you see the actors throwing stuff directly at the camera.

I hope you have a great weekend.

Infinities of love,

Janie Junebug

TIP TUESDAY: AVOID PASSIVE VOICE AND MARJORIE TAYLOR GREENE

Gentle Readers . . . and Maxwell,

Avoid passive voice; in other words, "the form of the verb which shows that its subject is not the agent performing the action to which the verb refers but rather receives that action: The ham was sliced by Emily" (Harbrace).

Furthermore, "the passive voice also lends itself to . . .  muddied, heavy-footed writing" (Fundamentals).

Sometimes, "politicians and CEOs of failing companies use passive voice or similar sentence structures in an attempt to avoid responsibility for their actions" (Instructions).

I noticed an interesting example of usage last week when Marjorie Taylor Greene spoke of how she has been "condemned and crucified" for words she used in the past. Greene stated: "I was allowed to believe things that weren't true."

Strictly speaking, it's not an example of passive voice because Greene has the subject (I) right. But most of us would say I believed things that weren't true because we want an active verb and because we accept culpability. Greene also could have said I allowed myself to believe things that weren't true so I could get elected, kiss trump's ass, gain power for my cause and so on.

By saying "I was allowed," Greene deflects self-blame and lies. No one "allowed" her to believe insane claims.

I considered including more of Greene's lies here, but I can't. They're abhorrent. So as Penelope usually says at the conclusion of her blog posts, That is all. 

Infinities of love,

Janie Junebug

Sources: Harbrace College Handbook, English Fundamentals, Instructions For Living by Janie Goltz 

MAIL MAIL MAIL!

 Gentle Readers . . . and Maxwell,

Will the U.S. Postal Service ever get straightened out?

On Jan. 28th, I received a card from one of my sisters. I wondered why. Christmas was long over. It wasn't my birthday.

But it was a Christmas card!

Was she so busy that she didn't send cards until the middle of January? 

Then I looked at the envelope more carefully.

Yup! Mailed Dec. 15th in Jersey and arrived at The Little House On The Swamp on Jan. 28th.

The postal service was one aspect of U.S. government that most of us liked, so of course 45 had to screw it up.

What stories do you have to share about problems with the mail? What's the longest it's taken for something you mailed to be delivered, or for something to arrive at your house?

I apologize for my recent absence. My sister-in-law died, which turned me into a lump of sadness. She was in a nursing home because of dementia, and she got COVID. 

Although I've mourned this loss, I'm recovering from the attack. I'm doing quite well, physically and psychologically. 

I'll visit as many of your blogs as I can this week. I miss you!

Infinities of love,

Janie Junebug