My maid steals my medication
Elderly care: One week as an intern in the nursing home
Ms. Bitterli * wakes up at 9:30, smiles and says: "Today we have black pudding." In the next room, Ms. Marti fell asleep again. I try to wake her up: rub her hands, her shoulders, call her name. She snores. The doctor says she should eat. So I hold a mug of vanilla shake to her lips, 400 kilocalories. She drinks it empty with her eyes closed. The blinds are open, but the winter light hardly dares to enter the room. It falls only hesitantly on the angular face.
Ms. Marti is 82, has Alzheimer's disease and is getting lighter and easier. I almost forgot her tablets, five pastel-colored balls that look like cake decorations. I dump it on the egg white fortified peach yogurt. "Do you still like it?" She doesn't answer. I keep spooning calorie after calorie wondering if this is right. I don't want to force them to eat. I feel sick. I smell the artificial peach aroma, her breath and her urine. Now the raspberry syrup. But Ms. Marti is already sleeping again. I wipe her mouth and cover her.
First working day
It's Monday, my first day at work. After getting up at five thirty in the morning, I clip my fingernails, tie my hair, and take off my earrings and necklace. This is what it says on the “leaflet on the external appearance” that I received from the HR manager. It is also prescribed: no watch, no scarves, no visible tattoos or piercings, no nail polish, no flashy hairstyles.
I will do an internship at the Am Süssbach nursing home in Brugg in Aargau for a week. I have no experience in caring for the elderly, but I know that in Switzerland there are more and more elderly people and far too few people who look after them. Why actually? What makes this job so demanding? I would like to pursue this question.
A bottle of disinfectant
It's a ten-minute walk from the train station to the Süssbach. When I turn into Fröhlichstrasse, it is getting dark, but most of the rooms in the large brick building are still in the dark. Dana welcomes me kindly, even though she doesn't really have time for me. She is the station manager, always has to do three things at once, always warm and always red cheeks. She leads me to the laundry and hands me a tunic, a short-sleeved blouse with four pockets, light yellow trousers and a bottle of disinfectant. The first thing I learn from her: rub my hands after each room.
It's just after eleven now. In the parlor, some residents are still having breakfast. I spread bread with or without rind, dip Möckli in coffee with milk, croissants cost extra. Mrs. Zobrist has a visitor. At 69, she is the youngest resident and suffers from a terminal brain tumor. Her husband caresses her face tenderly. The gesture is so intimate that I have to look away.
The Süssbach is a typical nursing home, medium-sized, in the Swiss Plateau, 111 beds, built in 1978. There are almost no pure old people's homes in Switzerland anymore because the Spitex is caring for more and more elderly people at home. They only come to the home when it is no longer possible at home. Nevertheless, there are more and more: every fourth inhabitant over eighty lives in a nursing home, that is 143,000 people. Most of them are women, including on my ward. At home they cared for the elderly husband until he died. When they needed help themselves, they came to Süssbach. Here they now live with a stranger in a double room.
The few single rooms have long waiting lists and are expensive. Ms. Bolliger witnessed the deaths of three bed neighbors. Mrs. Fritz shares the room with Mrs. Buser, who sometimes screams for days. Ms. Honegger is so confused that she sometimes goes to bed with Ms. Graf. No sooner have we cleared breakfast than we serve lunch. If you can't chew, you have three purees on your plate: yellow (side dish), green (vegetables), beige (meat).
Bisch en naughty sick
Dana instructed me to pour the brown sauce from the thermos flask over the food so that it slides down the esophagus better. Mrs Vögeli laughs, she seems to be enjoying the mud fight on her plate. While I feed them, Mrs. Giger and Mrs. Stirnimann are arguing at our table. You chew truck you. Ghöreder die. She just always snores. Bisch en cheeky Siech, e Tschättere. I cha au öppis saw: Bisch en Tubel. There is something cheerful about bickering. I am happy for both of them. You're the only ones who talk. The rest of the residents eat in silence, if not silently.
Now Frau Giger kicks Frau Stirnimann on the shin, but she only has enough strength to nudge her gently. I don't interfere, their argument seems teasing, not vicious to me. After dinner I assist Kai, 19 years old and in the third year of his apprenticeship. The nurses in my department have five different job titles. There are nursing assistants, nursing assistants, health professionals, health and social care assistants, and the corresponding titles in male form.
Kai treats the elderly as naturally as if they were his colleagues. He grips her gently, skilfully strips her and carefully bandages her wounds. Ms. Vögeli has an inflamed pressure point the size of a palm on her buttocks, Ms. Benedetti has an operation scar that goes from the knee to the hip bone, and Ms. Hasler can see a screw through the open wound on her arm.
Ms. Bitterli is offended because her roommate was allowed to go to the toilet first, and she is afraid of the patient hoist. It looks like a mini crane and is in constant use in the Süssbach. Anyone who, like Ms. Bitterli, can no longer stand on their feet is heaved to the toilet. She is actually a warm woman, knits pot holders for all employees and speaks with a high-pitched singing voice. Still, I watch out as I kneel in front of her to strap the wide tether around her stomach. Kai says she has already torn nurses by the hair and hit them on the head.
When we lift her out of the wheelchair using the remote control, she blushes and screams: "You're killing me!" Kai encourages her, drives her to the toilet and lets her down. When I'm supposed to wipe her buttocks, Kai notices how I hesitate. He advises me to put two plastic gloves on top of each other, it helps some people against their disgust. Later on, we do a so-called fecal line for Ms. The evacuation of the residents is recorded daily in a table. Many have digestive problems.
Not a diaper, but an insert
During the first day I learn: We don't say feed, we feed in food, not a bib, but a napkin, not a diaper, but an insert. We call the people we care about residents. We are allowed to address some dementia by their first name, because then they react more quickly.
Mrs. Honegger's name is Hedi. She wanders up and down the corridor for hours. Her son comes to see her every day. Chasch echli hollle, Mueti. Muesch niene meh ane. Ned? No Hedi was a contract child, "a maid for a bite," says the son. She worked hard all her life. When she was getting tired, she gave him the post office so that he could make the payments from now on and said: "I want to go to the home." Nevertheless, she cried on the first day in the Süssbach.
5600 francs per month
I meet Mr. Hug in front of the lift. Sleet has got caught in his wool sweater. He laughs, was in town in his wheelchair, smoked a chump and made sure that no one stole his wallet from his bum pocket. He must hoard the money. Although he needs little help and lives in a double room, his place at home costs him 5600 francs a month: food and accommodation plus deductible for care and maintenance costs. The Süssbach is in the Swiss average with its prices.
Mr. Hug takes off the white Olma cap and recites poems that he read as a fifth grader in the "Krone" in Wangen an der Aare. "You should check your day every evening." He thinks like Hermann Hesse: Before you go to rest, you should admit injustice and think about your loved ones. From his breast pocket he pulls a photo of his three granddaughters who live in Hong Kong.
My shift ends at 4:24 p.m. Outside I breathe in the misty winter air and am happy to be able to leave the overheated rooms: the yellow marbled linoleum floors and anonymous furniture that is practical, but reminds of hospital. Many rooms look as if their residents don't want to stay long: a postcard hangs on the wall or photos of cats printed on the computer, on the ledge there is a cactus or an orchid without flowers.
It motivates me when I can make people happy
Still, I'm looking forward to the next day. It probably has to do with Sema. I asked the 16-year-old intern why she wanted to learn this profession. She responded with a sentence that she had probably already memorized for the job interview, but which I believe in her word: "It motivates me when I can make people happy."
Tuesday goes by quickly. When someone rings the bell, the red lamp over the door lights up. It always shines somewhere. I run after the nurses and take on more and more work independently: making the beds fresh for the Tschumi couple, Ms. Zumbrunnen rinsing her mouth with chamomile tea, emptying the rubbish bags, washing Hedi. Before this internship, I have never seen an elderly person naked. The first intimate wash costs me to overcome, I don't dare to look properly and I'm afraid that I will act clumsily. But soon I feel safe, almost routine.
Sometimes I make mistakes at work: Ms. Vögeli sits motionless in front of the plate until I realize that I've forgotten to put in her bit. I pour water over Mr. Vonmoos' shirt because I'm holding the special cup upside down. Mr. Hediger complains that I'm unwinding his bandage too slowly. On Wednesday I got used to the smells a little, to the silence at lunch, the whistling of the hearing aids, to Frau Heinimann, who curses all day, and Frau Stirnimann, who moans for hours. And I made nice acquaintances.
After Mr. Hediger rebuked me with "You are a clumsy one", he offers me schnapps, Pflümli, distilled himself. I have to cough. Again, when he told me he doused his toes with it every day. They were constantly inflamed and began to rot, so neither Bepanthen nor Betadine helped. So the former farmer took the liquor and the wounds healed. He broke his lungs while turning hay, his teeth while playing the clarinet. Only the liver is still good. He blinks his little eyes and says, "Well, I never drank while working."
Scratched and beaten
On Thursday morning, Dana sets up the medication. Everyone gets something, some up to twelve a day: Temesta for restlessness, Dipiperon or Haldol for the mind, Zolpidem for sleep, Laxan or Colosan for digestion, Levemir or Victoza for blood sugar, Symbicort for breathing, Novalgin or Dafalgan for pain . The report is shortly after nine o'clock. A nurse said that Ms. Peyer scratched her while washing and hit her. “I had to hold her tight. Hopefully she won't get a hematoma on her arm. "
Dana decides that Ms. Peyer will in future be given the morphine drops before breakfast. As a station manager, she has a lot of responsibility. She came to Aargau from Berlin five years ago and is by no means the only foreigner in a Swiss nursing home: Forty percent of all qualified employees did their training abroad. Switzerland trains far too few skilled nurses. In this country, almost all homes have trouble recruiting staff, including the Süssbach. The problem will worsen as the number of people over 80 in the canton of Aargau will more than double over the next twenty years.
101 years old
An important part of the work in Süssbach is done by volunteers. The thirty women make it possible for a small entertainment program to take place almost every day. Frau Steiner takes me to gymnastics. Most of all, she likes playing with the balloon, which she passes to each other in a circle. "Ui ui, wo ane wetter?" Calls out Ms. Senn, 101 years old, and kicks him up in the air with her foot. Ms. Meyer invites me to sing: "In Aargau there are two Liebi, es Meiteli and es Büebli, they love handing each other so much." She would like to travel to Norway again, but can only make it to Lake Hallwil.
Ms. Zumbrunnen has never been abroad, Ms. Baumann once hiked barefoot on the Klewenalp. There are warm residents like Mrs. Graf, who is happy about every exchange of words, likes to hold hands and leans back as soon as you sit down next to her. I rub body lotion on her arms and legs. She calls: "Mei, that smells good!"
Schnapps as always. Cheers.
It is more difficult to deal with people like Ms. Lüscher, who makes life in the home sad. I help her in the bathroom. Can I wash your back? Hey yo. Are you? It has to. I'm still washing under my breasts, is it good? Dänk scho. I think desperately how I could steer our conversation in a happier direction, when Carmen pushes a cart full of medicines into the room, calls out "Minibar", hands Ms. Lüscher a mug and says: "Schnapps as always. Cheers." Frau Lüscher smiles.
I admire the nurses at the Süssbach. Mary, who always keeps one hand on her body when washing so that she does not lose touch with people. Robin, who already knew at 14 that he really wanted to learn this profession. Sema who cries for joy when she is praised. Farah, who twists the old ladies' curls, plaits pigtails, and adorns Bürzi with pearls. Dana, who makes sure that the bread rolls look appetizing in the morning. Melissa, who likes to come half an hour before the shift starts so she can take enough time for everyone. Caring is a gift. You have to like helping to enjoy this job.
The mood among the old 2013 people is often melancholy, many are in pain, are sad, tired, lonely. As a nurse you constantly try to spread a good mood, you want to motivate people, they should move, eat, talk, knit, jetting. This is called activation in technical jargon. But that takes time, and the carers don't get much of that. I'm free on Friday. At home I feed my eleven month old son and change his diapers. Although there are similar movements, it feels completely different: more familiar, more fun.
On Saturday I was back in the canteen in Süssbach in front of a plate of French fries and fish crisps when five nurses told me that the smell of urine or feces had become a smell like any other for them. They are no longer disgusted with that. Only after a long vacation do you have to get used to it again.
Still, everyone has their own inhibitions. Melissa can't see vomit. Annemarie can't smell it. She puts on a face mask and puts a peppermint tea bag in the front. Carmen doesn't mind washing a resident smeared with feces up to his neck, but she is disgusted when she has to help Ms. Bitterli to squeeze the blood sausage out of her skin. Sleet falls outside the window. The old chestnut that is to be felled for the extension has long since lost all leaves.
Death is part of it
"When the days get shorter, dying begins," says Carmen. Mr. Kobler's obituary is hanging in the corridor from the second floor. More will follow. Carmen says: «Death is part of it. It still makes you sad. " Frau Rebsamen was like a friend to her. It was agreed that Carmen would accompany her as she died. But death came swiftly and unexpectedly. «One night I dreamed that she was sitting on the edge of my bed. When I woke up, I knew she was walking alone. " Carmen was sad for weeks and was afraid of her own dreams.
Saturday night. I serve pureed food, spread bread with and without crust. Ms. Giger looks at me mischievously and says: “So I'm waiting for a coffee. It has to go quickly. I saw nume, I would expect one. " I will miss her. I hope I never have to go to the nursing home. But I could come to terms with it if, in old age, I became like her: far away in my thoughts, sometimes lost in a melancholy way, but unexpectedly all here again, argumentative, witty and wise.
After dinner we sit on the bench in front of the parlor and watch as they push their walkers down the aisle in a single row. She says: "If daddy laughs, alli laughs too." Two minutes later: "Me het ekei Ahaltpunkt meh." Then she reaches for my hand and giggles. «What’s going to be, what’s going. And what chunt, I know nöd. "
* The names of all home residents have been changed.
Nursing staff urgently wanted
More and more elderly people. The proportion of people over 65 is increasing rapidly. Today 17 out of 100 people are over 65; in 30 years it will be 27.
Switzerland trains too few carers. By 2020, the expected need for nursing staff will be almost twice as high as the actual number of apprenticeships.
Lack of staff and a lot of work. 92 percent of the homes have difficulty recruiting nursing staff. 12 percent of caregivers are considering quitting their jobs and switching to another profession, and one in three employees will retire in the next 15 years. According to a recent survey, nurses suffer from a lack of staff and a high workload. A third of respondents said they had to keep residents waiting for more than five minutes when the doorbell rang, and 19 percent said they'd used restraint or sedative medication in the past week because they couldn't supervise residents properly. The health of the nursing staff is also not particularly good: two thirds suffer from back pain as well as general weakness and fatigue.
Sources: FSO, GDK report 2009, SHURP 2013
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