Cecelia sat in her wheelchair in the corner of the nurses' area partially obscured by the aquarium. Loose tendrils of yellowish-gray hair fell over her hands as she held her head and silently wept. I was on my nightly visit to my mom in a skilled nursing facility while she recovered from surgery. I almost breezed right by Cecelia heading for my mom's room at the end of a long hall. But I heard quiet mewling sounds and there sat Cecelia, a picture of anguish and despair. I bent down and asked, “What's wrong? Is there something you need or that I can help you with?” She immediately tried to hide the fact she was crying, but she wasn't up to the task. “I just feel so useless,” she said, as the tears slowly coursed down her wrinkled cheeks. “I just feel so utterly useless,” she said again to no one in particular. I felt awful. She was so wretched and wracked with desperation I didn't know what to say or do. I stayed with her awhile and offered some lame platitudes about everyone having bad days and tomorrow would be better and we have a lot to be thankful for even with our problems, but I heard the hollowness in my own words. When I left, Cecelia had a brave, insincere smile on her face, probably trying to make me feel good after witnessing her mini-meltdown. I thought about her all night and the next day. The skilled care facility is Cecelia's last home. She is confined to a wheelchair, but her mind is sharp. She shares a room at the end of the hall with another resident. She has no family (at least none who come to visit). What Cecelia's life lacks is purpose.
Richard Leider, a consultant who helps people discover their unique purpose and meaning in their life, describes purpose in a MetLife study as, “the glue that holds the good life together. It's the reason we get up in the morning. Knowing one's purpose helps to create and maintain a sense of balance in life.” You don't have to be in a long-term care facility to lose your purpose in life and not all people in long-term care facilities have lost their purpose. The Greatest Generation, who largely populate today's long-term care facilities, are a tough bunch when it comes to adversity. They've steeled themselves into acceptance of most everything by having lived through two major life-changing forces-the Depression and World War II. One of the greatest gifts you can give your residents is a reason to get up in the morning. It doesn't have to be anything grandiose. Looking forward to a good meal, activities that challenge them physically and mentally, an in-house event like a cruise-themed week can do much to alleviate the boredom and sense of purposelessness that can invade and take over a residence-bound person's life. Having a vehicle for them to talk about “the good old days” to younger people and relive a time when they were vital and plugged in to what was happening around them goes a long way to feeling useful and having your life count for something.
I'll be the first to admit you have one of the most difficult and important jobs one can hold. Being charged with giving someone's life purpose is a heavy mantle to wear. But your residents' lives are in you and your staff's hands. Bringing the outside in, whether it's with school groups, community organizations, volunteers, clubs, and letting your residents' lives be verbalized and heard will go a long way to adding purpose to their life. Let your residents' sewing, woodworking, artistic, and any other skills enrich the community. (Knitting hats and booties to keep preemies warm is much appreciated by many area hospitals. Giving a picture of the child wearing the clothing back to the resident will be cherished.)
How many “Cecelias” do you have in your facility? One is too many.
Maureen Hrehocik Long-Term Living 2009 August;58(8):8