A Nursing Home Tour with Chiquita Smith

Last Thursday, we visited two nursing homes in Brooklyn with Chiquita Smith. Chiquita Smith is 88 years old but that number does not quite capture the vigor with which she lives. Moreover, she lost her vision a number of years ago as a complication of diabetes. Despite the obvious, these circumstances do not limit Chiquita Smith in her work defending the rights of nursing home patients. As Global Action on Aging interns, we serve as an extension of her vision. We fill in the details that she herself cannot paint alone. Also on this trip were two others: Fabiola Church, a Certified Nursing Assistant/Chiquita’s home aide and Pastor Caesar who, with a characteristic smile, drives the group to these on-site visits.

It was our first time visiting a nursing home in the United States. Though we’ve written about the subject countless times in the GAA newsletter, the experience of it first hand was quite different. There were few moments where Chiquita would confidently say how it is not enough to hear or read of the experience but it is equally if not more important to see it for ourselves. And for Louise and I that day was our special opportunity. We did not know what to expect but of course we had some of our own preconceived notions.

We first stopped at Cobble Hill Health Center, where Chiquita had already brought GAA’s blog intern Sanna a year ago. The Cobble Hill Health Center is a non-profit facility that houses almost 400 patients. From the outside, the imposing 5-floor brownstone building looks very well-maintained: visitors are greeted by flowers and the entrance is only a short walk away from the sidewalk. The first floor reminded us of a small village and we noted the effort to make the place feel homey. The little gift shop and the spacious restaurant-like dining room decorated with chandeliers and wall paintings almost made us forget we were in a nursing home. Though the presence of a hand sanitizer station did remind us of where we really were.

Chiquita told us we would be visiting her friends in both nursing homes, and we took a fairly clean elevator to the 5^th floor, where her friend Pearlie’s room is located. When it stopped on the 4^th floor to let an old woman out, we were all struck by a powerful and unpleasant smell of urine that unfortunately followed us to the upper floor.

We were taken to the family room by one of the nurses to wait for Pearlie, and therefore had time to look around the place. We acknowledged the presence of many posters concerning nutrition: what to eat, what foods should be avoided, the importance of exercising, and the consequences of diet on aging. Also, a sheet of paper was there to inform residents and visitors of the week’s activities, including reading, a fitness class and different religious services. Another displayed the week’s menu. Most of the residents were sitting in the recreational room. It was nice to see the involvement of the residents with real-life activities as they do lead to strengthening of coping skills and self-esteem. However, what was saddening was the array of elders in the hallway. Some residents were without any attention; one man was reclined in a mobile bed as he blankly stared down the corridor. Others were more active; one woman walked in her socks somewhat oblivious to what was happening around her.

Knowing that Fabiola is also a part-time Certified Nurse Assistant in the Bronx, we asked what her thoughts were of the Cobble Hill Center. She replied that people walking around shoeless was not necessarily neglect, but sometimes just a practical way of dealing with patients who either lose their belongings or simply feel more comfortable this way. Regarding the man in his bed, she stated that someone was probably cleaning his room, but admitted that he shouldn’t have just been left in the corridor and nurses should have made sure his privacy is respected. Her main point of conflict was the odor. A nursing home that does not clean after its patients or the linens and beds will carry the smell of body and urine odor. And this was evident as that smell permeated the halls and the very room we were sitting in together.

Pearlie then joined us in the room and we got to ask her questions about her life in the nursing home. She told us she has been at Cobble Hill for 2 years and really enjoys the staff’s devotion to residents, the racial mix and the diversity of activities. She said, however, that she didn’t always feel like that. She didn’t want to be put in an “old folks’ home” when her daughter first mentioned moving, mostly because she feels she can still do a lot by herself, but recognized that with time, being helped with daily tasks did feel like a relief. Chiquita was very keen on knowing whether residents could vote, and made sure her friend understood that it is their right to be able to do so. Pearlie reassured her by explaining the residence has purchased voting machines for residents and that the staff encourages them to do so.

Pearlie and Chiquita at Cobble Hill Health Center

As we were leaving the 5^th floor, a white female Alzheimer’s patient approached us and began to converse with us freely. She was not aware of the reality of the situation unfortunately. She was very calm and we followed suit as we walked into the elevator. The last glimpse we had was of her pointing and speaking to the elevator doors. We felt a little taken aback by the situation because we were under the impression that dementia patients would be on a different floor altogether with more aggressive care. She, however, was not really being supervised.

We said goodbye to Pearlie and headed to our second destination: the New York Congregational Nursing Center, also located in Brooklyn but closer to Chiquita’s home. There, we parked in the gated parking lot which is guarded by security, making it a lot safer and easier to take residents in. The setting was even more impressive: we entered the block-long building and discovered a huge fish tank, a cage in which happy-looking birds were tweeting and a little corner in which bowls indicated the presence of cats. Pets are always known to bring inner calm to their owners so the addition of animal and plant life definitely created a Zen-like feeling inside the nursing home. The hallways were airy and there were absolutely no strange odors of urine. The difference was a bit stark compared to Cobble Hill, in our opinion.

We sat on the 5^th floor to wait for Chiquita’s friend Minnie to finish her lunch. As we waited we observed our surroundings. The rooms were larger and brighter. The linens there had a calming pastel color (compared to the dark and aging drapery and sheets of Cobble Hill). Overall, this nursing facility had less of an institution feel. We enjoyed comfortable chairs and acknowledged that the visitors’ bathroom was clean. Two residents we watching TV next to us- one with a glass of juice coming from the automatic fountain in his hand, the other one wearing a blanket on her lap. At one point, one of the residents was shaking a small bell to get the attention of staff. After some noisemaking of the bell and her shouts, Fabiola decided to notify the working staff. She went to the office to get a nurse, and told us that just as every other nursing home this one was also dreadfully under-staffed. Minnie soon came in her wheelchair. We could not approximate her age but she was definitely mentally alert. She held onto Chiquita’s hands as the two talked in the few moments they had. We also noticed other residents expressing silent curiosity as to why we were there. One woman sat in her wheelchair, a blanket on her lap, and with inquisitive eyes positioned towards us. It was endearing and at the same time, upsetting. We did not know her story.

Comparing the two places, the first one wasn’t as welcoming and clean, and the smell was really repulsive. Fabiola assured us that this inconvenience can be easily avoided if the staff is cautious, which made us feel as though the staff wasn’t trying very hard. The second one reminded Louise of her grandmother’s nursing home in France, which is a private facility hosting people suffering from Alzheimer’s disease but at a very high cost. Chiquita mentioned what we already knew as we left the building- the second place, owned by a church, is also much more expensive than the first one.

As a Bengali-American, the concept of old age homes is somewhat new to Naoreen. Traditionally, the structure of the Bengali family includes elders. However, with modernization and an ambitious generation, values are being discarded as are the elders, regrettably. It is unfortunate that those who have contributed their entire lives for the progress and well-being of their children are now being left under the care of strangers. Despite this being a foreign concept, Naoreen does understand that there may be situations outside of our control that require complex care and rehabilitation. And we sincerely hope that this is truly the reason for the elders that we met last Thursday.

By Louise Riondel and Naoreen Chowdhury