Geriatrics: Never “Another Day At The Office”

For Licensed Practical Nurse Pat Medina, there’s no such thing as “another day at the office.” They don’t happen when your life’s work is geriatrics, and Medina’s has been that for the last 30 years.

“The day that this becomes a ‘job,’ is the day you need to be some place else,” she says. “Regardless of what your certificate says, the key is what your heart says. This is something you have to love. It’s not enough to just like it.”

For the last five years, Medina has loved being the administrator for At Home With Friends, a 30-resident, assisted living facility (ALF) in South Tampa.

At Home is a compact, tidy place where 29 seniors — 28 women and 1 man — reside in a mix of private and semi-private rooms. If you come by during a formal activity period, you may walk in on anything from light exercise and current-events discussion to bingo and even karaoke. Call it senior life in the steadfast lane — just east of the busy intersection of Bay-to-Bay Boulevard and South Dale Mabry Highway.

Average resident age is mid-80s. The oldest is 98; until last year, that figure was 104. The residents vary in their mobility and their dementia. There are vacant stares — as well as smiles of acknowledgment.

“I never see just ‘old people,’ says Medina, a 50-something with an easy smile and a heartfelt laugh. “I see 29 different personalities. And you can’t take things personally. A sense of humor helps.

“Sure, there is a lot of dementia (but no Alzheimer’s cases),” notes Medina, “but that doesn’t make me sad. In any situation, there is always some good. Getting a hug in return makes it worthwhile.”

There is also a sense of education, she says, in being privy to those who embody history.

“I learn from them,” explains Medina. “They’ve all lived through the Depression and several can tell you about the old days of Ybor City. One lady was in Pearl Harbor the day it was bombed. It can be fascinating to listen to.”

What Medina doesn’t do is dwell on the reality that At Home, not unlike Florida’s other 2,300 ALFs, has the ultimate turnover.

“We know we’re going to lose everyone,” she admits, “so we make the best of it. Yes, a part of us goes too, because we consider ourselves the ‘other family,’ but you reflect on what you gave them when they were with you. Our aim — and our philosophy — is to ‘Make today better.’ We want today to be the best today they can have.

“That’s what I would want for myself,” underscores Medina. “You just want people to care. To take the time and care. The older you get, the more you appreciate how much a little bit of time means. It’s precious.”

To that end, she has a short list of reminders to her staff of eight of what can make a day, maybe a final day, special and meaningful.

“A touch means so much,” emphasizes Medina. “So does a compliment — ‘Your-hair- looks-so-nice-today’ type of thing. That little extra attention can seem so big to people.”

Medina says that a key to a successful residential experience is working in concert with families to ease the transition from biological to the “extended” ALF family. Among the first things that Medina requests are objects of familiarity that can be transferred in advance of a new resident. Things like family photos and some favorite outfits to await their owner’s arrival. A quilt will be on the bed to further warm up the room.

Medina’s also oversees a staff that is uniformed in tan pants and flowery tops — to avoid any undue institutional ambience. But jeans are out; too generationally informal.

“I tell family members, ‘Give me two weeks,'” says Medina. “‘And we’ll know them.'” Indeed, Medina will personally befriend them and introduce and integrate them into their new “family.” Whatever it takes.

“But families need a lot of reassurance,” Medina stresses. “It’s hard on them. They feel guilty. But, really, we can give their mom or dad the sort of stimulation they need.”

She also offers another piece of advice to families of residents. Don’t get too literal or too precise with time; it can lead to needless anxiety.

“For example, don’t say you’re coming by at ‘noon,'” points out Medina. “Say ‘after lunch.’ Otherwise, they might start to worry about why you’re not here at 12 noon. If there’s a doctor’s appointment, don’t tell them too far in advance. They get anxious and ask about it every day.”

But even when they do, says Medina, it changes nothing. She still loves what she does.

“We’re not ‘babysitting,’ she says emphatically. “It’s about an environment that promotes stimulation and giving love. Our residents depend on us, and we’re their lifeline to their families.

“Never for a moment do I forget: we’re all going to be there too.”

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