Nothing Short of Excellence is Good Enough Care for Older Adults in Residences

In 1974, I saw Judith Jamison perform Cry with the Alvin Ailey American Dance Theater. Her performance so moved me that I went back to see her twice more that week. It was after the 3rd performance that I had a dream which ultimately led to my becoming a dance/movement therapist. Because dance informs my work as a dance/movement therapist, I continue to dance, attend dance performances, and perform with Back Pocket Dance Company.

Fifty years later, 2 nights ago, I went to see the fabulous Alvin Ailey American Dance Theater perform again. After a night of many colorful dreams, I awoke thinking, "It's good to see fabulous dance. It wants to wake me out of my relative stupor and live life more vibrantly. Terpsichore, the muse of dance and poetry inspires - breathes into me - excellence.

It is that excellence that our older adults, especially those who are dependent upon others, deserve and which is so sadly lacking in most, if not all, residences for older adults. While others tell me about facilities that they consider good, I think that is a relative assessment - better than others. To me, good means that every person gets individual attention.

Here is what I saw recently in long term care described as good when I was visiting during a sing-along with an outside entertainer. Some people were singing along, and the entertainer gave encouragement to the group. Others were staring at the wall. I heard "Sit down" repeatedly to a woman who was entirely capable of walking, but she wanted to get up during a program. Not allowed. CNAs sitting at the back of the space where the entertainment was, writing their notes. At a prescribed time, people were offered popcorn on small styrofoam plates. Zero individual attention. By the entertainer or by the CNA's. No one was looking at them, so didn't see when the popcorn hit the floor, nor when people bent over (good reaching though)  picking up the popcorn and putting it in their mouths. They didn't see the man tear his styrofoam plate up into small pieces and put it in his mouth. Chewed on it, but it wasn't quite satisfying. Because there isn't much difference between popcorn and styrofoam, is there? I saw people beaten by the tedium of the system.

People living with dementia, particularly those living in institutions (I could call them residences, but let's call them what they are) may be the greatest beneficiaries of dance. Told to sit down, likely because staff are afraid they'll lose their balance and fall down. Those folks are among the most inert - not because they can't move, but because they can't initiate and no one wants them moving. That's when trouble occurs. Nursing homes and elder facilities are graded on how many falls there are. So how do they deal with that? Put folks in geri chairs. You try getting out of them when your core muscles are atrophied.

Below is a poem written collaboratively by Dorothy Shea and myself some years ago. Dorothy had suffered from a stroke. Writing poetry together was the only way I could motivate Dorothy to get out of bed or to move at all. The words and images were all hers. I helped rearrange them somewhat. She gave me permission to publish her poetry. "The Last Station" was her response to having an alarm which went off when she attempted to get out of bed.

The Last Station

Written collaboratively by Dorothy Shea and Donna Newman-Bluestein

The depths are getting to me;

depression, dying, the sound of dying, not being.

It can be quite loud if it wants to be,

Heaven only knows what it wants to be.

Depression is the last stop of life.

Nothingness.

A place where you can’t get off,

a train station full of cinders.

No light, no color, no sound, no texture.

Nothingness.

Behind us is light, life;

Ahead of us, nothingness,

A melancholy scene.

I am so pursued by loss and death.

Why should I be pursued?

Surrounded by lovely gadgets that go off,

making ghastly noises.

A terrible engulfment greets me when I open my eyes,

being received in the depths of hell.

5 stages of death lie waiting for me in the morning,

and I’m held back by them.

Maybe this time it’ll get me.

I never thought I’d abhor death,

but now I do.

I’d like to be rid of this horror,

have the gadgets stop haunting me.

They have to push ‘em, poke ‘em, and punch ‘em

to get ‘em to stop screaming.

There’s terror in merely recounting.

I can’t run,

tagged by hideous squawking sounds,

making it all the worse.

“Look out. You may fall.”

I would trade poetry for life now.

I remember when n.h were smelly places, with diapers in hallways. Yes, we've come a long way. But do not accept that as good enough. This is not honoring our mothers and fathers.

What I want to see is what I offer. Individual attention to every person in my groups. Yes, it is a lot of work. But they deserve it. That's why I need the inspiration mentioned above. It's how I nurture and energize myself so that I can help animate people who need it.

This quotation by Ailey expresses my belief that, "Dance is for everybody. I believe that the dance came from the people and that it should always be delivered back to the people," And this from Pearl Primus: Dance reaches "that which we are without the veneer and sophistication and without all the language."

Learn how to bring excellence to older adults and people with dementia, including those who are nonverbal. June 1 and 2 in Dedham, MA. Find out more here.

You can click here to register.