I Want it That Way: Wine, Cheese & Chocolate

November 15, 2011

You wanna know what’s unfortunate?  That someone who has lived for almost a century isn’t allowed to have what they want later in life, because a nutritionist or a doctor said so.

In this post, I briefly discussed my grandfather’s love for ice cream and the nursing home’s refusal to let him have some.  The fear was that he would aspirate.  At 93.  I don’t know about other 93 year-olds, but my grandfather wanted his ice cream. He may not have actively wanted to aspirate, but he knew he cared less about that and more about his quality of life.  It was one of the only pleasures he was still able to enjoy that wouldn’t make him pass out (Cut to the one and only time he came to my parents’ house after his admission to the SNF – he wanted a Budweiser, drank it, and promptly slept for the next four hours in the shade of a tree outside while 15 members of his family played, talked, ate and drank around him).  Anyway, he wanted his ice cream, and my mother – a tough cookie – fought for his right to ice cream.  And won (after weeks of arguments with the dietary staff).  Should it have been this hard?  Shouldn’t a 93 year old be able to have some ice cream?  Shouldn’t an 86 year old woman be able to have some candy when she wants it, without having to focus on her “Diabetus?”

Looks great, huh? Imagine this every day.

In most elder care facilities, the food is less than ideal.  In “dietary’s” defense, there are some people who don’t have teeth.  There are some people who keep Kosher.  There are some people who have been discouraged from having sodium.  There are some people who don’t eat pork, and there are some people with food allergies.  This all makes a SNF chef’s job a bit more difficult, and because of the volume of food that all has to come out at the same time, it’s probably not easy to make a variety of meals, or food that tastes the way most of us would prefer.  BUT, it should be better.  When I get complaints (yes, I, the music therapist who has literally no control over this) from residents who complain that they have had scrambled eggs with no salt and dry toast every day for a month, it makes me want to bring them a waffle or an omelet or something.  When I find out that the kitchen has produced a chicken and rice dinner every night for a week, I want to go down and talk to the food department. Would you want the exact same meals every day?  I sure wouldn’t.  Would you want to be told you can’t have cheese because you’re lactose intolerant?  Lactaid, people!!  What’s the problem here?????

One of the problems is that there is usually one person organizing meals, ordering products and designing nutritionally balanced menus for sometimes 300 people with different nutritional needs.  That, my friends, is at least a three man job, and maybe that’s the real problem.  How can these issues be remedied?  I sure don’t know, but I have to imagine it’s a financial problem.  I also imagine its because we are deciding what food people can and can’t have at a time in their lives when it really doesn’t matter to most of them.

Alcohol is a little harder to support.  Sometimes, people have long running problems with alcoholism.  Sometimes, alcohol makes people with dementia and those on certain medications more confused, unbalanced, and sick.  But sometimes, someone who doesn’t have these problems and side effects just wants a Budweiser.  Or a glass of wine.  Or a little Jack Daniels.  What’s the harm here, really?  Some places say that a resident can’t have wine because then other people will want some.  Shouldn’t people be able to have a little locked refrigerator in their “apartments” where they can keep their own stuff?  Should other people be able to dictate what their quality of life is?

The thing is, most elderly people (at least the ones I work with) don’t care about the health risks – they care about their quality of life. In nursing facilites, there are doctors and nurses and care staff who decide what’s best for a resident, from what they’re allowed to eat, what medicines they should take, when they should have to go to the bathroom (don’t even get me started there…) when they should go to sleep, when they should wake up – the list goes on.  What are the things that our grandparents and elderly friends get to decide?  In my experience, not a whole lot.  Usually, they’re bound to wheelchairs, aren’t able to go outside more than twice a year and really aren’t living what’s left of their lives.  It’s very sad, and I wish I knew how to advocate.  ACTUALLY…I guess that’s what I’m trying to do.

I can’t save everyone and I can’t change someone’s current nutritional and dietary orders, but I can encourage anyone reading this to put this information in a living will, so when you’re 97 and have Diabetes, you can say you want to have some chocolate or a cookie with actual sugar in it.  When you’re 88 and have high blood-pressure, you can say that regardless of what a nursing home’s dietary department wants, you want to have salt in your food.  You can say that if you are dying for a beer, there’s no reason why you shouldn’t be able to feel like a person again and throw back a cold one (see roof scene in Shawshank Redemption).  Unfortunately, having a quality of life as an elderly person doesn’t come automatically.

Fight for your right to Wine, Cheese and Chocolate!

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3 Responses to “I Want it That Way: Wine, Cheese & Chocolate”

  1. SOOOO true! My father got sick after I graduated high school, and for most of the following 8 years or so we fought with nurses, doctors and whoever else thought that they knew better. About 3 or 4 years after he originally got sick they put a feeding tube in. For nutritional as well as aspiration issues. At this point my father was a 50 something year old man, confined to a wheelchair and unable to do most basic things for himself. His two things that he still had some control over were his TV and his “diet”. At many points in the last four years of his life he aspirated and was ordered NPO. This made his sad, depressed and even angry sometimes. At one point he was NPO but we were told to give him all of his mades by mouth, including his pain meds. He took much less of those than per scribed but they didn’t metabolize in his system. He ended up overdosing because of the doctors lack of knowledge and care in telling us to give him the meds. He was on a vent. for about 5 days and came out of that episode ok. After that we lived with the motto, if it makes Dad happy than give it to him and damn the consequences. People do need to fight for their loved ones especially in medical facilities. Doctors and nurses see so many people in a day taht they often times only see one level of care that is needed and not all of the underlying issues that could effect that care.

    • Thanks for leaving such a thoughtful comment, Kristin! I’m sorry to hear about your dad’s illness – these things are so much harder when there’s a loved one involved. Part of us wants to keep them safe, but the other part wants them to be happy. I wonder if there’s a happy medium, but if not, I say quality of life wins.

      • Quality of life will always win! Sometimes people just need to realize what they are trying to “push” on their loved ones. It takes a lot of fighting for what you believe in and doctors will never officially “agree” with you on quality of life type stuff. My dad’s doctor finally said to us unofficially that if it were him, he would eat and drink whatever he wanted.

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