Jim had long, greasy hair, a scraggly beard, and long, yellow fingernails. He always greeted the nurses at the dialysis center with a warm hello. Whenever anyone asked him why he didn't cut his hair or beard, Jim replied that he had no money for such things. Since I cut my father's hair, I offered to do the same for Jim. I shaved his head and face and he seemed pleased to be rid of the hair. After that, I became his barber.
When Jim could no longer afford his private nursing home, he was moved to a larger, state-funded home. Several months later he was hospitalized for a stroke. Since the dialysis center was attached to the hospital, I performed dialysis on him as an inpatient. That day he was delirious, thrashing about on the bed, unable to recognize me.
After his hospitalization, Jim returned to the nursing home. From then on, he seemed more talkative during his visits to the dialysis center. One day I overheard his primary nurse say Jim had told her he'd been hearing cries from his nursing home roommate at night and could see one orderly holding him down while the other climbed on top of him.
When I cut Jim's hair again, he told me he was afraid to return to the nursing home. Each time he came he reported similar incidents. I began to wonder what they could be doing at night. Baths and dressing changes are usually done during the day.
It was 1993 and abuse of the elderly was just beginning to receive media attention. My sister has a friend who investigated claims of abuse in nursing homes and told us stories that made me take Jim's fears seriously. I asked to have Jim assigned as my primary patient so I could keep closer tabs on him.
Months passed, and Jim pleaded with me to do something. "I can see their shadows through the curtains," he said one day. "It looks like one is holding him down, while the other is on top. He screams and cries!! Then the other day he just disappeared. I'm afraid they'll do the same thing to me."
I questioned Jim, trying to get names and dates that would provide me with evidence. The other nurses said Jim was just crazy, that he'd told them a similar story before. I wanted someone to back me up, so I spoke to his physician. He told me there was no evidence to suggest deterioration of Jim's cognitive ability since his stroke, but he offered no guidance as to what steps to take next.
I called the Elder Abuse Hotline and gave the representative all the information I had gathered. He gave me some guidelines for questioning the nursing home staff. I asked if he thought I was being paranoid, since Jim's mental state could be in question, but he told me they would rather investigate 10 invalid claims than have one missed incident result in suffering or death.
I called the nursing home director, gave her a synopsis of events, and asked her to look up the roommate Jim claimed to have heard being abused. I told her that the hotline staff would be following up on my complaint. She assured me she would investigate. When I told Jim what I'd been up to, he became more afraid than ever. I reassured him, telling him he would be safe, especially now that everyone was looking into the matter and watching out for him.
The nursing home director called to say that on the nights in question, Jim's roommate had been given a bath and evening care. The roommate had dementia and would frequently cry out at being disturbed. As for his disappearance, he'd been moved to another facility. A week later I heard from someone at the hotline that Jim's claims had been invalidated and the complaint dismissed.
The other nurses thought it was hilarious and chanted, "We told you so!!" Even Jim's physician thought it was funny. Didn't I feel like a fool? he asked.
When I told Jim what I'd been told in response to his claims, he looked at me and said, "You know, the other night I looked out my window and saw someone dragging a big plastic bag across the yard. I think it was a body. I think they chopped someone up and put them in the bag to get rid of them!!"
Since that time, I have reported other cases of elder abuse, all of which were substantiated. People now take suspicions of abuse more seriously than they did 15 years ago. Still, the sting of past embarrassment haunts me, stiffening my resolve to investigate every possible avenue before calling in a case. Each time, I remember the scorn of my coworkers, and I feel a little jolt of fear-just before I make the call I know I have to make.