02 - 2003

Growing older in Germany

A professor’s experiences as a geriatric nurse

by Roland Pauler

The observations of an untrained geriatric nursing aide show the kind of time pressure under which nursing personnel normally have to work. Hardly any time is left for the psychological needs of persons in care.

I am actually a professor who teaches medieval history. However, despite holding a doctorate and being fully qualified, I haven’t been able to get hold of one of the rare permanent positions in my field. As a single father, perhaps I never had the time for the sort of contacts one needs to get ahead in the university world. So I make my way from one substitute job to the next. However, in April 2000 I found myself unemployed. I wanted to do something meaningful with my time, so I applied for work at a home for the elderly near Munich. I worked there for three months as an untrained geriatric nursing aide.

I got up at four-thirty in the morning in order to begin my early shift punctually at six-thirty. Beginning at seven I had to wake the elderly people, even when they wanted to sleep longer, wash them, shower them once a week, dress them, change their diapers if needed, make their beds accurately and bring them their breakfast. There were 26 patients in my ward, the most part very confused persons who would not be able to find the dining hall without help. This home for senior citizens is considered relatively good and advertises "total care”. These 26 patients, some of whom need a lot of care, have three staff members who are responsible for them in the morning, two in the afternoon and one during the night.

After one week in this ward it was clear to me that "total care” meant at most for the nurse to wash these persons all over with a washcloth every day — there was no provision for psychological needs. It was piece work with human beings. Feeding, for example: seven elderly persons had to be fed every meal. It had to go quickly. There simply wasn’t time to allow the old people to finish chewing every bite. Those who could eat only gruel sometimes had it pressed into their mouths with a thing like a cake-decorating tool. Mrs. K., who is schizophrenic, said to me once, "Cattle have all the time in the world to eat. But we just have to swallow, swallow, swallow. Are we worth less than animals?”

At the beginning I sometimes gave them more time, and was ticked off by my colleagues. They were right — any additional time I devoted to one person was taken away from the others. It was shattering for me to be forced to block every human caring impulse for lack of time. For example there was Mrs. S., who was no longer able to leave her room, almost never had visitors and felt lonely. She often rang for me, to tell me her sorrows. I would spend ten minutes talking with her, trying to comfort her, and then excuse myself for having to leave again. "Sorry, I can’t help you either.” And I had already given her more time than she was entitled to have. Of course there are social workers who come to the home and work with the elderly people in groups, but no one gives them the normal human attention that everyone needs. So in the afternoons they sit there apathetically side by side in the common room while the television runs on.

Intimacy is a concept foreign to homes for the elderly. Not even in dying is one’s dignity preserved. One woman hung between life and death for months, scolding the care personnel and lamenting, "I just want to die.” She shared a room with the schizophrenic Mrs. K., of all people, who was treated to all the stages of her dying. I call that psychic torture.

I didn’t find any serious irregularities in our home for the elderly, just the normal craziness. In a nursing home ordinary daily life is catastrophic: washing, diaper-changing, eating, sleeping, all assembly line style. Perhaps that is why the few pleasant moments stand out in my memory, for example the happiness in Mr. K.’s eyes when I stroked his arm and smiled at him.

This time was enormously valuable for me personally, because it became clear to me what really counts in life. But financially these three months were ruinous; as a geriatric nursing aide I earned, after deducting transport expenses, 180 Euro — less than I would have received in unemployment insurance. Anybody who works with human beings in our country will do badly financially. No wonder people aren’t fighting for this job. In the winter semester I will return to the university, richer in significant experience. For the next five months I get to be a professor again.

From Publik-Forum, Zeitung kritischer Christen (Newspaper for critical Christians), No. 23/2002; the experiences of Prof. Pauler as told to Claudia Mende.