This can be as blessedly simple as reminding someone that it’s time to go to the bathroom – so called “cueing” (only a few residents are able to function with this minimal help) – or as labor-intensive as lifting a resident out of a wheelchair and holding her up while another RA (wearing gloves) rips off her diaper and assesses and deals with whatever is there. Then the two caregivers steer the resident to the toilet seat, sit her down, turn on the faucet for inspiration and pray for something. Whatever goes in the pot doesn’t go in the diaper, which means an easier change next time. Because each neighborhood has only one caregiver on shift, Frances would normally have to use her walkie-talkie to call for the “Float” – the one part-time extra caregiver who helps wherever needed – to accomplish these two-person assists. But Jasmine and I are here today.

We start with Old Frances who would be a two-person assist – that is, she is wheelchair-bound and needs total care – except that she weighs only 90 pounds so one caregiver can handle her alone. When we wheel her into her room, I notice something I had not noticed earlier: a handwritten sign taped to the wall that reads “Hospice patient. DO NOT CALL 9-1-1.” I ask about this. Apparently, Old Frances has pretty much stopped eating, and her family and her doctor think the end is near. Her designation as hospice patient is a kind of death watch. No extraordinary measures will be taken to keep Frances alive. She’ll get what’s called palliative care, only what is needed to keep her comfortable. She is what is known in the world of eldercare as a “DNR” – do not resuscitate.

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