A Step Down

Chapter One

Scene [6]

A Step Down

Town Manor Nursing Home
1995/09/01 - 1995/09/05
         Town Manor is located at 55 Lowell Street, across from the police station and next to the mid-town firehouse in Lawrence, Massachusetts.  It's a flattened ‘Y’ shape, two-story building, probably built in the 1950s.  The main entrance is at the crotch of the ‘Y’ facing south at the end of a short walk from the street, with the two residence wings extending about 150 feet on either side.  Large elm trees line Lowell Street, which over the years have buckled the sidewalks from their roots.  The city has done a fair job of fixing the walks but they remain a little uneven.  The walk up to the entrance is lined with Boxwood hedges, chest high.  The whole building is set back from the street so that the lawns on either side of the walk are not truly triangular, but rather imperfect rectangles.

         The rear of the site is divided into a staff parking lot on the left side of the building and a fenced, lawn/recreation area on the right side.  The street behind the building is elevated even with the second story, so a service entrance was built directly out the back of the second floor stem of the ‘Y’.

         The west resident wing extends to about ten feet from the property line with the firehouse, just wide enough for a driveway from the street to the rear parking lot.  The east wing ends thirty feet from the adjacent property, which was initially leased by Town Manor and used as visitor and overflow staff parking.

         Three very large (I believe Mulberry) trees makeup integral elements of the fence between the recreation lawn and the overflow parking.  Late in the summer, the fruit residue from the trees coats the ground with purple goo that can be quite slippery.

* * *

         Ferne and I arrived for our interview with the Social Services Director, Beverly Battaglia1, around 13:00.  I thought we could park on the street right in front of the building at first, but the big spaces available were marked with white ‘Ambulance Only’ signs.  So we parked in the police station lot across the street.

         The main entrance vestibule was small, equipped with two chairs, a large floor fan and a desk divider with a receptionist sitting behind it.  A rather odd looking fellow was sitting/sleeping in one of the chairs.  His pants were damp and there was a faint odor of urine in the air.  A guest sign-in book lay on the desk.  As I filled it out, Ferne inquired for Beverly.  I noticed there were few recent signatures in the book.

         Beverly's office was right off the vestibule.  She came out in less than a minute, greeted us, and escorted us into her small space.

         She described the typical Town Manor patients, mostly elderly, some with dementia, some with mild mental conditions, but a few younger and many that only stay for a short time.  This is not a ‘last stop’ for everyone.  They are usually quite full because of the large and growing need for Medicare providers.  They have only recently had an opening.  She gave us a short tour of the facility.

         Nursing stations are located at the center of the ‘Y’ on each floor.  The upper floor is used for more mobile patients and is really like an assisted living apartment building.  Each room has two residents and there are common cafeteria and recreation areas on each floor.  All exterior doors and stairwells are 24 hour cipher alarmed except for the main entrance (nights only).  There is a laundry and large kitchen on the first floor.  Meals are provided to the patients, but there are vending machines available for the staff and visitors.  Due to dietary monitoring, patients are discouraged from using the machines.

         While we were walking around the facility our noses were assaulted as we passed a few doors.  This was not the antiseptic environment of Jewish Memorial or Boston City.  The walls were painted, but several had severe use holes bashed into them.  They were patched, but clearly not in the best of condition.  I made mental notes.

         We returned to Beverly's office where we discussed Renee, her childhood, her required care, and equipment.

         Beverly said, “We use male and female aides to care for all of our residents.  Would you have a problem with male attendants working with Renee?”

         I said, “If they are completely professional, I don't see it as a problem.”

         Ferne agreed.

         Beverly asked about her finances, insurance and assets.

         I said, “She has none, except for her SSI Personal Needs checks.  I’m the ‘Representative Payee’ for her and have opened a trustee savings account in my Londonderry bank where the checks are deposited directly.”

         Beverly said, “No other insurance?  From an employer or school?”

         “No, none.”

         “Then she will remain a Mass Health client.”

         She continued, “It would be fine if you want to keep her SSI checks coming that way, but many patients have them sent directly to Town Manor.  It’s easier to pay for TV cable, personal items, special clothes, etc. from an account here.  Otherwise, we will have to bill you separately for each.”

         And maybe spend it on things we wouldn’t care to.  I like the idea of keeping watch on it myself.

         I said, “We could open a small in-house account for Renee to pay for those things, but I'll keep the savings account for the SSI checks.”

         “Fine.  I just want to make it simpler.”

         “She does have two Welfare checks that I can’t cash though,” I said.

         “We could handle that for you,” she said.  “We can deposit them directly into her Town Manor account once she is transferred here.  We will send you a statement quarterly of the balance and you could replenish it when it gets low.”

         I wonder how they can open an account in Renee’s name when the bank couldn’t.  Hmmm.

         I didn’t mention the guardianship issue.  She accepted us as being completely responsible for Renee's affairs, so, why complicate things?

* * *

         On our way home, Ferne and I compared our impressions.

         “I thought I was going to faint with that smell,” Ferne said, holding her hankie over her nose.

         “Town Manor is no hospital, that’s for sure,” I said.  “I wouldn’t even use the vending machines.  I think I saw mice droppings around the base of one.”

         “This will be a step down in care,” Ferne said.  “I wish we didn’t have to send her there.”  She dabbed her eyes.

         “Jewish Memorial is pushing her out.  I wonder how Larry got Gwen in there permanently?” I said.

         “Ask him.”

         “I might not see him until this weekend.  He’s never been there during my lunch-time visits.”

         “She’ll be gone by then.”  Ferne wept.  “Poor Renee.  This world stinks.  She never gets a break.”


Page count      6
Word count    1152

Footnotes
1  Battaglia, Beverly - Social Service Director (Retired)
  Town Manor Nursing Home
  Lawrence, MA
  508-688-6056