Stella had been in the nursing home several years before anyone had thought to refer her to the psychologist. She sat in her room reading her bible all day, emerging only for showers.
“Why don’t you try some of the activities?” I asked her. “They have lots of good stuff here — even church services,” I added hopefully.
“It ain’t my denomination,” she replied. “I don’t want to go.” She ran her hand absently across the worn cover of her bible, the pages dog-earred and frayed.
I scanned the room for other signs of interest and spied a small photo tacked to her bulletin board. “Would you mind if I take a look?” I asked her.
“No, go ahead. That was me with my girlfriends from church. Ooh-ey, we did like to travel. I went everywhere with them ladies.”
“And where were you in this photo?” I took the picture to her.
“We was at a convention in Baltimore.” She laughed. “That was some fun. This here’s Mayella. She been gone eight years now. And that one’s Ray Ann. She went down South to be with her family. And there in the middle — that’s me!”
I put on my glasses to get a better look at the tiny image of a buxom woman in a lavender gown and dramatic wig. “Wow! Look at you!”
Stella giggled. “I liked to dress up in them days. All my money went to clothes and travel. Arthur, God bless his soul, took care of everything else.”
I noted her dingy housedress and hair plaited into two simple braids. “If you enjoyed it so much, how come you don’t dress up more now?”
“Ain’t got no money,” she said simply. “I been wearing this dress ever since I got here.”
“What do you spend your personal needs allowance on?”
“My what?”
“Your personal needs allowance — the $50 you get each month after the rest of your stay is paid for.”
“Nobody told me about no money.”
I frowned. “Well, you should be getting it. Let me make some phone calls. Hold on a minute.” I left the room and returned triumphant. “You’ve got $1,850 in your account downstairs!”
“What!” Stella’s face lit up. “Why I got so much money?”
“If you’ve been here for three years getting $50/month you never spent, that adds up.”
“What I got to do to get it?”
“They said I could bring you down now if you want.”
“Let’s go.” She placed her bible on her tray table. “I want to buy me and my roommate some egg rolls tonight. Her people been treating me ever since I been here.” She started rolling herself toward the door and I jumped up to push her chair.
Stella never became a regular at activities, but she did enjoy the attention she received when she came down to the lobby to pick up her take-out food in her new wig and colorful dresses.
Is it common for residents to not realize that they have a personal needs allowance?
I'm so glad that Stella was able to put hers to good use!
Lydia, it's not common, but it's not unheard of. It's more likely to happen when a resident is overwhelmed or confused upon arrival and didn't take in the info about their new financial arrangements. An involved family member might ask questions about an allowance, but those without family members would be most likely to hear about it from other residents or staff. Residents who tend to be passive and withdrawn are unlikely to hear about PNAs from their peers. Usually the social worker would let the resident know, but occasionally this slips through the cracks during the initial admission, or the social work department is in flux, or other more pressing concerns take precedent over the PNA info, etc.
Considering the number of forgetful residents, stressed out caregivers, and the impact personal allowance money can have on their quality of life, I hope that additional precautions will be taken to prevent situations like this from happening. If you had not mentioned this money casually, Stella could have lived the rest of her life as a recluse in her dingy housedress. Getting her money has been life-changing for her.
There may be others who are not aware of the personal needs allowance. Stella's story is a reminder that the current system needs to be improved with an ongoing backup system for residents who "slip through the cracks."
Thank you for sharing this important story.
Entering a nursing home is so stressful, FSP, it's no wonder residents have difficulty keeping track of all the information given to them. People of all ages in the community are advised to write down their questions before a doctor's visit because it's so easy to forget something when speaking with the doctor. Coming into a nursing home is like going for a doctor's visit and being told you're going to be living in the office for weeks or months. Mind-blowing. Staff members, and especially social workers, can guide residents through the experience, helping ensure they're getting the most they can out of it.
Dr. El,
It's not unusual for me to come across a resident who has no idea how much they have in their account even if the know they get money each month. Then there is the resident who questions how much an activity will cost them if they attend. Understandably, some think it will cost them money, they wouldn't necessarily know unless someone explained it to them. More common then many would imagine, is the resident who has thousands in the bank, is aware of it, but do not want to spend any of it.