By Brenda Zimmerman
For The Salisbury Post
This past December I was notified that I had earned the privilege of being one of three activity directors representing the profession on a seven-member mission team headed to Nicaragua in January under the auspices of the Oregon-based Jessie F. Richardson Foundation. The foundation works primarily with seven of the 25 nursing care facilities “hogares de ancionos” — home of the ancients or elder homes — that exist in Nicaragua. Other team members included the president and CEO of the foundation, two board members (a lawyer and a nursing home administrator) and an RN.
The primary focus of this group was to explain to staff and volunteers who worked and helped in the hogares, the importance of elders being active and engaged in their immediate world. The goal was to explain the rationale then teach ways to do just that.
I recently heard a TV evangelist say that “an atmosphere of expectation is a breeding ground for miracles.”
Jamie Philips of Wilkesboro and Erica Johnson of Wilmington were the other two activity directors. Although we had participated in several pre-travel conference calls, we had never met one another until we were getting on our flight in Raleigh.
We were full of expectations, but had no idea the miracles would be so profound. The first miracle was that we got along really well even sharing a very small room in a country that none of us had ever been to. We had game plans, agendas, supplies, kits and “carpet bags” bigger than Mary Poppins’, but we had no idea the biggest hit of the entire week was not in anyone’s bag!
On Monday our driver/interpreter Daniel Rivera picked us in a blue VW van for the hour drive into the mountains near the west coast of Nicaragua. Our first hogare was Hogar de Ancianos Agustin Sanchez Vigil in Jinotepe (Hee-noe-tep-ee). The staff of 14 included care givers, cooks, a night guard, a nurse and an administrator for 37 residents. This building has running water, electricity and a sturdy roof thanks to work done by previous foundation teams. The facility depends on charitable contributions for over 90 percent of operational costs. JFR Foundation assisted them in setting up a pharmacy program that provides for the residents and is also able to generate a small income for the Hogare by selling pharmaceuticals to the general public.
We turned into a quiet compound with a mossy concrete block building concealed under coconut and palm trees. The three of us set up our materials in a large outdoor “ranchero,” and went over our individual notes, huddled for a moment and were ready for show time! There were almost 60 employees, volunteers and community leaders as well as four residents in attendance, far more than the 20-25 we were expecting. Keep in mind they spoke no English and we spoke no Spanish. Everything of course takes twice as long to tell with an interpreter. After some introductions and sentences about the basic need for activities, most of those in attendance quickly moved into a craft group or an exercise group.
One of the team members came up behind us and said we needed to get the interest of the ones that had not chosen to go to a group. In a matter of seconds we changed gears and Jamie was leading a rousing version of the hokey pokey! This was something that was not in the bag, but pulled right out of her hat. Erica and I followed along and the crowd was up and shaking it all about! When we were through, and the laughter let up, explanations were shared through the interpreters of why that would be good to teach to the seniors. Once we had their attention we followed through with other exercises and some craft ideas. The three of us played off one another and never missed a beat and never looked back at the original game plan! It was well received. Miracle two!
As the afternoon wrapped up, one of the volunteers pulled an interpreter to the side and had him translate for her. She told us of her recent illness. She had also been dealing with a diagnosis of depression. She showed us the craft she made and the certificate she received for coming. She smiled as she told us that while she was busy at the workshop, she did not think of how bad she felt and that she was happy for a while. “With what you are teaching me, I can do this for others.” Miracle three.
While there we toured the building. Keep in mind that any type of long term care of the elderly is handled by charities and ministries. Nicaragua has no system like Medicare or Medicaid or Social Security for the elderly. Two things that caught my eye during the tour were the laundry and the kitchen.
The laundry was a small room with a washer and dryer. Linens and clothing were piled two to three feet deep on top of the appliances and on the floor. The stench took your breath. One woman was there in that dark room and had personal laundry and linens to do for all 37 residents. The washer was running. There were lines out back with clothing hanging on them.
Outside beyond the laundry area, a black pot of beans and rice was cooking on an open fire. The open fire was complemented by a very small indoor kitchen where three women were preparing fresh vegetables. The stove top was being used a counter area. The room was relatively dark, no one wore hairnets, no gloves were seen, no plate covers, no trays. Small plates were being lined with the traditional banana leaf and the food was placed on that. Hogares assisted by the foundation were serving a minimum of two meals a day.
Over the next four days we visited two other hogares. The one in Masaya was maintained by charities of the Catholic church and was visibly more advanced in their understanding of hygiene and staffing. There was even an activity room with evidence of crafts programs and physical therapy services. It was noted by some of the board members that the church-affiliated buildings had more consistent access to supplies and staff was better trained.
In Masaya we had lunch at the home of Dona Kelly, the wife of a rancher who is the advocate for the hogare in Juigalpa (oo-ee-gaul-pa). After riding over some of the roughest ground you can imagine on what could only be described a cattle path, we were in the middle of nowhere. A front porch area was filled with volunteers, staff and residents waiting for us.
We did one of the things activity directors do best…we greeted folks, shook hands, smiled. The smiles, hugs and greetings were returned, with the exception of one dark porcelain-faced woman in a brilliant blue dress sitting off to the side. Much younger than the other residents, she showed no expression and would not make eye contact. She showed no acknowledgement of being touched on the shoulder. Another team member stated that in his three visits to this facility he had never seen her engaged with anyone or anything in her environment.
Within moments, Jamie pulled a life sized baby doll from our “bag of tricks.” She held it up to the woman’s, face and shoulder, pulled her rigid arms in place to hold it and rocked the woman from side to side. After only a few moments, she began to look at the doll and smile. Jamie manipulated the doll like a puppet to cuddle and kiss the woman. She began to laugh. Something as simple as a child’s doll had pulled her from some deep dark place within herself. Staff was amazed.
And “the rest of the story” as the saying goes? We later learned that she had a child that had died and that she was brought here and left when the family could no longer take care of her. She had basically been catatonic for her entire stay. Not one of us had a dry eye. Miracle four.
Craft supplies and exercise equipment were spread out at every site, creating the expectation of learning something new. And miracles happened over and over. Language is not a barrier where there is a thirst for knowledge. We kept our interpreters busy, but our non-verbal/non-Spanish communication skills improved moment by moment. At each setting we connected with a particular few folks really eager to learn and come back to the hogares to teach and work with the elderly. Everyone had a level of interest but there were a few at every site that you knew were going to use what we were teaching.
Many told us how much they appreciated us taking our time to come to their country. Through a translator a 21- year old- volunteer told me “I appreciate that you have come to help Nicaragua. God will bless you greatly for helping the poor.”
One particular miracle for me was that I could see the faces of my Lutheran Home residents in these impoverished abandoned elders. I could see personalities that were reflections of the individuals I work with every day. There was a hand shaker, a baseball cap collector, a silent one who grinned all the time, a prankster, a tearful lost one. Without understanding a word they said, I could see a bit of who they had been before they were abandoned and left in this place. And just like the residents I see every day, they wanted attention, laughter, hope, touch and the simple joys that come from interacting with others.
They were so like my residents and yet so different. They live in a world forgotten by most. They live a world where survival is the name of the game for most. They live in a world where bare minimums are the norm. They live in a world that is forgotten by their own people.
When I agreed to embark on this adventure, I had no idea what to expect. God certainly stirred our team and gave us miracle after miracle. The greatest miracle I think is the passion the trip has instilled in each of the team members to continue to support these abandoned seniors of Nicaragua.
Brenda Zimmerman is activity director at The Lutheran Home at Trinity Oaks.