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Nursing Home 'Patient' Checks Out, Part 3
07/29/2013   Reported By: Patty B. Wight

Last week, Anthony Pastore did something most nursing home residents never do: he checked out and went home. Pastore is a 25-year-old medical student at the University of New England who spent 10 days at the Maine Veterans Home in Scarborough living as if he were an 85-year-old man. The program - called Learning by Living - is intended to shape Pastore as a future physician. Patty Wight has been chronicling his experience and brings you this final report.

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Pastore 2

Anthony Pastore, right, with Certified Nursing Assistant Bobbie Vansteemburg.

A full morning before Anthony Pastore is discharged from the nursing home, his bags are packed and ready to go. By evening, a big grin spreads across his face. "It's like Christmas Eve," he says.

When Pastore arrived here nearly 10 days before, he was treated as if he had a stroke on his dominant side and was recovering from pneumonia. Pastore used a wheelchair, and eventually a walker. He needed help getting dressed in the morning and with basic hygiene - even using the toilet. He drank thickened water and ate pureed foods for a day.

"I thought it would be more living life with physical disabilites, and how I would kind of acclimate to environments and even social interations with left side paralysis," he says. "But it was more of an emotional exercise, and something that really tested your emotional capacity."

Pastore adapted well at first, then dipped into a depression halfway through his stay. He, like other residents, had some choice in how he spent his day, like what to eat or which activity to do. But the loss of control over small details of his life- like needing help to put toothpaste on a toothbrush - dragged him down.

"I was concerned about him. You could see it in his notes. He was feeling a lot of despair," says Pastore's professor, and the founder of the program, Marilyn Gugliucci.

Gugliucci says depression is a common emotion for new nursing home residents, but it should be temporary. "His interactions with staff, and definitely his interactions with buddies made all the difference in having him turn that experience around."

"We are about to go see my friend Arthur," Pastore says, as he walks into the Alzheimers and dementia unit. That's where he says he spent some of his most rewarding time, especially talking to a resident named Arthur. Sitting in Arthur's room, they recount the first time they met.

Arthur: "What was the first thing I told you?"

Anthony Pastore: "You asked me, if I could sing any song, what song would it be."

Arthur: "Was that the first thing I asked you?"

Anthony Pastore: "It was the first thing I asked you."

Arthur: "What was the second thing? I remember. I was across the hall, and I said, 'Wow! Look at the guy's tan on those legs!'"

Anthony Pastore (laughs): "I remember!"

Pastore says he's surprised at how easy it was to make friends with residents, and also, how happy some of them are.

"I thought that I'm going to come in here and everybody, including myself, is going to be really down. And that actually was far from the truth," he says. "There were definitely a fair share of people who were less than thrilled to be here. But for every person in that situation, there were some people who were really thriving and enjoying life."

Recognizing the importance of social connections, Pastore tells nursing home staff about a newly-admitted resident he met during breakfast. "Looking across the table at him, I saw a lot my first emotions," he says. "I saw a little bit of myself 10 days ago in him."

Pastore showed the new resident a menu and introduced him to other residents. He says he wishes he had had a peer ambassador, to help him transition into life at the home. Scarborough Veterans Home director Maureen Carland says this kind of feedback is one reason they host students like Pastore.

"You know, hearing Anthony talking about the ambassador, we do it on one of our units, but we haven't done it on this one, so how do we start to incorporate that elsewhere?"

After a debriefing session it's time for Pastore to go home. He says he can't wait to go for a run, play basketball, go see a band. But before he walks out the door, he visits one last friend. It's Norwood Grant's 81st birthday, and Pastore gives him a tin of muffins in celebration.

Grant is visibly moved. "How about a hug? Do you give hugs? I love you. Take care of yourself," he tells Pastore.

"See ya buddy," Pastore responds.

Marilyn Gugliucci says Pastore's experience will change him in ways that will emerge as he becomes a doctor. A lot of it has to do with his bedside manner - how he will talk to and touch people, how often he will look them in the eye.

"He will have a level of understanding that most - 99 percent - of the physicians will not have. When he writes an order for pureed food, he will be able to say, 'I have been on that diet - I understand. Be sure you order the thickened milk and not the thickened water.' He will have an experience that he can share with his patients, that they know - he understands."

Anthony Pastore wants to be a primary care physician. He begins medical school on Aug. 2.

Photos:  Patty Wight

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