During my shift, I wheel my over-sized, wooden medication cart past the art room on the third floor of RiverPointe. Without fail, I am playfully teased by a group of residents. RiverPointe is an assisted living and memory care home in Moorhead, MN. As a Certified Nursing Assistant/Resident’s assistant for RiverPointe, I spend my shifts at work helping residents with everything from basic cares (i.e.: brushing teeth, toileting, showers) to handling their daily medication(s). I am privileged enough to get to know these residents and have their trust. I see these individuals in their most vulnerable state(s) as they depend on me for both basic and important daily tasks, which makes me an essential factor in their lives.
The goofy comments from the art room on third floor are directed at me by a group of assisted-living elderly residents. They often tell me I’m working too hard and making a lot of noise with my squeaky cart. So much noise, in fact, that they are unable to completely focus on their card game. This noise complaint, of course, is simply a joke. This group of people is having fun and often uses humor to get my attention/interact with me because they know that I can take it and appreciate their humorous side. Over time, I’ve noticed that this same group of individuals occupy a table in the art room most nights during the week. This observation raised some questions about the culture of the small clique of elderly card players. I wondered why these people play cards and what the benefits of card playing are as one ages. Although this card-playing bunch claims to only play because it’s an enjoyable way to get together with friends, their minds and quality of life are also benefitted from the socialization and mental stimulation/engagement that the game brings to the table.
To answer my questions, I decided to do a somewhat “undercover” field research study of this culture. I had a simple approach to this ethnography, as I chose to use naturalistic observations and unstructured, informal interviews as the basis of my research. After interviews, observations, and other conversations, I immediately recorded my notes down into my iPhone as it was the easiest, most unnoticeable, and convenient way to annotate my thoughts and take-aways from the encounters. A good conversation starter that I often used when wanting to bring up the topic of card playing was, “You are part of that group that play cards here, right? My dad and I are looking for new card games to play, and I’m just curious about which games you think are best?” The conversation would then pick up, and I was able to ask any follow up questions that came to mind.
During my first couple of visits, RiverPointe was in a lock down due to an outbreak of influenza. This meant that visitors were not allowed unless they were immediate family or health care providers. I was able to be there, of course, because I work at RiverPointe. Due to the outbreak, the dining room/kitchen at was closed for over a week in order to prevent the spread of influenza. Residents were even encouraged to stay in their rooms as much as possible. This also meant that the group of card players were advised to take a week off from meeting so that no one would get sick.
On January 23rd, 2018, I took my break around 8:30pm. As I went to clock out, I noticed that one of the members of the card playing group, Edith, was just leaving the building to go outside for a smoke break before bed (all names used in this essay have been changed for safety reasons in order to protect the privacy of the residents at RiverPointe). When Edith returned to the lobby from outside, she came towards me wondering if I wanted company. I told her that I would love company, and that I actually wanted to talk to her about something. That’s when I started off the conversation by asking if she had played any card games recently. As we were talking, Edith described the basics of what a typical night of card-playing looks like for her group of (what she considers) close friends. First and foremost, the group only plays a card game called “whist.” She did her best to explain that Whist is a four-person game played in teams of two and went over the rules. Edith told me that Saturday nights are the designated card-playing nights for the group, but more often than not, they play multiple nights a week. After I asked how long she’s been playing, her eyes lit up as she explained to me that she and her husband, Gary, used to play a lot at his parents’ house when they were newlyweds. After Gary’s parents passed, they didn’t play as much because the couple didn’t really know many more people who enjoyed sitting around a table for hours playing cards. When the two moved in to RiverPointe, they found others who knew the game, and started back up immediately. Edith informed me that Gary no longer plays, as he has been struggling with some early phases of dementia, which makes it more difficult for him to play. The conversation then came to an end, as I had to clock back in and continue working my shift.
My next interview occurred on January 27th, 2018 around 7pm. I had a brief conversation with a resident by the name of Helen during my break. Helen was reading the newspaper in the lobby, sitting alone next to the fireplace. Helen eventually told me that she used to play with the group of card players when it worked with her schedule, but it doesn’t any longer. She explained that everyone has their own rules, and this occasionally causes drama that she no longer wanted to be a part of. She also expressed her frustration about not being able to relate well with the others that do play cards. She doesn’t have the same sense of humor, and has a hard time enjoying herself with that group. This is because she is very young compared to others living at RiverPointe, as she is only in her early-to-mid 50’s. She isn’t around many people her age often, which makes it hard to enjoy socializing. Helen tends to spend most of the day in her room, and because socializing and regular human interaction are rare occurrences for her, she struggles with loneliness and depression. Helen is a woman who is very reserved, so it surprised me that I was able to obtain even that small bit of information from her.
Thankfully, RiverPointe was free of the flu for my third-floor shift on February 7th. This time, I was actually able to sit in during one of the card games and converse with the group as I observed their culture. They were ecstatic when I told them that I had some spare time and asked to sit with them to “try learn how to play.” The group said that everyone is always welcome, and they love playing with new people. When asked, they also mentioned that their group was anything but exclusive. I truly did do my best to catch on, but I’m not the greatest card player if it isn’t a game of Old Maid or Go-Fish. Whist is a complex game that they considered to be a lot of fun, and a good way to pass time. Typically, the group starts playing around 6:30pm, or whenever everyone is finished with supper (which ever comes sooner). Often times, teams are set up so that the men play against the women. Occasionally, the spouses of the card players will come to sit and watch. It was comical to see that the female spouses who attended were rooting for the girls to win instead of their own husbands. The games do get fairly competitive, but I was told by the group members that there are never any hard feelings as the games are all played just for fun. Over the course of my observation, there was a lot of talk about daily life and family, but the main focus was on the game. There wasn’t much gossip at all, which surprised me, because since I’ve worked at RiverPointe, I’ve noticed that a lot of elderly love to gossip. There were also lots of jokes about who’s the better card player/team and light-hearted jokes about individuals forgetting small things. For example, one of the ladies playing dealt out the cards then, after getting her cards organized in her hand, asked who just dealt. I also noticed that, for the most part, the minds of the individuals playing were very sharp compared to other residents that I work with. They were able to think and respond more clearly and quickly than the average resident.
Before leaving the art room to get back to work, I asked the following questions to the group as a whole: “Why do you guys like to play so often?” and, “Are there any benefits to playing?” All four players agreed that it was simply a genuinely enjoyable way to socialize with good friends, and it gives them something to do. Due to their age, most of the players are unable to drive/don’t have cars anymore, so unless someone comes to pick them up, they’re stuck sitting inside. They also said that the activities director at RiverPointe schedules the art room at 3pm on Wednesdays for everything from board games to card-games to dominoes, and there is usually a pretty good turnout. Eventually, I had to leave to finish out my shift. When I was headed out of the room, Edith thanked me for stopping by and encouraged me to come again when I had some free time.
That night, before my shift came to an end, I went into Edith and Gary’s room to get Gary’s perspective on card games. All Gary said was that he used to love playing but doesn’t enjoy it anymore because he claims that it isn’t as fun as it used to be, and that he isn’t as good as he used to be. This broke my heart because, when I confronted him about Whist, Gary’s nonverbal behaviors changed. His lack of eye contact, softer tone of voice, and lowered head displayed that he might actually be disappointed that he no longer plays. Edith assured him it’s like riding a bike and told him that she thinks he needs to give it another shot. She said he needs more practice if he wants to get back in to the groove he used to have. Gary responded by saying that he has lost interest and no longer cares about the game that he used to love. Gary never once mentioned his dementia to me as being a reason to why he no longer plays. This surprised me because, knowing Gary and his good sense of humor, I assumed that he would be one to put blame on something out of his control (like a dementia diagnosis) rather than simply saying he has lost interest. I wished the couple a good night and left the room as my shift was over, and I needed to clock out.
The culture of the group of card-players on the assisted living side of RiverPointe is represented by laughter, story-telling, competition, and close friends. The members make up a very welcoming group of people that share a love for socializing, playing cards, and having fun. Researchers Jiska Cohen-Mansfield and Philip W. Wirtz argue that socializing is crucial to keep individuals alert and aid in preventing psychiatric disorders (354). Refraining from socialization can lead to loneliness as well as psychiatric disorders such as depression and anxiety. In their study, “Characteristics of Adult Day Care Participants Who Enter a Nursing Home,” the researchers found that those who have psychiatric diagnoses and a lower frequency of socializing tend to regress faster and end up in nursing home institutions sooner than others (358). This research supports the idea that the residents are benefitting from playing cards, as they are socializing, which in turn aids in maintaining good mental health and overall happiness.
As explained previously, Gary claims that he no longer enjoys playing because he has lost interest. In reality, Gary might just be in denial and scared of the fact that it’s simply getting harder and more confusing for him due to his fairly new dementia diagnosis. I also think that Gary might be nervous about getting made of fun of if his memory slips up on him while playing. As stated earlier, the group often teases others when they are forgetful about minor details. The group of card-players consists of big-hearted individuals with good intentions, but they may not realize that sometimes even light-hearted jokes can really affect someone and be taken personally.
Dementia is a memory-impairment disease in which the individual with dementia is dependent on others for common, everyday activities. Dementia victims also tend to lose interest in social activities and have a hard time recalling recent memories and events. Gary is a good example of this, as he has also lost interest in a game that he used to love. Dementia is more often than not frustrating and heart-breaking for both the individual and their loved ones. It was evident that Gary’s wife, Edith, was saddened that her husband is no longer willing to play Whist with her and would rather stay in their apartment and watch TV instead. According to Harvard Medical School, staying mentally active is of great importance, especially as one ages. One of the studies found that those who frequently engage their minds in activities such as reading, writing, crossword puzzles, music, group discussions and playing board games or card games are “half as likely to develop mild cognitive impairment” (Coltrera). This study supports the idea that another benefit of the RiverPointe residents playing cards is keeping their minds sharp and engaged, which will give them a higher quality of life and aid in preventing early regression.
Overall, what I thought was just an exclusive group of elderly card-players turned out to be a group of individuals spending time socializing with one another and engaging their brains in an activity that will in turn benefit them in the long run. After observing the group and getting to know the members more personally, I will have a greater appreciation for the genuine fun and conversations. I will also have a greater appreciate for the jokes made as I push my cart through the halls past the third-floor art room at RiverPointe in Moorhead.
Works Cited
Cohen-Mansfield, Jiska and Philip W. Wirtz. “Characteristics of Adult Day Care Participants Who Enter a Nursing Home.” Psychology & Aging 22.2 (2007): 354-360. Academic Search Premier. Web. 11 Feb. 2018.
Coltrera, Francesca. “A Guide to Alzheimer’s Disease.” Harvard Health Publications. 1st edition. (2012). Credo Reference. Web. 11 Feb. 2018.
“Edith.” Personal interview. 23 Jan. 2018.
“Edith & Gary.” Personal interview. 7 February 2018.
“Helen.” Personal interview. 27 Jan. 2018.