MARIA & WHY, A NURSING HOME TALE
By Karen Strickholm 12/06/2024
Today, I will tell you the tale of Maria. But first, a quick word about these missives.
Why do I write them?
Mainly, I want to share with you what life is really like in a nursing home. One out of four of you will be clocking some time here, after all. Yet most know little or nothing about it. Life can be hysterically funny, moving, inspirational, and yes, often horrifying. You will need some mad skills to survive and thrive when your turn comes, and so will your loved ones.
I hope to help with that.
Karen, fighting the good fight.
Second, sadly the public “safety net” is filled with holes.
Nursing homes are a patchwork system, based on models from the last century, run almost entirely by investment bankers – the same people running our prisons, and with many similarities. Hence, there is a fundraising component here.
Lastly, this life experience has evolved into a spiritual journey, as well as a medical one.
What has my life amounted to thus far? How do I recover from this extended traumatic experience? How to better co-create with the divine? How best to serve?
Deep inquiry indeed, and of value to share.
And now, on to the tale of roommate Maria…
Families here in New Mexico tend to be large sprawling networks, and Maria belongs to one of them. She and her mom are a local crack-dealing team at the street level, obtaining wares from cartel connections for their cottage enterprise.
In these joints, you get what you get as a roommate. If you are in a mainly publicly funded place, which most are, you’ll be sharing space with all sorts. Maria was with me for just a few months, recovering from an amputation. During that time, she was hard at work trying to win visitation rights for her son, whom she loved very much.
Why no visitation? Welp. That’s a story! A while back, Maria came to fisticuffs with the other baby mama of her son’s baby daddy. During the battle, that baby mama got the upper hand, and dragged Maria aways down a dirt road, scraping her heel in the process.
Due to the drugs and diabetes and whatnot, Maria’s foot had to be partially amputated. Due to more drugs and lack of proper wound care, the amputation site became badly infected. A second amputation at the ankle ensued.
Did Maria learn anything from this?
No, because she changed nothing after the second cut (par-tay!! 🍻🪅🥳) which resulted in – you guessed it – a third amputation, this time mid-calf.
When she left the hospital, she was assigned to my room.
As a roommate she was easy to be with – cheerful, funny and entertaining.
She shared freely about her life, her plans, her incessant craving for Taki’s. I had received a bunch of sample lipsticks earlier, and laid them on her. She got such a kick out of doing her lips, burning through multiple tubes in under a month.
Maria had twitchy energy, patrolling the halls, rolling outside for a smoke. Periodically she’d disappear into our shared bathroom to vape some weed. It’s legal here in New Mexico, but cannot be used at nursing homes that receive federal funding like Medicare or Medicaid, which is most of them.
For me, these extended bathroom visits fell squarely in the category of see no evil. If I were Maria, I’d be vaping weed too.
Learning to walk on her fancy new artificial leg, Maria trekked the hallways to practice, playing and sparring with staff, most of whom knew Maria and her tribe from around town.
Know that here in New Mexico, Maria’s story is not an anomaly but the norm.
Chronic poverty and drugs are a toxic brew. Don’t think I didn’t see the crushed spirit underneath all that acting out and addiction. The grief of losing her baby, no matter the cause. The hopelessness. The inability to shift course. Sharing lipstick and food was the best I could do.
A lingering memory – One afternoon, wall-shakingly loud rock and roll thundered down the hallway…
“What’s that?”
“Oh just Maria. She brought her boombox into the shower.”
I still think of her often, and send her blessings.
end
And now, here is your AMUSE BOUCHE, Carl Sagan’s Pale Blue Dot…
Next Episode:
MATT & ANTHONY. A NURSING HOME TALE
Previously:
THE NURSING HOME CONFESSIONAL, A NURSING HOME TALE
Return To Substack
About this series…
Karen Strickholm had a hidden brain tumor on her pituitary gland. The tumor she didn’t know she had until she was about 50, wound up taking her health and all she had built in life. Her tumor, diagnosed in 2008, caused a tsunami of symptoms and eventually forced her into long-term care in a nursing home and a series of hospitals.This is America, the only developed nation that does not have universal healthcare, and the only developed nation where medical debt can force you into bankruptcy.
Karen became one of the financial statistics due to her medical debt, and the fact that she couldn’t get Medicare unless she was literally penniless.
What made Karen different from many other people was her relentless optimism and belief that she was going to get better, would walk out of the nursing home to build a new life. She was smart, a good writer and she left behind a number of digital artifacts, which have been collected into this series. Karen relates, in her own words, her journey through the American healthcare system and the reality living penniless in a nursing home long term.
Karen Strickholm died 6 April 2026 in a hospital in Albuquerque, New Mexico, of sepsis and pneumonia. She was 67.
This multimedia documentary series is her story.
Medical bankruptcy
• Approximately 66.5% of non-business personal bankruptcies in the U.S. were attributed to medical reasons in 2019.
• 1 in 10 U.S. adults (10.5 million) have experienced medical bankruptcy since 2001.
• 78% of bankrupt individuals in 2022 cited medical expenses as their primary cause.
• Medical bankruptcy rates increased by 21% from 2010 to 2020, even as overall bankruptcy rates declined
• The average interest rate on medical debt from bankruptcies is 21% (2022)
https://worldmetrics.org/medical-bankruptcies-statistics/
Nursing home stats
• On any given day, more than 1.3 million individuals receive care in a nursing home or skilled nursing facility, and a total of more than 4 million receive care each year.
• 6 out of 10 residents (64%) are short-stay patients who remain in a skilled nursing facility for an average of 25 days.
• Nearly four out of 10 residents (36%) are long-stay residents. These individuals often have multiple health conditions. Their average age is 76.
• Nursing homes employ about 1.5 million people.
• Nearly 90% are women, and 60% are people of color.
• One out of every five nursing home workers is an immigrant.
• There are around 15,000 nursing homes in the United States.
• The average size of a nursing home is 109 beds.
• Medicaid covers the cost of care for nearly two out of every three residents (63%).
https://www.ahcancal.org/Data-and-Research/facts/Pages/default.aspx