Friday, March 09, 2007

nursing home

I spent some time not long ago in a nursing home, fuddling through some information I'd collected, trying to figure out why this person had this strange, intermittent loss of orientation.

It made me think about my first experience in a nursing home as an aspiring psychologist. I was sent to this woman's room. The people there wanted me to assess for the possibility of depression in a woman with fairly advanced dementia. (Which is quite a challenge, actually, but that's another matter). So I go in to see this woman, and she's there in her bed, looking up at me. And I start asking her questions, going through my little tests and checklists and things. But mostly she just looks up at me and says things like "you're so beautiful!"

I used to joke that I left that room saying, "she's fine! I don't see anything wrong." (To which my wife would remind me that I was dealing with a woman whose judgment and perception of my attractiveness may have been affected by late stage dementia. Never one to miss a trick, that one).

Being in a nursing home again, I was struck by the competing demands there. Such facilities are, for a variety of reasons, based on a medical model. In many respects, they are simply hospitals for the elderly with medical complications. And yet, they are "home." Many of these people lost all of their savings, nearly all that they own, so that they could come there (so that they would financially qualify for Medicaid -- which would then pay for their care). And despite the best efforts of the staff there, there is so little that feels like "home." The crowding, the cafeteria style eating arrangements, the constant presence of medical personnel, most of your activities documented and reviewed.

Some of it, perhaps much of it, necessary. But hardly conducive to a sense of "home."

It strikes me that we as a society should find a way to do better for our elderly. And I mean no disrespect for those working at nursing homes now, who do their very best under trying conditions themselves. But particularly at this stage in our history whn so many are going to need this kind of care, it seems to me that a new kind of model is called for -- a model of care that does a better job of meeting the emotional needs of our elderly for respect, privacy, and a sense of being "home" rather than in a hospital.

1 comment:

more cows than people said...

a beautiful dream, steve. i spent a lot of time in nursing homes. and, at times, i see home for folks. but more often holding cell or hospital. but some, with the help of family and caring staff, turn their rooms to home. but its definitely an exception to the rule.

how did your encounter go yesterday?

loved the memory- you are beautiful.

which reminds me of a song i learned some time ago in L'Arche. I think of it often in Nursing Homes, and hospital rooms, and sometimes when I read blogs too...
How could anyone ever tell you you were anything less than beautiful? How could could anyone ever tell you you were less than whole? How could anyone fail to notice that your living (loving?) is a miracle, how deeply your connected to my soul?

My memory is hazy, but, Steve, I often find myself humming this song as I read of your encounters, as I read of your deep convictions.