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.