The key to reform of the nursing-home system is the concerted effort of residents and their allies families, friends, community groups, and professionals. All must cooperate to improve both the present situation and the future of long- term care. Numerous coalitions of such interested parties have developed since the early 1970s. Many of them work together through the National Citizens’ Coalition for Nursing Home Reform, which can refer you to other groups in your area. Resident involvement is an increasingly important part of reform. A major “discovery” resulting from this trend is that even frail residents are more able and willing to get involved than most people would expect. Their involvement lends legitimacy to reform movements who knows more about nursing-home life than the people who live there? It also provides crucial opportunities for residents to exercise control and choice, and counter the negative effects of institutionalization. [Read more...]
Deciding to enter and choosing a nursing home are only the beginning. To make your transition as smooth and easy as you can, you should:
• Think about your personal belongings. Most nursing homes allow you to bring a few possessions, and some will store a few valuables. What do you want to have with you? What would you like to give to loved ones? What can you sell? Do you want to keep anything in storage especially in the event that your nursing- home stay is short?
• Think ahead about adjustments you will have to make. You will probably have to get used to one or more roommates, a large group of people in close proximity, a loss of privacy, and having a daily schedule set for you. Many residents do make good adjustments; humor, a spirit of compromise and self-confidence help. Think about ways to retain as much autonomy as possible. [Read more...]
In many communities, you can find nursing- home directories, information on how to select a home, and information about residents’ rights. Such information can come from the nursing- home ombudsprogram, a nursing-home licensing agency, the area agency on aging or other elder service organizations, advocacy groups, or your state’s nursing-home association. If you are in the hospital, the discharge planner or continuing care coordinator should help you. Word of mouth is another good source of information, although opinions may be colored by emotions, stereotypical attitudes toward nursing homes and residents, and conclusions drawn from an unrepresentative incident. [Read more...]
Many, if not most, nursing-home decisions are made in the midst of a crisis. But prospective residents and caregivers who prepare in advance retain more control of the process and cope better with the strong feelings evoked by such a major transition. The likelihood of a waiting list adds to the importance of advance planning. All of us, even those who are healthy, should make our wishes known to love ones in advance. Or, as caregivers, we can sensitively approach the subject before our loved one becomes incapacitated or we become exhausted. Decision making should involve the prospective resident to the greatest degree possible. Even confused people can respond to caregivers’ attempts to communicate lovingly the realities of a difficult situation. Avoiding the topic or misleading the prospective resident even if intended as kindness can have a devastating effect on morale. [Read more...]
“Medicalization” is an unfortunate fact of life in nursing homes. As in hospitals although they are called “homes” nursing homes’ medical orientation encourages a narrow approach to residents’ well-being. Loneliness, confusion, depression, and behavior problems resulting from a lack of freedom and meaningful activity are addressed medically (if at all). Drugs or other restraints are too often the first choice, rather than the last resort, in dealing with what are often sane reactions to an impossible situation. The medical model requires efficiency and hierarchy. Because it cannot incorporate the chaos of individuality and assertiveness, it treats residents as patients or cases instead of as people and rewards those who conform. [Read more...]