Could A Nursing Home Be In Your Future?

People come to live in nursing homes for a wide variety of reasons.  An assortment of physical ailments drives many people there.  But the leading cause of nursing home admissions is a mental deficiency known as dementia.  As we age, we slowly lose our strength and our power.  As we weaken, we slow down and day to day routine tasks become a hardship.  Part of the decline of our physical attributes is caused by the reduction in the size of our brains.  With reduction in brain size, there is often times a corresponding malfunction in our thought processes. This can lead to the development of profound confusion, disorientation, and ultimately, dementia.  The ability to take care of oneself is thus severely compromised and that responsibility is then passed on to others.  It can become exceedingly difficult, if not impossible; to care for loved ones at home for lengthy periods of time even if there is a strong desire to do so.  It can sap ones strength and drain someone so emotionally and financially, that the capacity to continue is gone.  To many families then, the nursing home becomes their only recourse.  It is difficult to place a loved one there.  Nursing homes are, for most part, not the ideal situation.  They have been described as the warehousing of the aged, but what else can be done?

Family members do come to visit their loved ones there and some will even participate in their care and develop strong relationships with the staff.  These individuals, however, are in a distinct minority.  Many residents remain alienated or lie awake through endless days and nights of episodic fits of abject loneliness!  You can hear residents cry out for loved ones who have long since died.  They beckon for someone, anyone to sit with them, hold their hand, and talk with them.  Too often, the nursing staff feel as if they are too busy with other duties to engage the residents in such a fashion.  And of course, many times they are too busy. You’ll rarely hear more than perfunctory greetings or terse exchanges between the staff and the residents.  Copious amounts of paperwork, attending meetings, and performing physical care tend to preclude the staff from sitting with and engaging the residents to any great degree. 

One morning, as I observed a nurse walking briskly down a hallway, she hesitated momentarily, and with a gleaming smile, asked an elderly male resident how he was doing that day.  Before the resident had a chance to respond, the nurse was off again.  How could it be going today for this frail man who’s incontinent and suffers from dementia?  His wife has died and his children are far away and do not come to visit.  He has outlived all of his close friends.  He tries to gesture and verbalize to those who pass him by in his wheelchair.  But his responses are too slow and he is not given adequate time to engage in an exchange with those who move and respond at a much faster pace.  So he moves his wheelchair down the hallway looking for someone else to chat with.  His wheelchair gets entangled with another resident’s wheelchair and that resident begins to scream and push the first man’s chair out of the way, nearly toppling it.  The first man calls for assistance from an overweight nurse sitting at the nurse’s station sipping coffee and eating a donut while chatting with someone.  She lazily turns her head and in a drone voice says, “You’ll have to wait a minute.”  “Can’t you see I’m busy?”  Somehow, the first man manages to free himself from the entanglement and moves his wheelchair further down the hallway looking for someone else to chat with.  He comes across a woman he seemingly knows who is flailing her arms aimlessly and apparently speaking to someone he does not know.  She is crying out for loved ones whose souls have long since departed this world and her beckonings go unheeded.  

The man continues to move on when suddenly there comes an announcement that lunch is about to be served.  A nurse approaches this gentleman, takes hold of his gastric tube, and hooks him up to a tube feeding.  The man has not been able to eat in the normal way for several years now and must be feed through a tube leading into his stomach.  Otherwise, this man would die.  He has said he prefers to die, but without a living will, the nursing staff will implement any and all measures deemed necessary to keep him alive.  The man is disconsolate, isolated, alienated, and agonizes over every moment of the horror he is living.  What can be done?