''I fell twice in one week. I told my daughter I don't belong at home anymore''. A remarkable statement by an 89 year old. Why remarkable? Because most seniors wouldn’t acknowledge that clearly half of all 80+ year olds cannot live alone safely.
I recently re-read an article published in the New York Times by Atul Gawande entitled “Rethinking Old Age”. Although the article does confirm the statistic that more than 75% of all baby boomers will likely need long term care at some time during their lifetimes (and usually at the end of their lives), this article reports on a growing interest by seniors in creating care facilities that are more like homes than institutions. This idea has become a reality as organizations such as the Green House Project, the Pioneer Network, and the Eden Alternative participate in building genuine homes that replace institutions for the disabled elderly. Why is finding an alternative living arrangement for seniors such an important issue? Because, over the next 15 years, there will be 80 million seniors. That’s almost 1/3 of our nation’s population.
The reason that most people reject the prospect of nursing homes are found in its priorities: avoiding bedsores and maintaining weight. Albeit necessary objectives, such goals give little to promote a meaningful life. It seems as if we've settled on a belief “that a life of worth and engagement is not possible once you lose independence”. In fact, with one’s belongings stripped down to what could fit into one cupboard and life reduced to when to go to bed, when to wake up, what to wear, eat or drink as determined by the rigid schedule of institutional life, is it any wonder most people dread nursing homes?
Our 89 year old lady puts it best when she observed, ''I know I can't do what I used to but this feels like a hospital, not a home.'' The near-universal reality of nursing homes are chronic boredom, loneliness, and lack of meaning — not fundamentally all that different from prison.
To the rescue are men such as Dr. Bill Thomas, a geriatrician who calls himself a ''nursing home abolitionist'', who built the first Green Houses in Tupelo, Miss. These homes, with 10 residents, are equipped with the kitchen and living room at their center, not nurse's stations. All bedrooms are private. Residents help one another with cooking and other work as they are able. Staff provides more than nursing care by mentoring seniors on all aspects of daily life. Most long term care insurance policies will help pay for living in these homes making them economically feasible for seniors to enjoy this lifestyle.
While these homes have been a great success, ''the No. 1 problem I see,'' Dr. Thomas relates, ''is that people believe [that] what we have in old age is as good as we can expect”. As a result, families don't press nursing homes with hard questions like 'how do you plan to improve the quality of your patients’ lives in the next year'? We must to push for improvement if we are achieve more than just safety in our old age.
Reference: New York Times, (May 24, 2007) “Rethinking Old Age”