Most of us would rather not have to live our last months or years in a nursing home. Certainly, almost no one would choose this option if all nursing homes were like the ones of past decades.
Based on military and prison hospitals and run for the efficiency of staff, the old nursing home model was a horror. Are there still homes like this? Unfortunately, yes. However, an educated public and an aging boomer generation that has never taken orders meekly are two powerful forces pushing change.
This change, led in the U.S. by the Pioneer Network and others who work hard for person centered nursing homes, is turning the nursing home model on its ear. Nursing home "culture change" leads to person centered care. The ideal would be for every home to have a brand new facility from ground up, plenty of well trained staff all with the personalities of angels and superb training. That's the ideal.
I think most of us agree that the ideal is rare. However, there is a strong steady glow of light at the end of this dark tunnel of historic nursing home care. During the fifteen years I spent visiting a local nursing home for one or more of my seven loved ones I ushered through their last years, I saw many changes. I see even more now.
This home I'm writing about had just, at that time, change its name from Fargo Nursing Home to Rosewood On Broadway. When my neighbor, Joe, for whom I'd become the default caregiver, broke his hip, I had to find a place for him. Rosewood was near our neighborhood and his being there made it possible for me to continue to visit daily. This was the early nineties, and the home was as good as could be expected at the time.
During the fifteen years when I was a fixture at Rosewood, since it eventually became home to my uncle, my mother-in-law and both of my parents, I saw the home go through three owners. The first, when Joe was there, was church based. By the time my uncle had his third stroke and could no longer be cared for at home, the home had been purchased by a secular agency.
While tending to my uncle once he was situated at Rosewood, I moticed improvements during the two years after Joe's death and my uncle moving in. Much was redecoration, but also there was a less rigid mentality when it came to residents and their individual personalities. I was pleased with the changes and got to know the staff well. Eventually, my dad had brain surgery that sent him into horrible, irreversible dementia. Then my mother-in-law became incapable of doing well even with my daily visits and she was too paranoid to accept in-home help for the gaps when I couldn't be there. She moved to Rosewood, which was just down the street from her condominium. She felt safe there and she flourished.
My mother eventually joined my father at Rosewood, as her falls were so frequent that my twice daily routine with her wasn't enough to keep her safe. It made sense to her to join dad, even though they each had their own rooms.
Shortly thereafter, the home was purchased by another church based agency. I sense another jump toward better care. Many more patient centered features were introduced including more church services for different religious denominations and a much better meal system, where people with light appetites could have many more choices and eat many times a day.
My uncle and my mother-in-law died and my parents remained the last of my family residents as I watched the new wing of the home develop. My dad died before it was completed and even though my mother could have moved to a new room, she chose to stay where she was. Though Mom has been gone a few years, I find myself still marveling at the constant change happening at Rosewood.
The old wing has been remodeled to blend with the new wing. The shared rooms are so large and divided that they are nearly as good as the old private rooms - in many ways better. The new private rooms rival a nice hotel. The staff remains as steady as any nursing home could hope for, with my favorite nurse having just celebrated 35 years at the home. Continuity of staff speaks well for any care center and is vital for the residents.
Is Rosewood ready to be a model for the Pioneer Network? No, not quite. But they are forward looking people intent on making the care center into the best model money and dedication can now provide. I have no doubt they will continue to grow and improve. And there are many homes like Rosewood, working with old physical plants but struggling to improve care and improve the physical facilities to make them more person centered.
It will, sadly, take years to rid the country of old "county homes" and badly run nursing homes. There are still those that are run for the convenience of the staff and enrichment of behind the scenes financers. State and Federal laws must come down hard on these places and rid them of abusive practices, shutting down those that aren't improved.
But I write this with hope in my heart that one day the words "nursing home" won't bring a cold shiver of fear to those of us who are now aging and may one day be a resident of a home. I believe that the outcry of boomer caregivers and their courage in forcing change when bad facilities are uncovered will one day prevail. This will enable elders to know that, should they one day need the care of skilled nursing in a home, they can go knowing that they will be treated as unique personalities deserving of respectful care. For this to happen, families and caregivers need to continue making noise when substandard care is uncovered. God willing, our nation will eventually see person centered care become the norm. It can't happen too soon.
Published On: August 17, 2009