Friday, January 7, 2011
Growing Older and aging in America
The point of it all
I have written several blogs concerning nursing homes and the need for every single one in America to usher in Culture Change. The nursing homes of our era have not changed much for many, many, many (that's way too many people) years and years. Why? Well mainly because people, loved ones and residents have not stood up, been counted and said: "Wait a minute, would You want to live like this when old?" I am always wondering why and maybe because we just need someone to care for our elderly or maybe because we, too often, feel like because a person is old, they aren't contributing members of society anymore and so let's get them out of sight and out of mind. What a sad, sad way to view people who are simply old.
In this day and age of 'youth is everything' and bombarded daily with botox ads, ads for the 'fountain of youth in a bottle', the 'face lift in a jar' and the media telling us 'older is Bad, Bad, Bad' I realize it is little wonder we view old age as an 'affliction' rather than a fact of life.
A person said we don't all get old, but there are only two sides to that coin, either we die young or we will grow old. I don't think old should be as depressing as our society of 'good little Christian' people make it out to be. I know, Republicans want to take Social Security away, telling everyone else they are socialists, but taking Social Security doesn't make them exactly humane, nice, caring people either. So watch who you call names.
But way too often nursing homes and care for the elderly are viewed as 'that's how it is and always has been, nothing we can do' attitude, which is wrong. Things, institutions and ways of life can and do change, if enough people care enough to make changes, to demand changes and actually voice an opinion. In nursing homes, residents are paying customers, few people, except for a handful of volunteers, are there out of the goodness of their hearts, they get a paycheck, otherwise corporations would not be owning so many. So while I sound like a 'rage against the machine' person, maybe I am, maybe that machine we refer to as Corporate America has gotten too far out of hand, so much so we just let it run us over. I'm here to say it does not have to be like that. So while we will grow old, most of us anyway since there are only two sides to that coin, you either grow old or are long gone before old age hits, it does not mean changes for the better are out of reach. That attitude would never have gotten Civil Rights off the ground. So buck up, sidle up to the bar of life, have a drink and then get off the bar stool and act like America is a caring country once again.
I've done political rants about corporations have no business telling us what to buy, what is news and they have even less business telling me how to live when I'm old. When is America going to quit bending over for big companies? Ever?
Choosing a 'good' nursing home, for the most part is an oxymoron, good and nursing homes do not belong in the same sentence for most of them that exist today. Like 'jumbo shrimp' or 'new and improved' they are contradictions. Unless a nursing home (BTW nursing and home are an oxymoron too) is a total Culture Change facility, the there is no good nursing home. Got it?
What does Culture Change mean? Exactly what it says, changing the culture of a nursing home, changing attitudes of staff, owners and families who have loved ones in there. Complete and total changes, to places that warehouse people. Warehousing of people is wrong, it went out with Nazi Germany, or at least it should have and it is a dinosaur, something that belongs in the Stone Age, not in the 21st century. I will s-p-e-l-l out the changes that need to take place, changes about simple things you and I take for granted living our lives as we so choose, but somehow get lost in human warehouses.
I don't know about your home, but mine does not have a nurse's station parked smack dab in my hallway. Nursing stations belong in hospitals, nowhere else, end of story, plain and simple, no two ways about it. In a nursing home if you want it to be my home then get rid of the damned nursing station. Do I want to live in a hospital, do you? I'm pretty sure the answer to that question is an emphatic No.
Nurses are needed, but their office, desks etc. do not need to be in my hallway, it is just another obstacle for people with canes, people who move slower, people who have a slower reaction time and people in wheel chairs, to have to maneuver around. If nursing homes really cared for something other than staff convenience, those stations will be delegated to an actual office, on the side, not right in my way.
Nursing stations, for the most part say this: "With their high counters (am I buying something, is this a retail store?) tell me, as a resident, right off, nurses and staff are higher than me, superior to me. Not so, since as a resident I help pay your paycheck, don't be acting all superior to me. Those high counters, if I'm in a wheel chair, are difficult, if not impossible, to even look over to see a nurse anyway. Give them an office with an eye level desk like any other person is having in a business. Getting my drift yet? No wonder many residents now feel intimidated because of this little superior island in a nursing home.
Aside from the noise those nasty med carts cause, there is the fact they have big, hulking, medicine books on the cart, in the hall, unattended by a nurse who is in a room dispensing medications. So if I walk by a cart, I merely flip a few pages, have a gander at your medical record and all your illnesses. Gee, I don't see any need for HIPPA here anyway since nursing homes insist on violating that rule, so HIPPA is an utter waste of time here anyway. Wrong!!!!!!!!
Another big nuisance in a nursing home is those darned med carts, also parked on the side of the hallway and used to dispense medicine to all people the same time of day, again, merely for staff convenience, not the resident's good or convenience. When I get medicine prescribed by a doctor, there is a label that instructs me when to take that medication. I have never seen, not even in nursing homes the instructions: "Take this medicine at staff convenience or discretion'
It just isn't written there. Why is it that nursing home staff have never heard of this wonderful invention called a medicine cabinet? I have one in my bathroom and nursing homes could have one in every resident's bathroom too. People will get into the medicine, you say? Well there is another wonderful invention called a padlock, costs sometimes a buck or two in a store and medicine can be locked up in a medicine cabinet using a padlock. So now each resident could get their medications as instructed on the bottle instead of ;one size fits all' mentality of dispensing everyone their medications at once. Novel idea, isn't it?
Med carts, rumbling down the hallways at night, when I need my sleep, do nothing to help me obtain needed sleep. So a nursing home's answer to lack of sleep? Well let's give those old people some sleep medication and by God we'll make them sleep so when I get them up at five AM, we'll go into that next, they can be groggy and not ready to get out of bed. Not a very good way to help older people sleep, but then drugging them is also for staff convenience too.
Getting old people up at 5AM, 6AM or even earlier so the poor day shift staff have less to do. I say, Tough cookies, to day staff then! Why in this world would anyone who is old, retired and having no job to go to, be forced by an utterly insensitive staff, to get out of bed at 5AM? What in heck are they thinking? Is this older people being punished for getting old?
All of this getting them up all at once, is for staff convenience too. Now we are up, we all have to have breakfast, at the same time while staff is in that mess hall they loosely call a dining room because half the residents do not care to eat. Well you just ruined my appetite by yanking me out of my nice warm bed at an ungodly hour. I may not be a 'morning person' (You Do remember I Am a Person?) so now we have to call dietary to force Ensure down my throat because no one bothered to ask me what I like in the morning.
Every person should be able to get up when they feel like it, not when staff decides because kitchen staff want a clean kitchen by a certain time or because nurse aides do not want to frog with a continental breakfast or any of the stupid reasons why this tactic is done.
If I'm paying $5,000 a month, yes, I expect a continental breakfast and then some. But corporations might lose a nickel by offering it to me. When in reality, culture change would, in fact, have more people wanting to go to that facility because they can be human and can have a life. So there is no reason not to change, except for pure laziness.
One of the nursing homes I worked in was dead set on 'allowing' old people to go outside into the garden area but only when temperatures 'allowed' staff to 'let' them go outside.
Well I go outside anytime I damned well please to do so right now, in my life, run by me. Don't you? I went round and round with the Administrator and staff on this one particular issue countless times. I'd go to the desk and ask for the key to the door to the garden, only to be told that 'the temperature isn't right for residents to go out right then' and I complained that by the time people reach 60, 70, 80 and beyond, they pretty much know their bodies and can decide what is good for them without staff having to make those decisions.
The only decision staff needed to make in this case was to fetch a resident's coat, hat, gloves, etc for them to be comfortable in winter and to keep watch to be sure digits didn't freeze up. Staff can decide to have umbrellas for shade in summer and keep watch to serve drinks so residents do not dehydrate in hot weather. The decision to actually go outside belongs to the individual resident only, not to staff members at all.
Would staff like me telling them now their shift is done it is too hot or too cold for them to go outside to go home? How about i follow them home to dictate what is good for them in their homes? Same difference when making residents decisions for them.
As you can see, all of the stuff mentioned here, are the simple things that we, living in the world, just take for granted every single day. We go where we please, we eat what and when we please, we shop when and where we please, we even do our banking when we feel like it.
We go outside when we feel like it, and no one tells us we cannot do these things, unless, of course, we are in prison or the modern prisons we call nursing homes. Culture change needs to come to Every nursing home in America. Older people, paying huge sums of money deserve better treatment for their bucks spent in facilities.