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Toby Laping Associates www.WNYCareManager.com
Eldercare News |
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You Need To Know . . . New Models for Nursing Homes by Toby F. Laping, Ph.D., C.S.W. Nursing homes don’t need to be the” same old thing”. There are some facilities that are using creative ideas for humanizing nursing homes and making them into places of hope and of life. Many nursing homes are based on what we refer to as a medical model. While there are great variations in physical plants and in responsiveness to the needs of older people, staff philosophies at diverse facilities are often not so different. As a general rule, physician orders set the parameters for resident freedoms. And, nurses and therapists make judgments about what is safe for residents to do. The convenience of staff overrules the preferences of residents. Why else would dinner be served at 4:30 or 5 PM when many people prefer waiting until 6 or 6:30 PM for dinner? Why else would people be gotten up in the morning at 6 AM or 6:30 AM, when all they have to do is to sit in a wheelchair for the rest of the day? There are some bright and creative ways of looking differently at nursing homes. There are philosophies that restore a reason for living to people who would otherwise be sitting and waiting and doing activities without real meaning. These new ideas aren’t perfect but that’s okay; they’re indications of creative thinking in efforts to improve quality of life for seniors who need help with living. Try these ideas on for size:
There are institutions implementing these ideas, and they seem to have considerable merit. A physician named Bill Thomas created something he calls The Eden Alternative in an institution near Utica, N.Y. He conceived of The Eden Alternative in 1991 as a new approach to long term care living. The Eden Alternative has developed and spread, and forms the basis for about 240 nursing homes across the country. Those facilities have adopted a philosophy and an active model that says that nursing homes can be places in which people are pushed to remain proactive rather than becoming increasingly passive. One particular example of what that means is appealing to me. In order to give life to the environment, these facilities generally have lots of animals around and residents are given responsibility for caring for them. One woman who was made chair of her facility’s “pet committee” was asked what happens if she or the assigned member of her committee forgets to feed the animals or if they neglect to make sure food is ordered as needed. The answer was that the animals then go hungry. And in fact, residents don’t forget to feed or water the animals because they know that’s their job and there’s no one watching over their shoulders on the assumption that they’re not up to it. To learn more, check web sites www.thegreenhouseproject.com. or www.edenalt.com These facilities are working to change the philosophies of long
term care that we all know and dislike. Change is exceedingly difficult
with multiple barriers such as intransigent or uncomprehending staff,
fearful boards of directors, Health Department regulations, family
fears, and residents’ entrenched expectations. But changes can be
made, and they bode well for the possibility of healthier approaches
to long term care.
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