"I Want to go to a Nursing Home When I Get Older" said no one, ever!
As a rehabilitation therapist I have a clear understanding about many aspects of aging. Having worked in home health care, nursing homes, hospice and rehabilitation centers for many years I am keenly aware of what aging and disease can do to bodies. That knowledge helped me commit to a personal fight against the controllable aspects of aging with diet, sleep, exercise, social interactions, mental challenges and timely medical care.
No one ever said “I want to go to a nursing home when I get older”. What everyone wants to do is stay in the comfortable familiarity of their own home. That’s called “Aging in Place” or “Staying at Home”. I understand that growing older is a series of losses that pile up and compound each other. You can expect to lose hair, vision, hearing, teeth, mobility, memories, comfort, friends, family, income, etc, etc, etc.
Aging in Place
One way to age in place and stay out of a nursing home is to avoid sickness and avoid falls. Easy, right?
Falls, fractures, surgery and illness, complicated by cognitive deficits and vision and hearing loss are common reasons why people “go to rehab”. In my experience, many people never leave rehab but instead transition from rehab to the long term care section of a nursing facility. If the patient is incontinent, especially of bowels, their chances of going home become even dimmer.
Cognitive and Medical Issues
Staying in a hospital, rehabilitation center or nursing home is stressful and difficult. None of those places is a luxury hotel with all the amenities.
They’re more like the experience of a crowded airplane, flying to an unfamiliar location. The trip is tolerable but not really comfortable or enjoyable. The basics are provided but it’s hard to sleep and the food is strange. Every passenger wonders what the scene will be at the end of the trip. There are prayers for a safe and smooth landing. Staff are present but minimally engaged with your needs since there are also many others on board.
Cognitive and medical issues are the usual reasons for such a difficult “trip” which add to the anxiety and stress.
New Rules, New Learning
Families are often surprised to hear about their loved one’s experience on the rehabilitation “trip”. If a patient comes to rehab with even mild cognitive deficits their whole world is suddenly turned upside down. Nothing is familiar. The food, the bed, the clothes, the noises, the temperature, the TV, the people are all new and different.
There’s probably pain involved for most people and new rules to remember and follow. One rule may be “don’t get up alone” which is confusing to many.
Then there’s the difficult work of participating in therapy routines and being on a time schedule that’s not of your making. Someone you don’t even know is in your room telling you to do something you don’t feel like doing.
Home Safety
Investing in basic home safety measures within our familiar homes is worth the price of the project if it means aging in place with dignity and comfort. No one plans to take the “trip” scenario above.
Unfortunately, most people have no idea what to do or where to start to get their home safe for Aging in Place. Often people can identify the need for a grab bar in the shower, but that’s usually where it ends. What size should it be? Where do I put it? How do you install it?
Resistance to home safety equipment is common because many have a negative impression and don’t want it in their home! In the USA home safety equipment is a stigma implying disability, instead of a sign of informed, proactive planning.
The National Council on Aging has wonderful resources detailing home safety recommendations that belong in every home regardless of who lives there or how old they are. See a screenshot below of their publication called Simple Fixes for a Safe and Supportive Home.
