Newspaper article St Louis Post-Dispatch (MO)

Useful Alternatives to Nursing Homes

Newspaper article St Louis Post-Dispatch (MO)

Useful Alternatives to Nursing Homes

Article excerpt

The recent protest by several St. Louis County families against the opening of a private residence as a home for five people with Alzheimer's disease demands examination.

As a geriatric social worker who has worked with hundreds of institutionalized elders and their families, I see development of these kinds of residences as a desirable alternative to institutional care. I believe they can contribute much to our communities.

I have observed hundreds of times the anguish that elderly people and their families go through in entering a nursing home. The anger and guilt felt within families are never fully resolved.

Thirty years ago, large-scale efforts were initiated to move people with psychiatric and intellectual impairments back into the community and out of large state psychiatric facilities because it was generally understood that this was an inhumane method of caring for people. It is time that we raise the same questions about how we provide care for our disabled elders.

Geriatricians know that depression is a frequent response to moving into a nursing home. Many in the health-care field also observe that people develop complex illnesses and disabilities - not as a natural function of aging - but as a response to nursing-home placement.

One gives up control over many aspects of life when entering a nursing home. This loss of control eventually leads to decreased overall competence. People are unwittingly encouraged to become passive and dependent to fit into institutional routines. As a result, confusion and other mental-heath problems may develop or become worse and physical abilities may decrease. One is then perceived to be sicker and less competent, and the cycle of decline continues.

How many of us have spoken to a relative or friend living in a nursing home who begged to be taken home? The conditions in many nursing homes are not the result of uncaring staff, administrators or owners. They result from the insidious nature of large, medically oriented institutions - white uniforms that separate caregivers from their dependents; diagnostic tools and terminology; use of physical and chemical restraints; staff shortages or high ratios of residents to care givers; and the paternalistic attitudes that eventually influence even the most caring and conscientious staff members. …

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