Sunday, January 15, 2006

nursing homes, adjustment to

Residence in a nursing home is the exception rather than the rule for the vast majority of older Americans--only about 5 percent of the population over age 65 and 22 percent of the population over 85 reside in nursing homes. When entry into a nursing home does occur, it is practically always associated with a disabling chronic condition or impairment, such as organic brain syndrome or paralysis resulting from a stroke, that obliges the affected individual to depend on others for help with personal activities (bathing, dressing, toileting, and consuming meals).
Though nursing homes do discharge about 20 percent of their patients, they serve as the last homes for most people who enter them. Largely because of the growing size of the elderly population, the United States now has 22,000 nursing homes with over 1.5 million residents. This rate of growth is expected to continue after the year 2000, when the nursing home population is expected to increase to about 2.25 million and then to more than three million.
Accounts of nursing home placements generally allege that moving to a nursing home is traumatic for both the client and family members. Such accounts disregard the obvious fact that transfer to a nursing home may come as a considerable relief to all concerned, not excepting the client - especially so when one considers that the average nursing home resident has at least four times as many chronic disabilities and impairments as elderly community residents, and faces severe problems when attempting to reside in a conventional home.
Once in a nursing home, individuals no longer need to struggle with the tasks of daily living that are routinely managed by the rest of the population but impossible for nursing home residents. Needs for personal hygiene and good nutrition are met, medications are taken under supervision, and increased social contact frequently occurs. Research shows that relocation stress following a move into a nursing is usually quite temporary, and the client comfortably adjusts to the new situation.
Some years ago nursing homes perhaps did suffer from low regulatory standards and did resemble dreary hideaways for the helpless, but industry self-regulation along with rising state standards for licensure have greatly improved the quality and character of nursing home life. When an individual or elderly couple is reluctant to move into a nursing home even in the face of obvious need, professional counsel from physicians, nurses, and social workers, as well as agencies that serve the elderly and the homes themselves, can be helpful.
The success of these sources in advising with moves to a nursing home grows out of their customary sympathetic understanding and their extensive experience with problems of relocation. Most professionals who offer services for the elderly can offer advice on how to make a move seem like a desirable solution to the individual's problem of coping with daily living.
Professionals recommend that plans for a move into a nursing home be discussed honestly with the person(s) who need to move, and advise candor when stress of caregiving becomes excessive. When a person does move to a nursing home, family members need to develop a routine of regular visits and supportive help. A number of valuable and well-written guidebooks are now available to assist individuals with arrangements and follow up of a move of an older family member to a nursing home.
Atchley, R. C. Social Forces and Aging, 4th ed. Belmont, Calif.: Wadsworth Publishing Company, 1985.
Deedy, J. Your Aging Parents. Chicago: The Thomas More Press, 1984.
Gillies, J. A Guide to Caring for and Coping with Aging Parents. Nashville: Thomas Nelson Publishers, 1981.
Hooyman, N. R., and Lustbader, W. Taking Care. New York: The Free Press, 1986.
Lester, A. D. and Lester, J. L. Understanding Aging Parents. Philadelphia: The Westminster Press, 1980.
Ward, R. A. The Aging Experience, 2nd ed. New York: Harper and Row, 1984.

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