By Steve Moran
In our recent article I want to Cry – Part 1, I talked about my dad’s nursing home experience primarily with respect to his physical needs. It is not the thing that frustrates me most; rather it is the seeming indifference to his mental health, his sense of belonging.
Senior living is mostly pretty good at meeting a very basic level of physical needs. But in too many communities we have a long way to go when it comes to meeting an even minimal need for meaning and belonging.
Starting with Dad . . .
Since being admitted to his nursing home, his sense of isolation and lack of stimulation is making him feel like he is rapidly losing cognitive ability. Perhaps like when you walk off a 5- or 6-hour flight and everything seems not quite right for a few minutes.
He sits in a room with plain beige walls. His roommate’s dementia is such that he is only good for short Q & A conversations. He does love to read and does use his phone, but he is hard of hearing and has this tiny TV on an articulating arm and crummy community-supplied earphones making it nearly useless.
He can have 2 visitors per day, but only one at a time, which means he can’t see his 2-year-old great-granddaughter. Family and friends are doing a pretty good job of being there and he is working hard at having conversations with staff (who are always overworked). He also has some human interaction during therapy.
He has not seen an activity director or been invited to any activities.
He will likely go home in a few days. But I found myself thinking that if I had to live there for the rest of my life, I would figure out how to hasten my death.
Sandy . . .
Sandy (not her real name) is 93 years old. She is friends with my wife and lives in an independent living community operated by a large national brand. Unlike my dad, her hearing is good, but she is nearly blind. My wife picks her up on Thursdays to go to the hairdresser and on Saturdays to go to church.
She can’t operate her own TV, she has some people she is friendly with during meals and does occasionally go to activities where she mostly sits in a corner.
What we are finding is that when she goes out of the community and spends a few days with family and friends, her cognition is good (though not great). When her only stimulation is the two outings with my wife and what the community either supplies or doesn’t, she becomes forgetful and confused. The forgetfulness and confusion seem to be directly tied to lack of stimulation, lack of human interaction in her community.
Because she goes to church every Saturday, by the time she gets back to her community lunch is over. It seems beyond the capability of the community to create a regular routine of making up a box lunch she can eat when she returns home.
They have completely placed the burden on her (and my wife) to make the request and it has to be done every week. And even then most of the time the meal does not get made.
We want full occupancy; we want residents and their families to talk about how great we are. We want residents to live a long time, making occupancy less of a problem.
And yet, this is reality. These are not atypical communities. The 2nd community is an average community in the marketplace and the nursing home is a bit above average. I promise you that this is happening right now to thousands of residents. And, very likely, it is happening in some of your communities.
The fundamental problem is that residents are supposed to get with the program rather than a program that is driven by the residents.
Worst of all . . . as leaders you mostly have no idea that this is a reality in your communities.