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“What Makes A House A Home?” Part 5: “Giving Meaning To Life: Practical Ways To Satisfy Human Needs For Privacy, Dignity, Comfort and Respect”

By Barbara Speedling

How do you measure the worth of your life?  For some, worth equals career, status, or position.  We might be defined by the contributions we’ve made or the things we’ve achieved.  It’s what makes life worth living for those who are driven to succeed and prosper.  When you’re sitting in your wheelchair in your fashionable hospital nightie waiting for the breakfast tray, you tend to blend in.  Will you care about tomorrow if there’s no challenge to face?

For others, family makes life worth living.  Again, the connection to others in our lives is what drives us to succeed in our careers and endeavors.  Family dynamics change over time, but we are still bound to that clan, that group that offers unconditional love.  Our family role satisfies us in a way that nothing else can.  How worthwhile will living be when your family is gone? 

Still others live for adventure, excitement, and grandiose dreams.  These are the astronauts, the daredevils, the mountain climbers, the explorers and those with endless curiosity and nerve.  How happy will they be when the biggest adventure of the day is a ride in the Hoyer lift?  More importantly, will the person operating the ride know that this individual has led an interesting and dynamic life?  Will they understand why he is so defeated and angry at this point in his life?

The things that drive us in our lives are the things that make life worth living.  Therein lies the biggest problem with growing old and living in a nursing home.  The roads we used to drive on are all dead ends. 

As caregivers, we have to really begin talking seriously about what is missing.  Most facilities work very hard to maintain a medically sound, appealing environment.  There are activities to engage me, plenty of food, and all the Jerry Springer reruns I could wish for.  What I don’t have is a chance to achieve anything, or an adventure to pursue, or a person to love and share secrets with.

Compounding these losses are the other complications and annoyances brought on by age and disability.  Once you’ve entered a facility, your needs and desires are compromised, no matter how hard we might try to avoid it. 

You want to be alone?  Forget it.  We can’t allow you to sit all by yourself in your room with the door closed.  Something might happen.  Besides, you have a roommate, whether you like it or not.

Privacy, dignity, choice…. all of these things are lost to dependence. 

There are ways for every facility to make life more worthwhile for those they care for.  Simple, common sense ways of making people feel better about themselves and the environment they are living in.  It begins with thinking about yourself and what you need to make life worth living.

Dignity, for example:  Stop teaching your staff about dignity and begin demonstrating and supporting dignified interaction.  All too often, the way we speak to each other in the work environment is less than dignified.  Teach your staff, instead, to first describe what dignified treatment feels like to them, then apply those emotions to the way they interact with others.

Privacy is a bigger challenge because of legitimate safety concerns.  We could, however, be less obvious sometimes in the way we watch people.  I’ve had staff stand facing residents sitting on the toilet, rather than standing to the side where their presence is not so obvious.  Even the best of environments has some caregivers who are careless about privacy.  I’ve observed many naked residents in my travels. 

Begin talking to the staff about privacy.  How do they feel about being watched by all the surveillance cameras being installed everywhere in our city?  Maybe a conversation about the nature of privacy and what it means to lose your privacy might make them more aware of privacy concerns. 

Choice is the simplest to satisfy.  Every facility could offer more choices, if they wanted to.  To achieve true satisfaction, people must have choices.  Making decisions is something we often rob from the elderly and infirm.  Offering choices often helps restore dignity.  With dignity, comes worth. 

Whenever I open the subject of what we could really do to improve quality of life, I am told we don’t have time to do the small things.  I respectfully submit that, if we invested some time in making the environment more livable, we might not waste so much time responding to crises and complaints.  Here are several simple ideas:

1)      Develop a program for new admissions where their direct caregiver and a resident acting as a buddy welcome them.  The buddy remains to talk them through the admission process, offering information and support.  Having staff and residents work together in this way will foster improved relationships. 

2)      Evaluate your meal service and the dining experience.  There are many things that could be done to improve ambiance and choice.  The key is to imagine yourself eating in the environment you’re observing.  What could be different?

3)      Look at what is available to do in the environment when there are no scheduled groups?  Individualized activity should be keeping pace with society and technology.  Are there computers available, Walkmans, DVD players, and current magazines and books?  Again, consider your own leisure routine and look at your facility’s offerings from that perspective.  Would there be enough satisfying choices for you?

4)      Lastly, look at ways to build relationships between colleagues, residents, families, and the community.  There are countless ways to bring people together.  In an industry that serves such a diverse population, it is imperative to quality of life that we begin to know and appreciate everyone in the environment.  Host picnics and cultural celebrations where you bring everyone together.  Develop creative ways of learning about each other – storyboards, recognition programs, and newsletter features.  Highlight and share across all lines of culture, position and status. Creating a livable environment begins with people and how they feel.  Find ways to understand and respond to the feelings of the people in your environment.  Make time for productive development, and minimize the time you spend responding to hopelessness, anger, frustration and fear.  Watch for Part 6:  Understanding Behavior:  Identifying And Addressing The Triggers To Common Behaviors Associated With Cognitive Loss Or Emotional/Mental Illness.

Barbara Speedling ©2006