Have you ever considered what it would be like to live in a nursing home? Really thought about it? I have spent the better part of my career in long-term care thinking about it. I don’t think I would like it.
I don’t think anyone does. They eventually accept it, if they understand what’s happening, but they never, truly like it. For the sake of keeping peace in the family, some may say they like it, but I don’t think they really do. It’s never home.
It’s not for lack of good care and cheerful surroundings. Contrary to what you may have heard, most long-term care facilities care well and work hard to accommodate the people they serve. There are just so many needs that are difficult to satisfy in an institutional setting.
How long can you sit still - in one place, without standing or changing position, with nothing to do, or with no one interesting to talk to?
Are you a busy person? Do you work, take care of a family, indulge in entertainment activities, do yard work, clean the house, shop, do laundry and still find time to work out in the gym and chair the PTA?
Now, how long could you sit there?
And what about the environment in which you will sit? There are many other people. Some like yourself, who are aware of their surroundings, and others who are mere shadows of the adults they once were.
There is noise: television, others calling out, multiple conversations, and music playing loudly down the hall. There are the aromas: urine, feces, cheap perfume, baby powder, body odor and bad breath, this afternoon’s lunch tray that’s still on the counter. There are the behaviors, someone is spitting on the floor, someone is picking his nose, another licking the food particles from her denture, and another performing a striptease and calling for her mother.
How long before you’ve had enough?
At home, you might shout at the source of the unwanted noise, “be quiet!” In the nursing home environment, however, your emotional response is labeled behavior.
There are countless examples of this type of behavior. Simple, human reactions to circumstances one finds distasteful, annoying or uninteresting. Reactions you and I display, too, in response to noise, traffic, coworkers, bosses, angry consumers, not getting what you want, and just about every other relationship and situation common to the human experience.
Do you like everyone you meet? Is there ”chemistry” between you and others you choose to associate with? Imagine being surrounded by people you felt no chemistry with, in an environment that didn’t appeal to you. Would you want to stay there, or would you leave in search of someplace more appealing? Imagine being forced to stay.
Could you share a home with someone you didn’t like? How would you feel if your roommate used your things, had annoying habits, invaded your privacy, or played his or her television too loud? Do you think you would argue? Could your dislike for him or her ever escalate to physical violence?
How do you express yourself when you are angry, or lost, or tired, or frustrated, or misunderstood, or worried, or bored, or stressed, or overwhelmed, or hopeless, or confused about what is happening?
The primary challenge to long-term care facilities in an age of sophisticated medical resources is to create environments in which the emotional and social needs of the people they serve are satisfied in a way that makes the added years worth living. The bigger challenge is to create an environment in which everyone’s needs are considered.
It is important to look at everyone from the perspectives of social groups, cultural differences, personal preferences, rituals and idiosyncrasies, education and exposure, and interpersonal relationships. It is equally important to look at self-worth, at what gives value to a life or to a job.
What makes a house a home, a job a vocation, a building a community? How do you create an organized, appealing environment that is equally satisfying to everyone involved? How to you address the behavior of everyone sharing the environment?
Considering the financial challenges, shrinking workforce, increased acuity, and heightened scrutiny by lawmakers and consumers, how do you create an environment that thrives both as a business and a home? How do you keep everyone happy, including yourself?
Whatever your status, CEO, manager, CNA, resident, housekeeper, family, you all want the same thing – to be comfortable, secure, and satisfied in the environment. There are several simple things every organization can do to achieve the type of community they aspire to.
This series will explore the most common challenges facing long-term care facilities: leadership and organizational development, staff education and training, and quality of life.
Next: Part 2: “What Makes A House A Home?” Empathy as the cornerstone of design.
Barbara Speedling ©2006 Posted 03-24-06
