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Nursing home fear fed by headlines

by Carol Bradley Bursack, Editor-in-Chief

There are some poor to terrible nursing homes in our country. Even one is one too many. However, these bad homes tend to grab headlines, making seniors and their families lump facilities into one category - bad. This mindset can hurt elders and their family caregivers. The need to get out and explore homes is great. The need to fight for change, if the nursing homes in your area are bad, is also great. Since many elders become so incapacitated that they need 24-hour nursing care, it behooves all of us to work toward nursing home improvement. Take the time to visit facilities in your area, and around the country, if you travel. You'll see there is a great variation in quality. Don't paint them all black with one swipe of the brush. Some are places where elders bloom.

I readily admit that I live in a part of the country with strict laws for nursing homes. Not all homes are exceptional, but I've been told by people who have worked at homes across the country that the "worst" homes in North Dakota and Minnesota are far better than some of the best in other parts of the country.

That fact is very disturbing to me, as I know that as a family caregiver with two decades of experience with seven elders, without good nursing home care, my elders and I would have gone under. My uncle had a series of strokes and needed more physical help than I could provide. He moved to a nursing home two blocks from where I live. Soon after, my dad's brain surgery threw him into severe dementia. He, too, needed around-the-clock help. I was raising children. I was also helping the other elders in my family.

With Nursing Home Care Mother-In-Law Blooms

While I was really pleased with the care my dad and uncle were receiving, and I was at the home nearly every day to witness this, my mother-in-law was the person who most obviously benefited from her move there.

Alice had lived in a very nice condominium. She was widowed. I stopped by her home every day around noon and fixed lunch, got her groceries, did her hair (very badly), got her to the doctor and did all of the other things a caregiver does. However, her dementia, which was never diagnosed but I suspect was Alzheimer's, was becoming a safety issue for her. Also, she was becoming uncommonly paranoid. She couldn't retrieve her newspaper which was just outside the apartment-style door, because it was "out there.""Out there" was a hallway with one neighbor across the way who she'd known for years.

She was afraid of the traffic out on the street. She "saw" intruders and was imagining children with her (she had once been a school teacher). She'd write her name repeatedly on a sheet of paper. That one tip alone made me realize she was struggling to hold onto who she was.

We had her on a list for at the same nursing home where my dad and uncle lived - just across the avenue from her condo. When an opening for Alice was available we moved her in. I was prepared for all of the adjustment issues people generally have when such a move is made, but Alice would have none of it. She bloomed under the care and structure of the home. They had her playing the piano again - something she'd given up years ago. They fixed her hair better than I did, and had a beauty shop equipped for her physical needs right there in the home, so she got regular trims and perms. To put it bluntly, Alice had a blast. She did eventually get pneumonia, which we pulled her out of with extra strong drugs, but she never was the same after that. Up until that event, however, she was extremely happy.

Good Facilities Can Give Elders Back Their Social Life

My point is that people can get very lonely in their own home by themselves, day after day. They may say that this is what they want, but often they "want" this because they fear change. The idea of assisted living or a nursing home terrifies them, because they remember seeing a friend a home years before, and they didn't like it. Also, they are influenced by news stories of truly horrid places that need to be shut down.

Tips for Checking Out Homes

One can hardly blame elders for fearing "placement" - like an object - in a nursing home. And loving family members often have the same fears for their loved ones. However, when emergencies arise that give you no choice, it's very good to have an idea of what the nursing homes and assisted living facilities in your chosen area are like. Here are some tips:

  • Get recommendations from others.
  • Visit at different times of the day and evening.
  • Watch how the staff treat one another. Is there respect in the air?
  • Does the staff show respect for the elders or do they shuffle them around like a piece of goods?
  • How are the meals? Do they follow the posted meal plan?
  • Go with your gut. You can check out the nursing home rating tool on - Nursing Home Compare, but remember that the rating of a "two" in one state may be a home that would get a "five" in another. Your gut and the reports of family members who have loved ones in local homes may be your very best guides.

Fear of nursing homes? Very common and, far too often, valid. But don't paint them all with a negative brush. Look around and plan ahead. Get involved in making homes better in your area, if they aren't good. And if you have no choice but to move loved ones to a nursing home, remember that you are their advocate and you are still part of the care team. Make sure your loved ones know you are not abandoning them. You will be part of the team until the end.