Visiting nursing home residents can benefit both young and old
We should value all ages in our communities, from the very young
to the very old. But the oldest old
in nursing homes and assisted living facilities often feel isolated and excluded. Developing stronger connections between these older adults and their community can have tremendous benefits for young and old. Even older adults with serious memory loss or cognitive limitations can still enjoy a visit, even if they don't remember it later. Elementary-aged children, especially those in fourth to seventh grades, often value the opportunity to make a difference in an older person's life. They are eager to help in a nursing home once they become comfortable. They learn how to interact with people different than themselves and they learn responsibility – because the older people depend on them.
While a single visit to a nursing home is a valuable experience for children and will brighten the day for older adults, an ongoing visitation program is most effective. Said one staff member in a nursing home, "We don't want it to be 'let's go see the old people' just like it's a trip to the Statue of Liberty." An ongoing series of visits allows the understanding and trust to develop which are essential for a real connection between people of any age.
Before children visit a nursing home, you may want to read and talk about some of these storybooks:
A Little Something by Susan V. Bosak; Sunshine Home by Eve Bunting; My Grandma's in a Nursing Home by Judy Delton; Loop the Loop by Barbara Dugan; Wilfrid Gordon McDonald Partridge by Mem Fox; Always Gramma by Vaunda Micheaux Nelson; Remember That by Lesléa Newman; A Visit to Oma by Marisabina Russo; Old People, Frogs and Albert by Nancy Hope Wilson.
Talk about what to expect during a visit to a nursing home (e.g. residents in wheelchairs, unfamiliar smells, some residents may not seem responsive, etc.). Answer any questions or concerns children may have. Talk about their feelings about visiting older adults. Many older people never have visitors and spend their days alone and lonely. Why do you think this is? Do you think it's because we don't want to think about growing old? Why or why not? Have you ever been in a nursing home or other seniors' care facility? How did you feel?
Now plan a visit to a nursing home or other seniors' care facility near you. Some general tips:
“My motivation is really to have somebody from the inside tell us what it’s like to be a resident,” said Rita Morgan, administrator of the Sarah Neuman Center for Healthcare and Rehabilitation here, one of the four campuses of Jewish Home Lifecare.
“But she is really there to study herself, her own feelings about living in a nursing home,” Ms. Morgan added, referring to Ms. Murphy.
Geriatric specialists hope the program and others like it help generate interest in the profession, one of the most underrepresented fields in medicine. Medical schools and residencies require little to no geriatric training, and many students are reluctant to get into the field because it is among the lowest paid in medicine.
In 2005, there was one geriatrician for every 5,000 people over 65, according to the American Geriatrics Society; by 2030 that ratio is expected to increase to one for every 8,000 patients. Geriatricians must participate in a two-year fellowship program after medical school to become certified. In 2007, only 253 of 400 fellowship slots were filled, and only 91 of the physicians graduated from medical school in the .
“It’s kind of a crisis,” said Dr. Cheryl Phillips, president of the society. “I don’t think many seniors recognize this.”
Like many medical students, Ms. Murphy was scared of nursing homes. The feeling began when, as a young adult, she visited her grandmother, who had .
“I think nursing homes are scary,” she said, “but I don’t think you can be a good doctor if you’re scared of the place where a lot of your patients live.”
The first few days, which included filling out paperwork, undergoing a full-body and sore check, eating pureed foods and being raised out of bed with a lift, did nothing to validate her decision. When she wedged her wheelchair into a corner and could not get out, she cried in frustration.
“All I wanted to do was shut my door and stay in here,” said Ms. Murphy, whose “diagnosis” was a mild stroke that affected her right side, difficulty swallowing and chronic . “But I understood I had to go out.”
Not everyone does. Some patients want to talk for hours, while others act out, like a woman who pinched Ms. Murphy as hard as she could. Many sit in the hallway by the nurse’s station each day because it is a hub of activity. Emotions run high.
Ms. Murphy said she soon learned that many patients cried because they knew that they would most likely never live anywhere else, or because they missed family and their old life.
“At times I felt really lonely and got depressed,” she said. “Sometimes it was an emotional roller coaster, up and down, up and down.”
No one said a word the first time Ms. Murphy showed up at the daily bingo game. She started to talk to anyone who would listen. And she was surprised what happened.
First she bonded with Camille Stanley, the “queen bee” of the social scene. Then she found Dr. Thomas N. Silverberg, 89, a former internist and specialist with advanced . “My specialty is slowly killing me,” Dr. Silverberg said.
The two talked for hours about life and medicine. Unlike the friendships she makes as an adult, slowly nurtured over dinners and drinks, in a nursing home, where there is nothing to do but talk, are forged quickly and deeply.
“When I came in, I was worried about working with older folks because I was afraid I wouldn’t be good at it,” Ms. Murphy said. “Now, if anything, I’m worried I’ll love them too much and it will really hurt to work with folks at the end of their lives.”
Most residents knew why she was there. During her going-away party they presented her with a big card, and shouts of “We love Kristen” were heard throughout.
The program has solidified Ms. Murphy’s desire to work with older people. And the hardest lesson she learned — that for some people, it is better to be in a wheelchair or to have limited mobility — will make her become a better doctor, she said.
“As a doctor, my job is to help patients live the life they want to,” she said. “And if they’re in pain, you have to say ‘That’s O.K. if you want to spend your time in a wheelchair.’
“For me that’s such a different place to be. Because I hate this chair. It still startles me that that’s the choice.”
Ms. Murphy said the care she received at the home was outstanding. But there were things that could use improvement: she did not realize she could ask for things like soda, and she felt that shower bars were too high for someone in a wheelchair. She also told the staff at a debriefing session that families should be included in more activities.
Dr. Phillips of the American Geriatrics Society, which is not involved with this program, said the challenge was to see “how this replicates everywhere else and how enthusiastic medical students are to take this on.”
Another of the 10 students who have gone through the program, William Vogt, spent 10 days last summer in a nursing home at the Veterans Affairs hospital in Augusta, Me. Mr. Vogt, who spent a day wheeling around with petroleum jelly smeared on his glasses and cotton stuck in his ears, said he was particularly struck by the fact that many patients considered the nursing home to be home and the staff “a second family.”
Mr. Vogt said the little things counted, like lowering nameplates so patients could locate their rooms and not putting a remote on top of a television, out of reach.
“There’s a little part of it that works its way into everything I do, from patient interaction and awareness of how I come across to what I say,” said Mr. Vogt, a medical student doing clinical work at a hospital in Watertown, N.Y. “There’s this shift of the humanity of it.”Continue reading the main story