Why Nursing Homes Are The Worst Places For Our Elderly

If you're thinking about sending your parent to a nursing home, it's time to seriously reconsider.

Facilities for the elderly, originally created as a by-product of an effort to free up hospital beds, haven't improved much  since then. Behind their beige-colored, soup-smelling facades lurks an even nastier problem: Our society has absolutely no idea what to do with its elderly.

Once an aging parent loses the ability to function on her own, it becomes the child's responsibility to ensure she's taken care of. For many, that means finding an atmosphere that guarantees her safety.
But those priorities are completely misplaced, at least according to Atul Gawande. In his new book, Being Mortal, Gawande describes how our misguided choices have trapped the elderly in places of boredom, depression, neglect, and  abuse.

There might be a solution yet. Gawande suggests that instead of making healthcare decisions based on how they make us feel (i.e.: Is my loved one safe?) we should make decisions based on how they'll affect our family member's quality of life.

This means choosing a facility that will also respect these choices. Instead of selecting a facility that will force an older man who has fallen recently to use a wheelchair, for example, pick a place where a staff member will ask him how much being able to walk — even with the help of a cane or walker — means to him. Preserving that ability could mean all the difference in his life, even if it means he's more at risk of a slip.

Gawande speaks from experience, both personal and professional: When he's not performing surgery at Brigham and Women's Hospital in Boston or writing for the New Yorker, Gawande teaches at the Harvard School of Public Health and Harvard Medical School. When his own father (also a surgeon) was diagnosed with a massive spinal tumor, Gawande helped him grapple with a variety of end-of-life healthcare decisions, from when he should stop working to when he should go under the knife (if at all).

Healthcare spending on the elderly is immense, but we shell out the most on our deathbeds. About 25% of all Medicare spending occurs in a person's last year of life, according to a recent review in the journal Health Affairs.

While we spend the most money trying to stave off death, we waste precious time we could have used to make life as good as it can be in our final years. And life can be good — something that's finally becoming more of a focus in eldercare. "Making lives meaningful in old age is new. It therefore requires more imagination and invention than making them merely safe does," writes Gawande.

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Why Nursing Homes Are The Worst Places For Our Elderly