This past week, I have been touring around Tennessee. On Tuesday, I spoke at Uplands Village in Pleasant Hill, and was joined by my friend Kort Nygard, psychologist and Eden Educator.
As usual, Kort was a mine of valuable perspectives on aging. Then Kort and I joined a team
of people to present two sessions for the Southeast Advocacy Center for Elder Rights, in
Chattanooga and Nashville.
In exploring ageist attitudes, Kort brought up two interesting and provocative points about
surplus safety. The first involved an intriguing link between safety and meaning. Kort told of a workman who became progressively disabled over the years and ended up in a local nursing home. One day, he told Kort he felt useless and needed something meaningful to do. Kort asked the man if he might be interested in helping fold laundry for the home. The man replied, “No, I don’t want ‘busy work’”. Kort asked him what would be meaningful, and the man replied, “I want something to do that, if I do it wrong, something bad will happen.”
Now that may make administrators and regulators tremble alike, but it occurred to me that much activity that is truly meaningful to us has important outcomes at stake and a need for accountability. How can we begin to use a little “risk arbitrage” to create meaningful, important work for our frail elders?
Kort also mentioned a woman whose mother lived all alone “way up in the holler” outside Nashville. She worried about her mother’s welfare and called her more than once a day to check on her. One day, her mother didn’t pick up the phone, and a trip to the house found her on the floor, needing help to get back to her feet. The woman told Kort she thought it was time for her mother to move to a nursing home, in order to be safe.
Kort’s response? “You know, I spend a lot of my time visiting people who live in nursing homes. Many, if not most, are very unhappy to be there, and wish they were home. Your mother may have some risk at home, but ‘safety’ and ‘quality of life’ are often on opposite sides of a teeter-totter.
“Right now, you are placing your own peace of mind above your mother’s quality of life. It’s true that something bad could happen at home, and that she might even live longer in a nursing home. But it’s also possible she will hate every extra day of life she gains.”
Tough choices indeed.
Tough choices for sure. If she falls and breaks a hip she’ll likely end up in Nursing Home anyway.
I say stay home as long as you can. And yes, I’ve seen the concept of “safety” go way overboard..
I think Nursing Homes can actually be great choices if the person is living alone AND lonely. I heard one NH resident say to her family,”Gee, I’ve got to get back by 7oclock. Thats when we “girls” meet in the living room to watch “Murder She Wrote” while we have snack.
It depends so much on the person’s personality; have they always been the social type; or are they a bit of a loner.. etc.
It’s very individual I guess.
Me? If I ever have to be in a Nursing Home and they try to get me to play Bingo…they’re gonna have “behavioral problem” on their hands. 😉
Darlene June Costner says
We all want to stay in our own home. The daughter should investigate ways that her mother can do so.
I fell and broke my hip and know my balance is not good. Because I do not want to leave my home I invested in a medical alert system, have 3 telephones, use a walker or a cane if I am feeling unsteady, . I am aware of the danger of falling so I watch every step that I take and do not take unnecessary risks.
My family live in another state and my neighbors would not hear me if I cried out, yet I feel perfectly safe in my home with the steps I have taken to minimize the danger.
Karen Overturf says
Absolutely right on! The idea of residents being able to manage their own risk is past due. They have to come up against risks the staff is not willing to take, even if the resident has done something the same way for years with no poor outcome. Managed risk is allowed in Assisted Living. Why should all risk be banished in skilled care? Are we really protecting society from these people who might make such mistakes?