This post is part of a 3 part series titled “Abolishing the Old Age Asylum”:
Abolishing the Old Age Home, Part 1
I’ve been working hard to change the system of long-term-care in our country and I am proud of what I have been able to accomplish but— there is much that remains to be done. As it stands today, too many people are compelled to surrender too much freedom in order to receive the care they need to survive.
Even though they brim with compassion, the people who work in long-term care institutions strip elders of dignity, choice and freedom. Nursing homes are intended to be benevolent but in reality they punish older adults for the crime of frailty and sentence them to a life in the Old Age Asylum.
What long-term care needs most is a very stiff dose of bulldozer therapy.
People hear me say this and they think I am only concerned about real estate, about real bulldozers knocking down real buildings. That image is, of course, quite compelling, but my meaning extends well beyond the literal. The practice of institutionalization isn’t confined to the nursing home building.
My rhetoric will seem inflammatory to some and there are those who might think, wrongly, that I am attacking the people who work in long-term care. These are, in fact, some of the warmest and most compassionate people in the world. Let me be clear, when I demand change in the status quo, when I attack the status quo, some people take it personally. But I’m not attacking them – I’m attacking a social order.
The error I am attacking is embedded within the core of long-term care. The root of this evil lies in the notion widely held in our society that older people are by definition broken human beings who are less than what they used to be. Nursing Homes are a symptom— Declinism is the disease.
This obsession with brokenness leads us to an approach to care that can be summed up by a nursery rhyme:
Humpty Dumpty sat on a wall
Humpty Dumpty had a great fall
All the king’s horses
All the king’s men
Couldn’t put Humpty Dumpty together again
None of us like to think about this but conventional long-term care and the institutions in which they operate are founded on the work of trying to put Humpty Dumpty together again.
I want something different. I want something better. I want an approach to care and caring that is built on the rock of human growth. This is Nursing Home Appreciation Week but I do not appreciate nursing homes. Instead, I honor, respect, value and appreciate the people who live and work inside nursing homes.
It can be different.
Read Next: Abolishing the Old Age Home, Part 3: What Comes Next
Rebecca Dutton says
I agree with you about institutionalizing the frail elderly to provide basic needs. Fortunately my OT training helped me stay in my home after a stroke. Your “abolitionist” stance is why I wrote a book called My Last Degree: A Therapist Goes Home After a Stroke. I may need institutional care eventually, but I am going to make that stay as short as possible.