I work as a Speech Language Pathologist in skilled nursing facilities (SNF).
I dream of another type of home for Elders.
If I had venture capitalists throwing piles of money at me, Elders is the ideal space that I would create. At this early point in my career, I feel inspired to continue – and specialize – in geriatric care.
Working in a nursing home evokes many existential questions.
- What is the meaning of life?
- Is there a right way to die?
- How much medical intervention is a good thing?
- How do we empower those in end-of-life situations to make decisions that suit their loved ones, especially if their loved ones are no longer cognitively able to make the decision for themselves?
- Is our plan of care for those with dementia and Alzheimer’s disease adequate?
- How do I want to die?
- What if I am diagnosed with dementia?
- Do I want to see that disease to its sometimes bitter end?
- How do I feel about euthanasia?
What I love most about my job are the connections I get to make everyday with patients and their families. Nursing homes are the opposite of private; life is played out in an institutionalized arena and one learns very quickly about a patient’s history, their preferences, their family and the conflicts that plague them. I am continuously fostering compassion and attempting to moderate empathy, as I believe they are different. The Yale psychologist Paul Bloom describes compassion as having love and understanding for another, but still remaining strong, positive and resolute in order to best help. Empathy is when one takes on the emotions of another, weakening reason and in a sense, disabling both parties.
I also cannot help but consider what it would be like to have dementia. I’ve seen many forms, and I know I will see infinitely more;
- the smiling patient who is constantly on a search for her sister and the train station
- the agitated patient who can only yelp “eee-iiii-eee-iii-ooo” at varying pitches
- the patient who has rapid, jumbled speech and cries uncontrollably
- the patient who looks out of watery eyes never saying a word
- the patient who works herself into a frenzy every five minutes writing her son’s phone number in a notebook over and over
- the patient who is fed through a tube and watches old movies from her wheelchair day after day, never uttering a word
- the patient who has forgotten about her life with her husband and fallen into a platonic love with her female roommate, appearing blissfully happy
Is there something to learn as an individual from this state? Do I want to be in this state?
I sometimes half-joke to Dan that if I can’t answer a 50 item questionnaire that he and I have created together, I’d like to drift off on a bamboo raft into the ocean with a lei of plumeria around my neck and euthanize myself. It feels shocking, scandalous and inappropriate even writing those words, but the constant query is there: Am I honoring my own life if I am no longer aware that I am living it?
For now, I present free-flowing thoughts on Elders, a different type of nursing home. It may be fantastical, geriatric sci-fi stuff, but I have to share it.
Elders is a place where I’d be happy to take care of my parents, and then take their place when it is my turn.
WATER – HEAT – STEAM
Elders features warm baths and jacuzzis reminiscent of the hammams of Turkey and the jimjilbangs of Korea. Daily, residents are massaged by massage therapy students – or other professionals – using aromatherapy and natural moisturizers. Skin is supple and unbroken.
PHYSICAL CONTACT – COMMUNITY INTERACTION
OPEN AIR – DEMENTIA SAFE AREAS
Architectural and engineering students could be given grants to design Alzheimer-safe, light-filled, community-oriented living spaces. Dining spaces would have state-of-the-art acoustics so that conversation is possible.
FINGER FOOD – HEALTHY FOOD – GARDENS
Eating is often affected in those with dementia. Many forgot how to use utensils and large piles of food can be intimidating. Fine motor skills decrease so even those using modified, built-up utensils may not be able to spear or scoop their food. Finger foods allow people to self-feed for far longer than if the traditional meal set-up. Elders features healthy finger foods for all meals using produce from the communal gardens.
WATER – HYDRATION
Dehydration is one of the main reasons that residents from nursing homes are admitted to hospitals. Elders features water bottles attached to wheelchairs, water stations and even “water volunteers” from the community who want to visit, chat and encourage the consumption of fluids.
SOUND SYSTEMS – MUSIC
Hearing aids will be blue-tooth friendly and residents can “plug into” any media that is being shared. Upon admission, residents and families will fill out a music preference list of their favorite tunes, which can be streamed into high quality, mobile headsets whenever desired.
Elders welcomes residents based on a series of interviews and letters of recommendation.
ROOMMATE MATCHING – CAT/DOG FRIENDLY ROOMS
Husbands and wives will be encouraged to room together, if they still want to, and roommates will be carefully matched. Certain rooms will be cat/dog friendly with student volunteers coming to aid with pet care.
EXERCISE – NATURE WALKS – WATER AEROBICS
Daily exercise offerings will include nature walks, water aerobics, gardening and other classes. Working with weaving, clay and other crafty projects will serve both occupational therapy and goals and provide an artistic outlet.
Residents will be matched with local high school students who will elicit the Elder’s life story and present it as a slideshow for other residents and family members as evening entertainment. The Elder’s life and accomplishments will be detailed, honored and acknowledged.
Elders will have a cinema with both comfortable chairs and wheelchair room with bluetooth adaptability for optimal listening.
END OF LIFE DECISIONS
Families and Elders will be invited to attend end-of-life decision meetings with medical professionals and any spiritual or religious affiliations that they adhere to. Even though Elders is secular, individual beliefs are welcome.
All staff at Elders will participate in ample training prior to beginning work and there will be ongoing workshops. Volunteers are welcome and a paid position will be focused solely on volunteerism and community outreach.
HIGH TEA – COCKTAIL HOUR
Every afternoon at 3 pm, there will be a high tea for those who would like to attend. High tea includes tea, coffee, smoothies, cookies and vegan treats. Sugar will be minimal in all food and beverages. Every Friday and Saturday will feature a cocktail hour before dinner.
NATURAL SUPPLEMENT DRINKS
Supplement drinks will be natural and will not have corn syrup, corn starch, thickeners, or high fructose corn syrup. The overall quality of the food will be fresh and pure.
EASTERN + WESTERN MEDICINE
Initially, Elders will not offer complex medical care. Eastern medicine will be encouraged in addition to Western.
Maybe in the future Elders will get built and lived in and we can change the tide of aging.