Why Is “Nursing Home” a Scary Phrase? Part I

The reality is that most people equate going into a nursing home with a fate far worse than death or zombiehood. And what’s even sadder is that most people who work in nursing homes feel they are dealing with the most difficult patients in the world. Both of them have reasons for the way they feel. So in this two-part series, I’ll try to explain the problem from both sides.

Remember that nobody goes to a nursing home because they wanted to. Call it a Rehab Center, or a Sub-Acute or Skilled Nursing Facility, the fact is that people are there because something terrible happened to them! They had a terrible injury, a life-threatening illness, or a disability beyond their ability to cope. Or they just got old and didn’t have the financial, physical, or mental capacities to handle everyday life itself. None of these are pleasant things. All of them pull the rug out from under you and knock you flat on your rear!

It can make you pretty depressed, anxious, angry, and just plain unsocial for a while.

First of all, getting old has some real disadvantages. Earlier aspects of your life do not remain the main purpose of your life. You may have retired from your career, lost your spouse through death or divorce, and your children are grown and have their own lives now. Nothing is the same, and that can feel very unsettling.

Then there is the nearness of death itself. If you were born, the only thing I can guarantee is that someday you will die. Proverbs to the contrary, death is more certain than taxes! If you have lived a long life already, death feels a lot closer. If you have just come from a life-threatening crisis at the hospital, it feels pretty close no matter what age you are. How do we prepare for contentment and peace when life ends? It’s not an easy task, even if it is a necessary one.

If the physical strength or beauty that you possessed, and the joys of the senses were among life’s greatest values, what do you do when they ebb away?

Besides, you’re still the person you always were inside. In fact, you’re likely to get more so as you age. The down side is that unresolved problems can become intensified, and some patterns of behavior that were only mildly maladaptive before are now making you dysfunctional.

I can quote from Greek, Chinese, even Ancient Egyptian sources, and show you that people have always recognized this. Did you think you would escape the fate of being mortal? Sorry, but we move from the familiarity, safety, and security of the life we’ve built to the uncertainty and vulnerability of another. And we have no other choice! No wonder we feel pain and grief.

Being in a medical care facility, whether hospital, nursing home, or rehab center just adds to the burden. 1) All of the burdens cited above are intensified. 2) The loss of independence, self-respect, and dignity are all exacerbated when we are struck down by physical illness. 3) We must trust our very being to the care of total strangers. 4) We loss all privacy, all choices, and have very little control over anything.

Yes, I know it’s being done to save your life. But when it happens to you, it feels more like life has been taken away. In a sense, it has.

Human beings are simple, like a piece of furniture. We are composed of many aspects, and all of them are affected by age and illness. Nothing is “all in your mind” because the last time I looked, your mind and your body lived in the same place! And they are always interacting. In fact, when I think of the human, I have to add the heart and the spirit into the mix, because human beings are feeling many more things besides just thinking and physical sensations.

Actually, you can use any schema or worldview you want. Just be sure it includes all the complexities of being human. Bear with me while I try to explain it in my fashion:

The Body is deteriorating and weakening. It is now fragile and easily sickened. It may lose control of unmentionable things like peeing, shitting, or bleeding. This is not only hard to comprehend when it happens to you, it is also terrifying!

The Mind finds that its memory and attention span are decreasing. As things become difficult, our own expectations of ourself can become negative and self-defeating.

The Heart is grieving. Many friends have died or moved. We’re in a place where the surroundings, the environment, even the language of people around us may be un familiar. Grief and loss predominate in our immediate feelings.

The Spirit may know that the need to move to an inner life is normal at this stage. Some cultures even have a description or place in life’s stages for it. But that inner life must be enriched and it must be supplemented by a full outer life.

The deepest misery comes from those who feel they are doing nothing. Patients may feel that their potential is locked up by their illness, their physical limitations, or just by being in a medical facility.

A dear, dear friend, mentor, and colleague of mine gave me the solution. Dr. Roy P. Fairfield, educator, historian, author man of almost unlimited interests and talents, is now 90. And he, in his firm New England way, decided that this nonsense wasn’t for him. Re-Firement, not retirement became his motto. And so, with his permission, I share it with you.

Re-Firement is the way to avoid getting stale and cranky. The delight of self-discovery is always available to us. This is also a time when you can become more authentic and find your own identity. Exercise and movement slow physical aging and help heal illness. And even more important, activities done with real passion and a social life that isn’t superficial slow down the other aspects of aging and help the soul heal itself.

The future can always be happier! How much time it contains doesn’t matter as much as how happy it is.

In the second part of this article, I’ll talk about the other side of the situation: some of the cautions and concerns involved, and the problems nursing home staffs face in dealing with them.

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