The Little Things

We often talk, in our organization, about transforming the long term care experience.  It’s a goal we’re striving for and something we are all committed to making a reality.  What does this transformation mean? I think the easiest way to crystallize this is to answer one very basic question.  We use this question often to open the dialogue around change.  “If you woke up tomorrow morning and suddenly found yourself living in a nursing home, what would you need to feel comfortable, to feel that your needs were being met?”  The answers are always interesting.  For me, I need a very hot shower and an even hotter cup of coffee.  Others need to know that they can have time outside, still others talk about the need for solitude and time alone.  We follow those responses with another simple question: “Why shouldn’t our elders have that? Why shouldn’t they have the right and the ability to make their own choices and to have their needs and preferences not just respected but also honored?

There are many lessons that resonate with me from this exercise, both from the standpoint of working with older adults and, in more general terms, for our lives in general.  In the work of elder care, I think that the underlying and powerful message is a reminder that, regardless of age or ability, we all are entitled to make choices and we all have, to varying degrees, the capacity to do so.  I have seen elders with advanced dementia be offered two items—whether clothing or food or even art/craft items—and even though they may struggle to speak, they can and do make a choice.

Older adults have been minimized and marginalized for a long time and the pandemic brought that fully to light.  Elders were treated as those without rights, without abilities, without preferences.  When our residential care facilities were “locked down” in 2020, for endless months, our elders were not asked what mattered to them, they were treated like objects to be kept in rooms and denied the company of their loved ones.

For those of us who will be fortunate enough to live to an advanced age, is that what we would want or expect? From the simplest needs (like my hot coffee) to freedom of movement, will we want to surrender to restrictions and rules made from afar? Will we be content to follow someone else’s schedule rather than our own?  I don’t think that you will want that any more than I do.

We must change the way that we, and our society, treat our elders.  We must recognize the value they can and should provide and honor their contributions to our world, both in the past and in the present.  Transforming long term care is, we hope, a large rock thrown into the water with ripples that will reach far and wide. But how much more effective it would be if we each threw a rock, if we each reached for enlightenment in the perceptions of, and care of, older adults.