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Toni Talks about PT Today

Society Needs to Rethink Elder Care

Published September 9, 2008 2:36 PM by Toni Patt
I've noticed a disturbing trend when developing discharge plans for elderly patients. Families aren't as involved as they once were. When I first practiced therapy discharge plans weren't a problem. Families took patients home to care for them. Sometimes home health was needed. But the bulk of care was provided by the family. Putting someone in a nursing home was almost a social taboo. It happened but the person had to be very, very sick or have no family left. Families were not only available but willing to help.

That isn't the case anymore. Whiles spouses can almost always be found at bedside, children are another story.  Many times one spouse will move into the hospital room to care for the other. People who can barely care for themselves are ready and willing to take the other one home. Children, on the other hand, seem to be MIA. Of course I'm not talking about everyone. Some children are very devoted. Others can't seem to be bothered. When I do evaluations, one of the questions I ask concerns family availability to assist with care. I've been told many times the children are too busy with their own lives. That statement makes me wonder.

I can understand wanting to remain independent. Asking a child to help could be seen as a step toward losing independence. Those on the brink of losing independence might consider asking for a help a sign of no longer being independent. I hate to ask for help. I've had to face that there are some things I can't do for myself or by myself. I don't like it but I get help. When this is the case I can understand the reluctance to ask the kids to help.

I'm more concerned about children who don't want to be bothered. These people have numerous reasons why they can't help that usually involve being too busy or having their own problems. One statement seems to sum it up. No one wants to make the lifestyle changes that would be necessary to care for an elderly parent. I've heard litanies of illness, work, distance and obligations. I've been told houses are too small. I've been told work is too demanding. Money, or lack of it, is always a problem. Those that have it don't want to spend it. Those that don't have it want things to be paid for. Social workers talk about families expecting Medicare to pay for everything including sitters and home care givers. 

Nursing homes fill a need in the health care continuum. An SNF stay is temporary to allow someone to regain independence. Residential living is available for those with no other option. An SNF is not a dumping ground for the elderly to be dropped off and forgotten. The same applies to emergency rooms around holidays. It makes me wonder about society. Somewhere along the line priorities changed. Some people have no other choice. They have no family, have no resources or require too high a level of care for home to be realistic. In other cases the priority isn't caring for the elderly but making arrangements for care. I don't think this is a change for the better. 

Many years ago the elderly were valued members of our society. The care they received reflected this. Our society has changed resulting in a change in values.  This is reflected in the way we treat the elderly. Some individuals do everything in their power to care for parents or grandparents which often requires sacrifice on their part. Others don't feel this way. Some are caught in the middle. I don't have a solution. I'm making an observation. I think it's a shame. 


Death is part of life, it happens to us all.  We need to be more compationate with the elderly because someday that will be us.

I know it's hard to take care of a dying parent at home, I have done this for both of my parents.  It was hard, yes, but also rewarding.  After all your parents took care of you when you were unable to care for yourself, its only right to return the favor.

When I grow old I would hope that someone I love would take the time to care for me if needed; as I have cared for them.  You can learn a lot from the dying.

Life is a circle!

Life is a circle.  

Cheryl, Reverend November 17, 2008 7:26 PM

Think about what those children are going through as they watch their parents decline cognitively and physically.  It is emotionally draining.  Their memories of a happy, healthy parent are being compounded with memories of incontinence, poor memory recall, and loss of function.

More importantly, these children want what is best for their parents but don't have the knowledge or skills to do it themselves- this is why they invest in a nursing home option.  Watching your parent pass away is much easier (for the child) if the parent is surrounded with skilled medical people.  

Working full-time, raising a family, and being held responsible your parent's care- it's overload.  Nursing homes offer a safe alternative.

Emily September 14, 2008 5:38 PM
St. Louis

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