Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The nursing home crucible

Gene Uzawa Dorio, MD
Physician
July 2, 2021
Share
Tweet
Share

Harriet broke her hip and needed surgery. Post-operatively, the hospital was swift to push her out the door, while Medicare controlled the financial strings. Instead of going home, she went to a nursing home.

During the pandemic, she never saw her family in person, then contracted COVID-19 and died alone.

For over 30 years, I have visited patients in nursing homes, and during this time saw older adults shepherded by the health care conveyor belt into this abyss.

The term nursing home has been modernized to “skilled nursing facility” or “rehab center.” But a nursing home is a nursing home, and the walls, beds, curtains, and smells don’t change with the name.

The COVID-19 pandemic will be stigmatized by a shameful reminder of how hospital greed and government failure contributed to the death of 136,000 senior Americans in nursing homes.

Your initial notion on entering these doors is of permeating bodily smells and uncontrolled screaming. This is rare. But you soon realize you don’t want the doors to lock behind you.

Most of the time, rooms are shared with at least one other resident. A thin curtain separates privacy. Rarely one has a ground phone line, no convenient WiFi, and sometimes no TV. When you do have TV, it has only basic cable.

Three bland meals a day are provided, and you are rolled out in a wheelchair in front of the nursing station to watch them work while they keep an eye on you.

There is no library, no garage to putz around in, and you cannot leave the facility unless you have a doctor’s appointment. No grocery shopping, going to the mall, participating in senior center functions, or visiting family and friends.

You are caged-in, controlled, and dependent on people you don’t know. This sorrowful situation relegates seniors to hopelessness when they could have remained in their home and received the same care. Our society has yet to provide this care as older adults are “put out to pasture,” disregarding their experience, talents, education, and wisdom.

Harriet would never have expected not to return to the home where she raised her children, gave piano lessons, cared for her dying husband, and tended her garden.

How do we solve this social scourge corralling seniors into a living situation where they are made susceptible to disease, but also makes them languish in a restrictive, depressing environment hoping to go home, yet feeling locked-in and sometimes waiting to die?

In order for older adults to “age in place,” we must develop “age-friendly homes” that adapt as we get older. Preferably single story with minimal steps; wider doors and hallways for wheelchairs; outside ramp adaptable; roll-in showers; grab bars especially in bathrooms and bedrooms; night-lit hallways; and padded gym-like flooring to absorb impact in case of falls.

ADVERTISEMENT

We can have robots assist us, body exoskeletons to get us out of bed, Hoya lifts to help transfer, and autonomous cars to get us to the grocery stores and doctor appointments.

Plus, we need to have continual monitoring for safety and Wi-Fi for communications (like teleconference doctor visits).

Most importantly, we must provide adequate home care services, including house calls from doctors, nurse practitioners, physician assistants, physical and occupational therapists. We must have the ability to obtain blood work, X-rays, EKGs, ultrasound, and scanning. This would have allowed Harriet to return home.

Providing senior-friendly homes with adequate health care services will allow older adults to “age in place” and keep them out of nursing homes.

Recognition and implementation of these changes are not yet on the horizon. Until then, how can we make nursing homes tolerable and less threatening physically and psychologically for seniors?

Instead of modernizing the nursing home name, let’s try to improve the ambiance and quality of the living situation for older adults who are relegated to these institutes.

Let’s enhance communications at nursing homes by furnishing WiFi with phone connections and cable TV. Why shouldn’t they be given access to newly released movies and local sporting events?

Provide them a kitchen for supervised cooking, a garage to putz around in, and a garden to tend flowers with vegetables and fruits. Let them have a library with ample access to newspapers, books, and magazines, and a computer room to maintain contact with friends and relatives.

Rarely will you find any of these amenities in a nursing home. Why not?

Visit a nursing home and talk with some of the residents. They are not only moms and dads, but also retired teachers, first responders, former athletes, government employees, and soldiers—the basis of our country’s past lives within these walls.

Older adults should be honored with the dignity they deserve.

As we again open as a society after this pandemic, make that commitment and visit a nursing home.

Just make sure after you enter, the door doesn’t lock behind you.

Gene Uzawa Dorio is an internal medicine physician who blogs at SCV Physician Report.

Image credit: Shutterstock.com

Prev

COVID vaccines' tragic dance [PODCAST]

July 1, 2021 Kevin 0
…
Next

The nuanced issues behind guardianship

July 2, 2021 Kevin 0
…

Tagged as: Geriatrics

Post navigation

< Previous Post
COVID vaccines' tragic dance [PODCAST]
Next Post >
The nuanced issues behind guardianship

ADVERTISEMENT

More by Gene Uzawa Dorio, MD

  • Aging in place: Why home care must replace nursing homes

    Gene Uzawa Dorio, MD
  • How doctors took back control from hospital executives

    Gene Uzawa Dorio, MD
  • Pope Francis dies at 88. What his care reveals about America’s failing hospitals.

    Gene Uzawa Dorio, MD

Related Posts

  • The gender imbalance in nursing

    Cole Edmonson, DNP and Paulette Anest, RN
  • The nursing home staffing crisis will not be fixed through transparency

    Harsh Moolani
  • The nursing shortage: then and now

    Way Chiang, BSN, DO
  • A physician’s addiction to social media

    Amanda Xi, MD
  • Nursing’s newest problem: The young eating the old

    Debbie Moore-Black, RN
  • How PTSD is hurting nursing

    Anne Naulty, RN

More in Physician

  • Love and loss in the oncology ward

    Dr. Damane Zehra
  • The weight of genetic testing in a family

    Rebecca Thompson, MD
  • A surgeon’s view on RVUs and moral injury

    Rene Loyola, MD
  • Reclaiming moral ambition in health care

    Mick Connors, MD
  • When language barriers become a medical emergency

    Monzur Morshed, MD and Kaysan Morshed
  • The burden of the eldest daughter

    Jessie Mahoney, MD
  • Most Popular

  • Past Week

    • A doctor’s letter from a federal prison

      L. Joseph Parker, MD | Physician
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • A surgeon’s view on RVUs and moral injury

      Rene Loyola, MD | Physician
    • Why doctors are losing the health care culture war

      Rusha Modi, MD, MPH | Policy
    • The hypocrisy of insurance referral mandates

      Ryan Nadelson, MD | Physician
    • A cancer doctor’s warning about the future of medicine

      Banu Symington, MD | Physician
  • Past 6 Months

    • Rethinking the JUPITER trial and statin safety

      Larry Kaskel, MD | Conditions
    • The ignored clinical trials on statins and mortality

      Larry Kaskel, MD | Conditions
    • How one physician redesigned her practice to find joy in primary care again [PODCAST]

      The Podcast by KevinMD | Podcast
    • I passed my medical boards at 63. And no, I was not having a midlife crisis.

      Rajeev Khanna, MD | Physician
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • The silent disease causing 400 amputations daily

      Xzabia Caliste, MD | Conditions
  • Recent Posts

    • How Gen Z is reshaping health care through DIY approaches and digital tools [PODCAST]

      The Podcast by KevinMD | Podcast
    • Love and loss in the oncology ward

      Dr. Damane Zehra | Physician
    • The weight of genetic testing in a family

      Rebecca Thompson, MD | Physician
    • A surgeon’s view on RVUs and moral injury

      Rene Loyola, MD | Physician
    • Meeting transgender patients with compassion and equity in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why your health is a portfolio to manage

      Larry Kaskel, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • A doctor’s letter from a federal prison

      L. Joseph Parker, MD | Physician
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • A surgeon’s view on RVUs and moral injury

      Rene Loyola, MD | Physician
    • Why doctors are losing the health care culture war

      Rusha Modi, MD, MPH | Policy
    • The hypocrisy of insurance referral mandates

      Ryan Nadelson, MD | Physician
    • A cancer doctor’s warning about the future of medicine

      Banu Symington, MD | Physician
  • Past 6 Months

    • Rethinking the JUPITER trial and statin safety

      Larry Kaskel, MD | Conditions
    • The ignored clinical trials on statins and mortality

      Larry Kaskel, MD | Conditions
    • How one physician redesigned her practice to find joy in primary care again [PODCAST]

      The Podcast by KevinMD | Podcast
    • I passed my medical boards at 63. And no, I was not having a midlife crisis.

      Rajeev Khanna, MD | Physician
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • The silent disease causing 400 amputations daily

      Xzabia Caliste, MD | Conditions
  • Recent Posts

    • How Gen Z is reshaping health care through DIY approaches and digital tools [PODCAST]

      The Podcast by KevinMD | Podcast
    • Love and loss in the oncology ward

      Dr. Damane Zehra | Physician
    • The weight of genetic testing in a family

      Rebecca Thompson, MD | Physician
    • A surgeon’s view on RVUs and moral injury

      Rene Loyola, MD | Physician
    • Meeting transgender patients with compassion and equity in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why your health is a portfolio to manage

      Larry Kaskel, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The nursing home crucible
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...