Maybe it’s because I grew up close to my maternal grandparents. Maybe it’s because my paternal grandmother lived with us in our home for many years. Maybe it’s just my nature. Whatever the reason, I’ve always loved older people. I’ve loved their stories and their histories.
These are people who have lived full lives. They deserve to be treated with dignity and respect no matter what age and disease has taken from them. Part of that respect is to allow them to make choices whenever they can. This approach is the aim of person-centered care, which is now the epitome of good nursing homes.
In a recent article on the New York Times site titled Giving Alzheimer’s Patients Their Way, Even Chocolate, writer Pam Belluck explores the philosophy of Beatitudes, a unique nursing home in Arizona that takes the idea that elders should have choices about pretty much everything, right to the edge. The lead paragraph cites a woman who was too difficult for most nursing homes to manage:
“Margaret Nance was, to put it mildly, a difficult case. Agitated, combative, often reluctant to eat, she would hit staff members and fellow residents at nursing homes, several of which kicked her out. But when Beatitudes nursing home agreed to an urgent plea to accept her, all that changed…Disregarding typical nursing-home rules, Beatitudes allowed Ms. Nance, 96 and afflicted with Alzheimer’s, to sleep, be bathed and dine whenever she wanted, even at 2 a.m. She could eat anything, too, no matter how unhealthy, including unlimited chocolate.”
According to the article, this care completely turned Margaret Nance around. She became easy to “manage,” once she was allowed to make her own choices.
Although I enthusiastically endorse person-centered care, I haven’t run into anything quite this “person centered” before. Personally, I’d lean toward a more centered approach for most elders in a nursing home, since presumably they are being cared for in this setting because they can’t care for themselves. The elder’s ability to make choices may be so limited that a diabetic could die because of the inability to “choose” to take insulin before a meal, or to eat the foods necessary to maintain even minimal blood sugar stability.
However, I do find the approach Beatitudes uses intriguing. I hear from families who have elders like Margaret Nance. These people are at their wits end because no home will care for the elder. These people must be cared for in the best setting possible, considering their needs.
Person-centered care should be the aim of good nursing homes. How far to take that philosophy will be debated for quite some time but the ability to make choices based on their unique personalities is key. Let’s hope we continue to progress as we find ways to include the uniqueness of each individual into their care plans.
Posted in Alzheimer’s, Dementia, Nursing Home | No Comments »
