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jerryking : nursing_homes   2

Old like me. Why elderly care needs more risk - The Globe and Mail
Saskia Sivananthan

Contributed to The Globe and Mail

Published Sunday, Mar. 23 2014

We must rethink our approach to managing risk in nursing homes, especially when doing so means limiting residents’ freedom to choose their own way.

It’s a poignant reminder of the daily challenges staff and residents at every nursing home face. They are also part of a theme that played into almost every aspect of my stay: How do you balance safety with autonomy for residents?

Safety is clearly important; often people move to nursing homes precisely because they can no longer manage living without 24-hour care. At the same time, this tightrope balance invokes the fear paramount in most people’s mind when they think about institutional living – losing their autonomy, not choking on breakfast.

The regulations for long-term care in most provinces prioritize medical needs and safety over autonomy. Public reporting of quality indicators at long-term care homes include safety as one of five attributes of a high-performing system – but autonomy is not considered.....we take these calculated risks every day: slicing bread, crossing the street, staying up late. Suddenly being regarded as unable to make decisions you’ve made all your life contributes to a feeling of disempowerment. In our attempt to remove all risk in nursing homes we have ended up with regulations that are so extreme that residents may no longer have autonomy or feel at home....Many of the new models of long-term care homes coming out of Europe have embraced this concept of calculated risk. There is a much lauded dementia village Hogeweyk in the Netherlands.....Denmark also focuses on autonomy. Nursing homes there are truly run as ‘homes’ rather than institutions, with the result that residents become family. One facility of 23 residents, 70 per cent of whom have dementia, takes Caribbean vacations together. Imagine the risk.

We must rethink our approach to managing risk in nursing homes, especially when doing so means limiting residents’ freedom to choose their own way.

One writer described a nursing home in Denmark as a place where “…old people could drink, laugh and love themselves into death.” When I have to go back to a nursing home, that’s where I want to go.
aging  elderly  free_will  freedom  nursing_homes  safety  autonomy  tradeoffs  disempowerment  risks  risk-taking  counterintuitive 
march 2014 by jerryking
Well - Physical Toll of Dementia Often Overlooked in Treatment - NYTimes.com
October 19, 2009 | New York Times | By TARA PARKER-POPE . The
lack of understanding about the physical toll of dementia means that
many patients near the end of life are subjected to aggressive
treatments that would never be considered with another terminal illness.
health  Alzheimer’s_disease  dementia  nursing_homes  palliative_care  living_wills  elderly  TARA_PARKER-POPE  mental_health 
october 2009 by jerryking

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