Just Say "Yes!"

Yesterday there was a meeting at church featuring an Assisted Living/Rehab facility in town.  I debated myself, should I or should I not go?  I decided that, even though I try to live a healthy lifestyle and hope to be in the 95% of those over 65 years of age who don't end up living permanently in a nursing home, accidents happen, and I might as well check out this place.

I was pleased with what the representative told us about herself and her facility here in Lexington, Kentucky, "Morning Pointe."  She dealt with a relative with Alzheimer's Disease, then wanted to be actively involved in their care.  The company is small, compared to the giant corporations for whom I have worked when I was active in Nursing.

After the program, several of those there mentioned that they had family members who were in nursing homes.  A good friend has a relative in a nursing home "just for rehab, but she has been refusing to go to therapy."

As a direct-care giving nurse, and worker in every job (including maintenance & housekeeping, actually!) in nursing homes for a number of years, I am definitely qualified to comment on the reality of the above problem.  In all the REHAB patients I worked with, there was only one patient who WENT HOME!  This is a terrible tragedy!

Who are the nursing home "rehab" patients?  They are adults of any age who had an accident or illness for which they were hospitalized but NEED ADDITIONAL THERAPY before they are safe to go home.  At nursing homes there is physical and occupational therapy, and in some, respiratory therapy.

Then, what exactly is the problem?  Why did ONLY ONE of the patients I worked with, go home?  Most of those needing nursing-home rehab are "elderly," that is, over 65 years of age.  Most have never been a patient in a nursing home.  If they have broken a bone, had a stroke or heart attack, they have lost a lot of strength just being virtually immobilized while in the hospital.  They don't recover as quickly as they did in their youth.  Also, they may still be in pain and may still need painkilling medicine.

Rehabilitation, making those muscles work again, is PAINFUL!  There's no way around this!  If a person is medicated to where he or she has no pain, they cannot do the work involved in exercising.  A nursing home resident quickly, the first session, finds out that going to rehab means they will have some pain.  They don't like pain!  (None of us do!!)  So the next session, they tell the therapist, "I don't feel like it."  They keep refusing!  What they don't know is that if a nursing home resident refuses therapy three times, they are taken off the therapy list!!  Therapy is done, over! Thus, they will never get strong enough to go home and will eventually be a permanent nursing home resident.

This was the policy/law ten years ago, when I was working in a nursing home, and, although I don't know for sure, I doubt if it has changed.

Another factor involved in why these nursing home patients who refuse therapy become permanent residents has to do with certain elders actually liking to not have to 'work' anymore.  They figure out quickly: you press a button and they come and do what you want them to do: get me this, get me that, take me to the bathroom, answer questions, etc.  They have worked hard all their lives and NOW THEY WON'T EVER HAVE TO AGAIN!  No more cooking!  No more dishes!  No more laundry!

The great majority of nursing home residents are women, more than two-thirds.  They make friends, something harder to do if they live alone.  There are lots of activities they may like.  Why should they go home!!

The ONE person who went home was in her mid-seventies and had broken her ankle.  When she first came to the nursing home for rehab, I was chatting with her son.  He told me, "Mother doesn't want to go to therapy.  What can I do?"  I told him, "Therapy is always painful and I can understand why she doesn't want to go.  But if she refuses to go, the therapists in a nursing home can't make her go.  However, YOU can make her go!  If you come to each and every therapy session with her, YOU CAN MAKE HER GO."

So he did!  He told her that he was modifying the bathroom in her home so that she would have direct access to her bathroom.  He bullied her (verbally).  He refused to take "no" for an answer.  Mother went to therapy.  She cursed her son.  She cursed her therapists.  She made progress.  SHE WENT HOME!

FYI: I had the same conversation about making a patient go to therapy with many families.  Some tried to do what the above son did but gave up.  Others never tried.  Some were unable to have a family member come to give encouragement and support for therapy.

So, bottom line: if either you or a family member ever needs therapy in a nursing home, now you know what to do!  Don't give up!  Independence is so worth the effort!!

Lord, we pray we will never, ever, have to be a patient in a nursing home, either for rehab or permanently.  Help us to choose the healthy lifestyle to maintain good health and strength.  Help us to be really careful and avoid falling or other accidents.  All for you, our Lord!