When an older person moves into a nursing home it’s generally due to a decline in their health. They may have physical or mental disabilities due to frailty or chronic disease, limited support from caregivers, or an increased dependence on others in activities of daily living. Personal feelings of security and changes in financial situation may also contribute to this decision.
People in nursing homes live a mean time of 2.8 years. As this will be their final home, many people see nursing homes as “God’s waiting room”. Instead, we should be supporting nursing home staff to enable the residents and their families to enjoy that time.
Our health, aged care and legal systems reflect society’s preoccupation with providing a nursing home that is safe. It is a place where we “care for” older people and keep them from any harm.
However, a good quality of life requires a certain degree of autonomy. This basic human right for older people in nursing homes is actively overlooked in our efforts to protect and keep this vulnerable population safe.
We rationalise and forgive this attitude by convincing ourselves that waiting to die is awful and it is better to leave God’s waiting room quickly. We focus our efforts on legalising voluntary euthanasia, promoting a good death, avoiding hospital transfers from nursing homes and exploring ways to reduce the high cost of health care in the final six months of life.
Life has so little value in God’s waiting room that we do not consider that nursing home residents suffer premature or preventable deaths. Instead death is usually perceived as a “blessing”. So much so that official death statistics collection by the OECD excludes people over 70 years of age from premature death classifications.
Our fear of ageing, disability and death blinds us to seeing the value of life in the very old. Societal efforts are overwhelmingly directed towards valuing the contributions of the young and those of working age. This reinforces the perception that when frail older people in nursing homes die, little of value is lost.
Our evolution to an enlightened society requires, among other things, recognition of the value of relationships and knowledge. Relationships and social inclusion are the fabric of any thriving community.
Relationships do not cease to exist nor stop being formed because we grow old, or are cognitively or physically impaired. Relationships are shattered when a person dies prematurely whatever their age.
Generational knowledge is accumulated from life experiences. There are lessons for us to learn from older people. The fact that we do not avail ourselves of this knowledge does not mean it is worthless.
Our health, aged care and legal systems should be actively seeking not only to protect the rights of older people to reduce abuse and neglect, but also to improve their quality of life by supporting them to make choices that may pose risks but would enhance their life.
Knowledge of what enhances life in nursing homes for residents and families already exists. We should be continuing and promoting new relationships, and ensuring meaningful activities for enabling people to do something that is worthwhile and to feel worthy – as well as preserving a person’s individuality, independence and autonomy.
The residents, their families and nursing home providers and staff cannot do this alone. It requires a collective response, a whole-of-society effort to implement the required policies, laws and services.
A good death, one that is quiet, peaceful, pain-free and surrounded by loved ones, does not equate to a good life. The pursuit of joyful, exciting activities with an element of danger, or the unknown, that we conquer is the stuff of life.
Sitting in a waiting room is not a way for anyone to spend their time. We actively seek to reduce waiting times in every other facet of life so we are freed up to be able to enjoy our lives.
We need to stop seeing nursing homes as God’s waiting room and understand the value in enhancing the lives of older people. Only then will we actively pursue ways to ensure a better quality of life for them. After all, that is what we want for ourselves.