Nursing home life story

by mymothersbrain

The New York Times has a great story today —http://www.nytimes.com/2009/08/24/health/24nursing.html?_r=1&scp=2&sq=nursing%20home&st=cse — about a University of New England program that allows future doctors to experience life in a nursing home firsthand. They are “assigned” an illness or condition and then they live in the home for several days as if they were really afflicted with that illness. They do this as part of their medical training.

According to the story, most medical schools require very little — if any — geriatric training and there’s not much interest in this field as it doesn’t pay as well as others. One of the stats the Times throws out is that by the year 2030, there will be one geriatrician for every 8,000 people over 65. This in a country where our elderly population is growing exponentially. Certainly, if you’re doing to be a doctor, it must be easier to have a specialty in which your patients are mostly healthy, mostly young (or younger). If I were a doctor I’d probably prefer to treat colds, sprained ankles, infections. But I would have thought that with our aging population explosion, more doctors would be entering the field of geriatrics, or that this would be a growing field due to demand.

I’m sure the Times is correct in that the financial benefits of geriatrics are less lucrative than other specialties. I would also think that there are also more stresses when your patients are less healthy and closer to death. Caring for the elderly must require a certain compassion, empathy and strength, and there are some great doctors and nurses who have it — my mother’s neurologist for one, and the nurses who care for my mother-in-law. The hospice nurse calls every time she checks on her, gives my husband the tiniest details about how his mother is doing, whether she was alert or not, whether she looked in her eyes or not. But I wonder if part of the geriatric reticence for those entering the medical field has to do, at least in part, with our general societal discomfort with aging?

It’s just a thought, no statistics or evidence to back this up, just a stray thought based on the things I see and hear. Granted, we visit my mother-in-law mostly on weekends because we work during the week, but there are a handful of folks at the residence where she lives who I swear never have any visitors. I get it. It’s difficult to be around people who can’t brush their teeth, who wear adult diapers and can’t control their bowels. It’s difficult to be around people who can’t speak to you, who can’t comb their own hair. I know: if my mother-in-law is soiled and hasn’t yet been changed, she smells. She wears a bib when she eats. My mother’s dementia isn’t that far along yet, but she too does things that are socially unacceptable — taking food out of her mouth with her fingers if it has an unexpected taste or texture, or rummaging through a public trash can for aluminum cans. But do I not owe these two women some kind of respect simply for having made it this far, for having contributed to society with their work and with having raised productive families? Or better yet, for simply being human? Does none of this count for something? Or is it true that in our society what matters most is our youth, complete with shiny clean hair and the ability to control our bowels, and with each new wrinkle we are a bit more forgotten and a bit more dispensable?