The importance of where the elderly live has many facets. Is their home their choice? Can they, either by themselves or with help, maintain their homes both inside and outside? Is the running of their home too costly for their finances? Is the home suited for their needs? Are they isolated in their homes with little opportunity to communicate with various other people? How would they continue to manage their homes with increased health problems? Would a livein arrangement, either with relatives or nonrelatives, be more suitable for them? How would they feel about moving in with relatives, into senior citizen housing, into smaller quarters, or into a nursing home?
The significance of one’s space, housing, can not be over emphasized. Teenagers are frequently warring with their parents over their territory within the home. Teenagers need to feel in control of their own space and attempt to demonstrate this need by being sloppy, decorating with posters, playing music loudly, and demanding privacy. The need for possession of a space is likewise evident in the elderly. No matter where the elderly live, be it in their lifelong home, in a large retirement condo in Florida, in their children’s home, in an apartment, or in a bed of a nursing home or the ward of a state hospital, they need to feel the ownership of a space. The “idea of self is diminished if there is not a corner which is his alone and where his treasures can stay with him. It has been said that home is where one feels safe to return. Without such a place a person is rootless.” (Smith, p 48)
Nursing homes have become big time business in America. These institutions in theory, solve the problem of what to do with the elderly when they can not care for themselves, but in reality, nursing homes many times create more problems for the elderly. Nursing homes are expensive to run, IF done properly, because they require competent staff and specialized facilities. Some nursing homes are excellent, but far too many are not. The subcommittee on Long Term Care of the US Senate Committee on Aging listed five major causes of substandard nursing homes:
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1.
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lack of a clear national policy with regard to the infirm elderly;
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system of longterm care with inherent or built-in financial incentives in favor of poor care;
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the absence of the physician from the nursing home setting and in general the deemphasis on geriatrics in American medicine;
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reliance on untrained or inadequate nursing staff;
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lack of enforcement of existing standards.”(Smith, p 63)
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My childhood memories of over thirty years ago include the poor house for the elderly on the site of the present New Haven Regional Center of the Department of Mental Retardation on Wintergreen Avenue. A look at the present New Haven telephone directory includes four related headings for the care of the elderly in the yellow pages which indicate businesses. 1) Convalescent Homes41 listings. 2) Boarding Homes14 listings. 3) Rest Homes18 listings. 4) Sanitariums2 listings. There is slight crosslisting, but most are singularly listed according to health care needed. This does not include nonprofit institutions such as the Jewish Home For The Aged on Davenport Avenue and city and state sites. The New Haven area is a prime location for the care of the aged. The New Haven Board of Education is presently establishing at Lee High School an Allied Health and Technical Careers alternative high school, because of the great number of jobs available in the New Haven region in the health care area. Local teenagers are frequently employed in convalescent/nursing homes because these jobs require low entrylevel skills. But I have found many teenagers become quickly frustrated with working conditions, pay, and are emotionally illequipped to deal with the headset of their job. They are not trained or prepared for the guilt and emotional pain that can arise when dealing with the elderly and death. Care of the elderly requires emotional commitment not detachment. The caring must start with the professionals who are responsible for the care of the elderly and filter on down to the general public. The elderly are living, breathing individuals, not merely commodities to make a profit off of.
