Journal of Gerontological Nursing

Readers Respond

Abstract

The "Readers Respond" column is designed to give you, our readers, a chance to respond to a particular article, ask a question of an author or Editorial Board member, or speak out about the Journal and care of the elderly in general. We will offer authors the opportunity to respond to criticism and/or questions that may be generated by their articles. Both the response and the original letter will be published in the same issue. If you wish to share your comments with our readers, please send your letter to the JOURNAL OF GERONTOLOGICAL NURSING, Charles B. Slack, Inc., 6900 Grove Road, Thorofare, New Jersey 08086.

Dear Editor:

The battle rages. One side says: "Most" nursing homes are good. The other says: "Most" are poor.

Most, many, some, few-these words are meaningless if we have not reviewed those studies which evaluate our institutions {studies from gerontology research centers, from the GAO, Ralph Nader, Dr. Robert Butler, to name a few). In judging a nursing home "good" or "poor," however, does it not depend upon whose standards, upon what aspects of care, upon who is researching and why?

Judging from the standpoint of cleanliness, "most" homes are clean, I find, from having worked in nine of them and observed them throughout the US. Or, from the viewpoint of attractiveness, "many" are just that if you prefer the "institutional look" (sometimes relieved by a potted plant or a painting) to the more home-like setting of the Swedish nursing home.

Then, if you judge a home from the vantage point of the resident-not just his or her "satisfaction level," but by the "joy-of-living" or "meaningful existence" criterion, how many homes are "good" or "poor?"

In my "Creative Geriatrics" class, we use as our frame of reference Abraham Maslow's "Hierarchy of Needs," as shown on the chart.

"Most" homes provide numbers one and two on the rung. Do "fewer" provide three and four? And how many aspire to number five for each individual resident? Have you seen those HEW studies which show what percent of patients need, but are not getting therapy? How is this need judged? Do doctors and nurses grasp the potential for intellectual, spiritual and physical rehabilitation in each patient, providing residents with sufficient daily rehabilitation measures to allow them to function at what Victor Frankl calls "The highest level of meaning?" And does the nursing home hold the view, as expressed by psychologist John Valusek, that "it is immoral to interfere with the potential of others?"

"What America needs," said Judge Brandeis, "is not to do for others but to keep open the paths which allow them to do for themselves." Do nursing homes keep open the paths to make the life of a resident joyous, creative, mean ingful? If a home suffers that "short-ofhelp" syndrome (meaning: "short-ofcare") can it be judged "good?"

It is futile to argue that some, many, few or all nursing homes are good or poor. Better to spend this energy defining and striving for our own goals of excellence. We might even ask ourselves the question: "What do our residents themselves perceive their problems to be and what do they want to do about them?"

Not just a few, some, most-but it is safe to say that all nursing homes are good where, despite an occasional speck of dust, loneliness is eradicated; the resident feels that he or she is someone special; where, surrounded by the warmth of outpouring love, he retains incentive to live.

Sincerely,

Nancy Littell Fox

Dear Ms. Stil well:

I was most interested and gratified to read of Thelma Wells appointment…

The "Readers Respond" column is designed to give you, our readers, a chance to respond to a particular article, ask a question of an author or Editorial Board member, or speak out about the Journal and care of the elderly in general. We will offer authors the opportunity to respond to criticism and/or questions that may be generated by their articles. Both the response and the original letter will be published in the same issue. If you wish to share your comments with our readers, please send your letter to the JOURNAL OF GERONTOLOGICAL NURSING, Charles B. Slack, Inc., 6900 Grove Road, Thorofare, New Jersey 08086.

Dear Editor:

The battle rages. One side says: "Most" nursing homes are good. The other says: "Most" are poor.

Most, many, some, few-these words are meaningless if we have not reviewed those studies which evaluate our institutions {studies from gerontology research centers, from the GAO, Ralph Nader, Dr. Robert Butler, to name a few). In judging a nursing home "good" or "poor," however, does it not depend upon whose standards, upon what aspects of care, upon who is researching and why?

Judging from the standpoint of cleanliness, "most" homes are clean, I find, from having worked in nine of them and observed them throughout the US. Or, from the viewpoint of attractiveness, "many" are just that if you prefer the "institutional look" (sometimes relieved by a potted plant or a painting) to the more home-like setting of the Swedish nursing home.

Then, if you judge a home from the vantage point of the resident-not just his or her "satisfaction level," but by the "joy-of-living" or "meaningful existence" criterion, how many homes are "good" or "poor?"

In my "Creative Geriatrics" class, we use as our frame of reference Abraham Maslow's "Hierarchy of Needs," as shown on the chart.

"Most" homes provide numbers one and two on the rung. Do "fewer" provide three and four? And how many aspire to number five for each individual resident? Have you seen those HEW studies which show what percent of patients need, but are not getting therapy? How is this need judged? Do doctors and nurses grasp the potential for intellectual, spiritual and physical rehabilitation in each patient, providing residents with sufficient daily rehabilitation measures to allow them to function at what Victor Frankl calls "The highest level of meaning?" And does the nursing home hold the view, as expressed by psychologist John Valusek, that "it is immoral to interfere with the potential of others?"

"What America needs," said Judge Brandeis, "is not to do for others but to keep open the paths which allow them to do for themselves." Do nursing homes keep open the paths to make the life of a resident joyous, creative, mean ingful? If a home suffers that "short-ofhelp" syndrome (meaning: "short-ofcare") can it be judged "good?"

It is futile to argue that some, many, few or all nursing homes are good or poor. Better to spend this energy defining and striving for our own goals of excellence. We might even ask ourselves the question: "What do our residents themselves perceive their problems to be and what do they want to do about them?"

Not just a few, some, most-but it is safe to say that all nursing homes are good where, despite an occasional speck of dust, loneliness is eradicated; the resident feels that he or she is someone special; where, surrounded by the warmth of outpouring love, he retains incentive to live.

Sincerely,

Nancy Littell Fox

Dear Ms. Stil well:

I was most interested and gratified to read of Thelma Wells appointment to Chief of Gerontological Nursing at Strong Memorial Hospital in Rochester, N.Y.

Since August 20, 1979, I have occupied a newly created post, "Coordinator, Gerontology Project", at St. Vincent's Medical Center in Bridgeport, Connecticut. I am a Geriatric Nurse Practitioner, 'Cornell'79, with masters preparation in Gerontological Counseling. My role, mutually defined by Nursing, Medicine and Administration, encompasses hospital wide education, clinical management and community liaison activities.

There may be other acute care institutions employing Gerontologists. Perhaps a future issue might serve to acquaint us with one another.

Sincerely,

Barbara Demmerle, R.N., GNP

Coordinator, Gerontology Project

Nursing Staff Development

Editor's Note: If you are a gerontologist employed by an acute care institution and would like to write in and become "acquainted," we would like to welcome your letters

10.3928/0098-9134-19800801-01

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