Promises to Keep: The Family's Hole in Nursing Home Care. Korr KL, Buffalo, NY, Prometheus Books, 1991 , 127 pages, softcover, $14.
This book is a concise, informative, and clearly written overview of how families may address a range of aspects pertaining to their role in nursing home care of an elderly relative.
The book is divided into six chapters, each of which is designed to meet specific learning needs of families and friends who have a significant other in a nursing home. Chapter 1 outlines some of the central issues families face after placing a relative in a nursing home. Another issue pertains to those family situations in which some members are not involved in the elder's nursing home care, and the importance for family members to explore this aspect in a "collective dialogue" rather than becoming involved out of guilt instead of love.
Chapter 2 provides a case history of the author's family's involvement during their grandmother's nursing home stay. The theme of this chapter is this family's sense of empowerment, including how they chose not to relinquish their role as primary caregivers.
Chapter 3 contains a discussion of how the family may supplement a number of basic and special care needs of the elders to help offset the loss of patient dignity, autonomy, and integrity that occurs among many institutionalized people. This chapter also includes the various forms of possible neglect for which families might observe and how these might be best addressed.
Chapter 4 outlines several ways families might make their visits with elder more meaningful by addressing these aspects of care, including the need for the family to encourage creatively satisfying activities, the importance of personalizing activities, and the role of music, poetry, reminiscing, and touch.
Chapter 5 outlines four aspects that are important for families to know: major emotional difficulties of the elderly; the importance for family members to acknowledge their own emotional needs; the need for families to advocate for social and political responsibility; and family support needs of those with a relative in a nursing home. A summary of these points is provided near the end of the chapter.
Chapter 6 presents a concise outline regarding how families can best help their elders find meaning and purpose in life, to feel a sense of belonging and being loved, and how to find reconciliation with some spiritual ideal and with themselves, their family, and the community. Particularly informative is how the family might deal with their feelings regarding their relative's impending death, including the gradual detachment of the elder prior to this event. At the end of the book is a 7-page appendix that outlines the nursing home resident's rights.
This book would be useful for families who wish to make the experience of nursing home living more meaningful for the elders, institutional staff, and themselves. The absence of an abundance of medical terminology and references, informal style of presentation, and the basic yet practical information provided indicates that families would welcome this book.
Furthermore, it would be a useful reference text for professionals working in nursing homes because of its phenomenological approach about the "lived experience" of nursing home life for the elders and families involved.
and Family Nursing
The University of Calgary