The Elderly Are Devalued

To be blunt, the frail elderly population tends to be devalued in American society. Since 78 million Baby Boomers are aging and will be added to the ranks of the elderly population during the coming decades, I sincerely hope that their expectations and experiences will contribute to placing a more positive spin on aging in America. Something must be done. Specialties Geriatric Article

During the many years that I have spent browsing these forums, I have noticed a common theme regarding the preconceived notions that many people in healthcare have expressed about long term care (LTC) and the elderly population in general. To be straightforward, my observations can be disheartening at times, but I believe that they reflect deeper attitudes about society's feelings toward aged people in America.

For starters, I have observed that LTC is sometimes viewed as the specialty of last resort for newly graduated nurses who cannot seem to secure employment anywhere else. I have read too many posts to count where the new grad will write, "I cannot get hired at my favorite community hospital, so I suppose I'll try to get hired at one of the local nursing homes."

I have also worked with a considerable number of these nurses during my years spent in LTC. They had ambitious plans of working in the fast-paced emergency department or the high-pressure critical care environment while in nursing school, but now they push medication carts at nursing homes with their passion gone and their dreams deferred.

Now that I am out of the LTC environment, I see firsthand how some nurses in other specialties view 'nursing home patients' and 'those nursing home nurses.' A handful of nurses who work in more acute specialties have referred to demented elderly patients with names that I cannot type due to their offensive nature.

Some also think that LTC nurses deal with less stress and lack the assessment and procedural skills that all 'hospital nurses' have. However, at least half of my colleagues in LTC had extensive acute care hospital experience in areas such as medical/surgical nursing, telemetry, ortho, ICU, acute rehab, and other specialties. Let's not forget the testy attitudes that LTC nurses sometimes receive from EMS personnel when attempting to get elderly residents transferred to a more acute level of care.

In my humble opinion, the attitudes about LTC being the nursing specialty of last resort tend to reflect society's generally negative opinions regarding the frail elderly population.

Much value is placed on the lives of infants, children, and younger adults. However, older people are often devalued in American society. We can see the bias toward youthful populations come to life when we tell the public where we work.

For instance, many people become excited at the very idea of a nurse who works in postpartum, pediatrics, trauma, the emergency department, reproductive medicine, the NICU, PICU, labor & delivery, or other specialties where a higher proportion of younger patients end up. On the other hand, these same individuals respond with far less enthusiasm when they discover that the nurse is employed in an area where many elderly patients are seen, such as rehab, long term care, geri-psych, hospice, assisted living, adult day care, or oncology.

I'll reaffirm that LTC can be a very rewarding area if the nurse has a passion for helping the geriatric population during their golden years. Since 78 million Baby Boomers are aging and will be added to the ranks of the elderly population during the coming decades, I can only hope that their experiences will place a more positive spin on aging in America.

Those that devalue the elderly are not old and frail yet. I have been a LTC LPN for a year now and while I'm still new, I can't for the life of me understand how it's perceived as being less stressful in LTC when we have a higher patient load than any other specialty. I did a preceptorship at a rehab unit in a hospital and it's not much different at the LTC rehab end where I work (except my preceptor had 7 patients and I have 25 - 28 residents). Medicare cuts are stretching us thinner and thinner and piling more documentation on while my employer aspires to please its shareholders. Sink over a million into a big remodel to make it look pretty, then make us deal with not enough towels, linens, chux and other supplies (not to mention lower-quality food for the residents), short-staffed constantly and have the balls to make us come to mandatory meetings to complain about what's not being done. The residents are the ones that suffer. Things would be vastly different if the elderly were able to oversee their own care.

Wow, sounds like where I work. When I first started, the daily shower list was based on how many towels were available. We have ran out of gloves many times. We rarely have wipes. Sometimes there aren't enough chux to go around. We've had some meals before that I was ashamed to have family members see (we have a lot of family members who come and eat with their relatives)

We also have a VERY nice LOOKING facility. Looks very fancy and upscale but it's all for show. We also have mandatory staff meetings 2x a month so they can complain about the employees.

Gee, do we work at the same place?

I worked in LTC for a year when I had my LPN license. I was out the door as soon as I got my RN license for the pure fact that it was so hardcore at my facility. There were management issues also but that facility should have been shut down anyway. I respect ltc nurses but realized it was not for me. I took away skills in time management, prioritizing, and assessment. In clinical at school at the hospital I took 4 patients. In ltc I had 30 residents and 2 cna's. Chest pain was a daily complaint. It was hectic and I think that the elderly are not getting as good of treatment as they deserve. With hospitals having such a quick turnover rate in regards to patients the ltc facilities are accepting more acute and unstable patients also.

Specializes in Near Future: ED, Future Future: ACNP!.

I am a new grad. I don't have a job yet. I don't mind working with the elderly, in fact most of my patients in my hospital rotations were elderly. My reason for not wanting to work in LTC is my experiences with LTC rotations in nursing school. The staff: patient ratios were ridiculous, supplies were short, and there was no organization whatsoever. It was pure chaos. I like a fast-paced high demand environment, but this was different. Definitely not for me. I don't think I would be able to provide quality care to my patients in that kind of environment.

If LTC was a decent environment to work in, then more people perhaps would work in LTC. If the standard is 5 days of orientation, being asked constantly to sign up for overtime or to stay for a double shift, gloves being reused because of the low supply level, and State pays a visit every 6 months, then no wonder LTC is not a desirable place to work.

The best part of working LTC was the residents. I really enjoyed the interactions and feeling like I knew more about them. However, the work load was very stressful. and impossible at times. A team of 25 residents with numerous chronic conditions that could become unstable at any time was the norm. Some days I felt like I had so many patients that I was trying to pull back from the brink of becoming unstable that I felt like I was working telemetry without the benefit of monitoring equipment. This facility did not have computerized documentation and I know this is not unusual. However, the amount of double and triple documentation was unrealistic. We had to do monthly summary of each resident where we checked for presence of and summarized documenation of all disciplines. Like I said the residents were the most rewarding part of it. To be fair, I had other stressors in my life while working there but I ended up resigning because for health reasons.

Specializes in LTC, assisted living, med-surg, psych.

I am a nurse by vocation, but a geriatric nurse by choice. :heartbeat

Specializes in Home Care.

Great articale, thank you.

I'd love to see more volunteers come into our facilities to visit our residents, so many of them are so very lonely.

Don't even get me going on the lack of LTC and dementia beds where I live.

I interviewed at a LTC facility. The first nursing job I interviewed for. LPN, fresh out of school and passing NCLEX. I was told I would be responsible for two halls, each hall having 30 residents each. Brand new LPN going to have 60 residents. Scared me to death. I absolutely love elderly people, but I don't think I am enough nurse to provide what they need. The job was offered to me - I declined. I accepted a job in a prison and feel much less intimidated than I did by the prospect of the LTC job.

I'm not at all suprised. Given the devalued attitude of this country in general has toward the 50 and over group, why would the true frail elderly in LTC be treated any differently. "Don't employ them, they don't deserve the medicare they paid into for years and years. They'll get respect when I get respect from them first!" It's a reflection of the moral standard now a days.

There will be no increase in the respect for the elderly even with the baby boomers aging.

Specializes in Med/surg, Quality & Risk.
Some also think that LTC nurses deal with less stress and lack the assessment and procedural skills that all 'hospital nurses' have.

HAHAHAHAHAHHAA

No way in Hades do I think this.

I enjoyed the article and agree with you 100%. To add to the conversation, our cultural views (Western, particularly American) on aging clearly have a strong influence on our views on aging and how we treat the elderly population in our society. It never occurred to me that caregivers of elderly may be stigmatized as well. Some Asian countries, like China & Japan, revere their elderly...we could learn from them. Maybe Baby Boomers can bring an end to Ageism as they grow older; after all, they do account for >25% of the US population; the rest of us will have to listen!

Specializes in Emergency, Med-Surg, Progressive Care.

Having worked on two med-surg floors, it seems that the demographics are similar to those of long-term care facilities. I really enjoy working with elderly people, but I don't think I'd ever want to work LTC because I wouldn't have the resources to take care of them adequately. On a med-surg floor, I'm guaranteed (at the very least) a somewhat manageable patient load. I did a few clinical rotations in school at a nursing/rehab center that had won several accolades, and even there staffing was terrible. I've heard stories from other nurses about 25:1 nurse-to-patient ratios with one aide. There are no bones about it...there is not a single person on the planet who could take those odds and succeed at providing safe, adequate, compassionate care. I wish that nursing homes were better for nurses and residents. Perhaps my my opinion is wrong; please correct me if it is.