The Elderly Are Devalued

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    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.

    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.
    Last edit by Joe V on Aug 14, '12

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    About TheCommuter, ASN, RN

    TheCommuter is a moderator of and has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a registered nurse.

    TheCommuter has '9' year(s) of experience and specializes in 'acute rehab, long term care, and psych'. From 'Fort Worth, Texas, USA'; 33 Years Old; Joined Feb '05; Posts: 28,546; Likes: 42,058. You can follow TheCommuter on My Website

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    44 Comments so far...

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    I totally agree with you.... I am a long term care nurse by choice! I love working with elderly people, that's what I am passionate about!
    LTCangel, cienurse, orthonurse55, and 6 others like this.
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    I couldn't agree more. I work LTC, and not because I wasn't offered employment in other areas. I was, but I actually enjoy geriatrics. Furthermore, nurses where I work perform the same skills as you would in med surg. But you deal with all the psych issues, too. I think attitudes will shift, since our population is aging.
    cienurse, orthonurse55, sunny3811, and 4 others like this.
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    Thank you for writing this. I totally agree. Our elderly are seriously undervalued and under cared for. In spite of my allnurses ID LTC is where my passion lies and where I intend to concentrate. I enjoyed being a Birth Doula and Lactation Counselor for many years and sill give advice but it's not what I want to do.

    I'm so thankful for those nurses who have the skills and experience and work in ER and ICU and other specialties but I feel what I have to offer can be well utilized in LTC. People look at me like I've grown a second head when I answer the question "what do you want to do in nursing." LOL. Does it bother me? Not in the least. We each choose our own path.
    LTCangel, itsmejuli, VivaLasViejas, and 4 others like this.
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    I am Canadian however your comments apply to my experience too. I worked in acute care for over 40 years and have to admit that I really never thought about how nursing in LTC could have many challenges. I then went to LTC to do a leave of absence for someone and discovered that LTC nursing presents many different/ difficult challenges-- the issues with these residents are frequently very complex and require in depth assessment frequently due to communications problems-- I.E. stroke or dementia patients or no family to help with information.
    These residents have contributed so much to our society . We need to provide quality care to these patients/residents by at least keeping them clean, comfortable and content--- it may soon be me in that bed!!!! It really is a great place to start out a career as every assessment skill will be utilized in this area of nursing.
    Hopefully we can change the image of nursing in LTC facilities through sites like this!!!
    I am now back in ER for a short stint!!
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    I agree also. I recently graduated from RN school but since I haven't yet found a job as an RN, I am still working as a CNA at a special care unit for dementia. The nurse consultant warned me just the other day to never take a job in LTC because then I"ll be "labeled as an LTC nurse and nothing more". There shouldn't be such a stigma attached to those who work in LTC. I enjoy working with the elderly but I am currently looking for hospital work so I can enhance my nursing skills. I do have an interest in working with the elderly, too, though.

    I also agree that the elderly are devalued and I feel that is even more true in populations such as dementia and Alzheimer's. I have co-workers who think nothing of the way to they speak to some of our residents because "they won't remember it anyway". That may be true but I'm sure that they are hurt in that moment and that matters to me.
    Katie13LPN, june42, cienurse, and 6 others like this.
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    People also need to each his own. Everyone has a place in nursing, which is great. I love the elderly, can't stand kids for long periods, for example. So, I would never work peds, whereas some nurses love it.
    anotherone, SHGR, Kornhonk, and 5 others like this.
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    I treat and care for everyone the way that I want someone to care for and speak to me-- the elderly deserve our respect!!!! and mostly we need to remember that many of them cant help themselves or explain their actions --so they need US to care for and protect them !!!!!
    june42, LTCangel, SHGR, and 2 others like this.
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    So I will be completely honest and please give me some feedback as well.

    I love geriatrics and would love to ONLY work with geriatrics come December when I graduate. That being said I feel torn because of the situations I have read about that go on in nursing homes. While I would love to work with them I think I would get so burnt out by the lack of staff, the lack of support, and the constant neglect I read about on here. I look at in two different ways: 1. I need to work LTC so that I can help stop the pattern of neglect I hear about. I realize this totally idealistic in theory and while I know people say that one or two people can make a difference, it's really hard to see IMO. 2. I will start in LTC, tuck my head and do what I'm supposed to so that I can work the population I love. Will I get burnt out dealing with the people you talk about who only take the job because that's all they can get. Will I become calloused because I have to pick my battles because there are too many to take on one at a time? Or will I be so appalled at what I see that I will feel compelled to turn in every person that I see neglect a resident and end up working by myself?

    I'm sorry this is choppy, my thoughts aren't quite formed yet this morning because I haven't finished my first cup of coffee.

    I have quite the ugly picture painted in my head of LTC facilities because of the things I have read and heard about. While I know some may be this bad I am not naive enough believe that there are not good facilities out there, but do I want to start in a bad one and quit in my first year?
    tigerlogic, anotherone, SHGR, and 1 other like this.
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    I work in a LTC/Rehab facility. Mostly on the Rehab side. I must say, I must be the exception rather than the rule, b/c I love where I work. The people there work as a team. There are CNAs, LPNs and a couple of RNs that are not in a supervisory position (I am one of those-I work the floor). No place is 100% perfect, but the atmosphere where I am is happy. People want to work, the pts are well taken care of. I am a new grad as of last May, and I chose to work here and love work with the older population. They have so much to share!! I literally learn something new every day. I wish it was not all about the bottom line
    june42, LTCangel, anotherone, and 4 others like this.

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