Related to complaints about nursing homes I've heard arguments like "If they really loved her, they wouldn't have put her in a home. They'd take care of her themselves, nothing is more important than family."
Also, "What do you expect when you go to the cheapest possible nursing home/whatever medicare will pay for. If they really cared they'd put her in a more expensive/better nursing home".
You have no business asking for an explanation, I think that is the point. What will you do with this explanation? Determine the validity of the family's absence? It is irrelevant to your patient care.
Actually it's to understand thank you very much. And you should probably learn to communicate as this is an open forum and not a place to attack. But if I want to judge I can. If I want an explanation, I can ask for it. And again, you are assuming that I wi use the exanation to judge. I am not. I want to understand what is goingthrough people's minds during situations. I have an interest in psychology and so I am always wondering. Plus, asking questions and getting answers gives you a better perspective on things. Got it? Good!
You only get the history people are willing to share. There are 4 people in this world that know the sexual abuse my ex-husband experienced at the hands of his mother, him, me, his psychiatrist and her. She's a prominent member of her church and community he would NEVER disclose that information if he even cared to involve himself in placing her. And it's not because of concern for her reputation, at 50 years old he's still humiliated by her treatment. You may get some background but I'll wager if someone has been abusive or cruel to their family their friends aren't going to know about it. You may get some background but very rarely is anyone going to allow a bunch of strangers to be privy to the secrets and scars they have carried a lifetime.
Your posts are riddled with judgment, you say you respect someones decision then demand an explanation.
If they don't know where they are or who their family members are then what does it matter if any of them visit? Would it be upsetting for you to have a total stranger suddenly showed your living room wanting to visit? That is what it is like for many, many dementia sufferers. How would you like to repeatedly learn that your husband is dead?
Even well meaning family members become invading strangers to disrupt their security and routines. Going to visit mom (who doesn't know who you are) when it triggers anxiety, agitation and behaviors is cruel and the majority of people who would do that are doing it purely for their own purposes, not because 'mom' wants or needs it.
You completely contradict yourself! You say you don't disregard someone's wishes and can respect another's choices then describe a loose plan to do exactly that if ever placed in that position. That you'd disregard their wishes because they are no longer competent, force them into an unfamiliar environment they didn't chose and if it didn't work out, further traumatize them with another move. And you work with dementia patients and think this is potentially a good idea.
I am not contradicting myself. Read carefully. I said I can respect that. But if put in that position, I would want to be able to be near by. Therefore, I would have to consider that if my parent were in such a condition that she is unable to orient herself to anything, then why not take the chance to bring her closer despite her wishes. I want to be able to be involved in her care, but to do that actively we would have to be close together. And why am I riddled with judgement just because I want to understand families' reasons? I respect their decisions to place family in the nursing home. That wasn't my question. My question was why don't they ever visit? If they are close by and are not estranged due to family conflicts what reasons are there? I'm not saying there isn't any reasons. I want to know the reasons so I can put them into perspective. I want to understand for mere curiosity. I can argue and give reasons for both sides because of the information brought up here. It's research, it's curiosity, it's trying to understand. I get furious when I see my residents alone on holidays. Of course we are there to betheir family, but I want to know why family can't be there. Or even send a card or some sort of contact. I am trying to understand others because for me, regardless of what a family member could have done to me, it wouldfeel coldhearted to just leave them there alone. If I couldn't face them, then I would send a letter or gift or whatever during holidays. Because I wouldn't want them to feel alone. But that is me. So me asking these questions helps me understand others views. It's not about judging it is understanding others. I am not debating to win. I probe with more questions to get explanations and comprehend them. So don't attack.
I am not contradicting myself. Read carefully. I said I can respect that. But if put in that position, I would want to be able to be near by. Therefore, I would have to consider that if my parent were in such a condition that she is unable to orient herself to anything, then why not take the chance to bring her closer despite her wishes. I want to be able to be involved in her care, but to do that actively we would have to be close together. And why am I riddled with judgement just because I want to understand families' reasons? I respect their decisions to place family in the nursing home. That wasn't my question. My question was why don't they ever visit? If they are close by and are not estranged due to family conflicts what reasons are there? I'm not saying there isn't any reasons. I want to know the reasons so I can put them into perspective. I want to understand for mere curiosity. I can argue and give reasons for both sides because of the information brought up here. It's research, it's curiosity, it's trying to understand. I get furious when I see my residents alone on holidays. Of course we are there to betheir family, but I want to know why family can't be there. Or even send a card or some sort of contact. I am trying to understand others because for me, regardless of what a family member could have done to me, it wouldfeel coldhearted to just leave them there alone. If I couldn't face them, then I would send a letter or gift or whatever during holidays. Because I wouldn't want them to feel alone. But that is me. So me asking these questions helps me understand others views. It's not about judging it is understanding others. I am not debating to win. I probe with more questions to get explanations and comprehend them. So don't attack.
Yeah. I hear what you're saying.....
But picture this (people I know- personally or patients)
- constant physical, emotional, and sexual abuse by the father. Father never acknowledged what he did; essentially blamed the sisters (he left the brother alone). They weren't visiting.
- father pulled a gun on the kids at night routinely when the mom argued with his drunk orifice. Wanted to terrorize the kids- it worked. This was nothing new for them- just dad having a bad night AGAIN. Cut off contact for their own sanity.
-father (or step-dad, but the man in the house) bit the kids' finger OFF....police found it in the ashtray...... not gonna be visiting
- father impregnates his TWELVE year old (years ago) , who has the baby- gives it up for adoption, but fortunately she and her sisters got yanked from the home; don't remember the sentence he got- but I wouldn't judge them for not visiting (or having their kids near him)
I can understand not going to see that type of parent. It would be nice if they saw what shape he was in (and not able to hurt them anymore) but some wounds cut to the soul of a person.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
my mum has always said not to put her in a nursing home. she says (if competent) she will simply refuse. i think as a society it's too convenient an excuse just to shove people into a place where they will probably, in most cases, just rot away. i've seen people literally die from loneliness in those awful places, cos their family are 'too busy' to visit them, or can't be bothered with them. i dread the thought of going into one myself. i've tried as a rn to spend as much time talking to these lonely people as i can, but most times, i just don't have the time.
i believe in keeping people in their home (barring illness such as alzheimers). i think the future should be geared towards community nursing and home support. it seems to work well at my hospital anyway.
to me, personally, nursing homes & ltcs are just a 'storage place' to put inconvenient relatives until they die. it's an old-fashioned, out-dated practice.
but the government won't keep people in their homes, as it costs too much money for community supports; even meals on wheels here only deliver 2 meals a day in smaller towns cos it costs too much to run. when it boils down to it, it's cheaper and more convenient just to herd people together - a bit like cattle.
the whole institution of 'caring for our elders in their twilight years with respect & dignity' stinks.
many, many of those poor elders whose families are too busy to visit them are only now reaping what they've sown for the past half century or more. it's easy to look at the bright eyed, social old lady and condemn her family for not visiting more than four times a year, but even while they were volunteering their time at the nursing home and running the ladies auxillary they may have been abusing those very children you're now condemning for not visiting. my mother-in-law was such a toxic individual that even before she went to the nursing home, her children only went through the motions of caring about her. and my mother, while everyone at the nursing home just loves her (or so they tell me) was using every spare moment during my last visit to remind me what an unworthy low life i am . . . . and yet i still spend $1000 to visit whenever i can and have the credit card debt to prove it.
you clearly don't understand that many of these elders are getting more care and caring from their descendents than they ever contributed to the care of those descendents.
it's easy to sit back and complain that the lovely little old lady in 32 never gets visits from her awful children when you have no knowledge of the 50 or 60 years when that "lovely lady" was constantly telling her awful children what total wastes of oxygen they were and how she didn't know why she bothered herself to allow her nasty, scum sucking children to visit her at all. or the 15 years or so she was beating her children silly every time she'd had one too many vodka cocktails before dinner and the 35 years after that when she refused to speak to her daughter because she married "that polack" or "that catholic" or "that foreigner." or the ten years that her son and his wife cared for her in their home while she verbally abused her daughter-in-law and beat on her grandchildren. it's easy to feel bad for that poor twinkly-eyed gentleman whose family never visits if you don't get that he was sexually abusing his daughters through their entire childhoods but they still tried to do right by him until they caught him raping his granddaughter. or that he left his wife when his children were babies and they hadn't seen nor heard from him since . . . until he was old and sick and needed their help.
m.k.a.u., I'm genuinely happy that your relationships have been sufficiently stable that your default position is to want to keep your family physically and emotionally close.
That's not the case for everyone. There are many reasons for this, some examples of which have been given throughout this thread. Some people don't have the capacity (psychologically, physically, emotionally, financially, logistically, occupationally) to care for family members; some people don't want to be cared for by kin; some haven't earned the right to anything from their children.
What I find... uncomfortable about your posts above and on the previous page is the idea that you have both a right to ask and an entitlement to judge. You don't.
I am not contradicting myself. Read carefully. I said I can respect that. But if put in that position, I would want to be able to be near by. Therefore, I would have to consider that if my parent were in such a condition that she is unable to orient herself to anything, then why not take the chance to bring her closer despite her wishes. I want to be able to be involved in her care, but to do that actively we would have to be close together. And why am I riddled with judgement just because I want to understand families' reasons? I respect their decisions to place family in the nursing home. That wasn't my question. My question was why don't they ever visit? If they are close by and are not estranged due to family conflicts what reasons are there? I'm not saying there isn't any reasons. I want to know the reasons so I can put them into perspective. I want to understand for mere curiosity. I can argue and give reasons for both sides because of the information brought up here. It's research, it's curiosity, it's trying to understand. I get furious when I see my residents alone on holidays. Of course we are there to betheir family, but I want to know why family can't be there. Or even send a card or some sort of contact. I am trying to understand others because for me, regardless of what a family member could have done to me, it wouldfeel coldhearted to just leave them there alone. If I couldn't face them, then I would send a letter or gift or whatever during holidays. Because I wouldn't want them to feel alone. But that is me. So me asking these questions helps me understand others views. It's not about judging it is understanding others. I am not debating to win. I probe with more questions to get explanations and comprehend them. So don't attack.
You don't always have the right to know. Sometimes the reasons are highly personal and excruciatingly painful, so much so that even with years of therapy these people can barely discuss it with family. What gives you the right to poke and prod into their private drama?
No matter what you would do with your family, it does not mean that these people are coming from the same place. Sometimes it isn't coldhearted, sometimes it is self preservation. Sometimes it is showing the pt more compassion than the pt ever showed their child.
I just have to say....to those of you who have shared some of the tragedies you have lived thru - I just wanna come thru my computer screen and hug you. I can not imagine surviving and eventually thriving after what has been done to some of you. Absolute unimaginable horrors.
2 points are just jumping out begging to be explored:
1. There seem to be a lot of people very upset about the fact that they feel "judged." And then they are very quick to offer an entire laundry list of reasons of why they had to do what they had to do. And then spend a paragraph blasting the "judger" for not having the insight, sensitivity or intelligence to understand where they are coming from. IS THIS NOT "JUDGING" THE VERY PERSON YOU ARE ANGRY AT FOR "JUDGING" YOU?
Having an opinion about something IS a judgment. We make millions of judgements every day. Is choosing 1 cereal over another in the morning making a judgment on all the other cereals that they are not as good? No- it was simply a culmination of what your needs/wants for that day are and making a choice.
I think a lot of people feel very defensive when someone states an opinion ie: "it is better for elders to be cared for in their home." That is that poster's opinion. They are not saying "you are a horrible waste of protoplasm for having your mother admitted to a nursing home." You obviously disagree, so shake your head and move on.
(I also wonder if guilt is part of what's driving these multi-paragraph responses- this drive to prove that mom/dad/whoever is better off in an assisted living or nursing home. And I think that's a whole other issue entirely.)
Point 2: The discontinuation of maintainence medications. I think this is a HUGE topic that deserves way more discussion than it's being given.
WHY ARE 93 year olds taking statins, 8 different daily vitamins/minerals, 4 different heart medications, getting monthly injections of vitamin b and Epo-gen, and an entire host of various other meds. ESPECIALLY if they are no longer able to feed, toilet, or dress themselves, cannot recognize family members and may or may not even be aware of their own name. HOW is this living with dignity? A nice, quick MI or CVA may be the best thing that could happen to them. And nobody wants to be the one to start discontinuing these, even when the pt is DNR, on comfort cares, etc.
I think that we are in desperate need of a wake up call to PLAN AHEAD. Get your loved ones talking about this, assign Health Care Agents and POAs. Make sure your spouse/kids know your wishes. And I think physicians need to start these conversations much earlier- perhaps along with that first rx for namenda or aricept.
This is coming from a long background in pharmacy, where elderly people would have to have their kids or Home Health aids come in and pick up hundreds of dollars of medications each month that probably provided hardly any real benefit and more likely were just delaying the inevitable. And now working Geropsych, where I see families torn apart over the decision to admit mom/dad to a memory care unit or nursing home, or whether to start/stop some therapy or another. Breaks my heart to see how difficult it is to have to make these decisions on behalf of another person.
I don't agree with euthanasia. But there is a HUGE difference between giving something to bring imminent death vs. discontinuing medications that are only staving off inevitability.
1. There seem to be a lot of people very upset about the fact that they feel "judged." And then they are very quick to offer an entire laundry list of reasons of why they had to do what they had to do. And then spend a paragraph blasting the "judger" for not having the insight, sensitivity or intelligence to understand where they are coming from. IS THIS NOT "JUDGING" THE VERY PERSON YOU ARE ANGRY AT FOR "JUDGING" YOU?
I agree that several members seem unhappy, angry or defensive about the judgemental statements of other members. I disagree that this is a hypocritical example of them being judgemental in turn, and suggest that it's a consequence of what could be perceived as an attack on a decision, series of decisions and/or situation that id both difficult and enormously emotionally loaded.
If I'd been in some of their positions, having to make medical and housing decisions on behalf of abusive, nelgectful, demented, sick or estranged relatives, on a background of years of problems, with no small amount of debate and internal conflict, and in the face of a societal expectation that I should give up my life, time and money to care for someone who didn't adequately care for me, it'd be an issue I'd have trouble being objective about.
If I then felt judged by people who had no concept of any of the details but who felt comfortable to render their opinion regardless, I might feel riled. I'd be more unhappy if the people making these pronouncements had not only no knowledge of my situation but in some cases no awareness of the lived experience of the care I'd already provided, or what's actually needed in these situations and were in some cases providing care to people whose families had possibly had similar experiences, likely making similarly uninformed judgements about them, I'd be angry.
this is a great thread; one of the best "argument" threads i've seen here in a while.
i feel like the real issue here (besides the harsh reality of what aging does to us) is the judging. it is human nature to judge; we all do it, whether we realize it or not. most common things we judge (or are judged for)
-what we wear/ how we look
-how we spend our money (oh, you can afford to go on vacation, but you're behind on bills?)
-decision to marry/not marry, have kids/number of kids we have (a total stranger in the hospital basically told me i was wrong for only having one child; i in contrast think anyone who has more than three are crazy... but would never tell that to anyone i know)
-decision to work outside the home (ft, pt, days/nights/weekends)
-decision to put children in daycare
-parenting (or inability to effectively parent)
things we (nurses) judge about:
-"frequent fliers" (often r/t noncompliance, although i don't feel we're really being judgmental here, it's obvious why they're back in)
-family members (i deal with a lot of peds; parenting issues, modeling appropriate behavior)
-drug seekers/dependency/addicts and perception of pain
-lifestyle choices (the 20 yr old single mom of three who whips out her wic/foodstamps card, but is sporting her ugg boots and gucci bag)
-(in peds) the parents who are not there at the bedside. god forbid they have a job, other kids, or maybe, just maybe they are in nursing school (we all know howinstructors have little sympathy for special circumstances ).
i worked in a peds ltf years back. some people may think "these places shouldn't even exist". imagine your child has a traumatic brain injury; he is one of four children, and you have an infant at home. the child is barely even wheelchair bound (because of his arched posture, and all of the relaxtion medications only get him into a semi-fowlers position). dependant on tube feeds. maybe you don't have room in your house for all the equipment for this child; his hospital bed does not fit into the room he has to share with his older sibling, who may be now scared to death of his little brother.
or maybe there are no other children in the house, and mom lives with grandma, aunt who is 15 years old and is a behavior problem, all in a one bedroom project, where the elevator is notoriously not working (and this child is way too heavy to be carried even one flight of stairs).
but i'm sure all of us here can honestly say to ourselves "i don't care what the circumstances are, i'll never put my kid away". are you willing to sacrifice your job, your marriage, the safety of your child, as well as any other children you may have just to save face in front of your family and friends, who would judge you for your decision?
i'm a former single parent (divorced, now re-married). i had a very unorhtodox visitation schedule for my child for a few years. people 'gently' judged me for it. now that it has changed, and i have my child full time, i hear the hindsight judgments. like the ones here who are being questioned (i won't use the word 'judged'), many people would say to me "why don't you just _____", or "just tell him _____" (referring to my ex). yeah, not that easy.
Having an opinion about something IS a judgment. We make millions of judgements every day. Is choosing 1 cereal over another in the morning making a judgment on all the other cereals that they are not as good? No- it was simply a culmination of what your needs/wants for that day are and making a choice.
If that were the case, 'judgement' and 'opinion' would be synonyms. They're not.
I think you may be confusing the concept of judgement in the context of having good judgement, weighing options and making assessments with the way it's been used in this thread.
Here's what I see as the difference between judging people and having an opinion: an opinion is a viewpoint, a judgment based upon observation in the context of our own experience and bias. We all have them, and we're entitled to them.
However, when we have an opinion with a "charge" to it, when our opinion is fueled with emotion—like anger and agitation—then the opinion is most likely a judgment. We're making someone wrong. We're being judgmental. (source; emphasis added)
I agree that your second point is interesting (opinion) - maybe you should start a thread on it; I think that it's distracting from the main point of this thread, though (judgement). Bringing it up here is a diversionary waste of time and makes me wonder what you're trying to achieve (judgementalism used for rhetorical effect).
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m.k.a.u.
15 Posts
Actually it's to understand thank you very much. And you should probably learn to communicate as this is an open forum and not a place to attack. But if I want to judge I can. If I want an explanation, I can ask for it. And again, you are assuming that I wi use the exanation to judge. I am not. I want to understand what is goingthrough people's minds during situations. I have an interest in psychology and so I am always wondering. Plus, asking questions and getting answers gives you a better perspective on things. Got it? Good!