I wonder if anyone has any experience or ideas about this?

I have a friend who is in a nursing home now that I have been visiting lately. The one he is in is actually very good, but it´s so depressing. There are some people screaming, it smells bad, horrible in fact. It is like a snake pit opened and you see inside.

Last night a woman was screaming and screaming. It was difficult to visit with my friend, so I went to her door to see what was going on. It turns out her bed was broken and she was very uncomfortable, so I got the help to look after it.  Everytime I go there someone is screaming in some room or hall.

My friend is an artist who was very elegant when he was younger. He had fabulous parties that were attended by hundreds. Now he is in the nusing home,  alone most the time. He is lucky in as much as he has friends who do visit him, but many do not.

What can be done to make these places better, any ideas?

Yes, I know exactly.  My grandparents lived in one home for a few years in their last years.  The place stank of urine and there were patients with dementia.  It makes you want to cry, to see these people who really don´t know one day from the next. 

My mother-in-law was in one for a couple of weeks after she had been in hospital, while the house was being altered for her, after she had a stroke.  That one was better than the one my grandparents lived in but again there were patients with dementia; one old chap was talking about someone he was in the army with and kept thinking it was my husband.

But in the UK there is a difference between a nursing home and a residential home, which is where my grandparents and my mother-in-law were.

I don´t have any family/friends in nursing homes, but I had this idea to volunteer once, when I was in my early 20s to visit people in nursing homes - the church I used to go to had this group of volunteers and they would assign people for you to visit - usually those who didn´t have anybody else who would visit them. I did it for a few months and then I couldn´t do it anymore. It is, I agree, very depressing. That particular nursing home smelled of urine, even though it looked very clean, which I guess would be somewhat normal (?) if there are many people with incontinence problems. It was difficult to communicate with some of the people due to either their medical or mental condition. The worst to the surroundings are people with dementia - in my experience they are the ones that would be screaming uncontrollably - although from a patient´s perspective I would image worse off to be those who are oriented to their surroundings and situation. When I was working in a psychiatric hosp, I found patients with dementa to be most difficult to work with as well - both emotionally and due to the amount of care required. Sometimes one can observe a tendency for the staff to overmedicate those patients just to keep them quiet. I don´t know what can be done to improve the situation. I think a lot depends on the staff, if they are providing quality care, but also on families if they are visiting the patients and bringing up any problems to the staff´s attention. It is not uncommon for patients to develop bedsores where the quality of care is not there. I hate to say it, but I think a lot depends on the money as well - you´ll probably find better quality care in the more expensive nursing homes. You´ll probably find as well that patients have more activities and entertainment in those type of places as well. In any way, it is extremely depressing in my opinion, and my hat is off to those people who work in nursing homes.

My hat is off to them ONLY when they provide sensitive compassionate care. One should remember, it is a business. Many of these institutions get all of their patients retirement benefits. IOW...their social security payments go directly to the institution, not the patient.

Of course, money talks....but no matter how much money you have, it will never substitute for loveing care.  Many times retirees savings are used up on nursing care, or end of life care. I´ve seen that many times.

As to the demented patients....how many times is the dementia caused by the situation they are in?  Maybe they are screaming because there IS a problem. I saw that the other night when I went to the door of a woman who was screaming. I was ready to dismiss her as demented, but decided to check.

She was quite lucid. As it turned out her bed was broken and nobody was paying attention and most of all fixing her most uncomfortable position. Her bed was broken and it looked like a children´s palyground slide. It took real energy to get them to look into the problem and resolve it.

Many are afraid to complaign because they are afraid they will be kicked out. If a patient is too difficult, they are dismissed. Then where do they end up?.....most likely the street....

I have started doing some research on the matter and found some resources...and most importantly, just what are the laws. I have a friend who´s mother and father are in the Netherlands, (national, not immigrants) They are able to provide wonderful care to their elders.  My hat is certainly off to them for their care for their elder citizens. In the USA, it´s a national disgrace.

It will become a major issue as the Baby Boomer generation ages.

I found this organization in California that does good work related to this issue.  Here is the federal goverment page related to nursing homes.

All good points you´re bringing up. Just a couple comments to your post.

In my opinion it does take a special person to provide care to people in nursing home. I would think providing sensitive compassionate care day in and day out would be something extremely difficult given the nature of the profession. Compassion fatigue and caregiver burnout are very real, combine it with understaffed facilities and overload of work and you have a recipe for maybe less than perfect care. There´s no excuse for neglect of course and for doing a bad job, but give those people a break too, working in a facility like that is quite different than visting once a week.

Dementia I was referring to is an organic brain disease - or rather a symptom of an organic brain disease. Hardly caused by external circumstances in most cases.

There are good and bad places and the important point is to ensure visits are made and questions asked , before making a decision.  There is a brilliant nursing home/residential care home (it caters for both) near where I live and my grandmother was there 20 years ago.  It has a waiting list as it is so popular.  It is a run by a married couple, who are nurses and they brought their children up there too.  They treat the residents with great respect and ensure they live a full life.  The organise outings and they have craft sessions and charity events.  They try to keep the residents occupied and have lots of different therapists visiting.  It´s a great place.

I am also reminded of a solution one elderly couple had.  It was on the radio news earlier in the year and I can´t remember the details fully.  For a great many years an elderly couple have been ´living´ in a Travel Lodge Hotel (or similar).  They lived in the same one for many years then moved to another.  They paid the going rate and then paid for their meals.  It all worked out cheaper than living in a residential home!!!  They must have had an arrangement for their laundry.  They had no stairs to climb, TV in their room, ensuite shower room and drink making facilities.  They had plenty of people to talk to during the day too!!!  They owned their own home but didn´t live in it for much of the year as it was cheaper to stay in the motel.

I though that was quite a quirky story. 

I disagree with you here. Of course those who work in care facilities are underpaid, and the facilities are understaffed. That does result in burn out. However, this should not be a solely a moneymaking endeavour. For sone it is just a job. Why don´t we take another look and reevaluate how things are done? Maybe there is a better way. How is it that Holland is able to do such a good job, and we in the USA are not?

As to the dementia problem, of course I know it is an organic brain disease, but my question is/was, how many are dismissed as being demented? Diet, emotional state can impact on how the mind works as well. I think we are too quick to attribute odd/antisocial behaviour as dementia, when maybe it is not.

Hmmm interesting peacetrain....how is this dealt with in England? I´m curious how other countries deal with the care needs of the elderly/end of life citizens.

 I am quite saddened by the care recieved in nursing homes and residential home in the areas where I live and work..... generally known as "don´t care homes". They are seen solely as businesses and are there for profit only..... It is hard work caring for the elderly but I have witnessed many times that the management team has not seen fit to provide the appropriately skilled staff to ensure the safety of those in their care.

I know there are good homes out there but in my line of work we generally only see the bad ones....people being left on toilets and commodes for hours. Suffering from malnutrition as they haven´t been able to feed themselves and no one thought to help them..... we regularly report these homes but they are still there and still providing only the most basic of needs.

It just really really breaks my heart to think that you work hard all your life to provide for yourself and your family and to have a decent quality of life.... to end it all in a state of neglect and subjected to abuse is just criminal (and really depressing!)

Where do you live and work, lessluv? What type of work do you do? Actually it´s not only the elderly who are in these facilities, it´s anyone who iis too sick to care for themselves and doesn´t have anyone who can provide that care. With so many working away from home, those numbers are increasing.

I know a 23 year old woman who was in one.

 yes you are right that it is not just the elderly....anyone who has to depend on someone else for the provision of basic needs is vunerable and with the ever dispersing family support it is easy for those in need to fall victim to systems that continually fail them

I don´t think we disagree all that much here, it appears that you agree that there´s a problem that comes from staffing issues that I highlighted. Maybe I´m just a bit more tolerant of less than ideal care empathizing with the issues that the care workers face who work in such facilities. It probably stems from me never having a loved one in a facility and being faced with the challenges of being on the other side in my professional life. And I do agree that perhaps there´s a better way to do things - for me that better way would involve improving the working conditions of the staff as well - I don´t necessarily mean better wages - for example by lowering the patient-to-staff ratio, and by appreciating the work that they do - I find that people will go an extra mile for a simple "thank you".

You´re right on the second point too. I think we were talking about 2 different things - I meant the diagnosis of dementia in my post and I think you´re talking about people dismissing others because of the label that the patient carries, which may or may not be a result of the diagnosis. You make a good point there and I think our "disagreement" was merely due to semantics. I´ve seen it other way too - sometimes people would excuse certain behaviors because of the label - or they would think having a label gives them permission to be as socially inappropriate as they want to. Maybe not so much in the nursing homes, but definitely in the mental health field.

Of course a simple thank you would go a long way, but many of the patients in nursing homes are hardly in a condition to be concerned about being polite. Many are alone and feeling, or actually abandoned. When I go to visit, it´s heartbreaking to see so many people with that pitiful look in their faces. They build up walls around themselves to protect themselves. If they are lucky enough to have family and friends who do visit them and are also able to interact in a positive way with staff, that would be wonderful, but many of these people do not have that luxury.

Yes, I know it´s a job many could not take, but some take it only as a job. I know persons in certain fields, like Drs and nurses have to distance themselves, but still I´m asking a hypothetical question, isn´t there a better way?From what I´ve heard of some European methods, I´d like to read how they deal with this.

With more cuts to funding for social services, things will probably get worse. It seems as a society we let the most vulnerable, and the ones who can least affort it, get cut first. Like Schwarznegger´s proposed cuts to health and human services.

I recently spoke with someone who had a loved one in a nursing home who told me one of the nurses kept telling the person, who was in agonizing pain,  that until he accepted Jesus he could not die. He had requested a stop to the dialsys he was getting.

While it´s easier to work with a nice patient, that´s not whom I had primarily in mind when I said appreciating the work that the staff does. Anyway, I don´t mean to go back and forth with you on that one, maybe we really do disagree and let´s leave it at that

People like that nurse you mentioned infuriate me. There´s not many things I hate more than religious fanatics who push their beliefs and religious agendas on others. How dare they! Especially on patients! I find it to be not only very unprofessional and unethical, but also lacking in compassion and respect.

The point of my starting this thread was not to discuss the situation of workers in nursing homes and end of life facilities, but to discuss the plight of the patients and the larger societal role in it, and see if there are any ideas on how to improve it......for everyone.How is this dealt with in Europe, how is it dealt with in Turkey?

I think what that nurse did is actually illegal.  Hmmm...did you see this?

States cut Medicaid Coverage further

I wish we could take some of those multi million $ bonuses some in the failing/failed financial industry got and apply it to causes like these.