Introduction
This paper highlights the experiences of elderly people living in nursing homes. The interviewees were a couple married for 56 years and living in a nursing home for the last five years. Mrs. Brown is a black woman married to a white man who has stood by her and defended her against mistreatment. The paper discusses the mission, vision, and services offered at Heritage Community health center, the chosen organization, and their areas of need. It also discusses the challenges the elderly in this organization face and how they are being handled, and what social justice means to them and their clients. The second section discusses the background of the interviewees, any major cultural events they have experienced, my reaction and new knowledge acquired, and the elements of gracism applied. Finally, there is a summary of all the information acquired during the interview and in the research.
Agency/Organization Interview
Heritage Community health center is a community-based organization based in Los Angeles. This organization is made up of two facilities servicing the population but with different needs. The first one is Heritage care center that offers both short-term and long-term rehabilitation for the elderly people recuperating from illness and/or injuries who require attention throughout. The second one is Heritage center of Assisted Living that helps people who need daily care but are not as dependent as those in the previous facility. Though offering different services, both share a common mission of providing high-quality, comprehensive, patient and family-centered service regardless of whether they can pay or not.
This organization provides numerous services centered around making the patient and their families comfortable. The aim is to make them feel at home but with constant help and administration of medication. At this home, they get 24 hours nursing supervision and have an on-site staff of registered nurses, licensed vocational nurses, licensed practical nurses, and nurse aides. They are also offered well-balanced meals matching their dietary requirements and nutritional needs. They evaluate each person individually for dietary needs because they all have different illnesses and conditions. Meals are given as often as required, but the usual routine is three meals a day and three snacks in between. When the need arises, they receive medical care; the staff is intentional about carrying out regular medical evaluations. Finally, there are rehabilitation services such as speech, physical and respiratory therapy and social services to keep them occupied and stimulate them both intellectually and emotionally. They are constantly under watch regardless of what service they are being offered.
Areas of Need
Like most publicly funded organizations, greatest area of need is underfunding. The two main sources of funding for Heritage Community health center are medicare and Medicaid. However, Medicaid has been seriously underfunded for a long time; with the emergence of COVID-19, the need has been magnified. This not only affects the management but the people inside as well. The management has been forced to adjust its already shoestring budgets and minimize its losses. This affects the quality of services these people receive; for example, the residents are currently complaining about the amount of food they receive nowadays. The residents also experience longer wait times to access healthcare than those with other types of medical insurance (Lee et al., 2018). This population cannot afford to experience such delays because of the urgency required to handle their conditions.
Challenges faced by the elderly living in the Heritage Community health center
While residents of this facility have been facing various challenges before, the COVID-19 escalated everything. The most common one that most complain about is disruptions in their sleep. Since care is given throughout the facilities, residents are often woken up for different reasons. For example, when a staff member comes in to deliver medication or take vital signs. Other times they are woken up by their loud neighbors or staff members having loud conversations during their sleeping hours. Management has banned loud noises when inside the building, especially around their sleep. Additionally, they lack social interaction and feel isolated from the world. There are currently limited visits to the residents for fear of acquiring the COVID-19 virus. They expect that staff members replace their family members, but with the current shortage of staff, they do not have the time to fit in the role. The management has set out to create a safe area where residents and families can sit and talk without getting any physical contact by separating the areas with glass or any other appropriate material.
Importance of social justice within Heritage Community health center and the elderly
Social justice is important for this nursing home as it eliminates the threat of health inequities that compromise the outcome of the patient. It ensures that this population receives the appropriate amount of resources and entitlements without discrimination by advocating for them. Staff should intervene on behalf of all the residents redressing inequalities based on age, gender, race, or religion. Staff can achieve this by raising the alarm about things they know are unlawful, such as wrong administration of medication, mistreating residents, inappropriate sexual advances, and rape. When patients are assured of social justice, their minds are rested, enabling a sound mental state. Social justice within this nursing home would translate to the delivery of high-quality care to the elderly population in this organization. It is a critical part of ensuring that people can maintain their highest level of health and wellness.
Individual or Couple Interview
Mr. Brown is an 83-year-old man married to Mrs. Olivia Brown, aged 82 years. The two have been married for 56 years, with five children and fourteen grandchildren. Two of their grandchildren recently gave birth, but they have not met them yet because of the COVID-19 restrictions. They have only seen three of their children since the year 2020 because the others could not travel. They hope the country opens up soon and medical professionals come up with a lasting solution to allow them to see their children once more. Mr. Brown suffers from dementia and sequels of stroke. He has had dementia for ten years now, but it is getting worse, and he was diagnosed with a stroke two years ago. On the other hand, Mrs. Brown suffers from Parkinson’s disease and diabetes. She has had diabetes for twenty years, but it the Parkinson’s disease that weighs her down; it was detected five years ago.
The couple decided to move to the nursing home five years ago after Mrs. Brown was diagnosed with Parkinson’s disease. This was the second home they moved into after they exited the first one. With this diagnosis, both of them needed constant help and attention. Their children could not be available for them throughout. Having nurses in their homes every time was both expensive and impossible. The nursing home would allow them to receive care twenty-four hours throughout the week. Before the pandemic, they always had a get-together with all their children every month since they came into this home.
Key Cultural Events
When they decided to check themselves into a nursing home, Mr. and Mrs. Brown chose a private home a few miles from their home. It was a referral from a friend, and they did not do much research on it. They lasted there for four months and could not take the discrimination that kept coming on Mrs. Brown’s way. She is a black American, and the staff there did not hide their unnecessary hate. The population of the residents and staff there was 95% white, the rest was shared among the rest of the minority ethnic groups. Often, Mr. Brown would ask for help from the staff who gladly help him out, but Mrs. Brown did they almost always had excuses to decline.
In one of the incidences, Mrs. Brown emotionally narrates how she was so sick she could not walk to the bathroom. She kept ringing the bell from her room, but nobody came, and she ended up soiling her clothes. When the nurse eventually came in, she was so upset and kept shouting at her and eventually left without helping her to the bathroom. Mr. Brown came into her room and found her in that state and could not take it anymore. He called his children to ask them to find alternative homes for them. He recalls how he had overheard the staff outside his room discuss with disgust what his “black” wife had done. Before this, their request to be allowed to stay in the same room as other couples did was declined, stating lack of extra rooms for couples.
My Emotional Reaction
I had a mixture of frustrations and terrified at the thought of having such people in society, working in such important professions as nursing. I could not help but cry as they narrated the ordeal. It is a sad situation, especially because this is an elderly woman in her late seventies and sick, it was the reason she was brought there in the first place. I have read and heard about incidences of discrimination based on one’s skin color in books, social media, and news platforms. But I had never come across someone that had had such a terrible experience firsthand. I believe this is the reason it was hard for me, and it still is. How does this happen in the 21st century despite the hundreds of civil and human rights movements across the world creating awareness against discrimination?
Added Knowledge and Gracism
From the interview with both the couple and staff, I have learned that dementia is not inevitable in old age. Even though the risks of suffering from dementia increase as people age, dementia is not a normal part of growing old. Many people live beyond their 80s without experiencing any significant declines in thinking or other characteristics associated with dementia. As people age, it is normal to have mild forgetfulness, such as not remembering where they kept the keys or forgetting an appointment. Mrs. Brown is 82 years old and has a fond memory of everything that happened more than thirty years ago. Unlike her husband, she remembers the day her firstborn son joined college and how excited they all were. She even remembers their first date and how it panned out. It is, however, important to talk to a doctor if one has any concerns about their thinking or memory.
The main element I see in this situation is protecting the most vulnerable in society against any form of harm and embarrassment. These two interviewees are quite old, and most of their body parts do not function as they used to. In this home, the staff takes care of them even when they are at their worst and cannot help themselves in the washrooms. The staff makes it easy for them to ask for help without feeling judged because they have intentionally created relationships with them. I will learn to honor and recognize the heroes among us like Mr. Brown is a hero who needs recognition (Anderson, 2010). He stood by his wife and condemned those who mistreated her, and looked for a place where they both would feel safe. He could have ignored everything that was happening because he was being treated well.
Conclusion
From both my research and the interview experience, it is clear that even though nursing homes are meant for both the old and the young, a big percentage is the elderly. Research shows that there is only 1% of people aged thirty years and under in nursing homes (Jin & Agrawal, 2017). In the Heritage Community Health Center, there are fewer than 10 residents aged 30 and below out of a population of 150. Young people associate nursing homes with isolation and lack of freedom, which explains the numbers. I found most of the research sources I came across advocated for nursing homes. However, being in the real situation has shown me that nursing homes can be harmful to people taken there, especially if it is poorly run. The extent of the consequences can only be felt by the people experiencing it or those who come across the victims at a personal level.
I was most surprised by the existence of facilities that still condone discrimination of whatever kind. It is even more surprising that such treatment would come from a private facility where one spends a lot of money to get the best quality of services. I have more respect, love, and understanding for older people now. I understand the challenges they go through, their love for family, and how they value memories. Starting today, I will spend as much time with both my parents and grandparents and create as many memories as I can. I have learned that when everything else is gone, only beautiful memories of the people we love most remain with us. I will strive to make more of those.
I have gained several insights about handling this population in general. Older adults require a little more patience and compassion. They are already struggling with poor health, and the last thing they want is people shouting or mistreating them because they could not meet their expectations. In addition, it is important to ask instead of assuming and offer choices whenever possible. They still have feelings and preferences they would appreciate if they were put into considerations whenever making decisions that involve them. I will use these insights during my interaction with my clients to make them feel appreciated and understood. My communication will be centered more around what they need rather than what I think they need unless it is the only option.
References
Anderson, D. (2010). Gracism. Ivp Books.
Jin, E., & Agrawal, R. (2017). State-by-State Variation in the Number of Children and Young Adults in Nursing Homes, 2005–2012. Maternal And Child Health Journal, 21(12), 2149-2152.
Lee, W., Chen, A., Kalil, R., Cohen, T., Berg, W., & Waltzer, W. et al. (2018). Medicaid Patients Experience Longer Wait Times at Academic Urology Clinics Compared to Patients with Medicare. Urology Practice, 5(5), 360-366.