Eldercare will challenge baby boomer generation

Rita Watson | 12/12/2012, 8:33 a.m.

SAN DIEGO — Nursing homes are often associated with the last chapter in people’s lives. But at least these days, involved families will consider making changes when they identify deficiencies in a nursing home’s care, are dissatisfied with placements made during hasty hospital-discharge planning or see patient abuse.

Although change is difficult, given what we know about longevity today, caregivers can lobby for high-quality care and cognitive-enrichment programs or find a more suitable home.

At the Gerontological Society of America’s (GSA) 65th annual scientific meeting last month, presentations from experts on caregivers, longevity, long-term care and optimal aging were particularly poignant for baby boomers. As the next generation of nursing home or assisted-living residents, the boomers will demand change for the better.

Reducing the trauma of change

One concern about making a nursing home change is the perception of “transfer trauma.” Robert L. Kane, M.D., who chairs the Long-term Care and Aging Department of the University of Minnesota, said there has been a belief that nursing home transfers, such as to a hospital and back or from a home care situation, are beleaguered with setbacks.

“What we know about care in general is that change introduces an opportunity for bad things to happen,” he explained. “You counter this by preparation and engaging the resident in the decision as much as possible.”

Kane advised, “Caregivers should recognize the importance of arranging for the information transfer of medical history, medication and behavioral records. The caregiver is the only person who really knows what is going on, and the more you can compile, the better the chances for success at a new home.”

While family caregivers may fret with worry, Kane, author of The Good Caregiver (Penguin, 2011) added: “We do know that humans are incredibly adaptable. However, if a person is happy in a situation that is not good, how do you weigh the benefits against the disruption? And keep in mind that you as ‘the weigher’ are already biased.”

Fighting abuse, finding positive change

Meanwhile, at last month’s GSA conference, Iris C. Freeman, associate director of the Center for Elder Justice and Policy at William Mitchell College of Law, in Minnesota, noted real difficulties families may encounter in dealing with elder abuse. She pointed out the difficulties that state and county agencies have in making some abuse findings hold up against appeals.

“We have seen cases where adult protective services or the health department document emotional abuses by a caregiver, but the findings are reversed on appeal owing to the subjectivity of documenting harm. These cases are very disheartening,” she said.

But there is much positive news, even for people with dementia. The documentary “Alive Inside” shows social worker Dan Cohen bringing iPods to nursing homes. Those who did not usually speak sang. Those with walkers danced.

After a screening of the film at the GSA conference, Jan Maier, a research analyst in aging, disability and long-term care, said: “Although it’s limited, research seems to indicate that people with dementia may retain their ability to participate in the arts. In particular with music, it seems the ability to sing, play an instrument or listen to music is preserved, even for those in later stages of dementia.”