Nobody's Home

Candid Reflections of a Nursing Home Aide

Inbunden, Engelska, 2004

AvThomas Edward Gass

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"At present nursing homes are designed... like outmoded zoos. Residents are kept in small rooms, emotionally isolated. Occasionally they are visited by family members who reach through the bars and offer them treats. Aides keep their bodies clean and presentable.... America invests huge amounts of money to maintain the body while leaving the person to languish, cut off from all they love."—From Nobody's HomeAfter caring for his mother at the end of her life, Thomas Edward Gass felt drawn to serve the elderly. He took a job as a nursing home aide but was not prepared for the reality that he found at his new place of employment, a for-profit long-term-care facility. In a book that is by turns chilling and graphic, poignant and funny, Gass describes America's system of warehousing its oldest citizens.Gass brings the reader into the sterile home with its flat metal roof and concrete block walls. Like an industrial park complex, it is clean, efficient, and functional. He is blunt about the institution's goal: keep those faint hearts pumping and the life savings and Medicaid dollars rolling in. With 130 beds in the facility, the owner grosses about three million dollars annually. As a relatively well-paid aide, Gass made $6.90 an hour.Seventeen of the twenty-six residents on Gass's hall were incontinent, and much of his initiation to the work was learning to care for them in the most intimate ways. One of the many challenges was the limited time that he had available for each of his charges—17.3 minutes per day by his calculation. Even as he learned to ignore all but the most pressing demands of the residents, he discovered the remarkable lengths to which aides and their patients will go to relieve the constant ache of loneliness at the nursing home.With Americans living longer than ever before, elder care is among the fastest growing occupations. This book makes clear that there is a systemic conflict between profit and extent of care. Instead of controlling costs and maximizing profits, what if long-term care focused on our basic need to lead meaningful and connected lives until our deaths? What if staff members dropped the feigned hope of forestalling the inevitable and concentrated on making their charges comfortable and respected? These and other questions raised by this powerful book will cause Americans to rethink how nursing homes are run, staffed, and financed—as well as the circumstances under which we hope to meet our end.

Produktinformation

Utgivningsdatum2004-02-13
Mått152 x 229 x 22 mm
Vikt907 g
FormatInbunden
SpråkEngelska
SerieCulture and Politics of Health Care Work
Antal sidor224
FörlagCornell University Press
MedarbetareVladeck,BruceC.
ISBN9780801442438

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Thomas Edward Gass has divided his life between working in the trades and using his psychology degree in a variety of social work settings. At the age of thirteen he entered a Catholic seminary, which included a year of silence. In 1970 he learned meditation, which he still practices daily. He has lived and traveled through most of Asia enhancing his interest in eastern thought. He worked in a nursing home in the Midwest for three and a half years, first as a nursing aide and then as a director of social services. Bruce C. Vladeck is Professor of Health Policy and Geriatrics at Mount Sinai School of Medicine and the author of Unloving Care: The Nursing Home Tragedy. From 1993 through September 1997, he directed the Medicare and Medicaid programs as Administrator of the Health Care Financing Administration of the U.S. Department of Health and Human Services.

For those of us who care about direct-care workers and the conditions of their work in long-term care, Nobody's Home: Candid Reflections of a Nursing Home Aide is a thrilling read.... Quietly eloquent and unfailingly honest, Gass shares his experiences and the thoughts they spurred in him, capturing the complexity of life and frontline work in what sounds like a fairly typical nursing home.(Quality Jobs/Quality Care Newsletter) In an interview, Gass elaborates. 'It was just natural for me to come in close, because there is such loneliness.'... Nor did he fall for the idea that his charges were inert, their minds blank and their spirits benumbed. 'It may seem on the outside that they're not doing anything, or that nothing is happening,' said Gass, a social worker who rose to become director of social services at the Midwest nursing home where he worked. 'But people have had a whole lifetime to build up their character, and they don't lose that, necessarily. And so there just a whole lot of texture and depth in how they interact and how they interpret what's going on.'.(Older Americans Report 28:17) Nobody's Home is a humorously written, easy airplane read, more useful than other Chicken-Soup inspirational texts in that it reflects insights from an author who has directed social service programs, has a degree in psychology, and helped his mother through the process of dying.... This book is written for anyone who has a friend or relative in a nursing home or who will grow old and frail and require nursing home care. In sum, it is written for everyone, and from that perspective. The reader comes to understand and perhaps the fear the limitations and dependencies that sometimes accompany aging. The reader also comes to understand what it means to be a resident in a nursing home and, perhaps, to hope that all nursing home aides are as sensitive as Gass is to the fact that life is happening behind these walls.... The main issue, however is that the reader comes away wondering, as does the author, what elder care would look like if it were not about controlling costs but, rather, fulfilling basic needs to be meaningful and connected until the time of death.- Sheryl Zimmerman (Journal of the American Medical Association) Nobody's Home, a disarming memoir of meditations and straightforward observations by former nursing home aide Thomas Edward Gass, is a stark yet illustrative look into an industry based on money and death but oiled by compassion and sacrifice.... Gass dives in and brings to the surface immensely rich stories out of an environment full of pain and decrepitude, whether it is an intimate conversation or an accident in the bathroom. He describes his residents in an intuitive yet brutally honest manner so that the reader can truly witness the realities of aging.... By the end of the book, you feel compelled to meet the author or, at least, want the kind of person putting the Depends on your own aging parents to be as caring and perceptive as he.(The San Francisco Chronicle)