Changing Aging: Respecting Elders and Asking Questions

"What we owe the old is reverence, but all they ask for is consideration, attention, not to be discarded and forgotten. What they deserve is preference, yet we do not even grant them equality. One father finds it possible to sustain a dozen children, yet a dozen children find it impossible to sustain a father."

                                                                        -Rabbi Abraham Heschel

                                                                        White House Conference on Aging, 1961

Lee Moriarty still carries the memory of her step-father’s days in a nursing home.

“He died without ever being able to go outside, which is something that was very important to him … That he died without ever being able to have ice cream because he was diabetic, that he was 97-years-old and they didn't want to give him ice cream,” Moriarty remembers, “He ate ice cream his whole life. He deserved to have ice cream.”

Moriarty is a veteran of the long-term care industry. Through her work with an organization called the Illinois Pioneer Coalition, she advocates for a movement called “culture change” that aims to give residents of nursing homes greater control over how they live.

“All our policies and procedures have to go out the window,” Moriarty explained after speaking to an industry group in Bloomington. “We have to go to the person and say to them ‘How do you want this done?’ and just do it that way."

That means allowing residents to wake, sleep, eat, bathe and do other tasks when and how they like, Moriarty explained. Culture change also means allowing residents to have a home-like environment, staff that is permanently assigned to a resident, the honoring of resident choices, increased community involvement and intergenerational programs, according to information provided by the Illinois Long Term Care Ombudsman Program, which advocates for those in long-term care facilities.

Some of those changes have been mandated by state law, according to State Long-Term Care Ombudsman Jamie Freschi.

Still, consumer advocates like Moriarty say families that are considering moving a loved one to a nursing home must ask serious questions about homes they consider, something she said some families are reluctant to do.

Last year, the Illinois Pioneer Coalition, a statewide coalition working to advance culture change, conducted a project called Your Way, to guide families and individuals in selecting nursing homes. The result is a questionnaire families can bring along during nursing home visits. Among the questions they recommend asking are:

  • Is the same Nursing Assistant consistently assigned to care for the Resident?
  • Can residents select between a bath and a shower?
  • Do residents look well cared for?
  • Can residents decorate their own rooms with bedding and pictures?
  • Is visiting time unrestricted?
  • Can families/visitors dine with the Resident if they choose? (At a cost or for free)
  • Does the food taste good?
  • Are there outings into the community?
  • Are you a Culture Change nursing home?

For a digital version of the questionnaire, click here.

Medicare also offers a searchable database of nursing homes with inspection information online here.

Along with helping educate families, advocates like Moriarty hope demanding consumers will make for better nursing homes.

“Those nursing homes that wanted to make change have made the change, and they’re doing it,” Moriarty said. “Then there’s that whole group that hasn’t been respectful of that need for change, and they’re doing things the same-old same old, and they won’t see a need for it because no one’s asking for it. So if we can create people asking for it, the change will happen.”