For the last five months I have been living in a nursing home, and because there is a Royal Commission inquiring into what happens in such dwellings I thought it might be useful to set out what it is like, at least in our place, whose name I shan’t mention, because this is not an advertorial.
My wife and I are here because we have the highest ACAT ratings, she because of dementia (I am her carer) and me because I have an incurable cancer that has robbed me of a lot of strength. I need looking after, too. And we are both looked after, very well. There is a lot of medical help. Our meals are provided, the rooms are cleaned every day, and our laundry is done for us. The whole place is quite new, well maintained, and cheerful. What’s not to like? We feel fortunate that we are here.
But it is a new life. A nursing home is a community, and new arrivals have to learn how the community works, and find their own place in it. That does not happen overnight. We have been in three different rooms, and our present residence is the final one. We sit in the same places at the same dining table, and over the weeks have begun to know and appreciate our table companions. A nursing home is a most democratic place: it doesn’t matter what you used to do or be in your past life. You are here because you need a lot of help.
Our place is privately owned, and well run. The senior management people are friendly and helpful. They are assisted by ‘carers’, mostly young women from Asian countries, quite a few from Nepal. They are well described as carers, since their attitude is caring, and their assistance to us all is uniformly positive. I have watched a video of rough behaviour by a male carer in another nursing home, and cannot imagine such behaviour here. About a third of the residents have dementia, about a third are mobility-impaired — there are wheely-walkers everywhere — and the remaining third have cancer or another life-threatening disease. And some of the residents are a problem, not knowing where they are, resisting having food or medicines, or wandering off before they have finished eating. The carers are kind and supportive, though occasionally there is an edge in their voices.
The residents are mostly in their eighties, and quite a few attend exercise classes, where they do what they can. The staff include several whose task it is to provide activities for the residents: Scrabble, walks (very short), concerts, bingo, celebrations of various kinds (Anzac Day provides an opportunity for a service). The pace is not lively. Since we do a lot of writing, reading and listening to music, we can look after ourselves easily enough. Nursing homes can be described as ‘God’s waiting room’, and there are a few who are waiting patiently for it all to end. On the whole, however, most residents take each day as it comes. Two of the residents in our wing have died since we arrived; one or two have moved out to be closer to family.
A common question from our visitors is ‘What’s the food like?’ There is no easy answer. Our place has a kitchen, and the food is served to four dining rooms, the high-care area first, and then us. Given the age and the experience of the residents, the prepared food tends to be somewhat bland, and it is the diner’s job to decide how much salt and pepper to add. The meals are well prepared, and true to the description on the menu. Since I have cooked for family and friends since 1959, entering a place where I have no role at all in the kitchen was quite unsettling, and still is. But I have made friends with the cooking staff, and my own wishes (for example, wet rather than dry dishes) are generally supported. I have learned to eat everything that is put in front of me, and I am slowly regaining weight.
We managed to acquire a sitting room adjacent to our bedroom, and that has greatly improved our quality of life, since we have space to hang some of our art, store a few CDs and DVDs, and most importantly, put the desk computer to work — there was no space for that in our bedroom. Yes, it cost, but that is what money is for at the end of your journey. None of our children is waiting for us to die, and all supported the decision to acquire the extra room. We too take each day as it comes. I imagine that all residents are alike in that we focus on our medical conditions: how are we today? Better or worse than yesterday? And so on. My wife and I have the same doctor, who attends the nursing home each week. He is sensible, caring and thoughtful, and we trust him.
My condition, though incurable, does allow for periods of remission while the drugs used to combat the cancer have their effect. Then the cancer will return, months later, and the cycle of chemotherapy resumes. I could go on like this for some years. I’ll be 82 in August, and my parents both reached 87. How long have I got? No one knows, and I’ve given up asking for that kind of prognosis. At the moment I seem to be improving, which makes me cheerful. My wife’s short-term memory-loss does not improve, and never will, but the decline is slow. So, to repeat, we take each day as it comes, with the great support we get here.
There are about a million Australians aged over 80 in our population of around 25 million. The post-80 years are those where medical support is most necessary. Over 170,000 of us live in some 2700 nursing homes. There is no doubt that they are expensive facilities; no doubt, either, that the carers are underpaid, and that staff generally would probably do better financially in other parts of the health system. Our governments would like more of us to stay at home and receive care there. We have tried that, but it didn’t work for us, and the nursing home is the best option. Perhaps I will get all my weight back (I have regained about a quarter of my original body weight), and could operate as the cook, shopper and so on once more. At the moment I rather doubt it.
For us, our nursing home ishome. We think those who run it do a great job. If you read of horrible things happening in nursing homes, and no doubt the Royal Commission will, it is useful to know that there are places, and ours is one of them, where what you would hope to be the case actually seems to be the case. Long may it continue to be so!