After having worked in personal care homes for over ten years, I have seen the range of attitudes from family members and staff towards the elderly. Some are incredibly loving, caring, and giving of themselves, while others are diligent and helpful. However, there are also the quiet resenters, the one's who've burned out emotionally, or learned to stop valuing the quality of life of elderly people.
It would be unfair to say that health care staff just fall into these categories innately. I believe that most health care workers start off either caring or actively helpful. Unfortunately, working in the field can be stressful, taxing, and thankless. In some facilities, the stress is compounded by management who like to weed out employees rather than support and encourage them.
A shift from caring to resentful can gradually occur over time, as can a shift from seeing value in the lives of seniors to ageism. A process of stereotyping and discriminating against the elderly solely on the basis of their age. It is being unable to fathom how an elderly person with a very different existence can value that existence.
Let's face it, young people have very different lives and participate in different activities than the elderly. In my experience, however, over 90% of the seniors in personal care homes, who were capable of communication, expressed gratitude at being alive. The other 10% I suspected suffered from depression.
It always came as a shock for me to hear a nurse or health care aid devalue the life of another person under their care. A good self-evaluation of one's work, in my opinion, would be to say, "I hope I'm lucky enough one day to get the same kind of care that I'm providing." How else could anyone feel satisfaction with their work if they don't ever want the very care they are delivering.
In my ten years in personal care homes, I heard staff make positive statements about the quality of life of their patients around five times.
What I heard countless times was a very negative self-evaluation of service and bleak perspective on the value of the lives of the elderly.
Ageism is a process of stereotyping and discriminating against the elderly solely on the basis of their age.
"In my experience over 90% of the seniors in personal care homes, who were capable of communication, expressed gratitude at being alive."
"When we stop valuing people's lives we make errors in representing their health needs. Those errors are often found to be abuse."
Here are some examples of what I frequently overheard:
1. "Why are we going to so much trouble to keep people alive in a state of hopeless suffering?"
2. "When I turn 80, just take me somewhere and shoot me."
3. "I couldn't endure having to wait two hours each time I needed to go to the washroom. I'd rather be dead.'
4. "Why can't we help these poor people get to Jesus, why prolong the inevitable?"
5. "We treat our pets with more dignity by euthanizing them."
6. What's the point of being alive when you have to live in a place like this?
7. "We could do more for some of these people and improve their health, but what's the point?"
Challenging these disturbing ageist and gerontophobic (elderly hating)views may be possible, but outside of a staff retraining approach unlikely to have lasting effect. Ageist views were the dominant culture in most of the nursing homes I worked in and there were no training seminars being offered, that I was aware of, to correct the problem
Once ageism sets in elder abuse is not far along. When we stop valuing people's lives, we make errors in representing their health needs. Those errors are often found to be abuse.
Making a person regularly wait for hours to go to the washroom or allowing pressure sores to form by not turning them is neglect. Failing to assist them with eating food or preventing them from having opportunities to exercise their bodies are also examples of abuse. If we want to stop abuse we need to challenge ageism.
Advocating with honesty and integrity...
David Chochinov, Occupational Therapist