Changes are Afoot!

© Imelda Maurer, cdp  July 28, 2015
ilmcdp@yahoo.com

Years ago in undergraduate philosophy courses, at least as I remember, we studied how classical thinkers envisioned change.  Heraclitus taught that things are constantly changing. “All matter is in flux.”  This ongoing change takes place while the underlying essence is maintained. Heraclitus taught, in fact, that change was necessary for an object in order for that object to maintain its essence.  An example:  I am the same person – in essence – throughout life.  But where is my five-year-old body?

We expect change.  As knowledge, awarenesses and technology expand, related, logical changes show themselves outwardly.  Let’s look at the hotel/motel industry for example. Basically the mission of this industry has always been to provide respite and comfort for the traveler, the person away from home.  Let’s quickly surf the changes over the past 60 years.  For those of you who can remember back that far, do you remember signs outside public buildings, motels included, that exclaimed “Air Conditioning!”  Later motel marquees began to note “HBO” followed by other up and coming amenities:  free Wi-Fi, a smoke-free environment, free breakfast. Can you imagine anyone even entertaining the thought of a night in a hotel or motel without most of these amenities being taken for granted? This hospitality industry has changed greatly, and yet has remained the same because its mission is basically the same:  respite and comfort for the person who is away from home.

What about institutions that serve our elders today?  Yes, that dreaded term, nursing homes.  Is the nursing home you visit, that you have a friend or relative in, the nursing home that perhaps you know you will one day be living in --  has that nursing home pretty much remained essentially the same over the past 50 – 60 years as evidenced by scheduled meal time, enforced rising and retiring times,  baths/showers scheduled by the sole decision of the staff,  an exponential diminishment in the ability to make choices about daily life, the ever-present groups of elders sitting purposelessly and  with a aura of isolation waiting for the next meal, the next whatever.

“They get really good care there” doesn’t cut it as the final standard of validation for any elder’s life if each day is lived within the above environment. Life is more than care!  While the mission of nursing homes has not changed, our deeper and broader knowledge of aging, of geriatric medicine and of psychology call for immediate, humane changes to the present institutionalized life too many elders live in nursing homes.

The Center for Medicare and Medicaid Services (CMS) has proposed some revisions and additions to its regulatory standards for nursing homes, introduced because of these very factors.  In the introduction to the suggested changes, open for comment until September 14^th, CMS states why these changes are being suggested.  They include significant innovations in resident care, the presence of quality assessment practices that have emerged and the growing knowledge base of evidence-based clinical services.

More on some of these suggested changes will follow on this blog.  If you or those you love are living in a retirement center that is not licensed, the information is still quite applicable for two reasons.  1) These regulations are referred to as minimum standards of care.  We all certainly want to provide more than the minimum  2) A close examination of Religious Congregations’ principal documents reveal an amazing basis for implementing all of the CMS regulations in the very spirit in which they were written – to enhance the quality of life and the quality of services provided for our elders.