AJPH First Look, published online ahead of print May 30, 2006
July 2006, Vol 96, No. 7 | American Journal of Public Health 1163
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2006.090506
Contrary to Stereotypes, a Nursing Home Resident Radiates Dignity and Joy
Susan Ladwig,
Elizabeth Fee, PhD and
Theodore M. Brown, PhD
Susan Ladwig is with the Center for Palliative Care and Clinical Ethics, University of Rochester, Rochester, NY. Elizabeth Fee is with the History of Medicine Division, National Library of Medicine, National Institutes of Health, Bethesda, Md. Theodore M. Brown is with the Department of History and the Department of Community and Preventive Medicine, University of Rochester, Rochester, NY.
Correspondence: Requests for reprints should be sent to Susan Ladwig, Center for Palliative Care and Clinical Ethics, University of Rochester Medical Center, Box 601, 601 Elmwood Ave, Rochester, NY 14642 (email: susan_ladwig{at}urmc.rochester.edu).
IT CAN BE DIFFICULT TO FIND images of healthy aging. Throughout most of the 20th century, most images of elders have reflected and reinforced a stereotype of advanced age as a time of decline, dependency, and disengagement from life.1 These stereotypes are commonly reinforced by the medical model of care, which emphasizes the hazards, risks, and disabilities associated with aging. This medical model largely determines the organization of nursing homes and influences the health policies aimed at elders. Recently, however, recognition of the deficiencies of the medical model has led to the beginnings of a revolution in long-term care aimed at enhancing the quality of life. The goal of a new culture of healthy aging is to seek life-affirming surroundings to honor and respect elders and those working closely with them.2
Visual sociologist Cathy Stein Greenblat spent 6 weeks photographing elders at Silverado Senior Living, a residential care facility in Escondido, Calif, that specializes in dementia care and embraces the social model of long-term care. Greenblat explains that the special moment shown here was not at all unusual or infrequent at Silverado. Her moving book, Alive with Alzheimer’s, documents how music, dance, mental stimulation, and the supportive relationships among residents, staff, families, children, and pets allow residents to live with much more meaning and vibrancy than many people think is possible for those with dementia.3
The resident shown here, Hanna, was in hospice care at Silverado when this photo was taken, and she died 2 months later. Too ill to join a group session with Heather, the music therapist, she still liked to sing her favorite song, "Sidewalks of New York," and enjoyed an unscheduled individual session with the musical therapist in the hallway. The young girl who is holding hands and locking eyes with Hanna is the daughter of one of the paid caregivers at Silverado.
Not everyone can afford such excellent and supportive care. More than 7 out of 10 people with Alzheimer’s disease continue living at home, where family and friends provide most of the care.4 Sadly, low-income paid caregivers in nursing homes are usually unable to afford for their own families the kind of care they provide for the more privileged people they serve.
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Acknowledgments
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Cathy Stein Greenblat, Thomas R. Cole, and Anne D. Basting made helpful suggestions.
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References
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1. Cole TR. Introduction. In: Cole TR, Winkler MG, eds. The Oxford Book of Aging. New York, NY: Oxford University Press; 1994.2. Pioneer Network. Our vision. Available at: http://www.pioneernetwork.net/who-we-are. Accessed March 11, 2006.
3. Greenblat CS. Alive with Alzheimer’s. Chicago, Ill: University of Chicago Press; 2004.
4. Fox PJ, Kohatsu N, et. al. Estimating costs of caring for people with Alzheimer’s Disease in California: 2000–2040. J Public Health Policy. 2001;22:88–97.[CrossRef][Medline]
Copyright © 2006 by the American Public Health Association
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