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Old 08-19-2011, 04:26 PM
 
Location: earth?
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I am wondering what the possible reasons are for people lingering in nursing homes. I have seen statistics that say that an average stay is around two-and-a-half years . . . I don't know if that is categorized by age upon entering or any details and I honestly don't know if that is even accurate.

But if you think about it, people entering nursing homes are typically old and sick. I am only speaking of the old people here, not young people who have had accidents, etc.

If you are old and sick and entering a nursing home, and it is a depressing place, and you have a roommate who bugs you and people are screaming and crying or whatever, and you can't get up to go to the bathroom and you don't like the food or the staff . . . WHY would you continue to live?

Do you believe that people CAN will themselves to die? Or are we doomed to live even when old and sick and we can't get up to go to the bathroom?

I personally cannot see any reason why a person would WANT to live in such circumstances (but I have been told that there may be spiritual reasons . . . things they need to experience or whatever).

A long time ago a doctor wrote a book called "How We (or You) Die" - something like that. I have not read it but I understood it described how various organs shut down - I don't know if it talked about circumstances or if it was just what happens to specific organs or systems . . .

I have always wondered about "the will to live," and if people can actually will themselves to die - if you can "let go" on your own - when people are dying, relatives will often advise them to "let go" and then they die - is that because they have permission? Could they have done it on their own?

I personally am against the warehousing of the elderly - I see it as "Big Business" - and I also think that people are too attached to living at any cost - through artificial means - whether it be drugs or machines. I like to think that the human body just wears out and then you go . . .that suffering does not have to go on for years and years . . .

Any thoughts on any of these issues?
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Old 08-19-2011, 04:49 PM
 
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I've been an RN for years and have worked w/ the elderly in nursing homes years back. People, as old and sick as possible, can live a loooong time. Even if they don't consciously want to. Who would want to live in some of the conditions? But, not all "nursing homes" are bad places--some are okay, even good. Depends on the home and who runs it, esp. director of nursing--and the staff, esp. the aides cuz they give most of the hands on care.
But, I've also seen women whose husbands have passed on, themselves pass away within a year, and not just a few. Something is happening there, maybe w/ the depression and its effects on the immune system.
But, I think quality of life is more important than years. Years are just numbers. If the quality isn't good, what's the point?
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Old 08-19-2011, 05:07 PM
 
Location: SE Florida
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The nursing home my grandmother was in was very good. She was not warehoused.

The only question I can answer is that I do believe people can often leave when then decide to. My grandmother was in a nursing home for a few months and died at the same hour we were all at the funeral of my brother. The night before my brother's funeral, I visited her in the evening. She had not been aware in a couple of days. I talked to her, as I always did, but mentioned nothing about my brother's passing. Before I left, I stroked her head as I said the night time prayer she said to us every time we would stay at her home. (Even when we came with our spouses as grown ups!) I told her we all loved her and that she could leave whenever was the right time for her.

I think it was too much of a coincidence that, in 86 years of life, she just happened to leave that same hour. I think she wanted to be there with us.

Last edited by Magnolia Bloom; 08-19-2011 at 05:42 PM..
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Old 08-19-2011, 05:12 PM
 
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I agree Phoenix Lady without the quality what's the point really.

I have had only 2 relatives in a Nursing home one died but she, I think, had a mini like stroke, I could see she was going to go soon. It's hard to explain but I just knew and warned my Mother before she saw her.

The other got better but not before getting worse! She ended up with terrible bed sores that got infected and had some kind of infection in her Colon. Geez that was horrible and it took months and months to finally go away. Anyway she ended up back in the Hospital and vowed never to go into a nursing home no matter how clean or nice the the people were.

I think some people cling because they don't want to leave loved one's so when a or that loved one does tell them let it go it's like saying it's ok I accept I cannot have you here anymore and we will all be ok. It's ok you will be safe when you let go.

Some cling because of medication that forces them to stay alive physically. I also think their organs and body parts slow down, stop functioning and get atrophy because they are bedridden not just from depression.

For some the point of living is they want to keep fight death right up the last second no matter what and yet some just don't. Some have a fear of where they think they might be going and that makes them fear it so much they fight to hold on out of that fear sort of like being strong willed to fight.
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Old 08-19-2011, 05:25 PM
 
Location: earth?
7,284 posts, read 12,926,647 times
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Quote:
Originally Posted by Phoenix lady View Post
I've been an RN for years and have worked w/ the elderly in nursing homes years back. People, as old and sick as possible, can live a loooong time. Even if they don't consciously want to. Who would want to live in some of the conditions? But, not all "nursing homes" are bad places--some are okay, even good. Depends on the home and who runs it, esp. director of nursing--and the staff, esp. the aides cuz they give most of the hands on care.
But, I've also seen women whose husbands have passed on, themselves pass away within a year, and not just a few. Something is happening there, maybe w/ the depression and its effects on the immune system.
But, I think quality of life is more important than years. Years are just numbers. If the quality isn't good, what's the point?
Thanks for your response. I think nurses are in a great position to comment on this subject because you have actually seen all of the variables, so you must draw conclusions . . . I still do not "understand" why super old/super sick people can live a looooooooooong time, as you said . . .Do you think it is because of their "will to live?" or something else?
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Old 08-19-2011, 06:10 PM
 
Location: Lexington, SC
4,280 posts, read 12,669,028 times
Reputation: 3750
Quote:
Originally Posted by imcurious View Post
I am wondering what the possible reasons are for people lingering in nursing homes. I have seen statistics that say that an average stay is around two-and-a-half years . . . I don't know if that is categorized by age upon entering or any details and I honestly don't know if that is even accurate.

But if you think about it, people entering nursing homes are typically old and sick. I am only speaking of the old people here, not young people who have had accidents, etc.

If you are old and sick and entering a nursing home, and it is a depressing place, and you have a roommate who bugs you and people are screaming and crying or whatever, and you can't get up to go to the bathroom and you don't like the food or the staff . . . WHY would you continue to live?

Do you believe that people CAN will themselves to die? Or are we doomed to live even when old and sick and we can't get up to go to the bathroom?

I personally cannot see any reason why a person would WANT to live in such circumstances (but I have been told that there may be spiritual reasons . . . things they need to experience or whatever).

A long time ago a doctor wrote a book called "How We (or You) Die" - something like that. I have not read it but I understood it described how various organs shut down - I don't know if it talked about circumstances or if it was just what happens to specific organs or systems . . .

I have always wondered about "the will to live," and if people can actually will themselves to die - if you can "let go" on your own - when people are dying, relatives will often advise them to "let go" and then they die - is that because they have permission? Could they have done it on their own?

I personally am against the warehousing of the elderly - I see it as "Big Business" - and I also think that people are too attached to living at any cost - through artificial means - whether it be drugs or machines. I like to think that the human body just wears out and then you go . . .that suffering does not have to go on for years and years . . .

Any thoughts on any of these issues?
I once saw Suzy Orman discussing Long Term Health Care Insurance and she said that the average stay in nursing home was about 3 months so it was not a wise purchase.

While I do not specifically know, I think your 30 months (2 1/2 years) is a number manipulated by sellers of Long Term Health Insurance.
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Old 08-19-2011, 07:21 PM
 
2,410 posts, read 5,821,055 times
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Quote:
Originally Posted by accufitgolf View Post
I once saw Suzy Orman discussing Long Term Health Care Insurance and she said that the average stay in nursing home was about 3 months so it was not a wise purchase.

While I do not specifically know, I think your 30 months (2 1/2 years) is a number manipulated by sellers of Long Term Health Insurance.
I agree. I think the insurance industry wants to fleece us with LTC ins. Personally, I wouldn't stay in a place longer than 3 months, if that. If I'm being kept alive by machines and have no quality of life, what's the point. That's a good reason to have a living will, so it you are incapacitated, you have written instructions not to go for heroics to keep you alive at the end, which is a waste of medical resources for a very short gain, not to mention going through extensive medical procedures at an advanced age. What's the point of spending hundreds of thousands of dollars for a couple more months of life at that point? This is part of why health care costs keep rising exponentially. People need to be realistic and not do "everything possible" to keep an elderly person alive at all costs.
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Old 08-19-2011, 07:30 PM
 
Location: earth?
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The average length of stay, per the Center for Disease Control is 835 days, so that equates to 2.2876712 years . . .i.e., more than two years . . .

http://www.cdc.gov/nchs/fastats/nursingh.htm

Last edited by imcurious; 08-19-2011 at 07:30 PM.. Reason: forgot something
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Old 08-19-2011, 08:02 PM
 
Location: Wisconsin
25,580 posts, read 56,482,264 times
Reputation: 23386
That 2.27 years is correct. I've read that 2 yr figure for decades, now. I don't think Suze is correct on the 3 months, at all.

My aunt went to a nursing home at age 88 because she couldn't be cared for at home anymore. While she was there her husband died. She remained alive another 2 3/4 years in the nursing home.

Nursing homes are anathema to every elder I've ever known. No one wants to go there. But age/infirmity forces it upon those who live past the time they are able to care for themselves if they can't afford live-in help or have no family able to care for them. I've seen enough of dependent elders to know I sure wouldn't want to wish that on my kids.

Once there, I don't think people cling to life all that desperately. Their own physical strength is pretty much the determinant of when they die. But, indeed, some are feistier than others and may internally rail against being helpless and their anger keeps them alive.

My aunt thought the nursing home was a living death. She said she had no real life anymore. Most of her friends were dead. Her husband was dead, her children too far away. But it took over three years for her to go. Because there was none of her real life there, she just withdrew, developed mild dementia, and faded away. No specific cause of death. My uncle had died almost 3 years earlier, but developed heart failure and was sick only a few months. At the end, the docs said all his organs had worn out. He died in a hospital. Both were 91 when they died.

Statistically, there is about a 25% chance of ending up in a nursing home. Obviously, the older you get, the higher the risk. So, paying for LTC insurance is a crapshoot. It isn't affordable for most people. In the end, after the assets gone, Medicaid picks up tab. That was the case with my aunt.

My stepmother died at 90. She was in assisted living until she developed pneumonia. Died in the hospital after about a week or so. So, she never was in a nursing home at all.
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Old 08-19-2011, 08:11 PM
 
Location: earth?
7,284 posts, read 12,926,647 times
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I just wish I understood more about old age and what is natural . . . what natural deaths are like - deaths where a person gets sick and there is no heroic anything and they just die . . .how common is that?

I know there are various causes of death:

- Cancer
- Heart Attack
- Accident
- Infection
- Organs wear out (not sure what the dynamic actually is or how it all works)
- Other
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