Once upon a time, most people who went into nursing homes were very old. Many were near death. The homes were set up for staff efficiency and the residents were pretty much considered generic "old people."
They were "treated" to the same kind of music, whether they loved it or loathed it. They had three hearty meals a day, with a heavy noon meal suited to a farmer still tilling the soil. The group exercise involved throwing a large ball around, which few could comprehend they were supposed to catch. The caregivers meant well (usually) and called them honey or dear. These old people stayed in the nursing home as they waited to die.
Times have changed. Or at least they are in the process of changing. Resident-centered care has gained a strong foothold in most good nursing homes.
Not only is it a good thing for the very old elderly who are still living in nursing homes. It's a good thing for the "young old," seniors who are more demanding. Yes, because of the leading edge of the baby boomers, and better health care for the very old – letting them live to be even older – many people in nursing homes are nearly a generation younger than the very old people (in their late eighties and nineties) with whom they share the home. And let me tell you, the music, the culture and the expectations of these younger elders are quite different than the older ones. Hence, a sort of culture clash.
The very old generation grew up during the Great Depression, some even before that time. Many were farmers or laborers with large families who were expected to contribute to the family well-being by working the fields or getting jobs in factories at a young age. The majority of this generation lived a fairly simple life. Silent movies became "talkies" and eventually television came around. The best way to spread information was through the neighbors or to make a call on the telephone – the party-line you shared with several other people. Private conversations were rarely private. It was a luxury to go to the drive-in for a meal out, perhaps once a month.
The young seniors who are now edging their way into the nursing homes are a generation who just missed being baby boomers (some are actually boomers, but may need nursing care at a younger age because of a stroke, MS or other ill health). This generation remembers sitting around a giant radio, often the centerpiece of the living room, listening to The Lone Ranger. Then later actually viewing the show in their homes on a huge television set with a small, round screen. They remember, as children, ducking under their desks during simulated air raids because of the cold war and threat of Communist attack.
They also got used to smaller families, a more stable financial situation and a comparatively sophisticated lifestyle. Many of these young elders are now doing yoga in classes and Pilates in gyms. They are volunteering in massive numbers, and running marathons. Those that are able to maintain their health live active lives within our global community. However, some who haven't been so fortunate with their health find themselves needing nursing care. They may acquiesce and move into nursing homes, but they have different expectations than the generation preceding them.
How Nursing Homes are Changing
These young seniors may want rock and roll for their afternoon music rather than the "kitchen band" from the neighboring town, or another go-round of Lawrence Welk on video. They want designer coffee, not that old, perked dishwater. Women wear jeans, not house dresses. They want computers, Wii and quality exercise equipment. Quite simply, this new generation of "younger" elderly residents want to continue living their lives with as little change as possible, not meekly follow the worn path into old age.
Generations, of course, overlap and I don't mean to stereotype them. But nursing homes are finding that they have to offer more variety to their residents. As modern medicine keeps Great-Great Uncle John alive into his 90s, Great Uncle John has a stroke, and moves into the same nursing home as his dad, though he is just 70. Shortly after, his wife Janet, a bit younger but struggling with rheumatoid arthritis, enters the same home. She is just 62. Such a wide range of ages in one nursing home? A stretch, yes, if you consider one family. But if you look at the age groups comprising the population of nursing homes, you'll see these numbers.
Are nursing homes up to this challenge? Can they deal with these multiple generations – especially with the more demanding "young elders?" They'd better be able to, because this situation is not going to change.
The good care homes and assisted living facilities are getting a handle on these changes. This leading edge of boomers, this "tsunami" of aging people that the news media beat to death, is a very real demographic. The good news is, these young elders are changing, and will continue to change, the way nursing homes operate. Their refusal to take aging lying down will force changes throughout the system, and all generations will benefit from this new flexibility.
So, will the really "hip" nursing homes have a Starbucks? It wouldn't surprise me if some do, though it may be set up in a room separate from the "country store" atmosphere preferred by the very old elders. No need for an uprising. It just takes a shift in attitude about aging, some planning and more resident-centered thinking. The young elders starting to enter care centers are the same people who challenged authority in the 60s and 70s. These seniors may have mellowed a bit and their bodies likely have lost some steam, but they are not that much changed. Their demands for more options will be good for all generations.