Younger Seniors & Older Elderly: How Nursing Homes are Adjusting

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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.

Carol Bradley Bursack

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Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen, "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.

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6 Comments

All that I am reading in the comments is about our genes and how lucky you can be if you took good care of yourself. My situation is quite different. My brother at the age of 57 was involved in a bad motorcycle accident here in Florida which left him as an incomplete Quadriplegic. It is now 9 1/2 months since his accident. My youngest brother took care of him for 4 months. He no longer can take care of him, which left my brother back in the hospital since August of 2017. So out of nine months since his accident 5 months of that, he has been in the hospital. His last date of August, he has only received 4 weeks of rehab. He is still in the hospital, ready to be discharged, but there is no where to discharge him to, so he remains in the hospital. I have been trying to put him in a nursing home and the problem I am mostly having is his age. First it was his Medicaid insurance(Prestige)no one wants anything to do with Prestige in Florida. Now he is pending Medicaid. I have called Nursing home after nursing home and all I keep getting is rejected from one nursing home to another. I have even looked outside of my area. Trying to keep him close to home, so that he can have his family watch after him and visit is out of the question. I keep hearing from one nursing home to the other that he is too young and socially we don't have anything available to interest him, therefore he will become depressed. Well I cannot take care of my brother. Believe me if I could I would. He has incontinence and I would have to help lift him, shower him etc. That will not work between a brother and sister. The state just puts you on a waiting list. We cannot afford to hire anyone privately besides my house is not large enough for us and all the equipment he needs for his exercise. So as far as the nursing homes are concerned and the state, he is better off in a hospital with the sick and the elderly, with no social life at all. Just the sickly, the nurses and drs. Eating at your bedside, sleeping while the nurses are in and out of your room, taking care of the sick patient you are sharing a room with, after all hospitals are for the sick and you just can't get a good nights sleep. My brother is now 58 because his birthday passed in Sept. We spent Thanksgiving in the hospital with him. Cooked at home and brought it to the hospital. Christmas we will be doing the same thing. My brother does not get the rehab that he needs or was getting thru the out patient rehab for the 4 months when my younger brother was taking care of him. So my brother determined as he is does whatever excercises he is capable of doing while in bed. The nurses take him for a walk with his walker one or twice a day and nothing on the weekends. The nurses have to walk with him because he is not able to do this on his own. He has no real exercises to help him. This is just the short of it all, but is this how my brother should live because the nursing homes here will not take in my brother and give him the care he needs because of his age. So let him vegetate in the hospital from lack of care and excercise and he's lucky if he makes it to the age of 60. After hiring an attorney, he is now pending Medicaid. He is too young for Medicare. With injuries such as his he has to wait 2 years before he can have Medicare at an early age. We have one Brain and Spine Assisted living that will take him, but they have to jump thru hoops to get it approved and to go thru because they want a guarantee that Medicaid will pay for their services. Then there is still no guarantee that they will take him, but they are the only place that is trying. It would be the best thing that could happen for my brother and it's still close enough for family and friends to visit him. I don't know what else to do. I left my job because I knew my brother would need my help. I spend 5 to 8 hrs per day on the phone calling nursing homes, physically checking nursing homes out and visiting my brother when a can.
All I want is my brother to get better and have as much independence that is possible in his case and to not become a vegetable by the force of the state and federal govt. Carol Bradley Bursack, I hope that you can help my brother or give me the proper guidance.
Thank you,
To a large extent, what you become is a reflection of what you have been doing all through your previous years. A sensible diet, proper exercise, cultivation of good habits, and an abstention from foolish and dangerous habits can make a great difference in addition to "good genes".
kathy112451, does the Florida version of the Area Agency on Aging have a disabilities department? Ours in Connecticut does. It's not always useful (the actual person you might need to speak with might not be there) but it can be. And you don't have to be elderly for this help.