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Hi everyone,
I'm a university student who's trying to learn more about elder care for an essay. I'd really appreciate some first-hand wisdom from those caring for an elderly loved one currently.

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Isabella, thanks for being forthright about your purpose in asking questions. Some students don't state that, and I find it somewhat disingenuous to be less than frank about the intent for asking the questions.

As others have written, it's somewhat difficult to answer because of the range of elders in "nursing homes", their medical conditions, purpose for being there, and the family's attitude.

If you have time, you might want to be more specific, such as focusing as FF describes on perhaps short term rehab, assisted living (AL), independent living (IL) or Memory Care (MC). "Nursing home" has I think segued into a catch-all term for some kind of facility that offers room, board, care, various ranges of treatment and emotional or psychological support. And of course the reason for being in a "nursing home" varies; some people will eventually have no option because they can't be cared for at home, but others will recover and successfully return home.

The end results vary widely, and that should be considered in whether or not caregivers believe that loved ones have fared better or worse. Someone recovering from a fracture or replacement will do better than someone with advanced dementia (who won't recover at all). So, some parameters should be identified.

E.g., for short term rehab, questions could focus on these factors:

1. Was the rehab post surgery, and if so was the surgery planned (such as knee replacement) or accidental (fractured hip)? If the latter, were there any contributing factors, such as impaired vision or mobility?

2. Did the family feel the therapy was adequate to allow the patient a safe return home, and success in fully recovering, or did the family feel that the therapy wasn't sufficient to reach that stage?

3. Was food a factor? Food in some facilities and even hospitals sometimes is considered to be unappetizing. That could create a major impediment to healing if nutrition is lacking.

4. Did staffing ratio play a factor in recovery? I.e., if there weren't sufficient CNAs, the patient might not have gotten as much attention was needed, developed a negative attitude toward the facility, and just wanted to get out of there.

5. What was the role of family visits and participation? What about activities? (Isolation can be helpful or harmful).

There are a lot more factors could influence someone's stay, and the family's conclusion that it was successful or not.

I realize that this may be beyond the scope of your paper, but just suggest that maybe you might want to narrow down the general scope and focus on some aspect more specifically.
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What's the essay question, Isabelle?

I am referring you to what should be at the top of every student's every page of blank lined A4 paper - READ THE QUESTION.

"Fared better..." Better than what? You have to consider:

the needs and priorities of the older individual
the resources required to satisfy them
the availability of those resources in the various care settings

What further reading has been recommended to you?
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My mother was in AL for 11 months...she went down to the dining room for meals, but never got involved with activities..when AL sent mom over to Rehab part to work on getting stronger, my mom put up a fuss. PT and SW asked if she wanted to move back to her AL apartment she would have to become stronger. She had become a two person assist. My mom said maybe she was done with AL. She was then moved to SNF floor and she is thriving. She goes to activities, goes downstairs for church service, helps fold towels for the hair dresser, and has friends. The staff does not know that I worked as a CNA, but they do a wonderful job. As soon as meals are done and the dining room is emptied they start toileting the Residents and I can tell that the Residents are cared for.
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It all depends on the resident and the level of care they need, if needs can be met in a NH. I am 100% convinced my Moms physical needs are being met, way more than I could give her at home. And when I look around at the other residents I’m pretty confident that goes for them as well. I would give them B+. Emotional needs are a different story. Some residents are fine or beyond caring what activities are provided by the activities team or interaction with CNAs. Mom however was/is a pretty social person and now that she’s lost her vision cannot participate in most of the activities. She is the only blind resident so I have asked the activity people to try to be sensitive to that as much as possible in their choice of activities. So as far as emotional support, I go in daily to do things with her one on one. It’s sad for me to see other residents who crave more interaction, but not getting it. So I always call them by name, ask how they’re doing, maybe make them tea or coffee if permitted, or help with a little thing if asked like getting a sweater in the dining room, if permitted by the overworked/grateful staff. I would give them a D on that. I hope in the future more emphasis is placed on the emotional aspect and enough staff is maintained to help with that. The staff wants it too, they’re just spread too thin to provide it. I bring it up monthly like a broken record at our Family Council meetings.
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Generally people who live in a nursing home are very high needs and meeting those needs at home is more than family can cope with - in that way a facility is better because they have the staff and equipment available to meet those physical needs. Meeting emotional needs and providing mental stimulation is more of a challenge because, despite the best of intentions, a facility can not provide one on one attention or cater to the individual rather than the group - in my experience boredom and isolation are the norm, even among the residents with higher ability.
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IsabelleA,
I think that it is great that you are interested in learning more about elder care. One of problems with elder care is that there are so many variables that influence whether family members think that their loved one has fared better or worse (emotionally or physically) while in a nursing home. What works for one person, does not work for another person. Family dynamics are very important in determining the outcome also. If the family members are always fighting or are usually negative then they might be more likely to have negative experiences when their loved one goes into a nursing home. Also if family members can not agree on whether or not to place their loved one in a nursing home, they may have difficulty thinking that their loved one has fared better (emotionally or physically) while in a nursing home. Then there is the HUGE GUILT TRIP that parents place on their children: "Please promise me that you will never put me in a nursing home!" So the child(ren) move in with their parent(s) or have the parent(s) move in with them until the child(ren) can no longer physically or emotionally take care of their parents and have to place their loved one in a nursing home. There's the money aspect and who has POA of the loved one. I could go on and on and on and on...

There are several different topics in this forum and I think you might find some of them helpful. Don't just look at the questions listed under "Emotional Wellbeing". Look at questions that mention dementia, assisted living, nursing homes, SNF (skilled nursing facilities), rehab...

Good Luck with your essay on elder care.
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I think a lot of it depends on the family who placed their loved one in the facility. We read a lot of posts from children who have placed elderly parents and the kids were not ok with it. They were eaten up by guilt and sadness. These children have an extremely difficult time handling this life change. No one can care for their parents like they would or have in some cases. Then, if their parent goes through a natural decline after placement they see it as being caused by the placement itself and blame the facility no matter how wonderful the facility is. In my case, as soon as my mom crashed and I heard the word “Dementia”, I learned all I could about it. As she declined, I wasn’t prepared; we are never “prepared” to witness our parent babbling like a 2 year old, but I wasn’t blindsided either. What I’m long-windedly trying to say is that it’s a group effort between the facility staff and the family as to how their loved one fares in a facility.

On the other hand, I’m no Susie Sunshine and I do know there are some facilities where the residents are neglected. That certainly hastens their decline. Those poor innocents certainly don’t fare well at all.

Is it the actual placement itself that causes the emotional or physical decline? All I could say is, it depends...
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IsabelleA, there are various types of senior facilities besides a nursing home. There is Independent Living where a love one can move if they feel it is time to downsize into some place more manageable. There are emotions with this type of move.

Then there are Assisted Living facilities for those who need help during the day with life in general but not quite ready to go into a nursing home or long-term-care. There are emotions with this type of move, too.

There are also Assisted Living/Memory Care for those who need help during the day and they also have Alzheimer's/Dementia. Thus more Staff is needed for this wing of the building. Again, emotionally challenging.

Then comes the nursing homes and long-term-care. These facilities are geared for those who need a much higher skilled care as their conditions cannot be met in Assisted Living. Again, emotionally challenging.
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My Dad lived in Independent Living, had a nice apartment, and he really enjoyed being there. It was his decision to move out of his house because at 94 it was just too much responsibility. I noticed he really perked up after his move, but again I believe because it was HIS choice.

Later down the road my Dad needed to move into Assisted Living/Memory Care. He didn't mind moving into a studio apartment as long as he was surrounded by his books. His only concern with moving was if he was going to have the same chef make the meals... when I said yes, he was a happy camper.
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