Nobody’s Home: Candid Reflections of a Nursing Home Aide
Nobody’s Home: Candid Reflections of a Nursing Home Aide Books
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“At bestow nursing homes are calculated . . . like outmoded zoos. Residents are kept in small rooms, emotionally isolated. Occasionally they are visited by family members who reach through the bars and offer them treats. Aides keep their bodies clean and presentable. . . . America invests huge amounts of money to maintain the body even as leaving the person to languish, cut off from all they like.”—From Nobody’s Home
After caring for his mother at the end of her life, Thomas Edward Gass felt drawn to serve the elderly. He took a job as a nursing home aide but was not prepared for the reality that he found at his new place of employment, a for-profit long-term-care facility. In a book that is by turns alarming and graphic, poignant and amusing, Gass describes America’s system of warehousing its oldest citizens.
Gass brings the reader into the sterile home with its flat metal roof and concrete block walls. Like an industrial park complex, it is clean, well-organized, and functional. He is blunt about the institution’s goal: keep those faint hearts pumping and the life savings and Medicaid dollars rolling in. With 130 beds in the facility, the owner grosses about three million dollars annually. As a relatively well-paid aide, Gass made $6.90 an hour.
Seventeen of the twenty-six residents on Gass’s hall were incontinent, and much of his initiation to the work was learning to care for them in the most intimate ways. One of the many challenges was the limited time that he had available for each of his charges—17.3 minutes per day by his calculation. Even as he learned to ignore all but the most pressing demands of the residents, he exposed the remarkable lengths to which aides and their patients will go to relieve the constant ache of being alone at the nursing home.
With Americans living longer than ever before, elder care is among the fastest growing occupations. This book makes clear that there is a systemic conflict between profit and extent of care. Instead of controlling expenditure and maximizing profits, what if long-term care focused on our basic need to lead meaningful and connected lives until our deaths? What if staff members dropped the feigned hope of forestalling the inevitable and concentrated on making their charges comfortable and respected? These and other questions raised by this powerful book will cause Americans to rethink how nursing homes are run, staffed, and financed—as well as the circumstances below which we hope to meet our end.
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3/17/05 Mr Gass’s book probably will be a fantastic boon to educational institutions as well as employment recruiters in raising the bar financially so that more men will want to go into the non-therapy,non-physican side of health care…His book emphasis the corporal challenges of the job, the “click(klatch)” environment that takes place more often than not when more than a link of women are “in community anywhere” (it starts very young),girls in clicks,boys on teams….);it raises questions about (?) diets (those who have freedoms to have their other snacks or in cases where previous mealtrays aren’t indifferent quick enough and those who forgot you can’t swollow chicken bones etc require instinctive rescue by the health care providers;(?)acceptance of the eccentric,aggressive,annoying etc that only lunancy,dementia and Alzhemiers as illnesses are also the only calming balm for those who are there because before being admitted they were the only eccentric in their environment and “Voila”, they’re seeing “much “Madder”. His Pg 173 emphasis the need of ministers to sermonize(which happened in the case of him sermonized to the resident Walter in Rm 301 who was dead, but whose eye lids were not closed and the oxygen line was still tucked below his nose causing a mechanical rattle).Gass showed in that chaper (“Back On Days”) as well that you can have 6 persons scheduled to work and 5 call in sick which means you then have to proceed to implore those who are already doing more than “maximum” overtime to burn themselves out a small more by appearance in on a day off..Gass does not mention that he, himself ever took the luxury of taking a “sick day” to handle his own overwhelmed corporal,mental & emotional system.
Rating: 3 / 5
The thought of this book is a excellent one–but it lost momentum toward the middle of the book. I have worked in long-term care in the past and more recently in a rest home facility..I knew in my mind what the author was saying was right–but it didn’t exchange any of the feelings I carry in my heart. I was disappointed in this book. A rating of 2 seemed to harsh and a rating of a 2 1/2 seems about aptly–but you can’t rate a 1/2 star so I will give this book a 3.
Rating: 3 / 5
A dark, fatalistic author who after to failing to find enlightenment in such places as seminaries, an ‘itinerant’ decade in Asia and seven years in a meditation community decides to find it working as an aid in a nursing home after the death of his mother. There is small to be gained by reading this. After trudging through the more prejudiced, jaded part of the book I skipped forward to the epilogue, to find what he really concluded from his experiences. There, I found small more than what can be found in other less cynical, more professional books.
I find the editorial review by Publisher’s Weekly listed on this Amazon page to be shallow and uninformed. They state above, “In the epilogue, Gass offers specific suggestions to reform nursing homes. He proposes having pets for the patients and letting children interact with older people more regularly…the book should be required reading for health care professionals and others in the medical field” As if these thoughts not only were originated by the author, but validate him as someone who should be listened to. Those in the industry know that these are not his thoughts. The author himself even attributed part of them (even though all of them should have been attributed) to the ‘Eden Alternative’ concept in nursing home care. Do your homework, Publisher’s Weekly.
Perhaps if anything, this might be of some help to families with a member in or entering a nursing home. But again, there are better, more productive books on the market.
After reading this, my greatest dread would be that I would make the mistake of hiring an aid like the author.
Tom Nieder
Licensed Nursing Home Administrator
Rating: 1 / 5
I’ve been a LVN for fifty years but I’ve worked aptly by the side of with the aids. Gass’s tale tells it like it is. I too wrote a book “Through the Eyes of a Nurse” and his tale reflected so much of what I wrote. Sure the ones who run and own the care homes won’t agree with what he says. They and the broadcast don’t want to see what’s it like because their day maybe appearance sooner then they would like it to. Jane Schuman Lester
Rating: 5 / 5
I am a male college graduate who has been working as an aide in a nursing home for two years (history major – go figure). In this sense, I am similar to the author because I am more educated than the typical nursing aide.
This book is an exceptionally insightful observation on the conditions of nursing homes. I found his descriptions so right and right to my own experiences I felt like he was stealing the words from my mouth. There are some very eloquent and tender passages in this memior, which makes this a real page turner. His philisophical musings on aging and life in general are compassionate and sensible. Warning to the weak of stomach: the author’s descriptions are candid, and sometimes have a bit of dark humor that will be familiar to anyone who works in nursing.
Rating: 5 / 5