The character Dorothy said in The Wonderful Wizard of Oz, “there is no place like home” (Baum, 1960, p. 45). Sadly, many of our elderly live in Long Term Care Facilities (LTCF). The transition from living in their own homes, to living in a LTCF, can be a traumatic experience. Poor adaptation to a LTCF may cause depression, malnutrition and significantly reduce the lifespan of the elder. Thus, it is imperative, that nurse’s recognize this promptly.
According to Agnes and Guralnik (2008) adaptation is “a gradual change in behavior to conform to the prevailing cultural pattern (p. 15).” When elders are placed in a LTCF, whether it be voluntarily or involuntarily, they must give up certain liberties that are taken for granted. This includes independently bathing, cooking their meals, and having the freedom to come and go. In most LTCF’s there are scheduled routines of activities, to include meals, bathing, a few physical activities and a lot of down time. The down time can be especially hard for the elders. It is in this period of time, when they may think about family, friends, and other activities they have had to give up.
Parker (2013) mentioned to me in an interview, she is very fortunate to have family members that still care for her since moving into the nursing home. Her daughters and sons come multiple times throughout the day and evening checking on her. She goes on to say that, many of the other residents do not have family or friends. They just sit in their chairs, and stare off into space, wasting away. Nursing homes have been looked at as institutions, rather than homes for the elderly. This leads to more negative thoughts about LTCF’s and the care provided there.
As Whitaker (2009) mentions, LTCF’s encompass suffering, loss, isolation, loneliness, stigmatization and alienation, but it is also a place of comfort, relief, a community of caring, safety, closeness and inclusion (p. 160). She goes on to say that adaptation to a LTCF is the process by which someone copes with the transition into the life of being a LTCF client (p.159). How the elders view their situation also plays a major role on their adaptation to the LTCF. When someone views the environment in an absolute negative way, they are going to struggle to become adapted. On the other hand, if they look at the positives of the environment they may adapt more appropriately.
According to Sister Callista Roy’s theory, adaptation is the process and outcome of individuals and groups, who use conscious awareness, self-reflection and choice to create human and environmental integration (Bergland and Kirkevold, 2006, p.686). This theory lends to adaptation of living in a LTCF by examining a key issue, the elders choice. With personal experience in this matter, it seems as if elders who make the decision of moving into a LTCF better adapt to the environment.
In my opinion, a lot of how elders adapt to living in a LTCF depends on the choices they make. If they...