Making lives meaningful in old age

“The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul… Making lives meaningful in old age … requires more imagination and invention than making them merely safe does.”

Atul Gawande

Old lady

“In 1991, in the tiny town of New Berlin, in upstate New York, a young physician named Bill Thomas performed and experiment. He didn’t really know what he was doing. He was thirty-one years old, less than two years out of family medicine residency, and he had just taken a new job as medical director of Case Memorial Nursing Home, a facility with eighty severely disabled elderly residents. About half of them were physically disabled; four out of five had Alzheimer’s disease or other forms of cognitive disability….

The staff at Chase saw nothing especially problematic about the place, but Thomas with his newcomer’s eyes saw despair in every room. The nursing home depressed him. He wanted to fix it. At first, her tried to fix it the way that, as a doctor, he knew best…. He set about doing physical examinations of the residents and ordering scans and tests and changing heir medications. But, after several weeks of investigations and alterations, he’d accomplished little except driving the medical bills up and making the nursing staff crazy…. “I was confusing care with treatment,” he told me. He didn’t give up, though. He came to think the missing ingredient in this nursing home was life itself, and he decided to try an experiment to inject some…

They ordered the hundred parakeets for delivery all on the same day…. When the delivery truck arrived, the birdcages hadn’t. The driver therefore released them into the beauty salon on the ground floor, shut the door, and left. The cages arrived later that day, but in flat boxes, unassembled. It was “total pandemonium,” Thomas said. The memory of it still puts a grin on his face… He, his wife, Jude, the nursing director, Greising, and a handful of others spent hours assembling the cages, chasing the parakeets through a cloud of feathers around the salon and delivering birds to every resident’s room. The elders gathered outside the salon windows to watch. “They laughed their butts off,” Thomas said…. They were so patently incompetent that most everyone dropped their guard and simply pitched in – the residents included…

“People who we had believed weren’t able to speak started speaking,” Thomas said. “People who had been completely withdrawn started coming to the nurses’ station and saying, ”I’ll take the dog for a walk.” All the parakeets were adopted and named by the residents. The lights turned back on in people’s eyes. IN a book he wrote about the experience, Thomas quoted from journals that the staff kept, and they described how irreplaceable the animals had become in the daily lives of residents, even ones with advanced dementia:

Gus really enjoys his birds. He listens to their singing and asks if they can have some of his coffee.

The residents are really making my job easier; many of them give me a daily report on their birds (e.g., “sings all day,” “doesn’t eat,” “seems perkier”)…

The inhabitants of Chase Memorial Nursing Home now included one hundred parakeets, four dogs, two cats, plus a colony of rabbits and a flock of laying hens. There were also hundreds of indoor plants and a thriving vegetable and flower garden. The home had on-site childcare for the staff and a new after-school program.

Researchers studied the effects of this program over two years, comparing a variety of measures for Chase’s residents with those of residents at another nursing home nearby. Their study found that the number of prescriptions required per resident fell to half of that control nursing home. Psychotropic drugs for agitation, like Haldol, decreased in particular. The total drug costs fell to just 38 percent of the comparison facility. Deaths fell 15 percent….

The most important finding was that it is possible to provide them with reasons to live, period. Even residents with dementia so severe that they had lost the ability to grasp much of what was going on could experience a life with grater meaning and pleasure and satisfaction. It is much harder to measure how much more worth people find in being alive than how many fewer drugs they depend on or how much longer they can live. But could anything matter more?”

From ‘Being Mortal’ by Atul Gawande



37 thoughts on “Making lives meaningful in old age

  1. Jan Litterst says:

    Phenomenal for all generations to have witnessed wisdom aka “life” at work!

  2. Piano girl says:

    Thank you for reminding me of this wonderful book, “Being Mortal.” I need to re-read. 😊

  3. oldmainer says:

    I see this every week at the nursing home that I visit. I smile at everyone, never knowing if they are coherent or not. I often get a smile back, but the response is a lot greater if I have one of my dogs with me.

  4. spirited13 says:

    Absolutely brilliant….we need more of this….

  5. Absolutely magnificent. To see a change that profound. I hope it has spread to every caring institute around the world. Here in Australia I have heard of pet dogs etc being allowed inside aged care homes etc and the change that it makes. Not sure how common it is though.
    Beautiful post too, it is good to see some light in a part of life we will all probably be a part of. Thank you for sharing 😀

    • Otrazhenie says:

      When my grandma started getting very depressed and lonely, I took her to live with me and my kids, who were very little then. It was amazing to watch how little children brought life back to her 😊

      I was also very lucky to know one of my great-grand-parents. She lived with her daughter and grand-daughter (my grand-mother and aunty) and their family. I used to stay with them for summer holidays. One summer my great-grandma broke her leg and could not get off the bed for a long time. I was little then – 3 or 4 years old. I don’t remember much of that time myself, but adults later told me that I spent all those weeks next to her bed, chatting with her non-stop and ‘treating’ her with various flowers and leaves gathered from the garden. They told me that was the best ‘care’ for her, as I kept her well entertained. She also felt she was ‘contributing’ to her family by looking after me. After that my family thought I’ll go to study medicine, however the ‘workings’ of the body never appealed to me. I was more interested in the ‘workings’ of the soul so psychology quickly became my favourite subject at Uni. 🙂

      • Yes our older generation do tend to get isolated with this busy world and it is amazing to see them brighten up again with even a little stimulation from interactions that we ‘younger’ ones take for granted. And I think you were on your path already with your ‘helping’ out others. It is amazing those things that touch us as we grow and begin the changes towards what has meaning in our paths 😀

  6. Goff James says:

    Wonderful post with a truly significant message for anyone concerned with caring for the elderly. Thanks for sharing.

  7. Mel Gutiér says:

    You’ve no idea how much this resonated. I’m not meant to come back to blogging for another week but I checked my blog which led me here.

    Life… One big connection.

    Great post!

  8. oneta hayes says:

    So very cute. She is probably like me -unable to bend over to feed them herself. She must have fine tuning with her arms and hands to work this marionette. Thanks for visiting me today and leaving the like on my Hot Yahtzee post. 😀

  9. totally and absolutely right…

  10. paulfg says:

    “I was confusing care with treatment” – how profound.

    And something so often we ALL do to each other ALL day and every day – and ALL call it “normal”.

  11. […] title of the post … “Making lives meaningful in old age”, Otrazhenie … is too specific for […]

  12. thebusinessdude says:

    I have a blog post to create about it still, but Happiness is a Choice is an amazing book. Full of perspective and views on old age, or aging, and how we view it. How the elderly work through… process… it. I absolutely changed my view about life and aging from it. Not unique perspectives… But someone took the time to put it into a format. Paint the scene.

  13. I loved this post. It has made me reflect on the difference between treatment and care. It is so easy to succumb to a boxed in view of medical treatment when what people want and need is compassion and care (and feather or fur therapy!).

  14. Yes I love a hug therapy. Really enjoy your blog!

  15. Proof positive that even a birdbrain knows that man does not live by pharmaceuticals alone.

  16. msw blog says:

    Wonderful story. I will have to pick up a copy of this book. Thank you.

  17. […] via Making lives meaningful in old age — Otrazhenie […]

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