by Hannah Russell

Created on: July 21, 2010   Last Updated: July 23, 2010

A common flaw in people’s understanding of health care is that it has one purpose—to make people live longer.  Some day, everyone is going to have to face the fact that everybody dies.  Health care is just making life as long, as prosperous and as comfortable as possible.  At some point, health care professionals realize that this particular person’s “long” is not very long.  So, attention is turned to making it prosperous and comfortable. At the next point, prosperous is becoming less and less, and then all attention is turned to comfort.  Nursing homes are facilities focused at some prosperity and a lot of comfort.

This is not to say that a nursing home will never do something to extend life.  If there is a procedure or medication available to extend the life of a resident, the only proper response is to pursue that.  However, nursing homes are not built with the assumption that people who come in, are ever really going out. That’s what a hospital is for.  Hospitals are where people are taken to cure them and then release them.

The staff at nursing homes are told four missions.  The first mission is to keep all residents safe at all times.  The second mission is to respect the privacy and autonomy that residents still have.  The third mission is to keep residents as comfortable as possible.  The fourth is to help residents to regain health.  Regaining health is second to everything else that staff are meant to help with.

Of course, with this view, most people go into a nursing home and stay there until they die.  However, the wording of this argument implies that this is a bad thing.  The implication is that it is wrong to make a place where people can die with dignity and comfort. There is no way that we can stay alive forever.  Even if someone were kept on a respirator and a bypass machine for 50 years, they are still not alive.  They are not alive in the common sense of the word because they cannot acknowledge loved ones and enjoy the things around them.  They are not alive, because they cannot live.  In the medical sense of the word, they are not alive because they often do not have brain activity. Perhaps, the question is not do nursing homes get people well or prepare them to die, but do nursing homes do their purpose effectively.  Their purpose is to keep comfort and dignity while people approach the ends of their lives. And they serve their purpose very well.

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