Living Dying Caring: Life and Death in a Nursing Home

As Australia moves into the 21st century, new strategies are needed to provide services that keep pace with the rapidly rising ageing population. Not only will there be a larger number of Australians over age 65, this age group will constitute a greater proportion of the total population (from 10 per cent in the late 1990s to 11.7 per cent - 2.33 million people - by the year 2001). The number of people 80 years or older will double during the next two decades and many will require nursing home or domiciliary care.

Nursing homes provide supportive accommodation and nursing for people who need assistance to reach their own aspirations in their daily lives. Although only 4.4 per cent of all Australians reside in nursing homes, the deleterious effects on older people living in institutional settings has been well documented. Commonwealth governments have instigated a series of reforms over the past 20 years, all aiming to provide quality care and to promote resident rights. Early measures focused on demedicalising nursing homes and providing a more home-like environment. There is now much less emphasis placed on the treatment of physical problems and more attention is directed to providing holistic care and improving quality of life.

Caring, intelligent, sensitive and creative nursing is central to quality care in the nursing home setting; it embodies the values identified, assembled and preserved by countless numbers of nurses throughout the ages; and it has touched the lives of a large proportion of the world's population at some time or other. Nursing's very essence, though dependent upon a thorough understanding of the physical and social sciences, lies in the nurse's ability to reach out to another in a very human, practical way and to 'be there' as a caring other. It is this very essence that nurses, doctors, health service managers and planners, governments and the general population find so difficult to describe or define, and it is the most difficult to pass on to those who are learning to become nurses. Most significantly, all of us who are nurses have experienced difficulty in holding onto the essence of nursing in the hurly-burly, ever-changing reality of contemporary health care.

This book skilfully and elegantly exposes the essence or core of nursing that is so highly valued by society as a whole and by nursing home residents in particular. Beautifully written, the practical wisdom of the authors and their ability to articulate complex concepts shines throughout this important text. Living and dying in a nursing home can be a positive, affirming experience for older people and their relatives and friends and this book offers a solid foundation on which nurses and care workers can create possibilities to ensure that such an experience takes place. I congratulate the authors on this illuminating work and commend it to health policy makers, managers, nurses, medical practitioners, allied health workers and care workers in aged care.

As Australia moves into the 21st century, new strategies are needed to provide services that keep pace with the rapidly rising ageing population. Not only will there be a larger number of Australians over age 65, this age group will constitute a greater proportion of the total population (from 10 per cent in the late 1990s to 11.7 per cent - 2.33 million people - by the year 2001). The number of people 80 years or older will double during the next two decades and many will require nursing home or domiciliary care.

Nursing homes provide supportive accommodation and nursing for people who need assistance to reach their own aspirations in their daily lives. Although only 4.4 per cent of all Australians reside in nursing homes, the deleterious effects on older people living in institutional settings has been well documented. Commonwealth governments have instigated a series of reforms over the past 20 years, all aiming to provide quality care and to promote resident rights. Early measures focused on demedicalising nursing homes and providing a more home-like environment. There is now much less emphasis placed on the treatment of physical problems and more attention is directed to providing holistic care and improving quality of life.

Caring, intelligent, sensitive and creative nursing is central to quality care in the nursing home setting; it embodies the values identified, assembled and preserved by countless numbers of nurses throughout the ages; and it has touched the lives of a large proportion of the world's population at some time or other. Nursing's very essence, though dependent upon a thorough understanding of the physical and social sciences, lies in the nurse's ability to reach out to another in a very human, practical way and to 'be there' as a caring other. It is this very essence that nurses, doctors, health service managers and planners, governments and the general population find so difficult to describe or define, and it is the most difficult to pass on to those who are learning to become nurses. Most significantly, all of us who are nurses have experienced difficulty in holding onto the essence of nursing in the hurly-burly, ever-changing reality of contemporary health care.

This book skilfully and elegantly exposes the essence or core of nursing that is so highly valued by society as a whole and by nursing home residents in particular. Beautifully written, the practical wisdom of the authors and their ability to articulate complex concepts shines throughout this important text. Living and dying in a nursing home can be a positive, affirming experience for older people and their relatives and friends and this book offers a solid foundation on which nurses and care workers can create possibilities to ensure that such an experience takes place. I congratulate the authors on this illuminating work and commend it to health policy makers, managers, nurses, medical practitioners, allied health workers and care workers in aged care.