What of the Elderly

When I was younger, I vowed to my parents that I would never put them in a nursing home — not even an expensive one with weekend excursions, not even one with a celebrity chef. Admittedly, I know little about geriatric care. I’ve read the medical writings of Atul Gawande and many other compassionate doctors. I’ve done CPR on frail, aging bodies in ambulances as an emergency medical technician and changed their socks in hospital rooms as a volunteer. But I’m not trained in the field, nor have I thought much about the difficult questions facing it. I’m young and live on a college campus, cocooned by people my age.

Then, in June, my grandfather was diagnosed with Parkinson’s, and his condition rapidly deteriorated over the course of the month. He went from being the family caretaker — sending us daily news clippings, caring for sick grandchildren, coaxing us each along our various paths — to needing home hospice care and having barely enough strength to speak. Although we always felt a step behind the disease and his latest infection, we were able to give my grandfather intimate care and limit his time in the hospital.

Not every family has the luxury of providing the care that they had planned for. Samantha Santoro, a charge nurse in the Center for Restorative Care at Yale New Haven Hospital, describes “caregiver burnout” as the most prevalent form of elder neglect they see.

“We’ll have families who drop off their family members because they can’t care for them any longer,” she said. According to Santoro, such cases are observed at least a couple of times a year in her department at St. Raphael’s Hospital, a branch of YNHH. Dementia, cognitive impairments and lack of mobility can push families to the breaking point and force generations to separate.

The Center for Restorative Care is one of many geriatric outpatient resources that Yale provides to help such families. Elderly patients with acute conditions such as pneumonia can be hospitalized there in a special department. The staff monitors risk factors like mobility and skin condition to prevent common dangers of hospitalization that disproportionately affect the elderly. Santoro says outpatient resources like these are most critical for relieving the burden on family members.

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