Cover image for Nobody's home : candid reflections of a nursing home aide
Nobody's home : candid reflections of a nursing home aide
Gass, T. (Thomas)
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Publication Information:
Ithaca : ILR Press, [2004]

Physical Description:
xxii, 189 pages ; 23 cm.
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RA997 .G376 2004 Adult Non-Fiction Central Closed Stacks

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"At present nursing homes are designed . . . like outmoded zoos. Residents are kept in small rooms, emotionally isolated. Occasionally they are visited by family members who reach through the bars and offer them treats. Aides keep their bodies clean and presentable. . . . America invests huge amounts of money to maintain the body while leaving the person to languish, cut off from all they love." From Nobody's Home

After caring for his mother at the end of her life, Thomas Edward Gass felt drawn to serve the elderly. He took a job as a nursing home aide but was not prepared for the reality that he found at his new place of employment, a for-profit long-term-care facility. In a book that is by turns chilling and graphic, poignant and funny, Gass describes America s system of warehousing its oldest citizens.

Gass brings the reader into the sterile home with its flat metal roof and concrete block walls. Like an industrial park complex, it is clean, efficient, and functional. He is blunt about the institution s goal: keep those faint hearts pumping and the life savings and Medicaid dollars rolling in. With 130 beds in the facility, the owner grosses about three million dollars annually. As a relatively well-paid aide, Gass made $6.90 an hour.

Seventeen of the twenty-six residents on Gass s hall were incontinent, and much of his initiation to the work was learning to care for them in the most intimate ways. One of the many challenges was the limited time that he had available for each of his charges 17.3 minutes per day by his calculation. Even as he learned to ignore all but the most pressing demands of the residents, he discovered the remarkable lengths to which aides and their patients will go to relieve the constant ache of loneliness at the nursing home.

With Americans living longer than ever before, elder care is among the fastest growing occupations. This book makes clear that there is a systemic conflict between profit and extent of care. Instead of controlling costs and maximizing profits, what if long-term care focused on our basic need to lead meaningful and connected lives until our deaths? What if staff members dropped the feigned hope of forestalling the inevitable and concentrated on making their charges comfortable and respected? These and other questions raised by this powerful book will cause Americans to rethink how nursing homes are run, staffed, and financed as well as the circumstances under which we hope to meet our end."

Reviews 2

Publisher's Weekly Review

This honest and heartfelt book is a firsthand account of the reality of life in a nursing home. Gass, who spent five years in a Catholic seminary, ran a halfway house and was a teacher, returned to the U.S. after many years in Asia to care for his dying mother. That experience led him to work as a poorly paid aide in a long-term care facility in the Midwest. In a calm, intelligent and matter-of-fact style, Gass describes his often unpleasant daily routines. He cleans, feeds and dresses the patients; tries to converse with them, although they are often senile; and mostly, attempts to preserve their dignity. Perhaps Gass's most important observation is how uncomfortable everyone is around the home's residents-the staff, the relatives and the visitors. To combat that, he tries to do something to engage them: "Face to face, up close and personal, I learn to focus my full attention in flashes. One moment at a time, out comes my inner child. When I happen to touch residents softly or treat them affectionately, something may melt within and they become temporarily free of these depressing walls...." In the epilogue, Gass offers specific suggestions to reform nursing homes. He proposes having pets for the patients and letting children interact with older people more regularly. While this volume's depressing subject may be off-putting to some people, the book should be required reading for health care professionals and others in the medical field. (Apr.) (c) Copyright PWxyz, LLC. All rights reserved

Choice Review

Those planning careers in nursing and allied health will find Gass's book a must-read. Readers will learn many lessons from the perspective of one of the most important caregivers in American nursing homes--the nursing home aide. Gass, a teacher who worked as a nursing home aide himself, offers vivid descriptions of nursing home residents, their daily routines, and their previous lives. Though readers will sometimes want the stories to move faster, the book's pace could actually be a well-orchestrated effort to make the reading audience realize to what extent control is lost in this often-lonely environment. Gass's stories are often poignant revelations. Blunt and overly descriptive of the body's primary functions at times, he is also extremely reflective and sensitive. Gass gives the reader an honest picture of himself and what he gains from his experiences. Many important analogies and conclusions about health care and the quality of life may be drawn from this book. Anyone interested in a depiction of the universality of aging won't be disappointed. ^BSumming Up: Recommended. General readers, undergraduates, faculty/researchers, and professionals/practitioners. J. Clawson Central Missouri State University