Nurse Residency Quotes

Obtaining a certificate in nursing assistant trains students to provide quality care to residents in nursing homes.

Not all residents could stand the pressure. One was simply unable to accept blame or responsibility. He was a talented surgeon, but he could not admit when he'd made a mistake. I sat with him one day in the lounge as he begged me to help him save his career. "All you have to do," I said, "is look me in the eye and say "I'm sorry. What happened is my fault, and I won't let it happen again. " "But it was the nurse who---" "No. You have to be able to say it and mean it. Try again." "But---." "No. Say it." This went on for an hour before I knew he was doomed.

I was surrounded by the surgeons and residents and nurses who helped me stay alive when I was born blue and if it weren’t for them I would be dead now. All those people I didn’t even know, I couldn’t pick them out of a lineup if I had to, but they had worked their whole lives to get the knowledge that ended up saving my life. It was because of them that I was in this magnificent wave of people and music.

If listening was truly a lifesaving measure, then night shift was a prime time for saving lives. The cover of darkness provided safe cover for the truth to emerge. Confessions, words that people didn't even know resided in them, flew like startled bats into the night. People confessed to stealing things, to hurting people, to loving some and hating others.

Although Garfield was dangerously ill, the idea of taking him to a hospital was never considered. Hospitals were only for people who had nowhere else to go. “No sick or injured person who could possibly be nursed at home or in a medical man’s private residence,

Three days a week she helped at the Manor Nursing Home, where people proved their keenness by reciting received analyses of current events. All the Manor residents watched television day and night, informed to the eyeballs like everyone else and rushed for time, toward what end no one asked. Their cupidity and self-love were no worse than anyone else's, but their many experiences' having taught them so little irked Lou. One hated tourists, another southerners; another despised immigrants. Even dying, they still held themselves in highest regard. Lou would have to watch herself. For this way of thinking began to look like human nature--as if each person of two or three billion would spend his last vital drop to sustain his self-importance.

But in residency, something else was gradually unfolding. In the midst of this endless barrage of head injuries, I began to suspect that being so close to the fiery light of such moments only blinded me to their nature, like trying to learn astronomy by staring directly at the sun. I was not yet with patients in their pivotal moments, I was merely at those pivotal moments. I observed a lot of suffering; worse, I became inured to it. Drowning, even in blood, one adapts, learns to float, to swim, even to enjoy life, bonding with the nurses, doctors, and others who are clinging to the same raft, caught in the same tide.

Are we really supposed to know what we want to do for the rest of our lives at the ripe old age of seventeen?” “Don’t you want to know?” “I guess? I wish I could live ten lives at once.” “Ugh. You just don’t want to choose.” “That’s not what I mean. I don’t want to get stuck doing something that doesn’t mean anything to me. This track I’m on? It goes on forever. Yale. Medical school. Residency. Marriage. Children. Retirement. Nursing home. Funeral home. Cemetery.

Being assisted by his son and granddaughter was too embarrassing, so he managed to secure a place at a nursing home. The fee structure there was income-dependent; residents with a lot of property paid more for room, board, and care. Poorer residents lived for free.

If women are Republicans, they’ve been brainwashed—the men have brainwashed them,” Nana said. The nurses at River Bend reported that my grandmother was always saying this. There were residents at River Bend who refused to sit with Nana in the dining hall; probably they were Republicans.

As we stood on our doorsteps and clanged our pans, politicians were handing out billion-pound contracts to their mates. As we put rainbows in our windows, nursing home residents were being all but murdered by their idiotic policies. And throughout, as NHS staff put their lives at risk, as they worked double and triple shifts, as the PPE cut into their faces, as they moved out of their family homes for months on end, the ghouls in charge seemed far more concerned with their own appearances and legacies. And there’s still nothing approaching an assurance that the NHS won’t be sold off in five years’ time, plunging us into an unfair insurance-based system that mostly benefits the former politicians who stuff the boardrooms of private medicine.

Dig deep, past the pain of knowing you failed or that you could have done things differently and past the temptation to self-loathe. Live in the pain of the mistake, notice your ego's attempt to protect you by justifying your mistake or blaming another for their part in a situation. We must go deeper into ourselves, to tap into the wisdom that resides underneath our mistakes.

There’s no dignity in this place, thinks Seda. No privacy either. Some fool is always poking his or her head into your doorway. And as if the residents and nurses aren’t bad enough, lately all kinds of people keep showing up, waving their tape recorders in her face, asking her questions about the past. Everyone is an amateur historian. They use words like witness and genocide, trying to bridge the gap between her past and their own present with words. She wants nothing to do with it. But the other residents have fallen under a confessional spell. They’re like ancient tea bags steeping in the murky waters of the past, repeating their stories over and over again to anyone who will listen. Who can blame them? Driven from their homes not by soldiers this time, but by their own loved ones, to this place so cleverly labeled “home,” a second exile. In some ways, Seda thinks it’s worse than the first: to the lexicon of horrific memories is added the immense shame of surviving, of living when so many others did not. Yet they all bask in their rediscovered relevance. But all the words in every human language on earth would not be enough to describe what

One ancient retired Air Force nurse does nothing but screams 'Help!' for hours at a time from a second-story window. Not six weeks ago, a huge stole HELP WANTED sign was found attached right below the retired shrieking nurse's window. Unit #5, kittycorner across the little street from Ennet House, is for catatonics and various vegetablish, fetal-positioned mental patients. It is, understandably, a pretty quiet place. But in nice weather, when its more portable inmates are carried out and placed in the front lawn to take the air, standing there propped-up and staring, they present a tableau it took Gately some time to get used to. A couple newer residents got discharged late in Gately's treatment for tossing firecrackers into the crowd of catatonics on the lawn to see if they could get them to jump around or display affect.

Saturday, July 2, 2016 1:51 PM "One ancient retired Air Force nurse does nothing but scream 'Help!' for hours at a time from a second-story window. Since the Ennet House residents are drilled in a Boston-AA recovery program that places great emphasis on 'Asking For Help,' the retired shrieking Air Force nurse is the object of a certain grim amusement, sometimes. Not six weeks ago, a huge stolen HELP WANTED sign was found attached to #4's siding right below the retired shrieking nurse's window, and #4's director was less than amused, …

Diamond Jubilee with him for extra contrition. Her father was clearly exhausted, sleeping almost all the time now, like an aged dog. Why didn’t he just go? Was he hanging on for a hundred? Two more years of this? It was mere existence—an amoeba had more life. “The triumph of the human spirit,” the new nursing sister said, new enough to talk about “positive outcomes” and “enhancement programmes”—emollient management-speak, meaningless to most of the residents of Poplar Hill, who were either dying or demented or both. It was called a “care home” but there was precious little of either to be had when you were run by a profit-based health-care provider employing

Risch points out that taxpayers spent $660 million building field hospitals across the country.44 Democratic Governor Andrew Cuomo and other Democratic governors kept these facilities empty to maintain bed inventories in anticipation of the flood of patients inaccurately predicted by the fear-mongering models, ginned up by two Gates-funded organizations, IMHE and Royal College of London, and then anointed as gospel by Dr. Fauci—seemingly as part of the crusade to generate public panic. With those quarantine centers standing empty, those governors sent infected elderly back to crowded nursing homes, where they spread the disease to the most vulnerable population with lethal effect. Risch points out that, “Half the deaths, in New York, and one-third nationally,45 were among elder care facility residents.

The schedule took a toll. As residents, we were working as much as one hundred hours a week; though regulations officially capped our hours at eighty-eight, there was always more work to be done. My eyes watered, my head throbbed, I downed energy drinks at two A.M. At work, I could keep it together, but as soon as I walked out of the hospital, the exhaustion would hit me. I staggered through the parking lot, often napping in my car before driving the fifteen minutes home to bed. Not all residents could stand the pressure. One was simply unable to accept blame or responsibility. He was a talented surgeon, but he could not admit when he’d made a mistake. I sat with him one day in the lounge as he begged me to help him save his career. “All you have to do,” I said, “is look me in the eye and say, ‘I’m sorry. What happened was my fault, and I won’t let it happen again.’ ” “But it was the nurse who—” “No. You have to be able to say it and mean it. Try again.” “But—” “No. Say it.” This went on for an hour before I knew he was doomed.

Physician, professor, and author Atul Gawande tells of a doctor working at a nursing home who persuaded its administrator to bring in dogs, cats, parakeets, a colony of rabbits, and even a group of laying hens to be cared for by the residents. The results were significant. “The residents began to wake up and come to life. People who we had believed weren’t able to speak started speaking. … People who had been completely withdrawn and nonambulatory started coming to nurses’ station and saying, ‘I’ll take the dog for a walk.’ All the parakeets were adopted and named by the residents.”5 The use and need for psychotropic drugs for agitation dropped significantly, to 38 percent of the previous level. And “deaths fell 15 percent.” Why? The architect of these changes concluded, “I believe that the difference in death rates can be traced to the fundamental human need for a reason to live.”6 Gawande goes on to ask “why simply existing—why being merely housed and fed and safe and alive—seems empty and meaningless to us. What more is it that we need in order to feel that life is worthwhile? The answer … is that we all seek a cause beyond ourselves.

Beneath the window, set between gravel walkways, a few woody lavenders, etiolated rosemary bushes, and ornamental thyme made up the aromatherapy garden that he had seen described in the brochure. Beyond this, however, running a long arc down the gentle slope of lawn, camellias in unrestrained bloom provided an alternative tonic. The lawn gave way to a flower garden, itself fringed by a wood, so that the incarcerated had at least the consolation of a pleasant enough outlook. Gabe stood in front of the fireplace and examined the painting that hung above the mantelpiece. It was a still life. It showed two apples and a brown and white feather laid on a velvet cloth on a table placed by a window. Although the picture was not, Gabriel assumed, of the highest artistic value, and was cheap enough to reside at Greenglades, and though it could not be said to have a photographic reality, and though he suspected it of not being "good," he was drawn to look at it and could see the ripeness of the velvet, reckon the bursting crispness of the apples, and the feather had a certain quality that he had never before observed, just as the painted window offered something that he had failed to notice at all when looking through the real one: the texture, the tone, the way the light fell, the very glassness of the glass.

Yet the homogeneity of contemporary humanity is most apparent when it comes to our view of the natural world and of the human body. If you fell sick a thousand years ago, it mattered a great deal where you lived. In Europe, the resident priest would probably tell you that you had made God angry and that in order to regain your health you should donate something to the church, make a pilgrimage to a sacred site, and pray fervently for God’s forgiveness. Alternatively, the village witch might explain that a demon had possessed you and that she could cast it out using song, dance, and the blood of a black cockerel. In the Middle East, doctors brought up on classical traditions might explain that your four bodily humors were out of balance and that you should harmonize them with a proper diet and foul-smelling potions. In India, Ayurvedic experts would offer their own theories concerning the balance between the three bodily elements known as doshas and recommend a treatment of herbs, massages, and yoga postures. Chinese physicians, Siberian shamans, African witch doctors, Amerindian medicine men—every empire, kingdom, and tribe had its own traditions and experts, each espousing different views about the human body and the nature of sickness, and each offering their own cornucopia of rituals, concoctions, and cures. Some of them worked surprisingly well, whereas others were little short of a death sentence. The only thing that united European, Chinese, African, and American medical practices was that everywhere at least a third of all children died before reaching adulthood, and average life expectancy was far below fifty.14 Today, if you happen to be sick, it makes much less difference where you live. In Toronto, Tokyo, Tehran, or Tel Aviv, you will be taken to similar-looking hospitals, where you will meet doctors in white coats who learned the same scientific theories in the same medical colleges. They will follow identical protocols and use identical tests to reach very similar diagnoses. They will then dispense the same medicines produced by the same international drug companies. There are still some minor cultural differences, but Canadian, Japanese, Iranian, and Israeli physicians hold much the same views about the human body and human diseases. After the Islamic State captured Raqqa and Mosul, it did not tear down the local hospitals. Rather, it launched an appeal to Muslim doctors and nurses throughout the world to volunteer their services there.15 Presumably even Islamist doctors and nurses believe that the body is made of cells, that diseases are caused by pathogens, and that antibiotics kill bacteria.

Wanna play in the snow? I text back right away: YES! It’s really hot in here. Meet me in the hallway in two min? K. I stand up so fast in my sleeping bag I nearly trip. I use my phone to find my coat, my boots. Stormy is snoring away. I can’t find my scarf, but I don’t want to keep John waiting, so I run out without it. He’s already in the hallway waiting for me. His hair is sticking up in the back, and on that basis alone I think I could fall in love with him if I let myself. When he sees me, he holds his arms out and sings, “Do you want to build a snowman?” and I burst out laughing so hard John says, “Shh, you’re going to wake up the residents!” which only makes me laugh harder. “It’s only ten thirty!” We run down the long carpeted hallway, both of us laughing as quietly as we can. But the more you try to laugh quietly, the harder it is to stop. “I can’t stop laughing,” I gasp as we run through the sliding doors and to the courtyard. We’re both out of breath; we both stop short. The ground is blanketed in thick white snow, thick as sheep’s wool. It’s so beautiful and hushed, my heart almost hurts with the pleasure of it. I’m so happy in this moment, and I realize it’s because I haven’t thought of Peter once. I turn to look at John, and he’s already looking at me with a half smile on his face. It gives me a nervous flutter in my chest. I spin around in a circle and sing, “Do you want to build a snowman?” And then we’re both giggling again. “You’re going to get us kicked out of here,” he warns. I grab his hands and make him spin around with me as fast as I can. “Quit acting like you really belong in a nursing home, old man!” I yell.

Once people believed her careful documentation, there was an easy answer—since babies are cute and inhibit aggression, something pathological must be happening. Maybe the Abu langur population density was too high and everyone was starving, or male aggression was overflowing, or infanticidal males were zombies. Something certifiably abnormal. Hrdy eliminated these explanations and showed a telling pattern to the infanticide. Female langurs live in groups with a single resident breeding male. Elsewhere are all-male groups that intermittently drive out the resident male; after infighting, one male then drives out the rest. Here’s his new domain, consisting of females with the babies of the previous male. And crucially, the average tenure of a breeding male (about twenty-seven months) is shorter than the average interbirth interval. No females are ovulating, because they’re nursing infants; thus this new stud will be booted out himself before any females wean their kids and resume ovulating. All for nothing, none of his genes passed on. What, logically, should he do? Kill the infants. This decreases the reproductive success of the previous male and, thanks to the females ceasing to nurse, they start ovulating. That’s the male perspective. What about the females? They’re also into maximizing copies of genes passed on. They fight the new male, protecting their infants. Females have also evolved the strategy of going into “pseudoestrus”—falsely appearing to be in heat. They mate with the male. And since males know squat about female langur biology, they fall for it—“Hey, I mated with her this morning and now she’s got an infant; I am one major stud.” They’ll often cease their infanticidal attacks. Despite initial skepticism, competitive infanticide has been documented in similar circumstances in 119 species, including lions, hippos, and chimps. A variant occurs in hamsters; because males are nomadic, any infant a male encounters is unlikely to be his, and thus he attempts to kill it (remember that rule about never putting a pet male hamster in a cage with babies?). Another version occurs among wild horses and gelada baboons; a new male harasses pregnant females into miscarrying. Or suppose you’re a pregnant mouse and a new, infanticidal male has arrived. Once you give birth, your infants will be killed, wasting all the energy of pregnancy. Logical response? Cut your losses with the “Bruce effect,” where pregnant females miscarry if they smell a new male. Thus competitive infanticide occurs in numerous species (including among female chimps, who sometimes kill infants of unrelated females). None of this makes sense outside of gene-based individual selection. Individual selection is shown with heartbreaking clarity by mountain gorillas, my favorite primate. They’re highly endangered, hanging on in pockets of high-altitude rain forest on the borders of Uganda, Rwanda, and the Democratic Republic of the Congo. There are only about a thousand gorillas left, because of habitat degradation, disease caught from nearby humans, poaching, and spasms of warfare rolling across those borders. And also because mountain gorillas practice competitive infanticide. Logical for an individual intent on maximizing the copies of his genes in the next generation, but simultaneously pushing these wondrous animals toward extinction. This isn’t behaving for the good of the species.

Almost two million people over age 65, or nearly 6 percent of those Americans (excluding nursing home residents), rarely or never leave their homes, researchers recently reported in JAMA Internal Medicine. The homebound far outnumber the 1.4 million residents of nursing homes.

One day, at a nursing home in Connecticut, elderly residents were each given a choice of houseplants to care for and were asked to make a number of small decisions about their daily routines. A year and a half later, not only were these people more cheerful, active, and alert than a similar group in the same institution who were not given these choices and responsibilities, but many more of them were still alive. In fact, less than half as many of the decision-making, plant-minding residents had died as had those in the other group.

In the trade, moves are known to cause “relocation trauma,” physically and emotionally, for the frail elderly person, already sick and scared, and for the adult children, who must orchestrate everything. The most dramatic example of relocation trauma occurred during Hurricane Katrina and a subsequent series of Gulf Coast storms, when long-term mortality and morbidity was significantly worse for the elders “successfully” relocated than those “sheltered in place.” In other words, those who survived by being bused out of the eye of the storm to higher ground died subsequently at rates much higher than those who remained behind. The main causes of death were twofold: deadly urinary tract infections from catheters inserted for the long bus journey; and falls, leading to broken hips and their cascade of health risks—for instance, if a previously healthy nursing home resident took a tumble while looking for the bathroom in an unfamiliar place or while wearing ill-fitting slippers borrowed after fleeing without all her own belongings.

I asked her about this. But she couldn’t put her finger on what made her unhappy. The most common complaint she made is one I’ve heard often from nursing home residents I’ve met: “It just isn’t home.” To Alice, Longwood House was a mere facsimile of home. And having a place that genuinely feels like your home can seem as essential to a person as water to a fish.

Their study found that the number of prescriptions required per resident fell to half that of the 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.

In one study, researchers gave elderly residents of a local nursing home a houseplant. They told half the residents that they were in control of the plant’s care and feeding (high-control group), and they told the remaining residents that a staff person would take responsibility for the plant’s well-being (low-control group).41 Six months later, 30 percent of the residents in the low-control group had died, compared with only 15 percent of the residents in the high-control group.

Volunteer to help a worthy cause. It will take your mind off your problems and you can feel good that you’ve helped support someone else. It’s hard to feel sorry for yourself when you’re serving hungry people in a soup kitchen or spending time with elderly residents in a nursing home.

It’s hard to feel sorry for yourself when you’re serving hungry people in a soup kitchen or spending time with elderly residents in a nursing home. •​Perform a random act of kindness. Whether you mow the neighbor’s lawn or donate pet food to a local animal shelter, doing a good deed can help bring more meaning to your day. •​Do something active. Physical or mental activity will help you focus on something other than your misfortune. Exercise, sign up for a class, read a book, or learn a new hobby, and your behavior change can help shift your attitude.

Such decisions include changing one’s residence, buying a house, quitting the current job, finding or choosing another job, taking six months off for a grand trip, getting engaged, addressing an important medical condition, choosing a school for their child, finding appropriate care or a nursing home for a parent, or retiring.

It took more than a month after the authorization of the first vaccine to begin vaccinating the 1.34 million residents of US nursing homes, where the most COVID deaths were occurring.

In some places, you can see ratios of 10:1 to 12:1 (one nurse for every ten or twelve residents). In other spaces, you’ll see numbers as high as 30:1. Numbers like that are distressing for a few reasons. First, the burnout rate for nurses with ratios that high are astonishing. No nurse is going to survive mentally and emotionally if they are responsible for caring for 30 people every day. With a high burnout rate, facilities risk their ability to create a positive culture in their community. When ratios are that high, it also means, if you need special attention you might not get it.

Their study found that the number of prescriptions required per resident fell to half that of the control nursing home.

Immy spent the next day or two undergoing tests, and I saw her several more times. The medal had been moved from her shirt to her hospital gown. It had seemed so important to her parents that I mentioned it in passing to the cardiac surgery resident as we sat writing chart notes in the nursing station on the evening before the surgery. He gave me a cynical smile. “Well, to each his own,” he said. “I put my faith in Dr. X,” he said, mentioning the name of the highly respected cardiac surgeon who would be heading Immy’s surgical team in the morning. “I doubt he needs much help from Lourdes.” I made a note to myself to be sure to take the medal off Immy’s gown before she went to surgery in the morning so it wouldn’t get lost in the OR or the recovery room. But I spent that morning in the emergency room, as part of

The medal had been moved from her shirt to her hospital gown. It had seemed so important to her parents that I mentioned it in passing to the cardiac surgery resident as we sat writing chart notes in the nursing station on the evening before the surgery. He gave me a cynical smile. “Well, to each his own,” he said. “I put my faith in Dr. X,” he said, mentioning the name of the highly respected cardiac surgeon who would be heading Immy’s surgical team in the morning. “I doubt he needs much help from Lourdes.” I made a note to myself to be sure to take the medal off Immy’s gown before she went to surgery in the morning so it wouldn’t get lost in the OR or the recovery room. But I spent that morning in the emergency room, as part of

Having heard so many stories similar to Mrs. Thomas’s, several years ago I decided to study the needs for ministry in the nursing homes of my region. With the help of a local pastor, we interviewed the administrators, activities directors, and residents of twenty-seven nursing homes. We could have stopped after the first interview. We learned almost nothing new in the remaining twenty-six nursing homes. As soon as we began asking our questions, we found almost instant anger against pastors and local churches. Everywhere we went we heard that, with almost no exception, within a few weeks of admission, no representatives from local churches visited their patients. Were it not for the families’ visits, their patients would have been totally abandoned. Few families truly abandon their loved ones who have entered a nursing home or assisted living facility.

documentation issues were more common in small private hospitals, where records were less standardized and notes were sparse because only the patient’s physician writes progress notes. In teaching hospitals, by contrast, there are multiple notes by residents, medical students, and nurses as well.

Residents and interns are the grunts of the medical profession, tasked, simply, with getting everything done. The practical side of the clinical buck stops with them (even if the ultimate clinical and legal responsibility rests with the attendings), and the house staff do whatever it takes to get everything done. With their scut lists in hand, their coat pockets doubling as supply cabinets, they are the embodiment of the pragmatic. While many still retain their interest in the theories and mechanisms of disease, the overriding modus operandi is utilitarian, because unlike the electricians, housekeepers, therapists, technicians, orderlies, dietitians, even the nurses and senior doctors, their job description has no bounds.

I worked in a nursing home long enough to notice something extremely devastating. Residents will rot in their rooms, barely any visitors, their mental disintegrating, dealing with different staff member personalities every day, their bodies ache from age, but the moment those people die, their funerals are packed with people. Why do we not treat each other properly while we are alive? People will fight against abortion, glorify someone when they die, never mentioning their flaws. But will spend the short amount of time they have in life, arguing with each other about EVERYTHING, it doesn't make sense to me!

They drank a cheap Hungarian riesling that spelled “headache” after the third glass. They held hands. The lights were going out at the Garibaldi nursing home across the street, a five-story residence built in the sixties to prove how closely a building could resemble Formica.

Discussion Questions 1. An institution for people with disabilities, the Willowbrook State School opened in 1947 on Staten Island, New York, and remained in operation until 1987. Despite having a maximum capacity of 4,000 people, by 1965 it housed over 6,000 intellectually and physically disabled children and adults, becoming the largest state-run mental institution of its kind in the United States. Due to staff and money shortages, there was only one nurse per ward, one or two attendants per 35 to 125 residents, and more than 200 residents living in houses built for fewer than 100. An estimated 12,000 residents died at Willowbrook from 1950 to 1980, approximately 400 a year, due to neglect, violence, lack of nutrition, and medical mismanagement or experimentation. What was your awareness of Willowbrook State School before reading The Lost Girls of

The Annals of Dermatology and Venereology reported that in a French nursing home, all 69 residents—average age 90—and 52 staff survived a COVID-19 outbreak.16,17 As it turns out, they had all taken ivermectin for a scabies infestation. COVID decimated the surrounding community, but only seven elder home residents and four staff were affected, and all had mild illness. None required oxygen or hospitalization.

Over three thousand robots work under the supervision of three nurses to take care of the needs of some three hundred residents in Sunset Homes. This is how we die now. Out of sight.

As a laboring person, it's hard to know whether the resident or nurse trainee is capable and caring or is following orders to do something to your body, to rush your labor because of hospital quotas and conventions, with or without your consent.

Again, those who wrote about personal traumas had fewer visits to the student health center, and their improved health correlated with improved immune function, as measured by the action of T lymphocytes (natural killer cells) and other immune markers in the blood. This effect was most obvious directly after the experiment, but it could still be detected six weeks later. Writing experiments from around the world, with grade school students, nursing home residents, medical students, maximum-security prisoners, arthritis sufferers, new mothers, and rape victims, consistently show that writing about upsetting events improves physical and mental health.

When Joy looked at humans, she saw animals so detached from the food chain that their own boredom was eating them alive. None of their instincts made sense to them; they were primates adorning themselves with skins and shiny things, all swagger and posturing with no idea what it's for. They were grotesque and ridiculous, and she loved them so, so much. They were all doing their best, and their best was just an appalling disaster. That was why she loved the nursing home; the residents were humans stripped of all their pumped-up self-regard, scared and forced to put their whole trust in someone else for the first time since childhood. How could you hate humanity after seeing them in that state, helpless and afraid, watching their strength trickle away? Even the worst of them, when reduced to that, become something that just needs to be fed and bathed and comforted. They begin that way, and they end that way, and you can't really get too mad about the stuff they do in the middle.

expanded to a second location in Portland—this one had 142 units and capacity for impoverished elderly people on government support—the state required Wilson and her husband to track the health, cognitive capabilities, physical function, and life satisfaction of the tenants. In 1988, the findings were made public. They revealed that the residents had not in fact traded their health for freedom. Their satisfaction with their lives increased, and at the same time their health was maintained. Their physical and cognitive functioning actually improved. Incidence of major depression fell. And the cost for those on government support was 20 percent lower than it would have been in a nursing home. The program proved an unmitigated success.

People who we had believed weren’t able to speak started speaking,” Thomas said. “People who had been completely withdrawn and nonambulatory 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.

how she’d ended up in Sanborn Place. That was when she told me about her son Wayne. Wayne was a twin born without enough oxygen. He developed cerebral palsy—he had trouble with spasticity when he walked—and was mentally delayed, as well. In adulthood, he could handle basic aspects of his life, but he needed some degree of structure and supervision. When he was in his thirties, Sanborn Place opened as a place offering just that and he was its first resident. Over the three decades since, she visited him almost every day for most of the day. But when her fall put her in a nursing home, she was no longer permitted to visit him, and he wasn’t cognitively developed enough to seek to visit her. They were all but completely separated. There seemed no way around the situation. Despairing, she thought their time together was over. Carson, however, had a flash of brilliance and worked out how to take them both in. They now had apartments almost next to each other.

One day, however, they had an experience that revealed just how fragile their life had become. Bella developed a cold, causing fluid to accumulate in her ears. An eardrum ruptured. And with that she became totally deaf. That was all it took to sever the thread between them. With her blindness and memory problems, the hearing loss made it impossible for Felix to achieve any kind of communication with her. He tried drawing out letters on the palm of her hand but she couldn’t make them out. Even the simplest matters—getting her dressed, for instance—became a nightmare of confusion for her. Without sensory grounding, she lost track of time of day. She grew severely confused, at times delusional and agitated. He couldn’t take care of her. He became exhausted from stress and lack of sleep. He didn’t know what to do, but there was a system for such situations. The people at the residence proposed transferring her to a skilled nursing unit—a nursing home floor. He couldn’t bear the thought of it. No, he said. She needed to stay at home with him. Before the issue was forced, they got a reprieve. Two and a half weeks into the ordeal, Bella’s right eardrum mended and, although the hearing in her left ear was lost permanently, the hearing in her right ear came back. “Our communication is more difficult,” Felix said. “But at least it is possible.

The language of medicine, with its priorities of safety and survival, was taking over, again. Wilson pointed out angrily that even children are permitted to take more risks than the elderly. They at least get to have swings and jungle gyms. A survey of fifteen hundred assisting living facilities published in 2003 found that only 11 percent offered both privacy and sufficient services to allow frail people to remain in residence. The idea of assisted living as an alternative to nursing homes had all but died. Even the board of Wilson’s own company—having noted how many other companies were taking a less difficult and less costly direction—began questioning her standards and philosophy. She wanted to build smaller buildings,

When I spoke to a colleague about Joe's report, her face registered surprise. She said, "Is it possible for a death in a nursing home to be premature?" Joe told me, "If it were happening in any other kind of institution, to any other part of the population - workers, say, or children - there'd be an outcry, media, inquiries, swift intervention. The truth is we do not value the last months or years of a person's life. The remaining life of someone old. Particularly if they are in residential care." If we are all just economic units who lift or lean, then very little is "lost" when a nursing home resident or anyone getting on in their years dies prematurely. In fact money might be saved - one less nursing-home bed to fund, and the kids can finally get their hands on the house.

The Deaf and Dumb Mother.—The late Countess of Orkney, who died at an advanced age, was deaf and dumb, and was married in 1753 by signs. She resided with her husband at his seat, Rostellan, near Cork. Shortly after the birth of her first child, the nurse saw the mother cautiously approach the cradle in which the infant lay asleep, evidently full of some deep design. The Countess, having first assured herself that her babe was fast asleep, took from under her shawl a large stone, which had purposely been concealed there, and, to the utter horror of the nurse, who largely shared the popular notion that all dumb persons are possessed of peculiar cunning and malignity, raised it up, as if to enable her to dash it down with greater force. Before the nurse could interpose to prevent what she believed would bring certain death to the sleeping and unconscious child, the dreadful stone was flung, not at the cradle, however, but upon the ground, and fell with great violence. The noise awakened the child. The Countess was overjoyed, and, in the fulness of a mother's heart, she fell upon her knees to express her thankfulness that her beloved infant possessed a blessing denied to herself—the sense of hearing. This lady often gave similar indications of superior intelligence, though we can believe that few of them equalled the present in interest. Filial

Medicine is becoming a business, and if people choose medicine as a way to make money, they should go to the States because there, health care is a commodity for sale and you can shop around for the best product. Patients are the customers and if you're rich you get better health care than if you're poor. In Canada, health care is a basic human right, a service that every human being deserves. Tell me, have any of you ever seen someone get preferential treatment? A Canadian over a non-resident? A white person over one of color? A VIP over an ordinary citizen?

...she had returned to the beach out of habit. Since dropping out of university, this stretch of sand was where her future resided. She would walk it until the day some man wanted more than just to have sex with her. Since she'd put aside her dream of being a nurse, she'd embrace the idea of being a wife, like her mother. A woman who minded the home, the children and lay on her back for only one man. The prostitution was just to make ends meet until that time came.

It seems we’ve succumbed to a belief that, once you lose your physical independence, a life of worth and freedom is simply not possible. Nursing home staff like, and approve of, residents who are “fighters” and show “dignity and self-esteem”—until these traits interfere with the staff’s priorities for them. Then they are “feisty.

The pattern is the same everywhere. Extremely elderly people are far more likely to die of SARS-COV-2 than anyone else. That is especially true for those living in nursing homes and assisted living facilities. Those people account for about 40 to 50 percent of all deaths from COVID in the United States. A figure of 43 percent has been widely used. It probably understates the real total because in some states, including New York, nursing home residents who die in hospitals are counted as hospital deaths.

When Zev still didn’t say anything, Toby visibly stiffened, seemingly steeling his courage, and then continued speaking. “Is something going on with Jonah?” “We haven’t talked about Jonah since he moved away,” Zev answered after a short pause. “I know.” “That was three and a half years ago,” Zev continued. “I know.” He probably should have been surprised that Toby had known he’d kept in touch with Jonah, but Zev wasn’t. Lori was pretty perceptive, and she probably knew exactly where Zev went when he traveled for business. And what Lori knew, Toby knew. Whether they were aware of the nature of Zev’s feelings for the human wasn’t clear, but Zev was too tired to try to make excuses. “He’s gonna go to medical school.” Zev still hadn’t moved his arm from his face, so he couldn’t see Toby’s reaction. “Medical school?” Toby’s voice was tempered but confused. “That’s, like, four years of school and then four years of residency. Which means eight more years away from Etzgadol.” Eight more years away from me. The last part was really the crux of the problem, but Zev didn’t dare say it out loud. It’d give away too much. Still, it didn’t make sense. A few years away so they could grow up and be old enough to tie when they came back together, Zev was almost able to understand. But that time had passed, Zev had figured out how to tie with a male, and he was ready for his mate to join him. Why would nature give him a mate who insisted on staying away? Zev felt like he was missing something. Like there was a lesson he should be learning, but he had no clue what it was. Instead, he just felt frustrated and angry. So many thoughts were swirling in his mind that he hadn’t registered Toby’s long silence until the other man spoke again. “You know my mom works with Doc Carson.” The change in topic was weird, but welcome, so Zev engaged Toby in the conversation. “Yeah, I know.” “So I was asking her the other day if she thinks he’d take me on at the clinic when I get my nursing degree, and you know what she told me?” The conversation was about as interesting as watching paint peel, but at least it got Zev thinking about something other than Jonah. Almost.

The triumph of the human spirit,” the new nursing sister said, new enough to talk about “positive outcomes” and “enhancement programmes”—emollient management-speak, meaningless to most of the residents of Poplar Hill, who were either dying or demented or both. It was called a “care home” but there was precious little of either to be had when you were run by a profit-based health-care provider employing minimum-wage staff.

priorities of safety and survival, was taking over, again. Wilson pointed out angrily that even children are permitted to take more risks than the elderly. They at least get to have swings and jungle gyms. A survey of fifteen hundred assisting living facilities published in 2003 found that only 11 percent offered both privacy and sufficient services to allow frail people to remain in residence. The idea of assisted living as an alternative to nursing homes had all but died. Even the board of Wilson’s own company—having noted how many other companies were taking a less difficult and less costly direction—began questioning her standards and philosophy. She wanted to build smaller buildings, in smaller towns where elderly people had no options except nursing homes, and she wanted units for low-income elderly on Medicaid. But the more profitable direction was bigger buildings, in bigger cities,

We go to the parlor on Stormy’s floor to sit and thaw out. There’s only one reading light on, so it’s dim and quiet. All the residents are in their apartments for the night, it seems. It feels strange to be here without Stormy and everyone, like being at school at night. We sit on the fancy French-style couch, and I take off my boots so my feet can get warm. I wriggle my toes to get the feeling back. “Too bad we can’t start a fire,” John says, stretching his arms and looking at the fireplace. “Yeah, it’s fake,” I say. “There must be some sort of nursing-home law about fireplaces, I bet…” My voice trails off as I see Stormy, in her silky kimono, tiptoeing out of her apartment and down the hall. To Mr. Morales’s apartment. Oh my God. “What?” John asks, and I slap my hand over his mouth. I duck down low in my seat and slide all the way off the couch to the floor. I pull him down next to me. We stay down until I hear the door click closed. He whispers, “What is it? What did you see?” Sitting up, I whisper back, “I don’t know if you want to know.” “Dear God. What? Just tell me.” “I saw Stormy in her red kimono, sneaking into Mr. Morales’s apartment.” John chokes. “Oh my God. That’s…” I give him sympathetic eyes. “I know. Sorry.” Shaking his head, he leans back against the couch, his legs stretched out long in front of him. “Wow. This is rich. My great-grandmother has a way more active sex life than I do.” I can’t resist asking, “So then…I guess, have you not had sex with that many girls?” Hastily I say, “Sorry, I’m a very inquisitive person.” I scratch my cheek. “Some might say nosy. You don’t have to answer if you don’t want to.” “No, I’ll answer. I’ve never had sex with anybody.” “What!” I can’t believe it. How can that be? “Why are you so shocked?” “I don’t know, I guess I thought all guys were doing it.” “Well, I’ve only had one girlfriend, and she was religious, so we never did it, which was fine. Anyway, trust me, not all guys are having sex. I’d say the majority aren’t.” John pauses. “What about you?” “I’ve never done it either,” I say. He frowns, confused. “Wait, I thought you and Kavinsky…” “No. Why would you think that?” Oh. The video. I swallow. I thought maybe he was the one person who hadn’t seen it. “So you’ve seen the hot tub video, huh.” John hesitates and then, says, “Yeah. I didn’t know it was you at first, not until after the time capsule party when I figured out you guys were together. Some guy showed it to me in homeroom, but I didn’t look at it that closely.” “We were just kissing,” I say, ducking my head. “I wish you hadn’t seen it.” “Why? Honestly, it doesn’t matter to me at all.” “I guess I liked the thought of you looking at me a certain kind of way. I feel like people see me differently now, but you still thought of me as the old Lara Jean. Do you know what I mean?” “That is how I see you,” John says. “You’re still the same to me. I’ll always see you that way, Lara Jean.

I once met an eighty-nine-year-old woman who had, of her own volition, checked herself into a Boston nursing home. Usually, it’s the children who push for a change, but in this case she was the one who did. She had congestive heart failure, disabling arthritis, and after a series of falls she felt she had little choice but to leave her condominium in Delray Beach, Florida. “I fell twice in one week, and I told my daughter I don’t belong at home anymore,” she said. She picked the facility herself. It had excellent ratings and nice staff, and her daughter lived nearby. She had moved in the month before I met her. She told me she was glad to be in a safe place—if there’s anything a decent nursing home is built for, it is safety. But she was wretchedly unhappy. The trouble was that she expected more from life than safety. “I know I can’t do what I used to,” she said, “but this feels like a hospital, not a home.” It is a near-universal reality. Nursing home priorities are matters like avoiding bedsores and maintaining residents’ weight—important medical goals, to be sure, but they are means, not ends. The woman had left an airy apartment she furnished herself for a small beige hospital-like room with a stranger for a roommate. Her belongings were stripped down to what she could fit into the one cupboard and shelf they gave her. Basic matters, like when she went to bed, woke up, dressed, and ate, were subject to the rigid schedule of institutional life. She couldn’t have her own furniture or a cocktail before dinner, because it wasn’t safe.

Poverty, imprisonment, and residence in a nursing home are confining conditions, each with its own set of visible and invisible boundaries. In nature, we find a temporary freedom from these constraints. In nature, anyone can have a full and free experience of the world.

A great number of Americans have made the same startling discovery that Francis Dane did: They are related to witches. American presidents descend from George Jacobs, Susannah Martin, and John Procter. Nathan Hale was John Hale’s grandson. Israel “Don’t Fire Until You See the Whites of Their Eyes” Putnam was the cousin of Ann Putnam. Oliver Wendell Holmes and Louisa May Alcott descended from Samuel Sewall; Clara Barton from the Townes; Walt Disney from Burroughs. (In a nice twist, the colonial printer who founded the American Antiquarian Society, where Cotton Mather’s papers reside today, was also a Burroughs descendant.) The Nurse family includes Lucille Ball, who testified before an investigator from the House Un-American Activities Committee. (Yes, she had registered with the Communist Party. No, she was not a Communist. In 1953, a husband leaped to a wife’s defense: “The only thing red about Lucy is her hair,” Desi Arnaz explained,