Old 03-16-2007, 09:45 PM   #1
Chrissi
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Default The state of nursing homes

In class, today's social psychology lecture was about health and control. The theory (with a lot of studies behind it to back it up) is that people are happier and healthier when they have more control (or at least perceive themselves as having control, even if they don't have it in reality.)

He began by explaining a study that he called the "executive rats" study. In this study, pairs of rats were housed near each other, and every once in awhile, they received electric shocks. However, in the cage of one of the rats, there was a wheel that they could run on to turn off the electric shocks (for both rats). So, when the wheel was spun, the shocks turned off, but only one rat had access to the wheel.

They found that the rat who could not control the electric shocks developed far more physical ailments than the ones who COULD control it. Now keep in mind, both rats got shocked, but one rat had the ability to turn off the shock for both rats. So neither rat received more or less shock than the other. They both received equal shocks - the difference is that one rat could turn the shocks off.

Why would this be? It appears that when a rat has control over its environment, it fares better, even if the environment is the same as another rat who does not have this control.

Now, does this work in humans? You bet.

A study by Singer and Glass was performed like so: the participant was brought into a room where they periodically heard loud bursts of static (loud enough to be uncomfortable). In the control condition, they just heard the static and nothing else. In the experimental condition, they heard the same static, but there was a button on the wall, and the participant was told that to keep hitting the button, and once they hit it enough times, the static would turn off. Participants in the experimental condition responded with less stress in a following survey.

What does that say? It works in people too, and not only that - they don't have to actually have control. Perceived control is good enough. If someone thinks they are controlling their environment, they will feel better, even if bad things are happening. If these things feel out of their control, it is stressful and/or depressing.

Now, this might feel like common sense, but beware the hindsight bias. Would you have been surprised if I had said something along the lines of "When bad things happen to people, they get depressed, even if they feel the situation is within their control" and backed it up with stats? Not likely. It all seems common sense once you've heard about it. You have to remeber that it is not. They do studies like this for a reason; because people want to know for sure, even if it seems common sense. Common sense is sometimes not common, and sometimes does not make sense.

Anyway.... that's just the background. Now onto the main point.

If you know anything about nursing homes, you'd know that they often have strict schedules and regimens. You must shower at this time, you must eat at this time, visitors are only allowed at certain times, you can only take walks at this time, and you can't control what's on TV. Sounds like hell? Well, I wonder why they do this, but more speculation about this after I've explained the study.

Rodin and Langer performed a more real-life-scenario type of experiment. They proposed the idea that people in nursing homes would be happier if they actually had control over their lives. So, they took over a nursing home and played administration. On one floor of the nursing home, they told them that they would have a lot of control and freedom. You could eat when you want, have visitors when you want, shower when you want, and they took votes on what to watch on the TV instead of being told what would be watched. As well, they were given a small plant to take care of. They were told they would be able to live their life the way they were used to living it - and that's how it was. They had as much control as possible over their own life and own schedule.

On the other floor, however, it was business as usual. No control and firm boundaries around the daily rituals.

In nursing homes, you don't really have to worry about word getting around, because most of the residents can't exactly traverse very easily between floors. So that did not affect the results.

After 6 months, they were amazed to discover that the residents of the "freedom" floor were happier and were suffering from less diseases. As well, the mortality rate was HALF of that on the other floor, where it was actualy pretty high (30% mortality rate in 6 months, sheesh.)

Do you get this? Giving them control over their own lives and routines actually makes them LIVE longer and makes their lives healthier and happier.

Now, this isn't really surprising news, but it is quite convincing, and it makes one wonder why exactly nursing homes still generally force their residents into strict, unforgiving rituals that they have no say over.

That's what I'm wondering. What do you guys think is the story behind this? It doesn't actually cost them anything to give the residents more freedom. There are no savings in giving each resident a schedule for their bathing. And there is certainly nothing saved by telling them what they must watch on television.

So why are they doing it? What's going on here? Do nursing homes WANT their residents to die? Is that how they're saving costs - by having less residents? Is there a conspiracy here? Kill off all the old people and make room for the new! Do you think that's their motto?
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Old 03-16-2007, 09:57 PM   #2
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Default Re: The state of nursing homes

This is good.
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Old 03-16-2007, 09:58 PM   #3
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Default Re: The state of nursing homes

......... get out of my thread please.

Or rather, get out of CT.
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Old 03-16-2007, 10:03 PM   #4
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Default Re: The state of nursing homes

What if somebody dies because they have freedom? They try showering when nobody is watching and slip and fall?

Reasons like that is the only reason why I can think nursing homes don't just let to people do as they wish. It is a very good idea though, and I agree with you.
I also think the nursing homes might think the people are incapable of making those (minor) decisions :/
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Old 03-16-2007, 10:04 PM   #5
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Default Re: The state of nursing homes

That is a really good point. They probably think the residents are often incapable, which might occasionally be true, in which case, why not schedule times for only the things that the person cannot do themselves, and let them be free in other aspects?
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Old 03-16-2007, 10:08 PM   #6
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Default Re: The state of nursing homes

Quote:
Originally Posted by Chrissi View Post
That is a really good point. They probably think the residents are often incapable, which might occasionally be true, in which case, why not schedule times for only the things that the person cannot do themselves, and let them be free in other aspects?
Sorry to be harsh, but for some reason I doubt most nursing home actually care that much about their patients.

But on the flip side, if their patients live longer, they get more money. :/ I think they should do as you said.
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