You don’t have to spend much time with the elderly or those with terminal illness to see how often medicine fails the people it is supposed to help. The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit. They are spent in institutions — nursing homes and intensive care units — where regimented, anonymous routines cut us off from all the things that matter to us in life.
Given how disliked they are, by patients and families alike, you’d think people would have rebelled. You’d think we would have burned the nursing homes to the ground. We haven’t, though, because we find it hard to believe that anything better is possible for when we are so weakened and frail that managing without help is no longer feasible. We haven’t had the imagination for it.
But in the course of writing my book Being Mortal (from which this is adapted), I did find several people who do, in fact, have the imagination to remake the nursing home and to help people in a state of dependence find value in their existence.
One of them is in the Boston suburbs. Just 20 minutes’ drive from my home, there is a new retirement community called NewBridge on the Charles. It was built on the standard continuum-of-care framework — there’s independent living, assisted living, and a nursing home wing. But the nursing home that I saw on a visit not long ago looked nothing like the ones I was familiar with. Instead of housing 60 people to a floor in shared rooms along endless hospital corridors, NewBridge was divided into smaller pods housing no more than 16 people. Each pod was called a “household” and was meant to function like one. The rooms were all private, and they were built around a common living area with a dining room, kitchen, and activity room — like a home.