Institutional Care for Older Adults

The care provision for older adults began with the option of poorhouses. These were the institutions where the adults encountering mental or physical disabilities could find shelter and food. Although these houses were a significant contribution to the solution of the problem with the placement of older adults, they provided miserable living conditions. Gawande (2014) introduces the opinion of their contemporaries describing these shelters as “grim, odious places to be incarcerated” (p. 55). In 1935, with the improvement of social security and the introduction of national pensions, this situation changed in the industrialized world (Gawande, 2014). Mainly, with the development of healthcare, the number of hospitals increased. They were the places where the elderly people could find help and care.

Later, nursing homes appeared throughout the United States, replacing the poorhouses. These institutions allowed the elderly to be free from the hospitals, and they provided decent medical assistance and nutrition to the aged adults. In the 1980s, the first assisted living facility appeared as a place where the individuals that were getting older could be more independent than in the nursing homes (Gawande, 2014, p. 73). In these establishments, the residents could feel at home because they were considered the owners. Consequently, these places were the improved version of the nursing homes because they allowed the elderly to be more responsible for their life and get sufficient care simultaneously.

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These advances affected medicine significantly because they allowed the healthcare system to separate care for the elderly and focus on the specifics of the condition of these people. First, introducing the specific shelters for the aging individuals allowed the hospitals to free beds for the other patients. Understanding the need to care for the elderly people differently than for the younger patients allowed the healthcare system to introduce separate instructions and regulations framing the care for the older adults (Kua, Mak, & Lee, 2019). In addition, physicians altered their attitude toward this part of the population, comprehending their need for communication and support. Consequently, the healthcare system increased its attention to the elderly people acknowledging their specific need for assistance.

This information is related to the quality of life of humans because it reflects how people should be treated to sustain their level of living. Since the analysis of the quality of people’s life includes such factors as chronic diseases, risks, and their prevention, the particular places where older adults receive medical assistance play an essential role. The ability of the pensioners to cope with chronic illnesses with the help of physicians and nurses and avoid being subject to the risk factors by staying in safe environments proves the significance of such institutions.

Although assisted living institutions improve the life and health of older adults considerably, some changes can still be made to continue this process. In particular, advance care planning, which determines the course of care in the case of progression of serious illnesses, can be introduced in all the facilities to guarantee a decrease in anxiety and stress levels among the pensioners (Mignani et al., 2017). This plan might help the healthcare personnel follow the specific steps in providing care and ensure that they follow the desires and expectations of their patients. It can be implemented on the national level with the obligation of all the healthcare establishments to include advance care planning in the caring for the elderly people strategy. It might help the patients and their families to have a precise vision of the future and death of the pensioner.


Gawande, A. (2014). Being mortal. Doubleday Canada.

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Kua, C. H., Mak, V. S., & Lee, S. W. H. (2019). Health outcomes of deprescribing interventions among older residents in nursing homes: a systematic review and meta-analysis. Journal of the American Medical Directors Association, 20(3), 362-372.

Mignani, V., Ingravallo, F., Mariani, E., & Chattat, R. (2017). Perspectives of older people living in long-term care facilities and of their family members toward advance care planning discussions: a systematic review and thematic synthesis. Clinical Interventions in Aging, Volume 12, 475-484. Web.

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