Product Description

"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.

Product Details

• Amazon Sales Rank: #217235 in Books
• Published on: 2005-07-28
• Original language: English
• Number of items: 1
• Binding: Paperback
• 224 pages

From Publishers Weekly
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.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Review
"Gass dives in and brings to the surface immensely rich stories out of an environment full of pain and decrepitude." -- The San Francisco Chronicle, April 11, 2004

From the Inside Flap
"Nobody’s Home is a brilliant ethnography, compelling and achingly vibrant and realistic. Thomas Edward Gass defines in human terms what it is like to be a frontline caregiver in a for-profit nursing facility, and he gives us an incredible sense of what it might be like to be a patient there. This book will surely be a tremendous resource for policymakers and for students of social work, aging, sociology, work organization, disability, and public policy."—Susan Eaton, Kennedy School of Government, Harvard University

"Thomas Edward Gass simply refuses to avert his gaze from frail elderly and disabled residents’ humanity, and so we witness the daily indignities of institutionalized care. The nursing home residents whom Gass must hurriedly turn and spoon feed and toilet have complex lives and rich histories, and throughout this heartrending account Gass reminds us regularly that, if we live long enough, we too will likely be reduced to medical charts listing our disabilities. Gass’s recounting of small gestures of tenderness and moments of compassion provide us with glimpses of what it might mean to really care for the elderly—and how our current long-term care system fails miserably at that elemental task."—Alice H. Hedt, Acting Executive Director, National Citizens' Coalition for Nursing Home Reform (NCCNHR)

"Thomas Edward Gass presents without embellishment a portrait of what life is like inside a modern nursing home. Nobody’s Home lets the readers see the cruel tricks aging can play on residents, the frustrations of declining health, and the indignities of not being heard. This book shows us the physically tough and emotionally sapping work that aides have to do every day in a health care system and society where their work is not assigned the monetary or cultural value that it deserves. Gass shows what happens when there are simply not enough caregivers to provide that care the way we would want. This book gives us portraits of real people—residents and workers—who deserve better care and a better health care system. Members of Congress who do not have better nurse staffing at the top of their legislative agenda should read this book!"—Andrew L. Stern, International President, Service Employees International Union

Customer Reviews

A candid and compassionate story
At 189 pages, the book does a wonderful job of telling the story of a CNA who goes to work in a nursing home in the Midwest after the death of his mohter. He wants to do meaningful work that would gain depth to his character. He is not the typical aide, having spent years working and learning in a variety of areas. His past experiences and education allow him to write about the job, the nursing home, his colleagues and the residents with beautiful insight and compassion. These words in his Epilogue have stuck with me. "Few of us are prepared for what happens. First we grow up and get stronger by the day. Then one day the process reverses. At first we deny and resist, but evenutally we all surrender."
Gass has some wonderful insights for people working in the LTC industry and for those of us who will one day be admitted.

Touching Portrait of Reality
Mr. Gass has truly captured the emotional hardship present within the American nursing home. A candid, unbiased look at the system which provides us with our eventual destination, "Nobody's Home" speaks to the mind as well as the spirit. Never have I been so moved by one man's everyday experiences.

Real life stories, spot-on analysis, and gorgeous writing. A+
I added this book to my library while preparing a "reading list" of sorts for my entry into the world of managing assisted living. Although Mr. Gass' residents are skilled nursing folks, there is strong overlap if you're dealing with a high care needs population and the caregivers who work with them. For my situation - turning around a badly run facility and getting perspective on the CNA's position, it's ideal.

Tom Gass is clearly an "in the trenches" story teller - but do NOT be put off by that and assume he's naive or unanalytical. Sure, the book is full of stories of coping with incontinence (aka the "poop factor"), but he has outstanding perspective on the health care and labor practices that lie behind the "incontinent war zone" he's writing about. If I have any criticism at all it's that the author could have written a bit more on the "big picture" while discussing the minute. He clearly has the mind and writing talent to tackle it.

Buy this book for anyone who is underpaying a caregiver for an elder. Buy this for yourself if you are working with elders in residential care. And let's hope Mr. Gass writes some more. Honestly, there are so many learned writers out there who write badly! It's a pleasure just to read his prose. I put the book down feeling touched, energized, politicized, and in love with Tom Gass' writing style. Come on, buddy - time to write another!

He belongs on the same shelf with Anne Lamott probably - although book sellers would never do that. Wry, irreverant, but ultimately in love with his subject - old people.

I'm not sure what the book is doing relegated to the arcane category of "culture and politics of healthcare work." It should be sold with books on aging for non-professional readers, healthcare practice etc.. Those readers need to hear these stories - and will be grateful for the introduction. This is not a wonk's book.