Eleanor Feldman Barbera, Ph.D.

I used to live in a fabulous old fourth-floor walk-up apartment in Manhattan. When I moved out of Manhattan to a borough of New York City for an elevator building with a laundry room in the basement, I made a conscious choice to pick a place I could live for the rest of my life if I had to. That ramp could come in handy if I need a wheelchair, I reasoned. And if worse comes to worse, I’ll move into a nursing home and blog from there.

A lot of residents tell me, “I never thought this (living in a nursing home) would happen to me.” After hundreds of these conversations, I have the opposite approach. I figure, “Why not me?”

But actually, I wouldn’t want to live in any of the nursing homes where I’ve worked. Sure, if I had to, I’d make do. I’d rabble-rouse and kvetch and roll to the administrator’s office if the situation called for it. I’m ready for a fight.

That was my thinking until last week when I toured the eldercare home of my dreams.

The Esplanade, a luxury senior residence located on the upper west side of Manhattan, is two blocks from the subway in one direction and two blocks from Riverside Park in the other. It offers wealthy seniors the ability to age in place surrounded by the best of New York City. Because they’re a senior residence and not governed by the regulations required of assisted living homes, people can bring in as much nursing care as they can afford and can even be on hospice during their residency.

Exactly how much it costs to pay for your own healthcare services would depend on how much care is needed, of course, but I’m guessing that I might be able to swing it if “The Savvy Resident’s Guide” becomes the Gideon’s Bible of nursing home rooms, I manifest my vision of a show called “Eldercare with Dr. El,” and I hit the Lotto. But it made me hopeful that there could be a place where I’d actually want to live.

It also raised the issue of what would need to change in my old nursing homes in order to make me enthusiastic about living there. What does The Esplanade offer that my nursing homes don’t? (My enthusiasm is based on the rosy picture painted by an admissions talk, I admit.) The place met a lot of my personal criteria: Manhattan. Check! Near the subway. Check! Close to a park. Check! Can age in place without needing to move to a new home. Check! Can come and go without needing to be signed out. Check!

I’ve worked in nursing homes where every one of those things was possible, but not one where all of those things were possible at the same time.

One of the biggest draws of The Esplanade, for me, was the philosophy, which was repeated at least five times during my half-hour tour: “We give them whatever they want.”

I’ve never worked in a nursing home with that philosophy, though the more Eden-ized, Green Housed, and culture-changed the facility was, the closer the place came to meeting their residents’ emotional needs. Much more common was the experience of even minor requests made on behalf of residents to be met with sighs, exasperation, and lack of follow-through. I frequently advise residents, family members, and staff to “choose their battles” so as not to wear themselves out from the struggle.

I’ve always assumed I’d have to struggle as a resident, or on behalf of my residents as a worker. But if I didn’t have to, and they didn’t, living in long-term care would be much more pleasant and hopeful.

The philosophy is the main thing I’d want to change about any of the nursing homes I’ve been in. Wherever they’re located, whatever the amenities, I’d be much more enthusiastic about living there if they made a sincere effort to please me and to try to give me what I wanted unless there was a good reason not to do so.

Would you want to live in the LTC home where you work? If so, why? If not, why not? Please let us know in the comments section.




Eleanor Feldman Barbera, PhD, the author of “The Savvy Resident’s Guide,” is an accomplished speaker and consultant with over 16 years of experience as a “psychologist in long-term care. This blog complements her award-winning website, MyBetterNursingHome.com, which has more on how to create long-term care where EVERYBODY thrives.