THE MERE mention of a nursing home is often enough to arouse feelings of terror, frustration, grief, or guilt among elderly patients and their families. Yet a strong reaction often belies an unfamiliarity with the subject and perhaps also a lack of appreciation for the role nursing homes serve in our health care system.
Many connotations of the term "nursing home" are grounded in reality: Nursing homes do provide largely custodial care, reflecting the progressive nature of many chronic diseases and the utter inability of modern medicine to reverse most illnesses associated with aging; they have been plagued by profiteering and by difficulties in recruiting and keeping quality personnel; frequently, they are impersonal and regimented, especially when compared with the family home.
However, there are many favorable aspects of nursing homes. For those elderly who cannot find it elsewhere, they provide a measure of security by guaranteeing that basic needs