Commentary

The Four Seasons and the Autumn Years

Author and Disclosure Information

 

I arrive on a hot August day. The exterior and grounds are immaculate: the shrubs neatly trimmed, the lawn freshly mowed, the annuals profusely flowering. As I enter, I am immediately greeted with a smile and escorted directly to my room. “Did you have a nice trip? Is there anything I can get you? Something cool to drink?” Moments later a glass of iced tea appears.

Once I am settled in, I always like to find the local paper. I walk past the lounge where live music is playing. The walls are adorned with original art. I am greeted enthusiastically by each person who passes. In fact, I marvel how every guest is acknowledged by name. I see a family laughing in the lobby, while another group leaves for the day. What a relaxing retreat this is.

As I return to my room, my reverie is broken. “Hi, Dr. Susman.” My first patient is an 87-year-old woman, here to recuperate from a hip fracture.

No, you wouldn’t confuse Autumn Years for the Four Seasons or the Ritz Carlton (at least not yet), but I enjoy every visit to this rural nursing home. The staff is warm and friendly, cats freely roam the halls, and the gardens are well tended. Even if the artwork tends toward needlepoint and feline prints, and the food is soft and bland, I am still impressed that even the youngest volunteers exude pride and compassion.

No, not every nursing home is run with such kindness. But I suspect our big city offices and hospitals could learn a bit from our rural nursing homes about teamwork, hustle, and caring. Despite the inevitable charting, nurses really know their patients. The staff will gladly find you a cup of coffee from the kitchen, and they make sure you see all the guests—er, I mean patients—and even get you their charts. There isn’t a lot of concern about who is in charge, who does what, or “that isn’t my job.” There is much discussion about the price of corn, the newest café, and how much it’s rained, which pretty much puts life into perspective.

Perhaps it is my early experience in rural practice, the stress of city life, or the often impersonal nature of large hospitals, but I find this day oddly relaxing. The patient challenges are the same—failing kidneys, faltering hearts, minds that are fading, spines that are crumbling. Maybe I just identify with the farm-bred ability to weather adversity and face life’s challenges with dignity.

I can’t imagine a better place to spend my day, murmuring over cross-stitch, and warmly greeting long-time patients. And even if the music is karaoke, the songs remain heartfelt, and optimism pervades the air.

Recommended Reading

In-Hospital Prevention Program Targets the Family
MDedge Family Medicine
Adherence to Process Measures Predicts Acute MI Mortality
MDedge Family Medicine
Antiarrhythmics Reduce Postablation Arrhythmias
MDedge Family Medicine
Dronedarone Reduced Cardiac Risks From Atrial Fibrillation
MDedge Family Medicine
Patients With Systemic Sclerosis Should Undergo Screen for PAH
MDedge Family Medicine
Vigilance Needed to Reverse Amputation Epidemic
MDedge Family Medicine
Electrical Stimulation a Promising Adjunct
MDedge Family Medicine
Irrespective of Weight, Exercise Benefits Men With Diabetes
MDedge Family Medicine
Pramlintide Equals Meal Insulin, Curbs Side Effects
MDedge Family Medicine
Population Screens for Type 2 Do Not Cut Mortality Rates
MDedge Family Medicine