"The Nursing Home Guide; A Doctor Reveals What You Need to Know About Long-term Care"

by Dr. Joshua D. Schor

This reviewer recently received a trade paperback nursing home guide for review from The Berkley Publishing Group that stated in its press release : "Did you know?...The U.S. population 85 years and older is increasing rapidly and experts estimate that 40% of this age group will find themselves living in a nursing home." Before reviewing the book, I decided to go to my computer, and, using Google Chrome, search the words "Nursing Home Guide".

I came up with 19,500.000 referral sites. I then searched "Nursing Home Compare" and was shown 7,330,000 sites. Finally, I searched "Nursing Home Ratings" and got 5,190,000 possibilities. Assuming many of the citations were duplicates and not direct referrals to the actual search I was doing, it still would be a daunting task to get information about nursing homes.

I also had personal experience with nursing homes. My brother and I had placed our mother in a nursing home in 1993 and had written a long essay on how to select a nursing home that appears on our web site, devoted to issues related to the elderly. I have also visited many nursing homes throughout the USA and spoken to people in Europe and Asia about long-term-care. This was a book I could relate to well.

"The Nursing Home Guide; A Doctor Reveals What You Need to Know About Long-term Care" by Dr. Joshua D. Schor, medical director at Daughters of Israel in West Orange, New Jersey, is an accessible, sensibly organized, succinct and clearly written book.. There isn't room to include everything one would like, and there isn't room for much of what has been included to be treated as fully as one would like.

This guide book encourages you to browse. Its approach is business like, its tone sober. Accuracy and, within limits, comprehensiveness are only to be expected. The issues discussed in this book are of critical importance to anyone considering a nursing home. The book is well organized and easy to read, and its contents are presented clearly, concisely and in a pertinent way. It serves as an excellent beginning for anyone in need of education about selecting a nursing home.

The book consists of two parts (296 pages): "Finding the Right Home and Navigating the System". Assumed under these two parts are 12 chapters ranging from "Choosing a Home" to such topics as "Medications: Just say no?" and "The Final Chapter: End-of-Life Care". Each chapter contains a summary that makes for more concise reading. The 15-page index is a guide in of itself for the individual too busy to read the entire book. It ranges from "American Association of Homes and Services for the Aging" to "Zyvox (linezolid)".

Dr. Schor makes practical suggestions that could help in the quality of life at a nursing home. This is especially true in his discussion of medications for the elderly. Select senate committees have held hearings on the use of medications in nursing homes and generally have found that they are overused and misused.

His philosophy of "keep it simple" is a mantra that should resound throughout nursing homes. He also has good words to say about nurse practitioners and physician assistants, probably the real heroes/heroines of the long-term care field. (In his introduction he pays tribute to one: "Mary Spielvogel has been the biggest-hearted director of nursing and has earned a good retirement".) He further points out that "[L]ong-term care is not quantum physics. It requires a careful eye and a good heart and knowledge of basic medicine. Moreover, it takes someone with an interest and training in geriatric syndromes that most physicians either never learned or in which they have no interest." (p.115).

It might have been helpful for the reader who would like to go more in depth on the topic of nursing homes if Dr. Schor cited primary sources for some of the studies he discusses in the book.

In summary, Dr. Schor offers information to help you select a nursing home and help you cooperate with your MD in your mutual quest for desirable health of your loved ones placed in a nursing home. Kudos to Dr. Schor for achieving this goal in a down to earth way. This information is pertinent in all our lives.


Harold Rubin, MS, ABD, CRC, Guest Lecturer
posted January 8, 2009

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