Book Review: “Nasty, Brutish & Long” by Ira Rosofsky

Working in a nursing home isn’t easy. There are cantankerous residents, sleep-deprived coworkers, and governmental forms to be filled out in triplicate. There are hoops to be jumped through to provide care–and hoops to be jumped through that inhibit care. There’s the pecking order of doctors, nurses, therapists, and other care staff. There’s the often contradictory demands of residents, family members, physicians, and government regulations. And then there’s the emotional toll of caring for people who inevitably die.

Living in a nursing home isn’t easy. There are bossy staff who insist that you can’t get out of your wheelchair but must wheel yourself on the long way to the dining room. There are buzzers and beepers and lights going off everywhere at all hours of the day or night. You can’t pick your neighbors–you can’t even pick your roommate. You’re constantly being interrupted by staff who insist on interviewing you about the same old stuff–or who keep asking you if you know your name and where you’re at. Staff insist that you go to “activities”; but the one activity you’d really like to enjoy–spending time with your children and grandchildren–isn’t available. And then there’s how everybody inevitably dies.

Ira Rosofsky’s Nasty, Brutish & Long: Adventures in Eldercare tells just some of the stories of life in a nursing home. Rosofsky, a consultant psychologist for a variety of long term care facilities, writes of life on both sides of the nurse’s station. He sympathetically shares the stories of the elders he’s met (fictionalized, of course, per HIPAA). He tells of the processes and paperwork that come along with working in long term care. And he reveals his own story as a son placing his father in a long term care facility.

As one who has had a lengthy acquaintanceship with long term care (considering my relatively young age), I found Rosofsky’s story to be… true. His writing resonates with the girl who went to assisted living facilities to conduct Sunday afternoon worship services–who gladly sang the old hymns at the top of her lungs and then listened as the residents told her about their parents, their children, and their grandchildren. His writing resonates with the girl who served coffee and wiped tables and fell in love with her elderly residents. It resonates with the girl who still remembers sitting with an elderly woman, reading her Psalm 23, explaining to her the gospel, describing how she can have assurance of salvation. It resonates with the girl who later that week removed that same woman’s tray ticket from the stack before meal service–she wouldn’t need a tray anymore. She was dead. Rosofsky’s story resonates with the girl who grieved as her grandmother moved from a retirement community to assisted living to a nursing home–a girl who felt increasingly helpless as her grandma’s dependence on the nursing staff grew. It resonates with the girl who is now a nursing home dietitian, loving to care for her residents, hating how hard it is to care for her residents.

The tale Rosofsky tells in Nasty, Brutish & Long is a true story–and it’s a story that’s being played out in nursing homes around the nation.

This is a memoir. It describes but doesn’t necessarily explain. It raises questions but doesn’t necessarily give answers. You’re not going to find the solution to the long-term-care crisis within the pages of this book. But you will find a powerful description of the realities that face many of those working or living in long-term-care.

I feel like everyone should read this–but then I wonder if I’m just being selfish. Maybe I just want everyone to read it so they can understand my world. Maybe that’s it. But the truth is that even if this isn’t your world now, long-term-care will likely be your world in the future. Maybe you’ll place a parent in a LTC facility. Maybe you’ll find yourself in one when your recovery from a surgical procedure takes longer than expected. Maybe you’ll find yourself in one long term. Or maybe you just need to be reminded of how vital your visits and prayers are to your church’s elderly. At any rate, I think this book is a valuable tool for understanding the challenges of life in long-term-care.

You should probably read it.

Rating: 4 stars
Category: Memoir
Synopsis:Ira Rosofsky paints a picture of life in long-term-care from the perspective of residents, staff, and family members.
Recommendation: This is a great intro to the challenges and pressures of life in long-term-care. It’s worth reading–if long-term-care doesn’t affect you now, it may very well affect you tomorrow.

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