The long-term care facility has not always gone by that name. Once upon a not too distant time it was called something else: Home. Not “The Home,” as in The Soldiers Home, or The Exempt Firemen’s Home, or The Distaff Home, but home, with a lower-case h, the place where homemade broths were served to the ailing fresh from a pot on the stove, where nobody needed a clipboard to remember who got kosher meals and who was on a sodium-free diet, where the title for “client” was grandma, or Uncle Dan, or Cousin John who “was never quite right.” The patients participated in their care, helping to shell the peas and peel the potatoes for their own meals. Music therapy was led by the client herself, as she taught the grandchildren the songs of her own youth. Occupational therapy for the nonambulatory patient might be whittling. Senior daycare programs were on a seamless continuum with preschool, as both were directed by Momma in the kitchen. Home was a prekindergarten, afterschool center, convalescent facility, assisted living program, nursing home, and hospice— sometimes all at the same moment. The “director” of such an institution depended on two medical professionals: herself, with the accumulated generations of folk wisdom and maternal common sense that rivaled the collective brainpower of the Mayo Clinic, and the Family Doctor, who had delivered most of her charges, perhaps even her, and who would be at the bedside of Mom’s charges, young and old, when their final moments came. The Family Doctor spent his days making house calls to the elderly, the developmentally disabled, the handicapped, the medically frail. He needed no charts, no files, no jackets with print-outs from insurance companies to know Little Johnny’s medical history, or when Grandpa’s gallbladder had been removed, or that Aunt Mary’s gait was caused by spina bifida. He was part of his patients’ lives, and they were part of his. They were not a billing code or a notation on an office schedule; he watched their cycle of life, traveled the path with them, and, in turn, they became his own journey through this world.
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