Nobody’s Home by Thomas Edward Gass

March 16, 2009

I am myself a transplant to the long term care industry.  As is clear from many of these posts, and the focus of my arguments, my training is in the law, with a particular emphasis on health law and health care administration.  So, if it is fair to say, I think I am intellectually well-equipped to work as a nursing home administrator, but I have not had the emotional experience in LTC that many of my administrator peers have had.  

To try to bridge this gap, I read the book Nobody’s Home: Candid Reflections of a Nursing Home Aide by Thomas Edward Gass.  Mr. Gass is himself a transplant to the long term care industry.  His training is in psychology, and before becoming a CNA, he was a student of transcendental meditation, traveling widely around the world.  

What I found interesting, and ultimately most useful, about Mr. Gas’ book is his unabashed way of describing his own reaction to the difficulties of LTC.  He goes into detail about how difficult it is to simultaneously be his resident’s caretaker, friend, surrogate child, scold, and advocate.  The nurses’ aide position is one that is, tortuously at times, both heartbreakingly intimate, and necessarily removed.  

From my first day in this industry I have heard tales about an administrator who put herself into the position of the CNAs or the residents for a time in order to more fully understand the operation of her facility.  Likely such stories are apocryphal, but even if they are true, such a strategy is simply impracticable for most of us.  However, Nobody’s Home is a good introduction to such an experience, and I would recommend it to any NHA looking to understand the emotions of our jobs.


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