Guest Blogger: Regina J Knox, MPH. Special Projects Coordinator, Texas AHEC East (

Caring for the Elderly in 1890

As a public health worker, I recently decided to take a nursing assistant course as a professional development activity. I thought that the class would provide me with some of the skills that I currently lacked, i.e. basic medical terminology, taking vital signs and experience working in a clinical setting. On the first day of class, I listened intently as my instructor explained the role of nursing assistants. Memories that I have unconsciously associated with “growing old” slowly began to playback in my mind. I remember not wanting to kiss my great-grandmother on the cheek as child because her skin was “too mushy.”

I recall escorting a group of cub scouts on a trip to a local nursing home and participating in social hour where they proceeded to bombard the residents with questions like “can I ride in your wheel chair?”

I also remember telling my mother that if it came to sending her or my father to a nursing home, my father would be out of luck. “I would never send you to an old folks home, Mom,” I quipped. Of course, I have since learned to refer to these places as “long term care facilities.”

I had no idea of the challenges that went into being a caregiver on a daily basis. As my instructor, Mrs. Nelson, frequently reminds us, nursing assistants are the “eyes and ears” of long term care facilities. Nursing assistants provide up to 90% of the direct care of residents and make up the largest group of health care workers in skilled nursing facilities.1

I expected to learn how to take vital signs like blood pressure and temperature. What I did not anticipate was learning the multiple steps required to make a bed in a way that reduces the risk of developing bed sores or how to safely transport an elderly patient from a wheelchair to bed. Nor was I prepared to hear how diseases like dementia or Alzheimer’s can diminish a loved one’s mental capacity while others render them to a state where they are unable to perform basis daily functions like bathing, eating and toileting.

I suddenly reconsidered my vow never to send my mother to a long-term care facility and asked myself “Am I really prepared to care for my mother and all that comes with it when the time comes?” Maybe not now, but the information and skills that I am learning in the nursing assistant class will ensure that I am.

As baby boomers like my mother prepare for retirement, their adult children should be asking similar questions. Community colleges, vocational and technical schools and some hospitals offer short nursing assistant courses which can be completed in as little as two weeks.2

If you have doubts about whether you are prepared or capable of caring for your parents or other elderly family members, you can start preparing now by gathering information, learning the skills and finding out what resources are available to ensure that you are well prepared.

Join us for a real-time discussion about  questions raised by this essay on Wednesday, September 26 , 8:15 to 8:45 a.m.  See Discussion and SL tabs above for details. Link to the virtual meeting room:


  1. Ehlman, K; Wilson, A; Dugger, R; Eggleston, Coudret & Mathis, S. (2012). Nursing Home Staff Members’ Attitudes and Knowledge about Urinary Incontinence: The Impact of Technology and Training.
  2. How to become a Nursing Aide, Orderly, or Attendant. Occupational Outlook Handbook. Retrieved from on September 20, 2012.


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Image source: National Library of Medicine: History of Medicine: National League for Nursing Archives, 1894-1952.