Isolation and Borders in Nursing Homes: Causes and Solutions
This paper examines the isolation and confinement experienced by nursing home residents, framing the physical walls of nursing facilities as symbolic and literal borders that restrict residents' freedom and social lives. Drawing on both primary and secondary sources, the paper analyzes why isolation occurs, how conditions such as Alzheimer's disease, MRSA, and other infectious diseases intensify confinement within an already restricted environment, and what strategies—including technology, community outings, and assisted living alternatives—can help mitigate negative effects. The paper also addresses the ethics of confinement, the use of nursing homes for the mentally ill, and the financial and management factors that shape quality of care.
- Introduction: Framing nursing home confinement and its tradeoffs
- Nursing Home Isolation: Describing the border created by nursing home walls
- Borders Within Borders: Medical and Behavioral Confinement: MRSA, dementia, and technology as responses to isolation
- Challenging the Narrative Around Nursing Homes: Defending nursing homes against unfair criticism
- Community, Autonomy, and Alternatives to Full Confinement: Outings, mental illness, and assisted living options
- Conclusion: Isolation restrictions are sometimes necessary but difficult
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- The paper uses a consistent central metaphor—the nursing home wall as a "border"—to unify diverse topics including infectious disease, dementia, mental illness, and assisted living into a single coherent argument.
- It balances critical concerns about nursing home isolation with a fair defense of nursing homes as a necessary institution, avoiding one-sided polemic and demonstrating analytical nuance.
- The annotated bibliography adds transparency, showing the reader exactly how each source contributed to the paper's argument.
Key academic technique demonstrated
The paper effectively uses primary source analysis alongside secondary sources, explicitly citing multiple regression methodology from one study (Carstensen & Fremouw) to support its claim that nursing home confinement produces measurably greater social anxiety than voluntary isolation. This shows how empirical research findings can be integrated into a qualitative essay.
Structure breakdown
The paper opens with a brief framing introduction, then devotes a named section to describing nursing home isolation before moving into a sustained analytical section that covers technology solutions, internal confinement (MRSA, dementia), institutional critique, community outings, and mental illness. A final section covers assisted living as an alternative before a short conclusion. The annotated bibliography follows, briefly contextualizing each source's contribution.
Introduction
Nursing homes and somewhat less restrictive care facilities are needed and necessary in certain situations to ensure the proper level of care and supervision. However, the isolation and removal from the outside world that residents experience as a result of nursing home placement can be oppressive and harmful. There are often opportunities for temporary outings beyond the nursing home or enjoyable activities within the facility that provide relief from monotony. Advanced medical conditions such as Alzheimer's disease, infectious diseases, and bacterial or hygiene-related concerns can all intensify the isolation already described, since they require even greater restrictions on freedom and activity.
Nursing Home Isolation
Beyond the obvious concerns about medical care and quality of life, perhaps one of the most troubling aspects of seniors living in nursing homes is the isolation and the invisible "border" created by the outer walls of the facility. Nursing home patients are confined to the interior of the building they inhabit in many cases. Even when they are permitted to move around outside, whether supervised or not, there are restrictions on where they can go and when they can go there. This paper explores the loneliness and isolation that nursing home patients experience, drawing on both primary and secondary sources to describe these conditions. While there is a genuine necessity associated with placing senior adults in nursing homes, there are a number of tradeoffs and negative effects that cannot be denied or, for the most part, avoided.
Works Cited (Annotated)
Carstensen, Laura L., and William J. Fremouw. "The Influence of Anxiety and Mental Status on Social Isolation Among the Elderly in Nursing Homes." Behavioral Residential Treatment 3.1 (1988): 63–80. Psychology and Behavioral Sciences Collection. Web. 29 Nov. 2016.
This is one of the primary sources used for this report. It examines social isolation and its symptoms using a multiple regression approach. The two groups compared are those who are free to come and go anywhere they please and those in nursing homes who are clearly confined. Both groups showed symptoms consistent with social anxiety and its negative effects; however, nursing home residents exhibited far more of these effects than those who were not confined. One reason for this is that nursing home environments tend to be monotonous and repetitive compared to environments that vary in space and structure.
Graham, Scott. "Give Care Homes a Chance." Nursing Standard (Royal College of Nursing (Great Britain): 1987) 25.50 (2011): 1. MEDLINE. Web. 29 Nov. 2016.
This source offers advice to those who dismiss nursing homes as universally poor, arguing that facilities with genuine problems are typically not failing because of frontline providers and nurses but rather because of inadequate funding and poor management.
Levy, Clifford J. "Mentally Ill and Locked Up in New York Nursing Homes." New York Times 6 Oct. 2002: 1. Masterfile Premier. Web. 29 Nov. 2016.
This article describes how nursing homes are sometimes used as de facto mental health facilities and asylums, and how this practice has led to widespread abuse and calls for greater advocacy regarding the freedom and appropriate level of care afforded to mentally ill individuals in these settings.
McLean, Athena H. "What Kind of Love Is This?" Sciences 34.5 (1994): 36. Masterfile Premier. Web. 29 Nov. 2016.
This source raises ethical questions about permitting romantic and sexual relationships between one or more nursing home residents who have dementia or other cognitive impairments.
Vitez, Michael. "Assisted Living Offers More Freedom than Nursing Homes." Philadelphia Inquirer n.d. Newspaper Source Plus. Web. 29 Nov. 2016.
This source discusses alternatives to full nursing home placement and provides examples of assisted living arrangements that offer greater autonomy.
Oliver, Debra Parker, George Demiris, and Brian Hensel. "A Promising Technology to Reduce Social Isolation of Nursing Home Residents." Journal of Nursing Care Quality 21.4 (2006): 302–305. MEDLINE. Web. 29 Nov. 2016.
Like the other primary source used in this report, this study focuses on the monotony and social isolation that are common in many nursing home settings. While some situations lack clear solutions, many facilities have turned to technology as a means of improving the daily experience of residents. Examples include use of a Nintendo Wii for interactive activity, telephone or video calls via platforms such as Skype, and other tools that allow residents to enjoy themselves or stay connected to the outside world.
Washio, M., et al. "Incidence of Methicillin-Resistant Staphylococcus aureus (MRSA) Isolation in a Skilled Nursing Home: A Third Report on the Risk Factors for the Occurrence of MRSA Infection in the Elderly." Journal of Epidemiology / Japan Epidemiological Association 6.2 (1996): 69–73. MEDLINE. Web. 29 Nov. 2016.
Weston, Alonzo. "Woman Gains Some Freedom: Nursing Home Patient Allowed to Attend Church." St. Joseph News-Press (MO) 20 Dec. 2009. Newspaper Source Plus. Web. 29 Nov. 2016.
Already a member? Log in
Unlock the rest of this paper
135,000+ research papers · AI writing tools · Plagiarism & AI detection
24-Hour Pass
Does not renew
Get 24-Hour PassMonthly
Renews at $12.99/month until canceled
Start MonthlyAnnual
Renews at $99/year until canceled
Start Annual- Unlimited AI writing tools
- Plagiarism and AI text detection tool
Plan details
Unlimited AI writing tools are for individual, non-automated use and are subject to our Terms of Service and abuse-prevention measures.
TextChecker scans: 1 during the 24-Hour Pass, or 5 per month with Monthly and Annual.
Prices exclude applicable tax.
Always verify citation format against your institution’s current style guide requirements.