Archival Ideas: Nursing Home Database

Archivists do not only wait for records to arrive on their doorstep, passively accepting whatever comes their way. More and more, archivists feel a responsibility for seeking out records to broaden and deepen our pool of knowledge about the world around us. I think that these proactive measures are going to become even more of archival work in the near future. Many young archivists have ideas for seeking out historical materials, and for finding ways to build an archival record before the records ever have to arrive at an archive. One of my ideas ties together oral history, community involvement, digitization of paper materials, and maybe even some therapeutic help for a community in need. 

My idea is for a comprehensive database for nursing homes, to capture a range of data about their residents. This would be paired with a template for a nursing home website. The website would allow for something similar to a social networking platform like Facebook or Google Plus, but with a greater emphasis on compiling photographs, letters, and oral histories. In so doing, it would create detailed accounts of the lives of the people who stayed at the home. It would also build the history of the nursing home, and contribute to our local histories.

Each resident of the nursing home would get a page. He or she would then be encouraged to work with a staff member--or perhaps a volunteer, like an oral historian--on adding materials to the page. The staff member would scan old photographs and letters, and would ask the resident about each one. Who is in the photo? When was it taken? Who was writing the letter to whom? These interviews could be recorded and added to the database as well; in the course of identifying people in a photograph, each resident is bound to remember interesting stories that are unrelated to that specific task of identification. Bit by bit, each resident gets to build the story of his or her life.

The residents are then active participants in building their stories, and in ways that could be done by anyone. They do not need, for example, the literary skill to write their own autobiography. Only the eagerness to reminisce and share stories with someone else. And the residents might find that it brings them together, which is where the social networking aspect fits in. A resident might learn that a co-resident served in the same military unit, had the same kind of job, or grew up in a nearby town. They might soon start helping each other fill in the gaps in their recollections.

They might also keep healthy in the process. Though I make no claims of expertise on mental health, my understanding is that keeping the mind active later in life is a therapeutic activity, and one that can perhaps help prevent certain mental illnesses, like Alzheimer's. Keeping residents engaged in remembering their lives would then have the added benefit of being a sort of therapy. It might keep their minds sharp. It might also help them feel good about their life, to have a chance to share these stories.

In the end, everyone wins from this. The residents get an activity they (hopefully) enjoy, and some socialization and mental challenge along the way. The nursing home gets to build a more comprehensive picture of its identity, which is surely shaped by its residents. (And this might in turn make the home more attractive to other prospective residents.) The staff or community volunteers who get involved learn about building the historical record, get to feel that they have contributed something meaningful to the world around them, and probably get to make new friends along the way.

To Your (Mental) Health!

I have been in therapy for about two-and-a-half years now. I began seeing a therapist after a particularly bad series of panic attacks at the start of grad school nearly kept me from leaving my apartment. Therapy was something I had considered for a while: I have suffered off and on from panic attacks since my undergraduate days, at the turn of the century. (I love using the expression "at the turn of the century" with regard to things that happened in my life.) But I also grew up in an environment where therapy "was not done," if not outright maligned.
Having gone to a therapist now for several years, I can strongly recommend the specific experience of therapy and the general experience of addressing mental health. I feel like mental health is still a stigmatized issue in many communities, and the sad result of this is that many people who might benefit from therapy do not attempt it, and in turn they can become worse. I am going to make a generalization and say that every single person alive today could make use of therapy at some time. But more so, every single person deserves access to mental health resources and should use them just as readily as they would any other health resources. Anyone who he thinks he will never need mental health care is, in fact, totally crazy. And he therefore needs mental health care.
So why is mental health care so important to me, and why do I think you need it too? Here are a few reasons, in no particular order:


1. Like a friend, but better. In many cases, a therapist can be like a friend, but better. You know that one feeling has been bugging you all week, and you really want to talk to your friends about it, but you are afraid that they will think ill of you if they heard about it? Well, a therapist will listen without thinking ill. Or, remember that time you got really upset about something involving a friend? You wanted to say something about it to a mutual friend but were afraid it would get back to the first friend and strain your friendship? And then you let it fester until you were really resentful? Would it not have been better if you had another person you could safely describe the situation to and get an independent opinion? A therapist is that other person.
And remember that friend you spilled your guts to, but he is really bad at listening and giving advice, so then you wound up feeling worse? A therapist is literally trained to listen to you and give advice. That experience will not happen. And if you have a therapist you do not like? Just get a new therapist. It is much easier than saying to a friend, "You are bad at giving advice. I will now replace you."


2. Check-ups are good! Are you the kind of person who avoids doctors like the plague, until you get the plague and have to go to get better? No, probably not. I am guessing you go to a doctor now and then for a check-up, to get a sense of your overall physical health and make sure you have no particular problems that need addressing. You probably check your blood pressure and weight, mention any strange pains or fatigue you might have felt, and as you get older, probably more tests start figuring in to check-ups as well. When you agree to go to a check-up, it is not because you have a specific problem, but you are just keeping an eye on any issues that might become problems if not cared for.
Now, many physical health issues develop over time, and most people I know understand that they can do things to prevent illnesses. For example, exercise and diet can help many people avoid certain heart problems. We have mostly moved past the idea that illness occur suddenly, and without prompting, like magic curses. But I feel like in the world of mental health, this idea is still somewhat controversial.
People who suffer from depression do not suddenly become afflicted with it, like a switch had been flipped. It can develop over time, for a variety of pathological and contextual reasons. Can anything be done to mitigate it, if not outright prevent it? Sure! You could talk to someone whose job is to look for early signs of depression, and that person could recommend exercises (often actual gym-based exercise, for example) to help head off worse health problems later. Preventative care is a good index of a sophisticated medical practice. A society that not only treats the symptoms of existing illnesses but also works to prevent future illnesses is a forward-thinking society. This is true for preventative mental health care as well.


3. Support now what you might need later! But maybe you think, "I do not need any mental health care now. Maybe when something bad happens, but why should I bother ahead of time?" Even if you do not subscribe to the idea of getting an emotional check-up, you might feel that you would like to have mental health care options available in case something awful happened in the future and you really needed it. The best way to guarantee future health care for when the unexpected happens is to promote the same health care now. If hospitals see regular usage of a specific department, they will probably try harder to support and enhance that service. If employers see that employees routinely take advantage of a specific benefit, they will be less likely to take that benefit away during a time of budget-tightening. Many people buy insurance against workplace accidents, even if they do not think they are likely to have an accident any time soon. Why? They might reason that, if they have disability benefits and something bad does happen, then they are covered. I would add that employees buying into disability benefits makes sure that coverage continues to exist in the first place. It sends a message that employees want this benefit, and a good employer should provide it. The way to persuade employers to acquire and keep mental health benefits is to use those benefits.

4. Only crazy people need mental health care? I grew up in a time and place where the idea of therapy was still pretty hush-hush. Mental health care was either for people with singularly awful problems (the "crazies") or for whiny, liberal, city folk who could not just--I assume--shrug off their mounting senses of depression or anxiety and act as if nothing was wrong. This attitude developed from a lot of different ideas, but it seemed to often involve some sense of nostalgia for a simpler time, when no one went to therapy. It was a time when no one talked about such problems, therefore, they did not exist. I am going to call this time "the 1950s." (The quotation marks separate it from the actual 1950s, when surprisingly enough, people actually did have emotional lives, complete with problems.)

The problem I see in this distrust of mental health care is that it reinforces how strange one must be to seek help, thereby fulfilling its own thesis about how people and their minds work. Normal people do not need mental health care, the story goes. Therefore, if I seek mental health care, I am abnormal. I do not want to be seen as abnormal, so I had best not seek mental health care. I can further prove my normalcy by telling others that "Normal people do not need mental health care." This keeps the meme alive and discourages anyone from seeking mental health care.
So what if someone really is suffering from a serious emotional problem and needs help? This meme makes them afraid to seek help, replicating itself while leaving the person to silently suffer.
The only way to overcome the idea that mental health care is only for abnormal people is for enough people to treat it as a normal part of their health care. This is not the same as saying, "Everyone needs mood stabilizers," any more than I would say of physical health care, "Everyone needs anticoagulants." Rather, by saying that mental health care is a normal thing--something everyone needs sooner or later--we can develop the idea that it is okay to go seek help when you do not feel well mentally. You do not need to feel guilty about it, any more than you would need to feel guilty if you got cancer.

5. Mental health and aging. Even if it were true that a normal person in the prime of his adulthood has no mental or emotional problems that require expert assistance, most people as they grow older seem to develop one kind of problem or another. This seems to be because bodies do not work as well as we get older, and sometimes that means neurological functions also do not work as well. The idea that people require more frequent check-ups for physical health problems as they age seems pretty non-controversial these days. But I am not sure that the same can be said about mental health check-ups. We all fear that our relatives' minds will start to go as they age, just as we probably fear that they might fall and break a bone. But where many people seem inclined to make sure their aging relative eats a good diet, takes vitamins, and gets exercise to prevent slips and falls, I have not seen the same kind of preventative care plans to avoid mental health problems.
Every now and then I come across the suggestion that activities like reading or solving crossword puzzles can help keep the mind sharp as we age. But I have never heard a friend say, "The doctor recommends Grandma read for one hour each day and do a crossword puzzle, for her health." To be fair, some doctors might have a lot of different health ideas (diet! exercise! medication!) to get through, and mental health issues are still pretty novel. I think this is all the more reason for aging people to have special visits to address mental health, just like they might have cancer screens. And I think everyone should get a prescription that says "Read for one hour every day."



I get nervous around doctors, and I do not like the thought of needing surgery, or even a shot. And I am a pretty healthy person, overall. But I still go to the doctor for physicals, I get flu shots, and I try to get opinions on what I can do to get myself in better shape. I believe that a little preventative care is much better than a lot of palliative care, just like I believe that some careful saving and investment of money is better than a lot of debt-repayment later. When I think of preventative health care, I now include mental health care in that category. My brain needs a check-up just as much as any other part of my body.