Reconfiguring nursing home living arrangements into "pods," in which a group of private bedrooms are connected to a central living area, works best with a homogenous population that functions at about the same level ("Being Mortal Asks for Bold Reimaginings," What I'm Reading, April). Most nursing homes do not have this type of patient population. There may be people who've just been discharged from the hospital and are receiving therapy for several hours a day, whereas others may be actively dying.

I am fortunate to work in a very good long-term care facility. Yes, we have schedules for medications, bathing, toileting, and activities. Some of the residents are at our facility because they can no longer maintain these schedules at home. Without an orderly approach to the day, our nursing care would be inadequate. The residents have as much autonomy as possible.

What we lack in our society is preparation for the later years of our lives. Nurses are in a good position to advocate for families. They can also talk to patients and their families about elder care before it's necessary and help to make arrangements-for example, for financial planning-as needed.

Ann Hinkhouse, MBA, MA, RN

West Liberty, IA