title: Between two worlds.
abstract: OBJECTIVE
  To reflect on the challenges of caring for an elderly ill parent who lives afar and to pronounce the importance of system-wide standards in nursing homes and elderly care.
  
  
  METHODS
  Personal memoire in which the author conjures up powerful images of contrasting healthcare systems and the tension of living in two countries.
  
  
  RESULTS
  The author discusses many aspects of healthcare for the elderly. Some of the pictures depicted include the picture of a gradually declining memory of an Alzheimer's disease patient and the challenges of elderly care.
  
  
  CONCLUSIONS
  There is a value of medical knowledge, an importance of nursing homes designs and regulation, and a significance of simple concepts such as a "do-not-resuscitate" order.
  
  
  CONCLUSIONS
  Care for the elderly can be exhausting physically and emotionally; system-wide changes and standards are important in minimizing its impact.
authors: Department of Medicine and Department of Clinical Sciences, Division of Outcomes and Health services Research, University of Texas Southwestern, Dallas, USA. Electronic address: Ishak.Mansi@va.gov.
authors: Ishak A
authors: IA
authors: Mansi
mesh_terms: D000368:Aged; D000375:Aging; D003431:Cross-Cultural Comparison; D004534:Egypt; D005853:Geriatrics; D006299:Health Services for the Aged; D006699:Home Care Services; D006801:Humans; D014481:United States
keywords: DNR; Dementia; Nursing home