THE term “nursing home’” hardly fits the American institution that houses 1.7 million feeble old people. First, no one who lives in a nursing home could possibly confuse it with a home. Sharing a bedroom with a sick stranger, being served institutional food on a fixed schedule, having no control over the design and furnishing of your room, and being cared for by indifferent aides contradicts the idea of home. Second, these institutions provide little professional nursing care for their residents. Residents in nursing homes receive attention from registered nurses for an average of nine minutes per day. The basic problem with nursing homes, however, is not the misleading name. Changing the name from nursing home to something else, as some institutions have done in recent years, does not change the experience of those forced to live in them. The fundamental problem is much deeper and more resistant to change. These institutions are costly, inhospitable structures, failing to meet the needs of the persons who must spend their last weeks or years of life in them because better alternatives are not available.