This is the first in a series of interviews I have done with professionals in the medical, legal and caregiving communities related to the current state of nursing homes in the United States. I am always in favor of getting different perspectives from professionals as to their perceptions and suggestions. I hope you find these interviews as informative as I do.

Who are you and what type of work do you do?

Angela Morrow, RN, BSN, CHPN. I’m a registered nurse with a specialty in hospice and palliative care. I care for patients and their loved ones at the end of life. I’m also a writer and the Guide to Palliative Care for About.com. As the Guide to Palliative Care, I write articles about hospice, palliative care, end of life concerns, the dying process, and grief and mourning. I hope that my articles, blog, and community forum help patients who are trying to make informed decisions about end of life care and supports their loved ones.

What are some positive trends (if any) in the nursing home industry?

I’m finding that nursing homes are becoming more proactive in end-of-life/comfort care. They are working hard to build relationships with hospice agencies to provide comprehensive end-of-life care to their patients. Nursing homes are also trying hard to create a home-like environment for their residents rather than a hospital-like environment for “patients”.

What are some negative trends (if any) in the nursing home industry?

Profits have always been important but especially during this time of proposed healthcare reform and drastic Medicare cuts, nursing homes want to maximize their bottom dollar. Unfortunately, this often means cuts to staffing levels and important programs.

What correlation do you see with respect to the national trends in the nursing
home industry and the impact on patient care?

I see patients on hospice care receiving top-notch care, above and beyond what “skilled” or “custodial” patients are receiving. Families notice the extra care hospice patients receive and are requesting hospice care sooner for their loved one. This is a positive trend for patients that qualify for hospice but it is unfortunate for those who do not. Current staffing levels in nursing homes mean many patients have to wait a long time to get needs met, or may not get their needs met at all.

How would you compare the nursing homes of today vs. those of 20 years ago?

Nursing homes today recognize the importance of focusing on the “person” not just the “patient”. As such, they provide important activities to promote exercise, socialization, and general well-being, whereas nursing homes 20 years ago were simply infirmaries for the elderly and disabled.

What suggestions do you have for families when it comes to selecting a
facility for their loved ones?

Choose a facility that feels like home. It should be warm and inviting and include activities that will stimulate and entertain your loved one. The staff should be attentive and caring – notice how long call lights stay on before they are answered and how residents are treated in the hallways and common areas. The nursing home should also have a good relationship with hospice agencies so when your loved one is nearing the end of life, you can rest assured they are receiving maximum care.

Three words to describe nursing homes:

Necessary, Understaffed, Underappreciated

Many thanks to Angela for her insights. You can read more about Angela’s work at her Guide to Palliative Care.