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Is it possible to provide good nursing home care?

mother-and-daughter-in-nursing-homeAs a really bad joke, somebody once told me that we need to be nice to our children because they will choose our nursing homes. The sad reality of the matter is that most nursing homes are set up more like prisons or mental institutions rather than the nurturing and loving environments that they should be. Our parents and grandparents worked a lifetime to provide for us and they deserve to be respected as well as to live out their final years with dignity and in comfort. Over the years, nursing homes were traditionally revered as glorified asylums for old people. Sadly, this was acceptable to society and it was not until the mid-1990s that the outcry was finally heard concerning how we treat the wisest and most valuable members of our society. We have made some general changes in the years since then, but we have not come nearly far enough. Our elders continue to live in facilities that lack warmth and due to understaffing and improperly trained staff; they even suffer from neglect and abuse— in some cases. We are making small steps however. Over the last decade, we have come to see nursing homes that are more welcoming and invoke more feelings of home through carefully thought out aesthetics. By allowing families to bring pets into the facility and involving the family members of elderly patients in their lives and treatment, our loved ones are able to feel more connected to both the world and their family members. This more personal approach is beginning to show a positive impact on many lives as nursing homes begin to implement more programs that are designed to meet the personal needs of each patient. A major obstacle standing in the way of further reform, however, is that of regulation. Each facility must meet a laundry list of requirements in order to qualify for Medicare/Medicaid and the federal State Operations Manual includes over 660 pages worth of requirements for nursing home facilities. Other regulations vary from state to state and each facility is required to meet licensing requirements and manage risk properly in order to avoid lawsuits for care that deviates from the standard care prescribed in this labyrinth of bureaucracy. In 2011, Medicare/Medicaid released new guidelines that were more focused on the individual than on standard procedure. The new guidelines, called the Quality Indicator Survey focuses more on whether a patient is receiving the proper nutrition rather than the time of day that the patient receives it. However, the new guideline does not erase the current regulatory requirements placed on nursing homes. While it may make a patient more comfortable to be able to arrange his or her own furniture, some states inhibit the ability to allow patients to do this by dictating where beds and other furnishings must be placed in rooms. Another roadblock in the journey toward more personal and warm care is the fear of litigation if the steps that nursing homes take to give the elderly more freedom result in the higher probability of injuries. Rather than allowing residents to cook meals, water plants and walk freely through the building, many nursing homes limit residents’ ability to do many things, even with supervision. This creates a very gray line between what is good for the patient and what will keep the facility out of legal trouble. The long term solution to creating care that is worthy of the loved ones who worked so hard for us their entire lives is to continue to make strides toward care that is orientated toward personal needs while providing better training for nursing home staff. By continuing to address the issue and demand better care for the ones that we love and holding facilities accountable for issues such as neglect or abuse, we are encouraging the evolution of policies that will be of greater benefit to our elderly. A nursing home should not feel like a prison or mental institution. This can be fixed through the implementation of more policies that make patients feel more in control of their care and more connected to their family members. Every journey begins with a single step, and the good news is that we have made the most positive steps in the last decade toward improved care than we had been able to in the one hundred years prior. Let us continue to take steps— even if they must be small ones at first. Source:

  • http://www.theatlantic.com/health/archive/2012/05/how-to-fix-nursing-homes/257153/
  • https://www.nursinghomelawcenter.org/nursing-home-staff/new-government-report-demonstrates-alarming-number-of-criminal-caring-for-elderly-in-nursing-homes/
  • https://www.nursinghomelawcenter.org/frequently-asked-questions/who-regulates-nursing-homes/

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