Long term elderly care culture

Coming from a multicultural background, long term care for the elderly has always been viewed as unnecessary and careless on the part of the children of the elderly person. Many cultures outside of the USA view that it is the children’s first and utmost responsibility to care for their parents. With these cultural differences aside, since America is so diverse in elderly care culture, how can these differences be taken into account by the government should the government start trying to fix the inequality in care giving that is going on due to the differences in privately owned nursing homes and assisted living companies?

Lack of Welfare in Elder Care

The article “Fighting to Honor a Father’s Last Wish: To Die at Home” by Nina Bernstein clearly highlights the shortcomings in institutionalized and home-care forms for the majority of individuals within the United States of America. Collectively as a society, there exists no proper or cost-effective solution for healthy, nurturing, burden-less elder-care. These failures in care are likely speeding up the decline of individuals in the face of the discrepancies. Such raises a huge, frightening, and charged question: is committing an elder to an institution akin to committing them to an earlier death?

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Live Long and Pay for It

After reading Live Long and Pay for it: America’s Real Long-Term Cost Crisis, I saw strong overlap from previous lecture and discussion conversation. It is absurd how much nursing homes cost but it is not surprising being that a large percentage of them are privately owned. I am surprised,however, that people are willing to pay the upwards of $70,000 a year for a nursing home when the quality of living usually doesn’t reflect the price. As seen towards the end of the article, people don’t want to confine their parents or grandparents to these homes in the first place, let alone use all of their assets to pay for them to be in there. My questions are what is the $70,000 a year being spent on if the quality of care in private homes is so poor? Is the markup on nursing home prices just due to the fact that they can charge more, like the “charge masters”in hospitals and Big Pharma? Although Medicare can be used to pay for some of the stay in these homes, 100 days according to the article, are there alternatives the government can provide for a more lasting/realistic stay?

Solution to Problems with End of Life Care

In the article “Fighting to Honor a Father’s Last Wish,” the main problem that seems to drag Joseph Andrey from hospital to nursing home and back, not allowing him to be at home where he wanted, was the issue of money. His daughter did not have the resources or to take care of him at home; however, all the nursing homes wanted was to make money off of him. Medicare refused to give them money to be able to have him at home, and would only pay for his stay at a nursing home. This forced his daughter to do just that. Since nursing homes have become for profit, and insurance companies worry about nothing but the money they make, is there ever going to be a way that allows us to get the end of life care that we deserve? Making patients like a source of money truly dehumanizes all of us, yet these places where the elderly spend their last years of life are doing just that. Is it possible to have a balanced system where either for-profit nursing homes and insurance companies are both happy or the nursing homes become non-profit?

Why are nursing homes expensive?

As discussed in lecture the cost of nursing homes exceeds college tuition. Older people end up spending their assets to afford living a long-term care facility. Semi-private rooms are also costly, therefore sharing a room with someone doesn’t really help to lower the amount that has to be paid. On the other hand, the staff working there is also not earning much. Nursing assistants work on minimum wage. Some work two shifts in a row and sometimes in different facilities. So where does all the money go? Is it the food? I worked at a nursing home over the summer and from what I saw the food wasn’t very appetizing.  The elderly staying there paid $8000 a month. Is it the administrative costs? Where is all the money going then? Only after answering these questions and understanding the reason behind the costs we might be able to solve the Long Term Care Crisis.

How do we justify our failing nursing home system?

It’s no secret that the life in a nursing home isn’t what people imagine it to be. Most expect a warm and nurturing environment that comforts the elderly, but realistically speaking, nursing homes revolve around a “profit-driven system” (Weitz, pg.241). Chapter 10 in Weitz emphasizes the truth behind modern-day nursing homes, indicating that may nonprofit nursing homes and for-profit homes significantly lack both quality of life and quality of care. Nursing assistants are considered “budgeted expenses”, nursing home administrators and owners keep overall care to a minimum, and health and safety violations are at an all time high. In fact, “federal regulators in 2008 cited more than 90% of nursing homes for health and safety violations” (Weitz, pg.241). This overwhelmingly large percentage of nursing home violations places residents at risk of “bedsores, malnutrition, pneumonia, and other avoidable health problems” (Weitz, pg.241).

With all these federal health and safety violations, it makes one wonder what is being done to fix these problems. Weitz indicates many problems that come with nursing homes, as well as at-home care and hospices, but fails to provide solutions to this increasing problem. And so I ask – What are possible solutions to this failing, profit-driven system that so many people rely on? How do we stop the process of commodification – turning patients into commodities?

How Do We Improve Elderly Care in Nursing Homes?

In the article, “Does Investor Ownership of Nursing Homes Compromise the Quality of Care?”, the authors notes that 2/3 of nursing homes are investor owned. They investigated whether or not investor ownership affected the quality of care in these nursing homes. After examining about 14000 nursing homes, they found that investor-owned nursing homes did in-fact provide worse care and less nursing care compared to non-profit and public homes. I wonder if there are any set regulations, rules or guidelines that these medical homes have to obey in order to remain running? If this study was known to more people, do you think other people will take this into consideration and send their loved ones into certain homes? Would they do further research in order to secure better care for their loved ones? Or would they just want to send them anywhere in the means to “get rid of them or let someone else take care of them”. If consumers do realize that for-profit homes provide worse care, do you think the owners of these homes would try to fix it and focus more on improving patient care? How do we ensure that the elderly get the best care possible? As mentioned before, do we need to set rules, regulations, and/or qualifications of care givers?

The Need for Oversight in Nursing Homes to Improve Quality of Care

In the article, “Does Investor Ownership of Nursing Homes Compromise the Quality of Care?” Harrington et al. sought to investigate if investor ownership affects quality of nursing home care. The study examined almost 14,000 nursing home facilities across the U.S and measured the institutions’ quality based on a range of measures including health outcomes, physician services, patients’ rights maintenance, and nurse staffing ratios. The study even controlled for confounding variables that could have muddled the relationship between investor ownership and quality being investigated. The results showed that investor-owned nursing homes had ~40% more deficiencies in all categories of quality of care than did non-profit and public facilities. Interestingly, investor-owned facilities had lower nurse staffing in each occupational category (registered nurse, licensed vocational nurse, licensed practical nurse, etc.) than the other types of facilities. The study concluded that investor-owned nursing homes provided lower quality care than do non-profit or public facilities.

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Nursing Homes: Friend or Foe?

In Does Investor Ownership of Nursing Homes Compromise the Quality of Care?, Charlene Harrington et al. reveal that investor-owned nursing homes deliver lower quality care than do nonprofit or public facilities and explores the factors behind this marked decrease in quality of care.

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Investor Ownership in Nursing Homes

In the study regarding the effects of investor ownership on the quality of care in nursing homes, the researchers found that investor ownership does indeed lead to worse care and less nursing care than non-for-profit or publicly owned nursing homes.  This leads me back to the idea that our healthcare system is frequently motivated by financial gain. Does this study reinforce this idea, and is there anything that we can do to reduce this effect? Also, are nursing homes in other countries facing the same problems, or are they generally non-for-profit like the rest of their healthcare systems?