Nursing Homes Need Wide-Ranging Systemic Changes
The National Academies of Sciences has published "The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff". This new report examines how our nation delivers, finances, regulates, and measures the quality of nursing home care with particular emphasis on challenges that have arisen in light of the COVID-19 pandemic.
What they found does not surprise any of us who work in health care that "Wide-Ranging Systemic Changes Needed to Transform Nursing Homes to Meet Needs of Residents, Families, and Staff".
We have witnessed thousands of our frail and innocent elderly die in nursing home with the onslaught of COVID in this county. The actual number of deaths is unknown since many governmental entities either lied or hid the actual numbers. The pandemic put a huge shining spotlight on a problem with nursing homes that has been going on for decades. The problem can be summarized in a short sentence: "Less care for bigger profits".
Nursing homes are based on a hospital model of care - with a lot less funding. Just look at any nursing home: it looks, feels and smells like a hospital ward, a badly staffed hospital ward at that. These are not places anyone wants to spend their golden years in. We should be ashamed that this is where we send so many people to die.
The vast majority of the elderly can remain in the homes. But they cannot live in the community without help. We not talking about complicated or expensive help: simple things like somebody to go shopping for them, clean their house or apartment, make sure they take their medications on time or have help with taking a shower or bath.... none of this is rocket science.
But right now the system is broken- there is a national home health aide shortage unlike any of us has seen in our careers. The "Community Medicaid" program here in New York has become a nightmare- the Medicaid Redesign Teams were formed to cut Medicaid spending in NYS - and the cuts they made are gutting what few community services were available for the elderly. Many of these elderly who could have enjoyed living in their homes are going to be forced into nursing homes.
For the few elderly who may need a nursing home, we need a new model. Not based on a medical model but based on what a home should be. Ask yourself- if someone told you that you have to live in a nursing home what would you want it to be like?
You can download a copy of the report here.