Tuesday, 25 October 2011

Creativity, Foresight And Compassion Needed In The Search For Nursing Home Alternatives

By Byron Jonas


As our loved ones grow older in increasing numbers, they require more care. One problem with nursing homes is that nobody wants to live in one. Another problem is that the industry is suffering financially. There are ways to keep our elders out of a care-center setting and in their own home or a homelike setting. There is a real need for nursing home alternatives now and in the future.

In the twentieth century, the trend has been toward putting our elderly in nursing homes. Some 1.6 million Americans live in one. Some of these have no one else left and nowhere else to go. The rest have families that for the most part had no other way to care for them.

If you ask just about anybody where they want to be for the last years, days, minutes of their lives they would not answer "in an old-folks home." Skilled nursing facilities are seen by many Americans as cold, with crowded wards -- antiseptic and fetid by turns. The aged and infirm lose their independence and dignity and could be subject to neglect or abuse.

Some facilities deserve this reputation more than others do, but it is hard to deny that they are anything but institutional by their very nature, even in some of the best. Our skilled care industry in general has been facing difficulties for some time from a shortage of qualified workers to low federal and state insurance payments with a greater burden of documentation and regulation to receive them.

There are in-home based services such as home health care and housekeeping. Independent living centers and adult day care centers provide supervision and care while the primary caregiver is at work. There are alternate living arrangements like retirement apartments or residential communities that provide meals and housekeeping and helps the resident with appointments transportation, etc.

If the time comes when your loved one can no longer live independently with assistance, or needs around the clock supervision, or develops other age or health related problems, there may be no other choice but to put them in a "home". One of the ways that the care industry is responding to the needs of its customers is by making fundamental changes in the way in which skilled care facilities are managed. These center on making nursing homes less institutional and more home like and giving the residents more autonomy and an active role in facility governance.

As we contemplate solutions to elder care we are reminded that the need for these solutions is growing rapidly. In a wave 60 or so years behind the human birthrate comes a bust for any boom. It is just a natural part of life, after all; but unprecedented population numbers will require exceptional creativity and flexibility to create nursing home alternatives at the personal, institutional, and societal level.




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