What is a Nursing Home?
Nursing homes are facilities that provide residential care to older people, senior citizens, or disabled individuals. They offer medical and other services, often with skilled nurses and nursing aides available 24/7. But have you ever wondered how these places came into existence? Let’s dive into the history of nursing homes.
The Early Days: Poorhouses
Back in the 17th century, poorhouses were the first institutions to care for orphans, the mentally ill, elderly people, and others deemed needy. These places were often criticized for their conditions, leading to the creation of private care facilities in specific communities. But how did these early institutions evolve into what we know today as nursing homes?
The Great Depression and Beyond
During the Great Depression, poorhouse conditions became even more dire, prompting the Social Security Act (1935) to be established. This act led to the creation of residential living homes, known as board-and-care homes or convalescent homes, which offered basic care and meals in a private setting for a fee. These homes were successful by World War II and eventually led to the development of permanent, state-federally funded nursing homes by 1965.
Regulations and Improvements
The Nursing Reform Act of 1987 defined nursing home services and added the Residents’ Bill of Rights. In the UK, modern public nursing homes were built after World War II, leading to health policy reforms in the 1950s. The Registered Homes Act 1984 and Care Standards Act 2000 regulated private care homes.
Services and Funding
Nursing homes vary in their services and funding sources, including Medicare, Medicaid, and personal funds. When considering a nursing home for yourself or a loved one, there are several factors to consider: managing progressive diseases, recent hospital admissions, unmanageable medical needs at home, social isolation, and inadequate caregiver knowledge.
Choosing the Right Nursing Home
Evaluating a nursing home involves more than just looking at its services. You need to consider activities, medical needs, finances, licensing, and staff qualifications. A visit in person can provide valuable insights into the resident experience. But what exactly should you look for?
Staffing Requirements
In the US, nursing homes must have a registered nurse (RN) available for at least 8 hours a day and a licensed practical nurse (LPN) on duty 24/7. Nursing staff includes RNs, LPNs, social workers, certified nursing assistants, and physical therapists.
RN Job Duties
Registered nurses implement care plans, administer medications, monitor medical changes, and provide direction to nursing assistants and LPNs. They play a crucial role in ensuring the well-being of residents.
LPN Responsibilities
Licensed practical nurses monitor residents’ well-being, administer treatments, and dispense medications. Their duties are essential for maintaining the health of nursing home residents.
Certified Nursing Assistants (CNAs)
Nursing assistants provide basic care under the supervision of a RN or LPN, including bathing, dressing, meals, and transferring patients. They play a vital role in ensuring that residents receive the necessary daily care.
Occupational Therapy and Physical Therapy
Occupational therapy helps individuals regain skills and adapt to physical or cognitive changes after an injury or illness. It focuses on daily living activities, instrumental activities of daily living, and social participation. Occupational therapists work with residents to reintegrate into society by practicing public dining, transferring to different surfaces, and assessing the need for home modifications.
Physical therapy aims to regain strength, endurance, flexibility, balance, and range of motion after an injury, illness, or surgery. It can help prevent injuries and accidents by restoring mobility and increasing fitness levels.
Elder Abuse: A Concern in Nursing Homes
Elder abuse is a significant concern in nursing homes, including physical, emotional, and sexual abuse, as well as neglect. Physical abuse results in scars and bruising, while emotional abuse leads to mood swings, anxiety, and depression. Sexual abuse involves forced unwanted sexual activity, often when the patient is sleeping, sick, or weak.
One factor unique to elder abuse in nursing homes is that many nursing home contracts require residents to sign delegation clauses, giving up their right to trial by jury and instead using an arbitrator to settle disputes. In states such as Connecticut, nursing home abuse is considered a felony charge with minimum mandatory sentences.
Funding and Types of Nursing Homes
Long-term care facilities exist under three major types: privately owned, non-profit/charitable, and municipal. Aspects of funding, admission criteria, and cost are regulated by provincial governments in Canada. Residents pay daily rates for ‘room and board’ and receive subsidies if they cannot afford the monthly fees.
In the United Kingdom, care homes and nursing facilities are regulated by different organizations. The cost of a care home is means-tested, and residents require an assessment of their needs and financial condition from their local council. Care Quality Commission regulates care homes in England, while Wales has its own inspectorate. In Scotland, Social Care and Social Work Improvement Scotland oversees care quality.
In the United States, there are three main types of nursing facilities: NFs (Nursing Facilities), ICFs (Intermediate Care Facilities), and skilled nursing facilities. NFs typically require private payment from individuals or their families, with insurance coverage available through private health insurance or third-party services like hospice companies. Board and Care Homes are facilities providing living quarters and care for those requiring assisted living services. They can range from small residential homes to modern facilities, staffed by licensed professionals, regulated to ensure proper care.
Assisted Living Residences provide supervision or assistance with daily activities for people with disabilities, offering independence and dignity. Skilled Nursing Facilities (SNFs) are nursing homes certified to participate in Medicare, providing 24-hour medical care for eligible patients. Medicaid eligibility varies by state.
The Role of the Centers for Medicare and Medicaid Services
The Centers for Medicare and Medicaid Services oversee Medicare and Medicaid programs, overseeing licensing of nursing homes, monitoring their compliance with minimum requirements, and setting regulations and manuals for implementation.
Choosing the right nursing home is a significant decision, and understanding the services, funding, and regulations involved can help ensure that you or your loved one receives the best care possible. Remember, every resident deserves dignity, respect, and quality of life in their golden years.
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This page is based on the article Nursing home published in Wikipedia (retrieved on December 23, 2024) and was automatically summarized using artificial intelligence.