What We Should Expect Out of Our Nursing Homes

Dorian Martin Health Guide
  • Nursing homes seem to be in the news every day.


    First in late September, the New York Times reported about the declining quality of care in nursing homes across the country as a result of their purchase by big investment firms.


    Now a list of 54 poor-performing nursing homes in the U.S. has been published by Medicare and Medicaid Services. For me, these reports indicate that our nation has reached a critical crossroads and that we need to have a serious discussion about what we want - and expect - for each aging and frail member of our society.


    The late Hubert Humphrey, a former U.S. vice president, was quoted as saying, "It was once said that the moral test of Government is how that Government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped."  

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    I'd extend his sentiment to include for-profit businesses and non-profit organizations who work in the health care area, including those companies who are running nursing homes, health maintenance organizations, insurance companies, hospitals, hospices, and pharmaceutical companies.


    Having watched my mother for the past several years move through the end-of-life issues, I've often found a disjointed health care system that can be focused more on the profit margin than the quality of life issues for those who are elderly or who are frail. I do understand the need for cost control, but I think there needs to be a commitment to a standard level of quality of care in every health care facility in this nation. It should not matter if a loved one is in a nursing home in Alabama or Washington State; the level of care should be equally equitable and of good quality.


    On the flip side, I also think that we, the consumers of health care for ourselves and our loved ones, have to be a lot more realistic about what the health care system can do as well as what it really should do for those who are in need of critical care. We need to demand coordination of services and well thought-out care plans that are realistic. But I also truly believe we need to be prepared to say "goodbye" and to let go and let our loved ones die when the time is right, instead of fighting for extraneous services that might prolong a loved one's life, but that don't add quality to his or her existence.


    Finally, I think that those who are on the front lines of health care, such as nurses and nurse's aides, need to be paid equitably for the services that they provide. I know that the nursing home staff that cared for my mom had to deal with so many issues, whether dealing with her increasingly complex physical issues or her emotional outbursts. These staff members need to be valued not only through our thanks and the snacks that we tend to bring during the holiday season, but also with the financial remuneration that is deserved by people who provide such an important service to our loved ones.


  • All of this is to say that we need to decide how we want to take care of our loved ones as they age or those who become increasingly frail due to illness. We need to start demanding accountability and quality in our health care systems by both those who run them and the policymakers who oversee them. And we need to realize that what we do today is setting the tone for the quality of health care that we will receive when we approach the end of our own lives.

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Published On: November 30, 2007