Nursing Homes

Nursing homes are where some of the most vulnerable live and work. In too many homes, the conditions of work make it difficult to make care as good as it can be. For the last eight years an international team from Germany, Sweden, Norway, the UK, the US and Canada have been searching for promising practices that treat residents, families and staff with dignity and respect in ways that can also bring joy. While we did find ideas worth sharing, we also saw a disturbing trend toward privatization. Privatization is the process of moving away not only from public delivery and public payment for health services but also from a commitment to shared responsibility, democratic decision-making, and the idea that the public sector operates according to a logic of service to all. This book documents moves toward privatization in the six countries and their consequences for families, staff, residents, and, eventually, us all. None of the countries has escaped pressure from powerful forces in and outside government pushing for privatization in all its forms. However, the wide variations in the extent and nature of privatization indicate privatization is not inevitable and our research shows there are alternatives.

This first hand report on the work of nurses and other caregivers in a nursing home is set powerfully in the context of wider political, economic, and cultural forces that shape and constrain the quality of care for America's elderly. Diamond demonstrates in a compelling way the price that business-as-usual policies extract from the elderly as well as those whose work it is to care for them. In a society in which some two million people live in 16,000 nursing homes, with their numbers escalating daily, this thought-provoking work demands immediate and widespread attention. "[An] unnerving portrait of what it's like to work and live in a nursing home. . . . By giving voice to so many unheard residents and workers Diamond has performed an important service for us all."—Diane Cole, New York Newsday "With Making Gray Gold, Timothy Diamond describes the commodification of long-term care in the most vivid representation in a decade of round-the-clock institutional life. . . . A personal addition to the troublingly impersonal national debate over healthcare reform."—Madonna Harrington Meyer, Contemporary Sociology

As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.

A NATIONAL BESTSELLER SHORTLISTED FOR THE BALSILLIE PRIZE FOR PUBLIC POLICY It took the coronavirus pandemic to open our eyes to the deplorable state of so many of the nation's long-term care homes: the inhumane conditions, overworked and underpaid staff, and lack of oversight. In this timely new book, esteemed health reporter André Picard reveals the full extent of the crisis in eldercare, and offers an urgently needed prescription to fix a broken system. When COVID-19 spread through seniors' residences across Canada, the impact was horrific. Along with widespread illness and a devastating death toll, the situation exposed a decades-old crisis: the shocking systemic neglect towards our elders. Called in to provide emergency care in some of the hardest-hit facilities in Ontario and Quebec, the military issued damning reports of what they encountered. And yet, the failings that were exposed--unappetizing meals, infrequent baths, overmedication, physical abuse and inadequate personal care--have persisted for years in these institutions. In Neglected No More, André Picard takes a hard look at how we came to embrace mass institutionalization, and lays out what can and must be done to improve the state of care for our elders, a highly vulnerable population with complex needs and little ability to advocate for themselves. Picard shows that the entire eldercare system--fragmented, underfunded and unsupported--is long overdue for a fundamental rethink. We need to find ways to ensure seniors can age gracefully in the community for longer, with supportive home care and respite for family caregivers, and ensure that long-term care homes are not warehouses of isolation and neglect. Our elders deserve nothing less.

Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.

Long-term care services include a broad range of services that meet the needs of frail older people and other adults with functional limitations. Long-Term care services provided by paid, regulated providers are a significant component of personal health care spending in the United States. This report presents descriptive results from the first wave of the National Study of Long-Term Care Providers (NSLTCP), which was conducted by the Centers for Disease Control and Preventions National Center for Health Statistics (NCHS). This report provides information on the supply, organizational characteristics, staffing, and services offered by providers of long-term care services; and the demographic, health, and functional composition of users of these services. Service users include residents of nursing homes and residential care communities, patients of home health agencies and hospices, and participants of adult day services centers.

The 1.5 million elderly & disabled individuals residing in nursing homes are a vulnerable population. Concerns with inadequate care involving malnutrition, dehydration, & other forms of neglect have contributed to mounting scrutiny from state & Fed. auth. There is also growing concern that some residents are abused -- pushed, slapped, beaten, & otherwise assaulted -- by the individuals to whom their care has been entrusted. This report: determines whether allegations of abuse are reported promptly to local law enforcement & state survey agencies, assesses the extent to which abusers are prosecuted & the impediments to successful prosecutions, & evaluates whether sufficient safeguards exist to protect residents from abusive individuals.