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.

Almost a decade ago, Peter S. Silin wrote Nursing Homes: The Family's Journey to provide family members with practical advice and emotional support. This successor volume incorporates the new and sometimes baffling world of assisted living. Nursing Homes and Assisted Living focuses on the psychological, emotional, and practical aspects of helping family members and seniors make a difficult transition. Silin approaches his subject with compassion and sensitivity, guiding readers through the process of finding the best possible care. He describes how nursing homes and assisted living facilities work and outlines the selection process; he explains how to prepare for the day a relative moves into a facility and suggests ways to help the resident settle in; he focuses on the family member's role in solving problems, obtaining good-quality care, and visiting. The author’s insights help caregivers cope with difficult decisions and deal with emotional issues such as guilt and grief, while celebrating the tender, rewarding aspects of being a caregiver. Vignettes from real-life caregivers narrating their experiences amplify Silin’s advice and will resonate with families. This book provides caregivers, family members, and seniors with the information they need to effect successful transitions. It is also a valuable tool for social workers, nurses, and family therapists.

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.

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.