Braden Despain Proposal Making Nursing Homes More Quality Effective

In the US, nursing homes are a type of long-term health care facility that houses disabled and dependent people largely due to old age. Whether or not people are aware, there is a significant portion of the United States population of the age 65 or older that lives in a nursing home, or similar long term health care facility. And according to research and statistics, that number of residents in long-term health facilities is growing and by the year 2030 it is predicted that over 70 million people in the United States will be at least 65 years old, with 5 million being over the age of 84. (Shin) It is evident that this is already happening and this population growth needs to be addressed. In the past, federal regulations have been made in an attempt to solve this issue of increasing residents of nursing homes; however they are now neither extensive nor current enough to meet todays needs and demands for nursing homes. Yes, there has been sincere attempts made to fix this problem and they were effective in previous years, but with the population shifting towards an older age bracket more actions must be made. This issue of increasing residents in nursing homes as already received a lot of attention. In 1987, the federal act called Omnibus Budget Reconciliation Act (OBRA) was passed which set the ground rules for the standard of care in long-term health care facilities. This all includes each residents physical, emotional, mental, spiritual, and social health. This law also established requirements for training and assessment of certified nurse assistants (CNAs) as well as rules for in-service training. (Zhang& Crabowsk) CNAs are the nursing employees that directly care for the residents. Not only are they required to meet basic physical needs, but CNAs are very

important in the emotional and mental well-being of each individual resident. OBRA has done a fine job, but since the baby-boomer generation is on the door steps of nursing homes there are more and more residents that will be in need of sufficient care. This concerns not just the residents in nursing homes, but also their family and friends. This may also be a concern for adults nearing senior citizenship that may one day end up in a nursing home. Even younger people worry about what their future will be like as they start to save and invest money and plan for their lives. It would be nice and convenient if friends and family members could take care of their aged loved ones, but in reality that would only be worse than a nursing home which would be much more extensive. Nursing homes are necessary. Those whove lived a full life, should be given comfort and security. Also remember the individuals in nursing homes who still somewhat have youth, but are disabled due to injury or illness. A good, comfortable, healthy environment should be provided. Mental health greatly influences physical health. This applies to elderly with Alzheimers or Dementia just as much. Even though they may not be aware of their quality of life, they deserve it all the same. That is why updated and improved federal regulations should be made in order to meet the comfort and needs of each resident. The benefits outweigh the costs. Going deeper into the financial aspect, this is one of the main reasons the government is satisfied with its current law. Not only does it cost money to make and enforce more legislation, but long-term health care can be expensive in of itself. Nursing homes are faced with balancing the cost and quality of care (Bowblis). But when a minimum is set to maintain quality, administrators and other representatives immediately go with the minimum to go with the cheapest price. Both the governments and nursing homes dont want to spend more much than is required. The contingent factor that plays into this is that there are more and more residents

being admitted to such long-term health care facilities. This is a potentially a problem because as the population in nursing homes increases, there is a demand for more caregivers, which would cost more. The balance and correlation between cost and quality of care is then negatively affected, because when that demand gets neglected the quality suffers. The minimum requirements were suitable to the corresponding Census, no doubt about it. But the baby boomers arent babies anymore. Now they are all coming to the point where living life independently is becoming more difficult each year of their lives. Eventually, a majority of them will be living in nursing homes, and many of them already are at that point. In response, both nation and state legislations should consider imposing new laws that would increase the minimum standards of care of long-term health care facilities. The reason for this is because increased costs are inevitable. To explain, the more residents there are in nursing homes nationwide, the more money that is going to be spent towards long-term health care. Cattle dont need comfort and luxuries and so ranchers dont spend extra money on messages, air conditioning, or exquisite food for their cows. But for a human being who has lived their life in full and is starting to lose both physical and mental functioning, the care they receive shouldnt be just the bare minimum. Im not suggesting that everyone needs to die driving a Ferrari or relaxing on a cruise ship, but it is important to provide the elderly with ample care, no matter the resources and costs. The immediate cause of this issue is the imbalance between the numbers of residents compared to the numbers of CNAs. (Shin) As nursing home populations go up, and the number of hired employees stays the same, the time allotted to each resident increases. Its just simple math. To avoid the ratio getting smaller, more CNAs would be required. In order to increase the minimum of CNAs and other nursing employees, such as nurses and social workers, new and

improved federal legislation needs to be made, regarding the standard of care in long-term health care facilities. In addition to updated regulations as well as more regulations, education for nursing care givers should be up to par. Its true that a subject can only be taught so many ways, but it could prove to be useful to have continuous and updated training on current glitches in the system. Glitches refer to anything that interferes with the quality of care, such as outdated routines or teamwork management. When it comes to caring for people there should be constant efforts to improve the standard of living and quality of care of the nations elderly. This is the case for many higher-class people in the United States, so should also the circumstance be for the age group nearing the end of life, if not more. All aspects of these senior citizens health depend solely on the care givers that work directly with them, so it is vital that these employees receive superior and more frequent training. I commend those who have and currently work to better the lives of those around them. I assume that there are many of the people like that in the world that have sincerely worked to establish a high standard of care for all nursing homes in the United States. However, things involuntarily tend to change over time, specifically age and populations. And when things change, there needs to be voluntary change to accommodate. Expectantly, government officials and lawmakers should recognize the demographics trends in regards to nursing homes and act appropriately.