PAY:
The articles and editorials in the Post-Dispatch regarding nursing home care
in have prompted discussion of very fundamental issues regarding long-term
senior care.
Unfortunately, this series started with the premise that nursing homes in
general are bad and that we all need to be wary that something evil is lurking
beyond our sight in the backrooms of every nursing home. Such a cynical
portrayal of nursing home operations in general is inaccurate. We are
caregivers, not criminals. And our nursing homes are an integral part of the
senior care system we as a society have developed.
The Post-Dispatch series chronicled the attempts of one husband and son to
take care of one wife and mother on their own. As depicted in photos and prose,
the decision was eventually made to seek professional nursing home care. The
reasons were many.
Her home was not handicapped-friendly. No professional medical care was
available on site. No one who was physically strong enough was always available
to adequately assist the woman when she did fall. And the full-time process of
personal health care proved to be more mentally and physically taxing than just
two primary caregivers could provide.
In every nursing home in this region, all those things missing in a private
home setting are automatically provided. The facilities, staffing and
nutritional programs are all designed to provide elderly patients with an
environment that takes their special needs into consideration.
And that is just the starting point.
Nursing homes all provide programs and activities designed to stimulate
social interaction, protect patients from self-inflicted injury, provide
much-needed laundry service on a frequent and regular basis, assist in daily
personal activities like bathing and shaving, and take care of house cleaning
and maintenance.
Most people who live in nursing homes are not capable of managing all of
these aspects of their lives by themselves. Some cannot walk, or read or even
converse. It is inevitable that some will fall, or become confused or become
sicker than when they entered a nursing home. In fact, most people who are
admitted to nursing homes do spend their final days there. Not because they are
abused or neglected -- but because people naturally decline as they get older
and the nursing home has indeed become their home.
In nursing homes, we deal daily with those conditions and those
inevitabilities. And we are always looking for ways to improve. Our nursing
homes do suffer from staffing shortages, primarily because enough people are
not entering this field of work to fill the positions required. The work is
demanding, and the pay is not great. The investment in staff salaries is,
however, the biggest line item in the typical nursing home budget.
Unfortunately, when the federal government cuts per-patient nursing home
reimbursements -- as it did this year -- or when the state withholds
patient-care dollars due to budget shortfalls -- as it did this year -- this
staffing problem is unlikely to improve dramatically in the near future. We are
being asked to do more, for more people, for a longer period of time with less
money. Now we hear a call for more expensive regulation than ever before.
We in the nursing home industry recognize that bad things happen to good
people all the time and that bad things can happen in good nursing homes on
occasion. In those instances, we do not as a group condone such behavior or
defend it. We work to prevent it and ensure that such incidents do not occur
again. But what is not warranted is a major overhaul of the laws pertaining to
nursing home care or the shutdown of one of the only options many people have
for quality long-term care.
Please do not let the drama or the cynicism of the Post-Dispatch series
scare you or make you doubt the legitimacy and value of our Missouri and
Illinois nursing homes. Rather, let it motivate our leaders to re-evaluate the
commitments and priorities they have made to our seniors.
A FORUM FOR OTHER VOICES, IDEAS AND OPINIONS\
Earl Carlson is executive director of the Missouri Health Care Association,
Jefferson City. Bill Kempiners is executive director of the Illinois Health
Care Association, Springfield.
