Wednesday, February 17, 2010

Nursing Homes

The term nursing home is a broad term and means many things to many different people. Nursing homes, to many people are perceived as places where one goes to die. “As institutions, they were properly seen as the choice of last resort” (Pratt: 2004 70). The National Center for Health Statistics (NCHS) defines a nursing home as a “facility with three beds or more that is either licensed as a nursing home by its state, certified as a nursing facility under Medicare or Medicaid, identified as a nursing care unit of a retirement center, or determined to provide nursing or medical care” (Evashwick 1996: 44).

As the years have gone by, nursing home care, the facilities and the quality of care has greatly improved. Nursing homes are now commonly referred to as rehabilitation centers, skilled nursing facilities, health care centers, etc. according to Nancy Ferrone (2010). However, while much has changed over the years, there will always be issues that need to be addressed regarding nursing homes.

Nursing homes have evolved greatly since the beginning of the 20th century. According to Linda Zinn (1999), there were many fortunate elderly during the early 20th century who had families who were able to care for them. Others may have been cared for by religious or ethnic communities. However, those who were less fortunate often found themselves in poorhouses. “And poor it was in every way: poor (if any) sanitation, poor food, poor clothing, poor sleeping arrangements, no nursing care and little, if any, medical care” (Zinn 1999: 22).

The non-profit homes which were sponsored by churches and other services for the communities did offer more quality care to those who were in need of housing and other services, but they (like the poorhouses) did not provide nursing care in the very early years according to Zinn (1999). As the years went on, these “nursing homes” evolved and grew out of the early charity-based forms of care. “They really came into their own, however, when the federal government became involved with assisting the needy, beginning with passage of the Social Security Act in 1935” (Pratt 2004: 70).

Nursing homes provided an institutional alternative to extended hospitalization. Hospital stays began to increase in price and therefore there became a need for less expensive places of care. “Nursing homes also served (and continue to serve) as homes away from home for the elderly and others needing assistance with daily activities and some level of medical care merely to survive” (Pratt 2004: 70). “Today, they are filling a greater and ever expanding role in the community.

The objectives of the modern nursing home are of a positive and challenging nature” (McQuillan 1974: 3). According to McQuillan (1974) the objectives are:

1. To provide continuing care for those recovering from surgical or medical disorders.
2. To assist patients in reaching optimal physical and emotional health.
3. To provide for the total needs of patients- physical, emotional, and spiritual.
4. To assist the aging toward an active participation in life.
5. To provide for rehabilitation services when the need exists.
6. To work cooperatively with other community and social agencies.

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