Persuasive Essay on The Problem with Nursing Homes
Introduction
As numerous observers stress out, the term “nursing home” is often associated not with home but with a setting where elder people feel isolated and do not receive the service they hoped for. Many nursing homes in the United States face the problem of high turnover rates and fail to create a homelike environment, both in terms of physical layout and atmosphere. These are serious issues that are a result of several factors: low reimbursement rates from state Medicaid payment systems and a lack of government accountability regarding spending on direct resident care within the settings. This essay seeks to examine the existing challenges related to quality and safety within nursing homes, and proposes potential solutions to address these issues.
The Current Problems
Like in other organizations, in nursing home settings, the team dynamic is one of the crucial factors that determine whether caregivers can effectively provide their service. Some specialists frequently question the use of the term “nursing homes,” stressing out the prevalent shortage of nursing staff and the lack of home like culture within these facilities. This is a fundamental observation that underscores many current issues within nursing homes.
According to the recent findings, there are severe understaffing issues in nursing homes and the situation with an overly institutionalized physical structure and culture also needs improvement. Additionally, these issues, which have persisted for decades, were worsened during the pandemic period. In addition to staffing shortages, many nursing homes in the United States maintain an institutionalized atmosphere, both in terms of their physical layout and their cultural norms. Unfortunately, nursing homes often resemble outdated hospitals, with the environments that lack the warmth and comfort of a true home. Thus, shared bedrooms and bathrooms are still common in these settings, and residents usually cannot organize their daily routine according to their personal perspectives. For example, they may not have the opportunity to organize meal or sleep schedules. Over the past few decades, a few alternative models, such as small-home and resident-directed approaches, have emerged in the United States. The Green House project, one of the most notable small-home models, has been associated with higher quality of life and care. However, widespread adoption of these models has been hindered by various factors, including the significant capital costs involved in renovations and new construction projects (Gandhi & Grabowski, 2021).
The Possible Solution
If the aim of policymakers is to enhance staffing levels in nursing homes and create a more homelike environment, the initial step is to revise the payment and regulatory frameworks governing these facilities. Since public funding constitutes the majority of revenue for nursing homes, public investment will be necessary to support these enhancements. For facilities primarily serving Medicaid beneficiaries, the task of investing in improved care delivery is particularly daunting. Such facilities cannot easily raise private fees to hire additional staff or finance the construction of small-house care models. While some of the funding shortfall may be recovered through increased oversight of existing government payments, it remains uncertain whether the substantial changes advocated in this discussion—such as significant staffing increases and the implementation of resident-directed small-home models—can be solely achieved through enhanced accountability measures. The transition toward smaller nursing home models like the Green House initiative has largely been driven by the broader culture change movement within the healthcare sector. This movement encompasses a range of innovative care models aimed at reimagining the structure, roles, and processes of nursing home care, transforming these institutions from healthcare facilities into person-centered homes offering long-term care services. Fundamental aspects of culture change in nursing homes include prioritizing resident autonomy, fostering a homelike atmosphere, nurturing close relationships, empowering staff, promoting collaborative decision-making, and implementing quality-improvement initiatives (Grabowski, 2022).
Conclusion
In order to promote higher staffing levels and the adoption of care models that resemble home environments more closely, policymakers must overhaul the payment structure for nursing homes and ensure that facilities are transparent and responsible in their use of government funding. Through these reforms, nursing homes in the United States can better live up to their name. Additionally, revising payment policies can serve as a crucial initial measure in facilitating the expansion of small-home models across a greater number of facilities.
References
Gandhi, A., Yu, H., & Grabowski, D. C. (2021). High nursing staff turnover in nursing homes offers important quality information. Health Affairs, 40(3), 384–391. doi: 10.1377/hlthaff.2020.00957
Grabowski D. C. (2022). Putting the Nursing and Home in Nursing Homes. Innovation in aging, 6(4), igac029. https://doi.org/10.1093/geroni/igac029
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