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Paper Abstract: Discusses increasing number of elderly in long term care facilities. What can be done to make long term care better. Impact of cost, quality, access of Medicare and Medicaid, and new technology in nursing homes. Reasons why costs vary. What constitutes quality nursing homes. Problem of access. Alternative care. Paper Introduction: Nursing Homes Introduction The number of elderly who are living longer is on the rise because of new methods of treatments, new medications and use of medical technology to improve their life span. On any given day, nursing homes, or as many are now called, “long-term care facilities”, are caring for about one in twenty Americans over the age of 65. Almost half of all Americans turning 65 this year will be admitted into a nursing home at least once. It is projected that in 2020, 40 percent of Americans will die in nursing homes. As the numbers increase in utilization of nursing homes, there is increasing concern about cost, quality and access- concerns that need to get attention. The purpose of this research paper is to discuss what has been done in recent years and what can be done in th Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. Nopart-time low-wage workers can do that. 88). These services are provided topatients and their families in their home or place of residence. Today thereare many different technologies that can cure a wound better in less time.The problem of having this kind of technology, which helps the quality oflife, is the cost. Nursing Homes: The Complete Guide. New York, 199 .Kovner,Anthony R. But there are some alternatives to nursing home care, For example,there is home health care. The machine then sucks out bacteria and excessfluid"(business and company Journal). Some have worked long hourson many different clients because of the absence of other staff during thatday. The answer is undoubtedly NO. This means hiring new people, training them, getting them to work asa team,. For most patients, especially the elderly, nursing homes may well bethe best solution. And those nurses and assistants do not come cheap! Home health care is a better alternative in somecases because it helps the elderly who are afraid of nursing home to staywith in their home. In order tocover some of the extra costs of nursing homes some people purchasesupplementary insurance, like Medigap or other kinds of insurance, whichwill protect their assets from any kind of risk. At times itis difficult to work with an elderly person and a lot of patience isneeded. The purpose of this research paper is to discuss what has beendone in recent years and what can be done in the future to make long termcare better for the elderly who are no longer able to care for themselves.We will also look at the impact of cost, quality and access of Medicare,Medicaid and new technology in nursing homes. And, besides,Columbia is now under investigation by the federal government for Medicareand Medicaid fraud- over-billing in many cases, listing more complicatedprocedures when actually, simple ones were performed. But now, the ice-berg, in theform of the Baby Boomer generation is upon the industry. It is quite possible within a few years, as thebaby boomers become senior citizens, the demand and the cost for nursinghomes will climb even higher Private insurance is unlikely to cover the full cost of long-termcare. Medicare has two parts: Part A and Part B. Bedford, MA, 1993.Robertson, Kathy: " Cost keeps Technology Out of Many Nursing Homes." Sacramento Business Journal, Dec 3, 1999. Home careis a method of delivering nursing care and other therapies as required bythe patient's needs for example new technology. As the future will bring us more and more elderly who may need longterm care, the obligation of the medical and care industries are to findthe funds- either through public offerings of stock or affiliation with afoundation or church, to build as soon as possible in order to be ready forthe flood-tide of new arrivals. It can run anywhere between $117 and$13 a day to operate, in addition to the cost of the nurse that have tochange the dressing more then 3 times a day. There are a number of public corporations, such as Columbia/HCA thatoperate more than 2 for=-profit health care facilities coast to coast.But these are mainly hospitals and not nursing homes. All these problems can affect the elderly physically andemotionally. Virginia: 1989.Ridge, Dorothy Kirk, R.N,C. (See table below) Medicare is a federal health care program that has been the center ofattention. and Steven Jonas. At times many of the staff are tired. The future does nothold much financial relief. Part A of Medicare iscovered by the taxes that are collected from employees and employers. One needs to satisfy the differencebetween what it would cost for home care, compared with stay in a long-termfacility. The most important aspect of trained employees who stay at thefacility is that patients have little contact except with one another andthe staff. The nurses and staff may be over-worked and tired so that result in toanger and abuse of the elderly who lack the will to cooperate withtreatments. So the result is inadequate treatment and low quality of care. More recently, managed health care programs and nursing homeshave been highly criticized for their lack of quality services. The average cost ofstaying in nursing homes, depending on the level of care received, can runanywhere from $35 to $2 a month. It is a place to live if a person must have human help in several of these activities: Getting food to the mouth (or otherwise into the body), moving the body from place to place, breathing, knowing where the patient is, being continent of bladder and bowels, or coping with incontinence, being in need of special nursing treatments for rehabilitation (Davis 1 ). Almost half of all Americans turning 65 thisyear will be admitted into a nursing home at least once. Nursing homes can vary by type ofownership, type of certification, the number of beds, and the region of thecountry. Most families care for their relatives as long as possible, until the physical, emotional or social demands become too great for the family to continue without assistance (Richards 11).This situation will only worsen in the next decade, and there are noavailable statistics about plans for constructing new, modern long-termcare facilities. As thenumbers increase in utilization of nursing homes, there is increasingconcern about cost, quality and access- concerns that need to getattention. However, if the facility is determined to keep good, productiveemployees, it means raising their pay, which then has to be reflected inincreased rates for patients and their families. Cost, quality,and access are the major areas in which to confront that choice. The patientsthemselves often have come to depend on a special nurse or orderly, andwhen they leave and someone else comes in fresh, the rapport must bereestablished. 77). One of the problems with federaland state programs, such as Medicare and Medicaid, is the fact that thecost of the services provided has a way of increasing at a much greaterpace than the government's ability to do anything about it. The Nursing Home Primer. So, at least atthe outset, those fears and stress need to be calmed and alleviated. Where quality care is vital for the patients is in helpingsolve the fear that the very term "nursing home" brings to many elderly.They tend to see it as a last stop before the mortuary, and their attitudeand stress levels are high. Because of wage scales and the hours ofshifts, and the st6ress on employees, there is usually a very high turnoverrate. WORKS CITEDDavis, Ruth: The Nursing Home Handbook. In the Sacramento Business Journal, Kathy Robertson points out, We deliver care like we did in the 196 s and its time we move in to the next millennium. There have been many reports in the news about peoplebeing abandoned in their rooms, leaving them sometimes for a day or morelying in their own feces or urine. A study indicates that 46% of 75-year-olds are bankrupt after 13 weeks of nursing home care"(Forrest 2 9). For example a VAC "promotes woundclosure by applying localized negative pressure to draw the edges of thewound to the center. Health Care Delivery in United States. So that brings us to two programs that are funded by the federal andstate government that help to cover part of the cost for nursing homes,Medicare and Medicaid. As vital as avoiding huge turnover is the training given to thefacilities' staff. (InCalifornia, there is also a supplementary program called MediCal.) In orderfor elderly persons to qualify for nursing home care under Medicaid, The potential recipient must be able to demonstrate that he/she has income below the minimum set by the state and that the kind of care he/she needs can best be provided in either a skilled or an intermediate care nursing home (Pieper pg. While it is true that people now live longer, it is also a fact that a longer life will incur more and different ailments and medical conditions that home care may not be able to solve. According to Growing Old in America (1996), "Homehealth care is one of the fastest growing segments of the health careindustry" (p 114) Alternatives for home care can often meet both themedical and non-medical needs of a patient. Chances are, if round-the-clock professional help is needed(assuming family members are not trained enough) the expenses may be morethan it would cost per day in a facility. (Acute hospitals andspecialized medical care are excepted)" (Davis 1 ).Cost Issues Long term-care is very expensive and it often becomes a financialcatastrophe for the elderly person and their family. "More then 5 percent of nursing homes revenue comes from Medicaid" (Pieper 86). On any given day, nursing homes, or as many arenow called, "long-term care facilities", are caring for about one in twentyAmericans over the age of 65. Sometimes this causes a setback for some of the most fragileparents. We need to establish whatnursing homes are, and how they operate. According to the" Medicare and You 2 1" booklet, the co-payment after 21 days has been changed to $99, which shows that as demandfor health care rises, so has the cost. A sponge-like device is placed in the wound cavity orover flap or graft. But, while costs vary even within a community- "Rates around the country vary from under $1 to over $2 a day...And you should realize that higher prices may not always mean better service (Davis 43).Why do costs vary so much? While patients love to share memories and experiences withothers in the facility, they depend on the staff to take care of them andgive them a sense of hope. Some of the regulations that have beendesigned by the government to ensure the quality at the long-term carefacility are by state licensure regulations, federal regulations and JointCommission on Accreditation of Health Care Organizations (JCAHO). One can easily ascribe the present need formore long-term care facilities to the Titanic. It is the home setting and the surroundings that thepatient is used to that help his emotional well-being and relieve stressand anxiety of being in a strange place, where all the others are eitherthe same age, and mostly infirm. Holbrook MA: Adams Media Corporation, 2 .Forrest,Mary Brumby , LPN, Christopher B. The cost is putting a damperover the use of technology at the nursing homes.Access The major question about access is Do we have enough long term, skilled care facilities to meet the demand. The same thing is true with the long-term care facilityindustry. Access delayed isaccess denied. It requires specialists ingerontological care. The best way to describe quality is when "right care is provided atthe right time, care is provided in the right manner, and care can beobtained when is needed" (Kovner, 1999, pg.374). The decisionfor a facility or home care is often a difficult one for family members,because it is not merely a medical and financial burden, but an emotionalsituation as wellConclusion A nursing home is not a home. Nursing HomesIntroduction The number of elderly who are living longer is on the rise because ofnew methods of treatments, new medications and use of medical technology toimprove their life span. To sum up- long termfacility costs are high and bound to go higher, as government fundingcannot keep pace with rising rates, and many seniors and their families areunable to pay for Medigap and other private insurance to bridge the gap.Quality The health care system in this country has been under scrutiny formany years. New York, 1999.Pieper, Hanns G., Ph.D. With transportabletechnologies such as durable medical equipment, oxygen supply andintravenous fluids there are countless possibilities for treatment withinthe home setting. Someone in the federal government needs to step forward andmake it not only possible, but financially meaningful for new facilities tobe built now- not years from now.Alternative choice The question whether there is an alternative to long-term care in afacility cannot be totally answered, because some elderly and others whoneed long-term care have conditions that could be handled at home, whileothers require round-the-clock care with medication and technology notavailable to be placed in the home. But, not the only solution. We invent all these wonderful medical technologies and when it comes to implementing them, they are so cost-prohibitive that there's limited use (Robertson, 1999).Many years ago patients with infectious problems were taken cared of bytraditional kinds of treatments that used Band-Aids and Maalox. There is also a question of howmuch Medicare or Medicaid or Medigap insurance would cover. It is projectedthat in 2 2 , 4 percent of Americans will die in nursing homes. Some of the problems withnursing homes are lack of technology and lack of training that affects thequality. At its construction, itseemed impregnable. Itcovers hospital insurance, home health care, and nursing home care."Medicare does not cover nursing home stays beyond 1 days annually andrequires $95 per day co-payment after 21 days" (Kovner, pg.23 ) (see thetable below). Statelicensure is mandatory, Federal regulation is only necessary if thefacility participates with Medicare and Medicaid, and JCAHO standards arevoluntary. Most of the elderly become eligible for Medicaid,which has become the main funding source for nursing homes. It's a crime. Nevertheless, as more andmore people age, grow ill or feeble, and require moiré than home care canprovide, a long term facility may well be the only answer. Numerous alternatives areavailable for persons seeking health care at home. Medicare and Medicaid don't cover many of thesetechnologies, because they cost a lot. These aspects are lack of trained staff, and the lack oftechnology at the facilities. And, as was mentioned earlier, the fact that the Baby Boomer generation is aging and will increase the demand for space in long-term care facilities makes it vital that new facilities be built that will include the latest technological and medical advances. Nursing Homes or Board & Care: Making the Right Choice. Whilecosts may be within a family's budget, and quality may be the answer tocareful selection, it is still access that presents the major problem.Until there are enough facilities, modern, clean, up-to-date medical andsocial facilities, at reasonable cost and with caring professionals incharge, there is still a cloud that hangs over the future of an entiregeneration. Accidents can be minor or can be severe, theycan be anything from a fractured hip caused by under-trained staff "tryingto transfer a very heavy male resident from bed in to a wheelchair, butthey forgot to lock the wheels of the chair"(Ridge, Pg. Forrest, M.D., and Richard Forest. Still, with so many regulations and laws, two main aspects thatmakes a nursing home a home-like atmosphere has not been given enoughattention. By the time afacility's administration becomes aware of such problems, it may already betoo late for some residents. There have been reports of over- orunder-medication, accidents, and even physical abuse. Nursinghomes present an even more complex problem because it is the vulnerableelderly who cannot speak, walk or talk that most often need professionalcare and help. And getting them familiarized with the patients. As Davis (43) points out: One reason islocation, even the age and condition of the building, staffing, actual day-to-day costs, and whether the facility is supported by an organization suchas a Church, foundation, or government sponsorship. At one time, it was able to solve the needs for elderly patientswhose families could no longer maintain them. When and if a decision must be made about placing an elderlyperson in a nursing home, no matter what its title, care must be taken thatit is a "skilled nursing facility- a government category for a Medicare-certified, state-licensed organization that must provide room and board aswell as all the care that is needed by the resident. There have been many rules and regulations that have been passed toprovide high quality nursing homes. The key to proper access, as rooms become less available, is to have afamily member or members do a very careful search and examination ofavailable facilities- checking everything from climate control to diet,medical facilities as well as social opportunities, and preferably alocation close to home which would allow for more frequent visits. If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.