Hotmail
|
Windows Live® Search Results
Windows Live® Search Results
Article Outline
Nursing Home, residence that is equipped and staffed to provide care for people with serious medical conditions. Nursing homes are designed to provide food, shelter, and medical care for their residents, as well as social, religious, civic, creative, and intellectual activities. Most nursing home residents are elderly; the largest group is 85 years of age and older (see Aging). In the United States about 87 percent of nursing-home residents are Caucasian, and 74 percent are women. According to the Centers for Disease Control and Prevention (CDC), approximately 16,000 nursing homes, with more than 1.7 million beds, currently operate in the United States. Nursing-home residents are people who have serious medical conditions but are not sick enough to require hospitalization. The level of care provided by a nursing home depends on the patient’s medical needs. For example, skilled nursing facilities provide medical care 24 hours a day. Intermediate care facilities are appropriate for people who are seriously ill but who do not require around-the-clock medical care. In addition to providing medical care, nursing homes help residents with basic daily activities such as eating, dressing, bathing, grooming, going to the bathroom, and moving from place to place. They also provide constant supervision for patients with dementia, the intellectual impairment caused by strokes or neurodegenerative diseases such as Alzheimer’s disease. These patients need supervision so that they do not wander off or harm themselves or others. Many nursing-home residents have a chronic illness such as heart failure, diabetes, lung disease, or degenerative joint disease. About two-thirds have dementia. When people with a chronic illness enter a nursing home they usually stay for the rest of their lives, an average of three years. However, not all people in nursing homes are long-term residents. Some people require only a short stay, usually three months or less, for rehabilitation from a stroke, broken bone, surgery, or acute illness such as pneumonia. Other people enter a nursing home during the last few months of a terminal illness such as cancer. Although 35 percent of people over age 65 will spend some time in a nursing home during their lifetime, only about 5 percent of elderly people in the United States are in nursing homes at any one time.
Nursing assistants, people who are trained to help with residents’ daily activities, provide most day-to-day care in nursing homes. Licensed nurses supervise the nursing assistants, give prescribed drugs or treatments, and monitor residents’ health. The nursing staff is led by a registered nurse, and a physician oversees each resident’s medical care. Physical therapists and occupational therapists work with residents to help them maintain physical strength, coordination, and as much independence in daily activities as possible. A variety of other staff members, including social workers, activity coordinators, cooks, and housekeepers, help create a sense of community life. Nursing homes are run by a licensed administrator, who coordinates the staff members to ensure the best possible quality of life for residents. More from Encarta For-profit companies run more than 60 percent of the nursing homes in the United States, and many nursing homes are part of multi-home chains. Nonprofit organizations such as religious charities operate more than 30 percent of nursing homes, and federal, state, or local government agencies operate less than 10 percent Particularly for long-term residents, nursing homes can be costly. In 2006 the average cost of a private room in a nursing home reached more than $75,000 per year. Many residents pay for their own care when they first enter a nursing home, but when their savings run out they switch to Medicaid, a government-funded health-insurance program for the needy. Overall, residents and their families pay for about 25 percent of all nursing-home costs, and Medicaid pays for 45 percent. Medicare, the federal health-insurance program for the elderly, covers short-term nursing-home stays for rehabilitation after an injury or illness (see Medicare and Medicaid) and pays for about 17 percent of all nursing-home costs. Private long-term care insurance pays for about 7 percent. Like all healthcare facilities, nursing homes struggle to balance the need to control costs with the need to provide the best possible care. Individualized care, a variety of social programs, and a high ratio of staff to residents are all desirable, but are sometimes difficult for nursing homes to afford because they must rely on fixed rates of reimbursement from Medicare, Medicaid, and other government programs. Such difficulties have led to reports of abuse and neglect at a few nursing homes. For example, some understaffed facilities have used physical restraints or sedative drugs to help control residents. To ensure good care for all nursing-home residents, a variety of state and federal laws and programs exist. State health departments conduct annual inspections of nursing homes using criteria developed by the federal government. These detailed inspections, carried out by teams of nurses, administrators, and other healthcare workers, may take a week or more at large homes. The inspections focus on quality of care (including whether care is adapted to the special needs of each individual), residents’ satisfaction, staff size and training, and safety. Nursing homes must pass these inspections to be licensed by the state and to receive Medicare and Medicaid reimbursement. Beginning in 1987, Congress passed several laws to encourage nursing homes to provide more individualized care and reduce the use of physical restraints and chemical sedatives to control residents. In recent years, nursing homes themselves have made numerous innovations, offering creative activities such as art and music, activities for a broader range of interests, and programs aimed at specific populations such as Alzheimer’s patients. Reforms are also making nursing homes less institutional. For example, many nursing homes create a cozy environment with plants, pets, and decor that is more like a home than a hospital. These innovations help ensure that nursing-home residents lead lives that are as productive and independent as possible, despite being limited by illness.
Choosing a nursing home can be a stressful experience. Some elderly people are reluctant to enter nursing homes because to them, nursing homes represent the end of life, a place to go to die. Family members often experience guilt and stress when they can no longer care for an aging loved one and must decide to place that person in a nursing home. Carefully investigating a nursing home can help dispel these fears. Visiting each home and asking questions about the care provided is a crucial part of the decision-making process. The home should be licensed by the state and long-term patients should learn if it is certified to participate in Medicare and Medicaid. It should also be clean, well lit, and kept at a comfortable temperature. A high staff-to-resident ratio is desirable, and staff members should demonstrate that they treat the residents with respect and enjoy being with them. The best homes have a variety of activities available daily and weekly, not just once in a while. The dining room should provide three balanced meals each day, including food choices appropriate for people on restricted diets. Residents should have sufficient privacy (for example, curtains that may be used to divide double rooms), should be allowed to keep personal items in their rooms, and should be able to see friends and family during convenient visiting hours. It is also important to understand what services are covered under the home’s basic fee, and the costs of additional services such as laundry or haircuts. As the population ages, more nursing homes will be necessary. By 2030 the elderly will represent 22 percent of the United States population, and the federal government predicts that 2.4 million additional nursing home beds will be needed. Alternatives to nursing-home care are also becoming more widespread and affordable. Home healthcare enables even seriously ill patients or those needing complicated treatments to remain in the comfort of their own homes, cared for by a visiting nurse or home health aide. Assisted living, which provides board, lodging, and social activities, but not healthcare, is attractive to people who need some help with daily activities but do not need constant medical care.
© 1993-2009 Microsoft Corporation. All Rights Reserved.
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2009 Microsoft
  |
