Can nursing homes get past their bad reputation?


Spry old people seem so happy. But if you want to make them frown (and why would you?), here’s a more depressing topic: nursing homes.

Almost no healthy person in their 70s, 80s or 90s hopes to move into a retirement home as they get older. The very idea fills them with dread.

In a recent survey of older adults, 71% said they did not want to live in a nursing home in the future. And 57% of respondents said COVID influenced their willingness to live in a nursing home.

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Nursing homes are all painted with the same brush,” said Terry Fulmer, Ph.D., president of the John A. Hartford Foundation, which conducted the survey. “It didn’t help that the media kept calling them ‘death traps’ early on with COVID.”

Even before March 2020, most seniors wanted to “age in place” at home. It’s hard to be optimistic about the years to come when you fear finding yourself in a charmless, understaffed establishment.

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“You see people slumped in wheelchairs napping near the nurse’s station,” said Gail Samaha, founder of GMS Associates, a senior consulting firm in Scituate, Mass. “It’s not an uplifting environment.”

Yet even though older people resist the idea of ​​landing in a nursing home, many do. In 2020, nearly 1.3 million people lived in nursing care facilities in the USA

The popular perception of institutional care settings reinforces the idea that they are undesirable. The high incidence of COVID deaths of residents and staff over the past two years has not helped.

Read: ‘Caregivers are exhausted by the pandemic’: Labor shortages weigh heavily on nursing homes

But some industry observers see a sea change in the evolution of these facilities.

“A lot of people are going back to the old stereotype that nursing homes are these sterile places with white walls and floors and drooling residents,” said Kristi Stalder, author of “Navigating Assisted Living.” “But in recent years there has been a concentrated effort to change the stereotype.”

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Over the past two decades, nomenclature has evolved to reflect ever-expanding models of care. The term “long-term care community” replaces “retirement home,” Stalder says, to convey a more positive environment. People with dementia are moved to “memory care” facilities.

Additionally, the term “nursing home” sometimes describes skilled nursing facilities, which provide care for people recovering from a medical condition such as a stroke. The patient’s long-term plan may be to return home after completing rehabilitation.

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An elderly person with a chronic illness who needs direct care can stay at home. But it will take a village of helpers (paid helpers as well as supportive family and friends) to make it work.

However well-intentioned, such arrangements can be exhausting to manage and sustain over time. If the elderly person lives alone, the isolation can have harmful consequences.

The socialization that comes from living among others, as well as having aides and nurses nearby, can offset some of the disadvantages of institutional care. That’s why Stalder tackles the resistance of older people to move on.

“It’s a constant battle,” she said. “But I ask them to visit a long-term care community so they can see it for themselves.”

If your parents swear to stay home until they die, don’t fight. It is better to honor their concerns than to rush to suggest a possible move.

“You have to understand your parent’s goals, values ​​and preferences and align them with what you think,” said Fulmer, who is also a registered nurse. She urges families to discuss these issues early on – before a crisis hits – so that all parties agree on a plan of action under various scenarios.

Prepare for conflict during these conversations. Expect your siblings (and parents) to express conflicting opinions, at least initially. Educating everyone about the different housing options – and identifying nearby facilities that might be worth a visit – helps demystify the process.

Like many businesses, nursing homes struggle to hire and retain staff. When visiting facilities, ask about staffing ratios and employee turnover.

“There are major shortages of CNAs [certified nursing assistants] and nurses are retiring,” Samaha said.

An exercise buff, Samaha is in her 60s. She is one of the many baby boomers who want to stay put.

“I invested a lot of money and time in my health,” she said. “I don’t want to move to a retirement home. This is the last place I want to be.


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