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Nursing home
A nursing home is a facility for the residential care of elderly or disabled people. Often, these terms have slightly different meanings to indicate whether the institutions are public or private, and whether they provide mostly assisted living , or nursing care and emergency medical care. Nursing homes are used by people who do not need to be in a hospital, but cannot be cared for at home.
The nursing home facility nurses have the responsibilities of caring for the patients' medical needs and also the responsibility of being in charge of other employees, depending on their ranks. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day. In the United States, while nearly 1 in 10 residents age 75 to 84 stays in a nursing home for five or more years, nearly 3 in 10 residents in that age group stay less than days, the maximum duration covered by Medicare, according to the American Association for Long-Term Care Insurance.
Some nursing homes also provide short-term rehabilitative stays following surgery, illness, or injury. Services may include physical therapy , occupational therapy , or speech-language therapy. Nursing homes also offer other services, such as planned activities and daily housekeeping.
Nursing homes may offer memory care services, often called dementia care. From before the 17th century to modern day, many families care for their elders in the family's home.
While this is still common practice for many communities and families around the world, this has become increasingly more difficult over time as life expectancy increases, family size decreases, and increased expertise in caring for a person with a chronic disease. In the 21st century, nursing homes have become a standard form of care for most aged and incapacitated persons to account for those complexities.
Nearly 6 percent of older adults are sheltered in residential facilities that provide a wide range of care. Yet such institutions have not always existed; rather, their history and development reflect relatively recent demographic and political realities that shape the experience of growing old.
In the 17th century, poorhouses also referred to as almshouses originated in England as municipalities were expected to care for their poor. Orphans, people determined to be mentally ill , and elderly people were often placed into these living commons while able-bodied individuals were expected to work and could be imprisoned if they refused.
This model was brought to North America by English settlers. Placed alongside people deemed insane , people who were inebriated , or people who were homeless , they were simply categorized as part of the community's most needy recipients. Poorhouses gave a place where they could be given shelter and daily meals. In the s in the US, women's and church groups began to establish special homes for the elderly persons. Often concerned that individuals of their own ethnic or religious communities might die alongside the most despised society.
This led to the creation of private care facilities for the elderly in these communities. In the US, the Great Depression overwhelmed the poorhouses, but not enough space and funding. Due to muckraking in the s, the less-than-favorable living conditions of the poorhouses were exposed to the public.
This led to the provision of the Social Security Act to only give people their pension if they did not live in poorhouses, but could live in private institutions. In the US, poorhouses were then replaced with residential living home, known as board-and-care homes or convalescent homes.
These board-and-care homes provided basic levels of care and meals in a private setting for a specific fee. Board-and-care homes proved to be a success and by World War II , the new way of nursing homes began to take shape. As the times continued to change, the government identified the issue of people spending extensive amounts of time in hospitals.
To combat these long stays in short-term settings, board-and-care homes began to convert into something more public and permanent that was state and federally funded. From this, by nursing homes were a solid fixture.
Nursing homes were a permanent residence where the elderly and disabled could receive any necessary medical care and receive daily meals. These nursing homes showed improvement in maintaining care and cleanliness standards in comparison to almshouses and poorhouses. From the s through the s, the dynamics of nursing homes began changing significantly.
In the United States, Medicare and Medicaid began to make up much of the money that would filter through the homes and the amendment laws enforced nursing homes to comply with safety codes and required registered nurses to be on hand at all times. Additionally, nursing homes may sue children for the costs of caring for their parents in jurisdictions which have filial responsibility laws.
Later in , in the U. In the UK, after World War II many soldiers and civilians needing hospital care due to casualties during the war were planced in the hospital along with the many elderly patients present there, leading to overcrowding. The implementation of the NHS in and the abolishment of the Old Poor Law allowed for the creation of what would become modern day, public nursing homes. In the s, Professor Peter Townsend brought to light the discrepancies the standard of care between the publicly and privately funded cares homes, leading to health policy reforms that assured the standard care practices for the elderly living in NHS funded care homes.
The s and s saw care homes becoming a large industry in the UK. Thus, policies ensuring that private care homes are regulated Registered Homes Act and patient needs are met Care Standards Act of were established. Today, nursing homes are varied. Some nursing homes still resemble a hospital while others look more like a home. Nursing home residents can pay for their care out of pocket or with government assistance.
In the U. Across the spectrum, most nursing homes in the U. Also consider finances, such as medical insurance and personal funds. Ensure the nursing home is properly licensed and has qualified staff. If time allows, visit the nursing home in person to receive a walk through of the facility and if given the opportunity to speak with a guest or family member of guest, ask about their experience thus far.
All of the nursing homes employees are all required to be licensed or uphold a certificate in the state of which they work. In most facilities, nursing homes are required to provide enough staff to adequately care for residents.
Nursing homes require assessment and monitoring of residents by a registered nurse RN who is typically required to have between two and six years of education. The RN's job duties include implementing care plans, administering medications, recording and maintaining accurate reports for each resident, monitoring and recording medical changes, and providing direction to the nursing assistants and licensed practical nurses LPN.
To gain recognition as a specialized nurse professional, RNs typically need education in their specialized field, and further experience through clinical practices.
LPNs are typically required to have a year of training before working with any patients. The LPN monitors residents' well-being and administers treatments and medications, such as dressing wounds and dispensing prescribed drugs.
LPNs are responsible for patients' direct bed care and carry out a daily routine. These basic care activities, also referred to as activities of daily living , can include assisting with bathing and dressing residents, helping residents with meals, either serving them or with feeding, transferring to and from the bed or wheelchair, making and cleaning beds, assisting with toileting, and answering call lights.
They can include Certified Nursing Assistants CNAs , nursing aides, caregivers, patient care associates, patient care technicians, personal care attendants PCAs , and care assistants. At skilled nursing facilities, in addition to required 24 hour skilled nursing, a licensed physician supervises individual patients.
These physicians are typically employed by a private agency that sends physicians to nursing homes per the request of the patient, nursing home, or patient's family.
The majority of these physicians are family medicine doctors or internist; however, some specialists such as cardiologist, nephrologist, etc.
Depending on the size of the nursing home, a nursing home may have either a nursing home administrator or an executive director. Some nursing homes may have both, but their job duties are similar and can include overseeing staff, supplying medical supplies, and financial matters.
Some nursing homes also have human resources personnel, who are in charge of all aspects of hiring new employees. Human resources job duties vary but can also include coordinating payroll, organizing orientation programs for new employees, interviewing, disciplinary actions, and ensuring compliance with federal and state laws.
Compliance with the federal and state legislatures are reviewed regularly for adherence to strict standards of building codes, care plans, behavior and altercations between residents, nutrition and dietary services, medical services, nursing and personal care, religious and spiritual practices, pets, and recreational programs.
Housekeepers perform everyday cleaning and upkeep in nursing homes. They play a huge part in ensuring that nursing homes are kept clean and free of disease causing agents. Housekeepers have a long list of duties which include cleaning floors, changing linens, disinfecting bathrooms, changing towels, washing clothes, emptying trashcans, sanitizing rooms, replenishing supplies, dusting, vacuuming, and keeping windows and woodwork clean. These duties can vary from facility to facility but it will overall include basic cleaning.
Housekeeping does not require any licensure or schooling, but some jobs may prefer experienced housekeepers. Recreational staff usually include an activity director and possibly activity assistants depending on the size of the nursing home. Activities aim to meet each residents' emotional , intellectual, physical, social, spiritual, and vocational needs. The transition from being independent to having to depend on others and be away from home is oftentimes very difficult, which is why activities are important to combat depression and anxiety.
Volunteer involvement is also an important part of nursing home activities given that volunteers can act as a link between the nursing home and the outside community. One of the many services offered in a nursing home is occupational therapy. Occupational therapy may be necessary following an injury or illness in order to regain skills and to receive support during any physical or cognitive changes.
Occupational therapy also assists with instrumental activities of daily living which include home and financial management , rest and sleep, education , work, play, leisure , and social participation.
Occupational therapists work to allow the person to safely and comfortably reintegrate into society by practicing public dining, transferring to different surfaces chairs, beds, couches etc.
Another important service found in a nursing home is physical therapy. Physical therapy may be necessary following an injury, illness or surgery. Physical therapy works with the person to help them regain strength, endurance , flexibility , balance and range of motion. There are many conditions that can benefit from receiving physical therapy in a nursing home, these conditions include arthritis , pain associated with cancer , dementia , Alzheimer's , stroke and incontinence.
Speech-language pathology is another service found in a nursing home. If the person is having trouble with speech, this points to an issue with coordinating the movements and muscles used to produce speech. While trouble with language points to the person having difficulty with understanding what they are hearing and seeing. The SLP will also look at difficulty with swallowing food and will evaluate the person in order to figure out which part of the swallowing process is not working.
Some of the many speech disorders worked with by the SLP are:. Elder abuse is more prevalent in hospitalized settings including nursing homes than in the general community.
Physical abuse is the intention or action to hurt an elderly person resulting in scars and bruising. Emotional abuse occurs when an employee makes verbal threats and continuously degrades the patient, resulting in the patient experiencing mood swings , anxiety , and depression. Sexual abuse is when an elderly patient is being forced into unwanted sexual activity by an employee, resident or visitor, usually attempted and reported when the patient is sleeping, sick, or weak.
Nursing home neglect is similar to elder abuse. It is when employees begin to repeatedly ignore and leave a patient alone, neglect the patient's personal hygiene like bathing and brushing of teeth, provide the patient with an inadequate amount of food and water, or neglect to provide the patient with the correct amount of medication they require.
One factor unique to elder abuse in nursing homes is that many nursing home contracts require residents to sign delegation clauses , giving up their right to trial by jury and instead using an Arbitrator to settle disputes. Regardless of their ownership, aspects of funding, admission criteria, and cost to the individuals are all regulated by their respective provincial governments.
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You can also submit an application by mail, click here to download and fill out the Application Form for Employment. Or submit via Email to hca casacentral. Under the direction of an assigned supervisor, the Home Care Aide performs or provides assistance with activities of daily living and personal care including bathing, grooming, assistance with grocery shopping and other essential errands; performing routine housekeeping and laundry; assisting with meal planning and meal preparation, and providing self-administered medication reminders. Must be willing and able to travel to various locations within Chicago and surrounding areas, as needed. Accompanies participants to appointments via public transportation or other community sources e. Actively participates in all staff meetings, monthly in-service training and regular individual supervision with an assigned supervisor.
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Thanks for the interesting article. I will wait for new announcements.