Nothing so conflicts the American Dream as the prospect of ending life in a warehouse of older bodies called the American Nursing Home. HMO type management systems have provided fairly efficient cost effective solutions for managing care and health needs for the most vulnerable of all populations, the mindless and will deteriorated compliant elderly and younger disabled.
1.4 million people are in today’s nursing homes in the United States. A study out of Cornell University in the fall of 2010 concluded that 12% of these could reasonably be cycled back into the mainstream of society provided certain measures were in place. These 168,000 are ‘low need’ for nursing or assisted living care. The provisions could be made in a living environment of their own choosing which most call- HOME, and there is nowhere else like it.
So is the nursing home of the future a nonnegotiable for future generations or are there now more options on the table. Rhoda Meador authored the Cornell study. She is with the College of Human Ecology at Cornell as associate director of outreach and extension. The report is titled Project Home. She believes that nursing home living doesn’t have to be a given for every situation.
The retirement industry itself is becoming more marketing savvy and realizes that many sandwiched generation care takers are themselves becoming their own future advocates. The new market is for those who have had to care for their parents in an almost forced without options scenario. They are looking forward and just say no. There has to be a better way. The medical community is aboard. Legislators are listening. The money makers are trying to come up with plausible and marketable alternatives. Where there is a will there is a way.
The first decision is one of culling the ‘low need’ from the ‘must have’ groups in the vulnerable population. A realistic assessment standard is the first need. The study began with social worker selection for those in nursing homes who they believed could be transitioned back. The researchers established that 57% of these would successfully live independently or could reasonably live at home with provided measures.
The critical factor is the provision for medical care where the condition is complex. Other factors are the availability of family and social support coupled with feasible housing options. Some institutional variables such as oxygen supply, pharmaceutical delivery, equipment supplies, security monitoring, food preparation, are already in place and would just need to be authorized for in home delivery and use.
Another is a change in the way nursing home length of stay is envisioned. At present the sign on the nursing home door is like Dante’s Give up all hope you who enter these doors. Someone needs to be in place to advocate for returning home for every individual and trained to know what could make it work.
Nursing Homes are expensive. They have a powerful lobby which is beginning to crumble.