The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Famil

Michael Ellenbogen

 https://nap.nationalacademies.org/read/26526/chapter/1

 Cahpter 10 is the recommendations

Donr

Thanks for posting Michael, I will read it tomorrow.

markus8174

Michael,

  I am all for any improvement in nursing homes ability to provide dignified care for our loved ones. The core problem still remains- where do we cut funding to be able to provide the improvements needed across the board in healthcare, especially in elder care?  My DW is in one of the highest scored facilities in our state and at the wages they are able to pay they cannot recruit or even retain staff now? They cannot repair the facility, obtain needed supplies, offer amenities to enhance the residents stay, provide timely care .... I remain committed to my DW getting the best care possible, but I can only visit every other day. For any "recommendations" to be put into practice, the $ has to be found. This country has been notoriously cheap in providing for our elderly with helth problems. Joe Biden's recent speech included a lot of great plans for improving nursing home care(and some bad) reminded me of Bushe's speech about going to the moon to mine Helium 3, and  harvesting invasive plants to provide bio-fuel instead of depleting our corn crop. Sounded great, but ain't gonna happen in this version of the multiverse.

Michael Ellenbogen

I do not know what the answers are on how to resolve these issues but I can assure you there are many other organizations at this time that are also writing there own reports on how improvement is needed. Something will need to happen and I have doubt changes will take place. Just don’t know if it will be enough. One huge problem is there are many greedy people out there and the model needs to be changed.

markus8174

Michael,

Greedy people and ignorant legislators. It used to be in non-acute (and in acute care as well) care the nursing staff had an approved set of "standing orders" to deal with common issues that could be managed at their discretion. (a doctor would adjust these based on their medical judgement for a specific patient). Constipation- laxative of choice, heartburn/nausea- antacid of choice.... That way, trained, licensed, health care professionals could at least make the routine decisions to provide your loved ones the relief they need without having to "mother-may-I" a doctor or Nurse Prac. a dozen times a day. You know, the decisions everyone makes at home with or without dementia being in the mix. It's getting to be so bad that even when the Nurse Prac. or physician is called, they can't exercise their judgment without coming up against the ever-expanding regulations that tie their hands, enacted often my well-meaning but ignorant legislators bending to the will of some rabid, special interest group. I can solve half the issues of our current elder-care system without forming a committee and issuing recommendations based or years of discussion. LET OUR DOCTORS BE DOCTORS! Let the Nurses be Nurses. Let caregivers give care rather than spending 1/2 their day jumping through unnecessary hoops that do far more harm than good and take caregivers away from the bedside. The only benefit of all these interfering regulations is for providing exorbitant profits to mega-corporations running long term care chains like a McDonalds. No need to actually care about the patient, following the regulations is your only job and you do it with the least expense possible. A doctor with the highest ethics and a dedication to provide the best care possible in long term care is an anachronism in today's nursing home system. The same applies to other areas of health care, but that is for a different forum. 

I've got to go find my ladder. I seem to have gotten up on my high horse again.

Michael Ellenbogen

I agree with much of what you said.