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Research Paper

  1. 1. Akins 1Mindy AkinsMs. TilleryBritish Literature12 October 2012 Nursing home problems Whether nursing homes are safe havens or not is questionable. Nursing homes are wherepeople go when they can no longer be cared for at home. Nursing homes are supposed to providetheir residents with a comfortable and dignified environment. While many facilities do live up tothis idea, others have failed. To its residents, a nursing home is a home; but to the owner, it is abusiness. Many owners put their desire for profits over the residents‟ needs, and the result isunnecessary suffering (Couch). Many of the problems in nursing homes are not hard to fix. The most common injuries toresidents can easily be avoided if the nursing homes complied with the federal regulations andwere adequately staffed. The higher the number of staff hours means better care, and the lowerthe number of staff hours means poorer care. Profits are the reason why nursing homes do notjust hire more staff and provide better care. Staffing is the easiest expense to control. A nursinghome owner can make money by reducing the hours of its nursing staff (Couch). A facility that does not have a sufficient staff can decline residents or discharge them.The law requires that facilities keep residents only when they can provide for their needs, butnursing homes are hesitant to do this because that means giving up the revenue that the residentsbring in. The result is that the homes continue to take in more residents without hiring more staff.
  2. 2. Akins 2In nursing homes, the connection between staffing and quality of care is clear. If cuts in staff andresources in a nursing home lead to harm, then whoever makes the decision to make those cutsare responsible to those that are harmed by it (Couch). A large number of frail, elderly Americans in nursing homes are suffering fromineffectual care at the end of their lives. One study shows that putting nursing home patients withkidney failure does not improve their quality of life and may even push them into further decline.The other study shows many with advanced dementia will die within six months and perhapsshould have hospice care instead of aggressive treatment. Doctors, caregivers, and families needto consider making the feeble elderly who are near death comfortable rather than treating them asif a cure were impossible (Couch). Patients need to be cared for to make the last days of their lives as comfortable aspossible. Within the first year of residing in a nursing home, many patients die while othersdecline in their ability to do simple tasks such as walking, bathing, and getting dressed. Researchfound that during the patients‟ final three months, forty-one percent received aggressive care;however, if the person making their medical decisions was aware of their poor prognosis, theywere less likely to receive aggressive care near the end of their life. Nursing home residents whohad hospice care during the last month of their lives are half as likely to be hospitalized (Couch). The Leas Cross nursing home scandal was exposed by a nurse using a hidden camera.Installing cameras into nursing homes should be an option if the staff, owners, residents, andrelatives agree to it. Tapes would make inspection easy and make sure that nothing is happeningthat is not supposed to happen. If necessary, an online inspection could be carried out. Since therelatives are paying for their rooms, they should be allowed to request that a webcam be installed
  3. 3. Akins 3so that, after visits, families could do a late-night check. If the nursing home has nothing to hide,this should not be a problem (“Film all nursing”). Serious overuse and misuse of powerful drugs are found in nursing homes. Many patientsare being drugged into a stupor just to make them easier to care for. Drugs can help stopagitation when they are prescribed properly. They also permit patients to be alert, responsive,and capable of interaction. Instead of giving them the right doses, patients are being drugged intostupor for the convenience of nursing home staffs. Stupor is the result of inept prescription oradministration of drugs (“Why Nursing Homes”). Elderly citizens are treated as lesser humans, and it is becoming clear. The elderly die innursing homes every day. It seems it should not be considered a tragedy since they are elderly.Many patients in nursing homes are not treated properly. Although their screams from pain areaudible, the staff does not come to their rescue (“Elderly treated as lesser”). Many of the diseases patients are diagnosed with have no cure, but families can help byvisiting more often and choosing a nursing home carefully. Patients who have malnutrition anddehydration need special attention. It is not always possible for busy families give their lovedones this kind of attention. The shortage of staff also makes it difficult to give them the attention.That is why it is important for families to choose a good home (“Starving for Care”). Families and staff have to work together to make sure patients are cared for. For families,improving care means watching their loved ones more closely. Improving care means to helpwith meals and getting hands-on with care. Mostly, it means just showing up, but this issometimes hard to do. Some facilities have tried harder to make meals more appetizing andstressing the importance of nutrition, but experts say families can have a bigger impact.Elderly
  4. 4. Akins 4people have no one to protect them. Nursing homes can take simple steps to ease problems withpatients who have malnutrition and dehydration. Buffets, finger foods, and smoothies would bebeneficial. When residents lose too much weight, it can mean a number of things. The residentcould be ill, refuse to eat, is depressed, or a medical problem.The patients‟ losing weight couldalso mean that the resident is not being fed properly, or the nursing home‟s nutrition program islacking what it needs to have (“Starving for Care”). Investors acquire nursing homes, reduce costs, and increase profits and quickly resellfacilities for significant gains. Many regulatory benchmarks say that residents at those nursinghomes are worse off than they were under previous owners. Mangers at nursing homes that areacquired by large private investors have cut expenses and staff, sometimes below minimum legalrequirements; residents at these homes suffer. Facilities owned by private investment firms haveresidents that are fared more poorly than occupants of other homes (“Golden Opportunities: AtMany”). The typical nursing home has low scores when it comes to tracking aliments or illnesses.The ailments include bedsores and easily preventable infections, as well as the need to berestrained. Before they were owned by private investors, many homes scored well. Residents‟families tend to respond to such declines in care by suing. Regulators levy heavy fines againstnursing home chains when under-staffing leads to lapses in care. Private investment companiesmake it very challenging for plaintiffs to succeed in court cases. By contrast, publicly ownednursing homes choose who are allowed to control their facilities in security filings and otherregulatory documents. Some families of residents say these investment companies protect overinvestors who profit while care for the patients decline. When this happens, it makes it unable tofind out who is responsible for the patients‟ care (“Golden Opportunities: At Many”).
  5. 5. Akins 5 Cutting costs has become an issue at homes owned by large investment groups. Ownersneed to stop laying off nurses that are essential to keeping patients safe. Chains make a lot ofmoney doing this, but it is at the cost of human lives. Nurses are often residents‟ main medicalproviders. Most nursing home residents need at least 1.3 hours of care a day from nurses, buthomes owned by large investment companies typically provide only one hour of care a day.These owners refuse to hire people and say they can make do with the staff that they have.Regulators usually visit nursing homes about once a year, but in some cases, they have to visitmore due to residents‟ complaints of the home failing to follow doctors‟ orders, cutting staffbelow the legal minimums, blocking emergency exits, storing food in uncleanly places, and otherhealth violations. One patient suffocated because his tracheotomy tube became clogged. Hecomplained he could not breathe, but there were no records showing that staff had checked onhim for almost two days (“Golden Opportunities: At Many”). Our nation is beset by outrageous scandals. One of the biggest and most shamefulscandals of all has been largely overlooked: The unspeakable treatment of the helpless elderly inwhat are mistakenly called „nursing‟ homes. Thousands of elderly people are being killed byneglect each year because their nursing homes fail to provide them with basic care. Nine out often homes do not have enough nurses and to provide the residents with sufficient food and liquidor to prevent bedsores. A large number of aged residents in poorly supervised nursing homes lieunattended in their own filth. They suffer from bedsores that often expose their bare bones, andthey gradually die from dehydration and inadequate nourishment.Millionaires have nothing toworry about. They can pay for someone to care for them. Unfortunately, the poor who mustdepend on Medicaid will most likely fall into the hands of neglectful custodians in the last yearsof their lives. What really kills people in nursing homes rarely show up on death certificates.
  6. 6. Akins 6These are often signed by doctors who have not autopsied – or even seen in real life – the peoplethey are signing off on. The elderly in this country have done nothing wrong to make theirgovernment and their neighbors willing to have them starved, neglected, and uncared for(“Neglected to Death”). In dozens of nursing homes across Illinois, elderly people are living side by side withrecently paroled inmates. Some of these inmates are murderers and sex offenders, and they wereplaced into the most geriatric homes by the state Department of Corrections. The state isdumping inappropriate people – especially mentally ill patients – in nursing homes in order toget the federal government to help pay for their care. Nursing home administrators claim to beaware of which residents are parolees, but they place no special restrictions on them. They do notadvise other patients, their families, or visitors that convicted murderers, rapists, and armedrobbers may be living down the hall. These are people that nobody would want in a nursinghome. Screening is not being done appropriately when criminals are living beside residents.Many of these inmates who have been paroled into nursing homes have been sent back to prisonfor parole violations committed while in nursing homes. At least a dozen of the approximately150 inmates who have been paroled into nursing homes since 1999 have been sent back to prisonfor parole violations committed while in nursing homes. One parolee sexually assaulted a womanat a southern Illinois nursing home. The only way to judge whether individual parolees pose athreat to nursing home neighbors is to watch them once theyve moved in. Elder advocates worrythat crimes may be going unreported. Not reporting crimes poses as a great threat, especially forseniors that suffer from dementia. They are the least able to defend themselves, and they are theleast able to report incidents when they occur. It is up to the nursing home to determine whethera parolee is suitable for admission. Nursing homes are relied on to make honest assessments as to
  7. 7. Akins 7whether or not they are able to handle the individuals‟ needs without compromising the care ofothers in the facility. Families and young woman who apply for jobs at the nursing home are notbeing notified that criminals are residing there (“Ex-Inmates Sent to Live”). Nursing home patients have been dragged down hallways, doused with ice water,sexually assaulted and beaten in their beds, yet few prosecutions have been made. Many physicaland sexual abuse cases in nursing homes are not treated the same as similar crimes elsewhere.Acrime is a crime, whether in or outside of a nursing home. Residents should not spend their daysliving in fear. Nursing homes lie about what really happens to patients. A resident at theWestpark Rehabilitation Center in Evansville, Ind., in September 1999 was knocked unconsciousby another resident. She died a month later. The home reported to a hospital that she had fallen(“Neglected to Death”).
  8. 8. Akins 8 Works CitedCouch, David. “The Elderly in Nursing Homes Are Vulnerable to Abuse.” The Elderly. Trans. Sylvia Engdahl. N.p.: Greenhaven Press, 2011. N. pag. Current Controversies Series. Gale Opposing Viewpoints in Context. Web. 14 Sept. 2011. <http://ic.galegroup.com//// ViewpointsDetailsWindow?displayGroupName=Viewpoints&disableHighlighting=false &prodId=OVIC&action=e&windowstate=normal&catId=&documentId=GALE%7CEJ3 010427263&mode=view&userGroupName=cant48040&jsid=8b0ff238d4c4580b4ff1a3c 86bdc1584>. - - -. “Some Nursing Home Elderly Get Futile Care.” The Elderly. Ed. Sylvia Engdahl. N.p.: Greenhaven Press, 2011. N. pag. Current Controversies Series. Gale Opposing Viewpoints in Context. Web. 14 Sept. 2011. <http://ic.galegroup.com////?displayGroupName=Viewpoints&disableHighlighting=false &prodId=OVIC&action=e&windowstate=normal&catId=&documentId=GALE%7CEJ3 010427256&mode=view&userGroupName=cant48040&jsid=3e5494e0d80f4c26e62cd4a 3984ffa70>. “Elderly treated as lesser humans; Nursing home gave Tylenol to resident with broken leg, July 21.” Editorial. The Toronto Star 26 Sept. 2011: n. pag. Global Issues in Context. Web. 26 Sept. 2011. <http://find.galegroup.com// infomark.do?contentSet=IAC- Documents&docType=IAC&idigest=b527955b5caccdb4b4a2d40e86fe061a&type=retrie ve&tabID=T006&prodId=GIC&docId=CJ262365657&userGroupName=cant48040&ver sion=1.0&source=gale>. “Ex-Inmates Sent to Live with Elderly in Nursing Homes.” Chicago Tribune 29 Nov. 2002: n. pag. SIRS Issues Researcher. Web. 26 Sept. 2011. <http://sks.sirs.com/bin/hst-article-display?id=SSCHEH-0- 2744&artno=0000162828&type=ART&shfilter=U&key=Nursing%20homes%2C%20Co
  9. 9. Akins 9 mplaints%20against&title=Ex%2DInmates%20Sent%20to%20Live%20with%20Elderly %20in%20Nursing%20Homes&res=Y&ren=Y&gov=Y&lnk=Y&ic=N#summary>. In Illinois, elderly people are living with paroled inmates who were placed into the homes by the state. This is believed to put their lives in danger. They need to be living in a more appropriate place.“Film all nursing homes.” Letter. Sunday Times [London] 26 Sept. 2011: n. pag. Global Issues in Context. Web. 26 Sept. 2011. <http://find.galegroup.com//.do?contentSet=IAC- Documents&docType=IAC&idigest=b527955b5caccdb4b4a2d40e86fe061a&type=retrie ve&tabID=T006&prodId=GIC&docId=CJ259795076&userGroupName=cant48040&ver sion=1.0&source=gale>. “Golden Opportunities: At Many Homes, More Profit and Less Nursing.” Letter. The New York Times 15 Sept. 2011: n. pag. SIRS Issues Researcher. Web. 26 Sept. 2011. <http://sks.sirs.com/bin/article-display?id=SSCHEH-0- 1831&artno=0000269122&type=ART&shfilter=U&key=Nursing%20homes%2C%20Co mplaints%20against&title=Golden%20Opportunities%3A%20At%20Many%20Homes% 2C%20More%20Profit%20and%20Less%20Nursing&res=Y&ren=Y&gov=Y&lnk=Y&i c=N>. significant gains. “Neglected to Death.” Health Letter Jan. 2003: n. pag. SIRS Issues Researcher. Web. 26 Sept. 2011. <http://sks.sirs.com/bin/article- display?id=SSCHEH-0- 2744&artno=0000165266&type=ART&shfilter=U&key=Nursing%20homes%2C%20Co mplaints%20against&title=%22Neglected%20to%20Death%22%3A%20The%20Scandal ous%20Condition%20of%20American%2E%2E%2E%2E%2E%2E&res=Y&ren=Y&go v=Y&lnk=Y&ic=N#summary>. “Nursing Home Abuse Unlike Other Crimes.” Chronicle-Tribune [Marion] 4 Mar. 2002: n. pag. SIRS Issues Researcher. Web. 26 Sept.
  10. 10. Akins 102011. <http://sks.sirs.com/bin/hst-article-display?id=S4450859-0-2833&artno=0000150094&type=ART&shfilter=U&key=Nursing%20Home%20Abuse%20Unlike%20Other%20Crimes&title=Nursing%20Home%20Abuse%20Unlike%20Other%20Crimes&res=Y&ren=Y&gov=Y&lnk=Y&ic=N>. “Starving for Care: FamilyMembers Can Curb Nursing Home Malnutrition.” Detroit News 29 Nov. 2004: n. pag.SIRS Issues Researcher. Web. 26 Sept. 2011. <http://sks.sirs.com/gi-bin/article-display?id=SSCHEH-0-2744&artno=0000207701&type=ART&shfilter=U&key=Nursing%20homes%2C%20Complaints%20against&title=Starving%20for%20Care%3A%20Family%20Members%20Can%20Curb%20Nursing%20Home%20Malnutrition&res=Y&ren=Y&gov=Y&lnk=Y&ic=N “Why Nursing Homes Use Antipsychotic Drugs.” Letter. The New York Times 5 Apr.1989: n. pag. Global Issues in Context. Web. 26 Sept. 2011.<http://find.galegroup.com//.do?contentSet=IAC-Documents&docType=IAC&idigest=b527955b5caccdb4b4a2d40e86fe061a&type=retrieve&tabID=T006&prodId=GIC&docId=A175675621&userGroupName=cant48040&version=1.0&source=gale>.

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