Getting old is not very fun when considering the opinions of the elderly. This is true because many hard and difficult decisions must be made in terms of health and health care. Two options immediately arise when one is not able to take care of themselves and seek the assistance of others. The first option is home health care and the other is nursing home health care. The purpose of this essay is to examine, weigh and discuss these two options. This essay will then conclude on when it is best to choose nursing home care and when it is not wise or advisable to do such a thing.
Home Health Care
What exactly is home health care and what does it entail? Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care. More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one's daily regimen of prescription and over-the-counter medications (Medicare.gov).
The number one benefit of home health care is that it allows patients to receive personal care in the privacy and comfort of their own homes. For aging and homebound individuals, in-home care facilitates them in remaining as functional and independent as possible, providing a much higher sense of security and dignity. Receiving home health care helps to reduce unavoidable readmissions to the hospital, and studies have shown that patients recuperating from illness, injury, or surgical procedures heal more quickly and more successfully when recovering at home vs. In a medical facility.
Home health care can include broad care given by skilled medical professionals, including skilled nursing care, physical therapy, occupational therapy and speech therapy. Home health care can also include skilled, non-medical care, such as medical social services or assistance with daily living from a highly qualified home health aide. As the Medicare program describes, home health care is unique as a care setting not only because the care is provided in the home, but the care itself is "usually less expensive, more convenient, and just as effective" as care given in a hospital or skilled nursing facility.
It seems that most elders would very much like to stay in their own homes and age gracefully and under their own control. Moving to an institution can be very scary and intimidating especially at an advanced aged. Friedland (2009) disagreed when she wrote that "Things that can make "aging in place" -- the current term for staying in one's own home as one ages -- problematic are tasks such as cooking, cleaning, toileting, shopping, doing laundry, and driving, as well as falls, which for frail elders could initiate a downward spiral."
The cost of in home house care can be very expensive depending on the services that are needed for the patient. "In-home health aides average $19 an hour, and hired companions who don't provide health care are slightly less expensive. Do the math and you'll see that for round-the-clock assistance, the tab can run as high as $170,000 a year, making home care a very costly option," (Polyak, 2011). Abrahms (2012) also suggested that this is very expensive endeavor: " The cost of home health care will soon outpace the total spent in that same demographic unless some radical changes are made within and without the system."
Home health care does have some very good advantages. Resnick (2011) suggested that "Patients who are treated at home by a doctor and nursing staff who know them intimately and can be available 24/7 are happier and healthier. This kind of care decreases the infections, mistakes and delirium, which, especially among the elderly, are the attendants of hospital care. And it is far more efficient. According to a 2002 study, for the patients treated by the Veterans Affairs' Home-Based Primary Care program, the number of days spent in hospitals and nursing homes was cut by 62% and 88%, respectively, and total health care costs dropped 24%."
In addition new types of home health care are being created where the elderly can spend time at day camps and other places while still receiving their medical treatments at home. Berger (2012) wrote " In the newer model, a team of doctors, social workers, physical and occupational therapists and other specialists provides managed care for individual patients at home, at adult day-care centers and in visits to specialists. Studies suggest that it can be less expensive than traditional nursing homes while providing better medical outcomes." Berger continued by saying "Seniors and others who have chronic health needs should not have to give up their homes and independence just to get the medical care and other attention they need to live safely and comfortably," Cardinal Dolan said in a statement before he opened a 250-patient program at Saint Vincent de Paul Catholic Healthcare Center in the South Bronx."
Nursing Home Care
So, what exactly is nursing home care. According to Medicare. gov " Nursing Homes serve as permanent residences for people who are too frail or sick to live at home or as a temporary facility during a recovering period. " Patrick (2013) wrote " Nursing homes can be broken down into three categories. They are intermediate care facilities, skilled nursing facilities, and skilled nursing facilities for special disabilities. An intermediate care facility (ICF) must provide at least eight hours of nursing supervision per day. It generally caters to patients who are mobile and need less care. At the least, an ICF provides medical, pharmacy, and dietary services."
In other words nursing homes are some sort of hybrid between a hospital and a home. Nursing homes are highly regulated. The 1987 Nursing Home Reform Act virtually guarantees a safe and warm stay at any nursing home that is up to federal regulations. Klauber (2001) wrote "The basic objective of the Nursing Home Reform Act is to ensure that residents of nursing homes receive quality care that will result in their achieving or maintaining their "highest practicable" physical, mental, and psychosocial well-being. To secure quality care in nursing homes, the Nursing Home Reform Act requires the provision of certain services to each resident and establishes a Residents' Bill of Rights."
Best of all it appears that nursing homes are much cheaper than home health care. Mullin (2013) seemed to agree when she suggested that "An assisted living facility with a high vacancy rate or no waiting list may be more willing to negotiate a monthly rate. If you're considering a home health agency, you may be able to secure a lower hourly or daily rate if you indicate that you're shopping around for the best price."
The bad thing about nursing homes is that sometimes the care can be very sporadic and poor. Many times these facilities are not properly operated and abuse is rampant. Bojorquez (2013) suggested that this was a problem " According to the report, just seven states provided nursing home residents with more than one hour of professional nursing care daily. States that did the best had larger and more experienced staff. Advocates for the elderly say improvements must be made soon. The nursing home population is expected to increase 40% over the next decade.
Deciding What Option is Best
It appears there is no absolute wrong or right choice in deciding between home health care and nursing home care, rather the right decision rests with the relative circumstances and conditions of the individual in question. Both quality and price vary throughout the industry and…