Issues affecting quality of care in long-term health facilities

Nursing -- Elder Care Issues

Assume that you have an elderly relative in a long-term health facility. You and your loved one are insured, However you are not receiving the care that you should receive. What are some of the issues that are causing this? Is it the facility you are dealing with? Is it government policies or regulations that are causing this? What can be done to improve the quality and conditions of long-term healthcare facilities across out country? Please be sure to support your statements rationally.

The quality of elder care, particularly in nursing homes and other similar facilities, is largely dependent on the character, commitment, and motivation of the staff members who are most directly responsible for patient care. Unfortunately, the tremendous growth in need for Certified Nurse's Assistants and Home Health Care personnel in the last decade seems to have resulted in large numbers of new entrants into the field who may be less motivated by the traditional reasons that people enter the healthcare fields and who are primarily motivated by the earning prospects within the field. Instead of pursuing careers in patient care out of a genuine concern for others and any altruistic desire to contribute to society, they view their career choice mainly from the pragmatic perspective of the lifestyle and earning potential it may represent.

This problem is not unique to any specific institution; rather, it seems to be something of an epidemic within the field. While the medical fields in general and nursing in particular still attract individuals who are benevolently motivated, there seems to be a predominance of self-centeredness within the newer crop of CNAs and HHAs that is, in principle, at odds with the reasons that most health care workers chose their professional fields in previous generations. Having spent considerable time in nursing homes and related facilities, I can attest to a climate of relative lack of genuine concern and a culture of treating the responsibilities of patient care as little more than formalities and technical requirements necessary to earn a paycheck and avoid problems with supervisors, administrators, and government regulators.

Unfortunately, this is not a problem that is readily amenable to any concrete solution, especially from the perspective of regulatory control. Simply put, it is impossible to regulate motivation and concern on the part of caregivers. On the other hand, there are various ways that at least some of the external manifestations of lack of concern for patient welfare can be better identified and addressed than they seem to be at many facilities. Failure to adhere to fundamental protocols, such as those pertaining to antisepsis have been proven time and again to contribute directly to the unacceptably high rate of nosocomial infections in clinical environments (Reid, 2009). Generally, those types of protocols, such as compliance with hand-washing requirements and glove changing are some of the first signs that a health care worker is not highly motivated to provide the best possible care to patients (Hamric, Spross, & Hanson, 2009). That problem is one that government regulators have sought to resolve, at least indirectly, by shifting the financial burden of several types of nosocomial infections (such as those occurring in connection with urinary catheters) to the institutions since the change in CMS reimbursement policies in that regard that took effect in 2007 (Reid, 2009).