Nursing home facilities as a solution for long-term care

Nursing Home Facilities: A Solution for Long-Term Care
Introduction
Nursing home facilities offer a unique setting for long-term care of elderly persons. Serving as places of residence where the elderly person can obtain assistance with daily living and with medical needs, the nursing home acts exactly as its name suggests—as a home wherein nursing care is provided on a daily basis. This paper will describe the setting of the nursing home, where it falls on the long-term care continuum, how family and friends can play a supportive role, what the role of public relations is in the nursing home, and how oversight of the nursing home is provided by government or other organizational agencies.
Setting
Long-Term Care Continuum
The nursing home typically falls at the end of the long-term care continuum spectrum. This spectrum can include four stages: 1) aging in place, which consists of self-care, home support, and adult day care; 2) adult foster care, which consists of non-medical care in a family-style residence; 3) assisted living, which consists of a congregated care residence with medical support on an as-needed basis; and finally 4) institutional care, which consists of nursing homes with medical care support. While there is no need for adults to pass through the first three stages before arriving at the final stage of nursing home care in the long-term care continuum, it is not uncommon to see such progression. Nursing home care provides a solution for long-term care because it offers the setting conducive to each of the first three settings while supportive of the medical needs of the final two settings. While Rowles and Teaster (2015) point out that nursing homes can act as short-term care settings for rehabilitation, they more generally serve as long-term residences for elderly persons in need of nursing care.
Nursing homes can serve as rehabilitative centers for post-acute care patients who required rehabilitative treatment. However, as Sanford et al. (2015) point out, “it is important to distinguish between short-term care provided after an acute hospitalization, often called subacute care, post-acute care, or skilled nursing care, and care provided on a long-term basis” (p. 182). Subacute and post-acute are typically provided in different settings—often in the geriatric unit of a hospital. A nursing home is most often used as a setting for long-term care in which assistance is needed with daily living and with the instruments needed for daily living, as well as geriatrics suffering from behavioral illnesses such as dementia or Alzheimer’s (Sanford et al., 2015). The nursing home focuses on providing a safe, stable, supportive environment for long-term care of elderly residents.
The Support of Family and Friends
In this setting, it is helpful to have the support of family and friends. Friends, family and others can offer their support of the elderly person in a nursing home by making frequent visits, spending time with the person, checking the person out for short excursions (if permitted by the rules of the nursing home and allowable in conjunction with the person’s health issues), and serving as a source of social comfort for the individual. Elderly persons can suffer from isolation, depression, and withdrawal when living in a nursing home (Landeiro, Barrows, Musson, Gray & Leal, 2017), so it is critical that they receive attention from family and friends so that they do not suffer these symptoms too badly.
The support of family and friends can come in various forms and different interventions have been identified by researchers as helpful in the goal of reducing isolation and depression among elderly persons in nursing home care. Music therapy is one way that family and friends can assist (Ray & Mittelman, 2017): music offers a pleasing atmosphere for elderly persons, who find that music gives peace, enjoyment, and relaxation. When family and friends support this approach by providing the nursing home resident with access to music, the quality of life of the patient can improve. Overall, the main manner in which family and friends can provide support is through making frequent contact with the resident, communicating with the resident, and maintaining a presence in the resident’s life.
The Role of Public Relations
Public relations (PR) are an important part of a nursing home as it is with any organization today. Bad PR can result in damage to the institution’s reputation, which can lead to a decline in services and financial support for the institution. This can have a cascading effect that results in poorer care, poorer reviews, and further declines in the rate of admissions. Thus, to maintain a positive presence in the public’s eye, the nursing home must utilize a public relations department or firm to assist in maintaining a positive image and in developing a positive brand.
Public relations challenges within the nursing home setting are numerous. These include maintaining communications with the public on a regular basis through press releases or updates of policy within the institution, communicating with the families of residents, and sharing stories in the news that promote the institution’s image. One of the main challenges today, however, is monitoring and moderating the image of the institution over social media. As Roshan, Warren and Carr (2016) point out, social media plays a critical part in the way the world operates today, in the way it shares information and news, and in the way reputations are managed. An organization that does not engage in active use of social media is one that will not be able to manage a story when a crisis hits. Social media can spread rumors and information (both true and false) in a matter of minutes all over the world—there is no vetting, no disclosure, and often no immediate verification: it is the ultimate gossip-facilitating machine. A nursing home can be impacted negatively by social media if negative news of something that has happened at the nursing home is spread via social media and the home is unaware of it. To better serve its residents, families and stakeholders, a nursing home today must have an active presence on social media so as to contend with issues that may arise in public and to counter any narratives that could damage the organization’s reputation. As it sometimes happens, some individuals will use social media to vent frustrations or to lash out at an institution they feel is not treating them well. By monitoring social media and actively engaging with users, the nursing home can better manage its own image and also gain insight and feedback from persons involved with the nursing home.
Oversight
The U.S. Department of Health and Human Services is responsible for overseeing the operation of nursing homes in the U.S. Individual states’ Department of Health may also work in conjunction with the federal agency to ensure oversight. Every aspect of care is regulated—from the way in which the home is staffed to the way in which resident care is provided. Policies and medical equipment all have to meet certain standards set by these regulatory bodies to ensure that the appropriate level of quality care is being provided to residents. Otherwise, the home’s status can be revoked and the home will not be covered by Medicaid or Medicare.
One way in which oversight is conducted is through routine inspection. To make sure every nursing home is in compliance with the rules and regulations of state and federal law, surveys are conducted that are typically “surprise” surveys—i.e., not pre-announced—and that consist of a representative of the state or federal government inspecting the facility. A report on the condition of the facility is then written based on the observations drawn from the survey, and the report indicates whether the nursing home is in compliance with the laws. This survey is conducted once a year but for nursing homes that routinely violate laws and suffer from non-compliance they can occur multiple times a year. Penalties and fines can be levied against nursing homes that fail to meet regulations, and they can be closed if they continue to fail to comply with state or federal law. The purpose of this oversight is to protect the patient residents and to ensure that they receive the same kind of quality care that they would expect from a regulated hospital.
Conclusion
The nursing home facility is a solution for long-term care because it provides a stable living environment for elderly persons who require daily assistance with standard living needs and medical needs. Nursing homes are often used for elderly persons who suffer from dementia or Alzheimer’s, as these can be especially difficult issues for care providers within the family to handle on their own. The nursing home offers 24-hour professional care and knowledge that most families are unable to provide. By placing an elderly person in a nursing home, care that meets both state and federal guidelines can be expected and families and friends can still provide support through frequent visits to the resident.

References
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