The Lives of Elders

Economic Impact on Nursing Homes

To this point the economic impact on nursing homes has been fairly minor. There has even been some good news about federal spending accelerating for nursing homes. But with the increasing instability in the global financial market, and businesses in every sector cutting back staff and reducing budgets, the impact on long term care will be felt sooner rather than later

This is a time for creative thinking for the nursing home industry. How can they maintain and raise quality of care for their residents and maintain a solid financial position? It’s no secret that a successful nursing home “chain” can be an extremely lucrative for-profit business in the good times. Even well managed nursing homes will be fine in hard financial times.

The nursing homes that scare me are the ones that consistently have staff and compliance issues. These are nursing homes that have high staff turnover and low staff morale. These are the nursing homes that will struggle through this hard economic time.

It’s easy for a corporation to save money by reducing staff. When you are dealing with manufacturing or retail style field staff reduction is easily done with little consequence to the consumer and corporation. But when we start to hear that staff is being reduced in the care fields it becomes scary. Just this week two companies have announced layoffs of staff citing the economy as a problem. We can’t let corporations reduce their quality of care by reducing their staff. Their commodity is people in need not sellable goods.  By finding ways to make budgets without reducing staff or quality of care will be a difficult thing for managers and board members. But they have no choice! Selling assests, restructuring loans, revising their business plan are all options that should be acted upon before staff reduction.

In the coming months you will see the types of nursing homes that are managed correctly and the ones that aren’t by the headlines in the health section in the paper.

Baby Talk

I received a great comment the other day from a frustrated reader of this blog that I felt would be useful to everyone dealing with elder care.

“… My mother is 93 and is still living in the assisted living part of the
institution… This particular care facility is owned and operated by a huge
corporation. The physical plant is attractive and my mother lives in a
very nice double apartment which we refurbished and furnished with my parents'
own belongings” the email goes on to say “As our beloved father's condition
deteriorated we were forced to move him four or five times until we finally
found a wonderful facility where he was living when he died. As a result
of seeing these various places and of dealing with God only knows how many
administrators, nurses and low-paid workers of all sorts, I feel that I know
what I'm talking about here, and this (among many other more serious issues) is
my complaint.”

“It seems to be a universal practice among all of
these people to talk baby-talk, both to and about their elderly residents and
patients. This practice is demeaning and insulting to people who are
already coping with the unpleasantness of growing old, being ill and dying. I
finally lost it yesterday when the care-giver I was talking to on the phone kept
referring to "Mom." I interrupted her and said, excuse me, but are you talking
about my mother or yours?”

“I wish that all of the institutions
that employ or teach these workers would emphasize the importance of not
referring to these elderly people as "Mom" or "Dad," and never to use the term
"we" when "you" is the correct and polite form of address. -As in "Have we
gone potty yet today?" Or "What would we like for dinner tonight?" These people
have their dignity, or did, before they were institutionalized. They are
not children. And even if they are so demented that they don't know the
difference anymore, their children and other loved ones knew them before they
became old and sick, and they remember them as human beings…”

Have we in the long term care industry forgotten the important adage “Respect your Elders?” What sort of respect are we showing the people that helped shape the world as we know it. The people now in long term care lived through some of the most amazing times in history, World War II, the Great Depression, laid the ground work for computers, saw the first television broadcast and many raised families in spite of enormous financial sacrifices. The elderly are not children. They are mature adults that due to unfortunate circumstances need assisted living. It is extremely important for caregivers to remember who they are dealing with. The incontinent man with dementia that you are now caring for could have been a World War II fighter pilot. A simple change in the tone of our language would help give these great people the respect that they deserve.