It's time to give nursing homes a break

So there aren't enough home care aides to take care of us now, let alone when the boomers hit prime time age 85+. Such a great human interest story for the Washington Post Magazine, ya gotta love it.  And I know how we all want to age in place, sitting alone in our own living rooms, with the home health care aide coming in to care for and check on us. And key to the plot -- our deep fear of nursing homes.

What are our options when we're frail? Maybe we'll sell the house (unlikely now) and enter an assisted living facility (shrinking both in current census and our willingness to go there, though not in cost), as I heard ALF marketing execs express concern about at the ALFA convention, despite seeing 'light at end of dark tunnel', according to McKnight's, an industry magazine.  

At the conference, the words 'nursing home' seemed fraught with dread. There was quite a bit of discussion about lobbying, specifically great concern about any possibility of federal regulation of ALFs which today do not fall under the detailed and specific federal regulations for nursing homes.

So today at an ombudsman meeting, I also listened to complaints filed with the Florida Long Term Care Ombudsman program about inadequate care at various ALFs and administrator response to the complaint:  'We don't need to provide that level care to residents -- we're an ALF, not a nursing home.'So let's be clear. Nothing about being called an Assisted Living Facility makes the care excellent. And nothing about being called a Nursing Home by definition makes the care poor.

And absolutely nothing about home care for the very frail makes that inherently preferable to either.  In a well-managed nursing home or assisted living facility, seniors can thrive on the social interaction, good food, and available and trained staff -- as one follow-up comment to the Post article attests: "My mom's health improved markedly in assisted living, with regular meals and meds, and she bloomed with bridge, happy hour and lunch outings. She lived four years, and even had a beau for the last two." Ditto for the socialization and experience in some nursing homes that are visited by my fellow ombudsmen.

Furthermore, home care aides are hired by agencies or you. Maybe the agencies know what they're doing, but you and I probably aren't that skilled at hiring or retaining individuals in this tough, low-paid, and lonely job. ALFs and nursing homes (also low-paid, unfortunately) at least have workers who have co-workers and supervisors to joke and talk to - in addition to the seniors in their care.  And sometimes nursing homes -- Like Fort Pierce Health Care in Fort Pierce, FL, have committed staff with long job tenure, a love of the residents, attention to food quality, and even Internet access!

The most important requirement for any of the long-term care alternatives to be of good quality is good management and involved family. If we want to consider the whole picture, we should be realistic about what we want -- and what we need from long-term care, regardless of where it is. It is no more guaranteed in a senior's home than anywhere else.  And if we can't be there all the time to watch, that's where home monitoring technology, webcams -- and everything else mentioned in this blog -- can help. Really.