Wednesday, April 8, 2009

Culture Changes in Nursing Homes

How will nursing home changes affect Parkinson's Patients - part I

During the next few decades the United States is going to be facing demographic changes in many areas, one of the most important being, providing long term care for a growing elderly population.

In many Northern and Midwestern states the children of the baby boomer generation and their children have not been able to find jobs in the cities where they were born and raised and so have moved to areas of greater growth ...West Coast, Florida, southwest and deep south. Now as the boomers age and need nursing homes and assisted care facilities, they are being put into institutions near where their children now live because it is easier to visit when someone is nearby. The boomers will move from their homes and friends to another geographical area to spend the rest of their days. Some folks will adapt well, some may not.

It is difficult for the family relationships to continue easily when children are living out of state. It is just as difficult to maintain life-long friendships as people move for work or retirement.

Another demographic occurs as elderly people are living longer which then increases the duration and cost of treatment as well as housing costs. The birth rate of the post World War II generation greatly exceeded the rate of prior generations accompanied by an unprecedented increase in life expectancy.

Large elder care organizations in the areas which are losing population will suffer financially because they are having to adjust from not having enough rooms to having many more than are needed. While in the South and in the West there will be too few facilities available, in the North people will be out of work creating a domino effect as the income and tax bases erode.

Besides the issues of continued financial viability for long time care, there has been a movement since about 1990 to change the culture that exists in the design and operation of these facilities. Called by various names in different parts of the country, Eden Alternative, Pioneer movement, Green House, Culture Change and Home Health. All strive to treat elders as as individuals. They feel that nursing homes should be less like hospitals and more like homes.

These are some bills in Congress to provide funding for culture and demographic changes in long term health facilities.
S.776 to provide for the establishment, construction and rehab of small group home nursing homes.
H.Res.271 to include long-term care in health care reform
H.R.271 to change the Internal Revenue Code of 1986 to provide an increase in the rate of charitable mileage for delivery of meals to elderly, handicapped and frail.

Because assisted living facilities and, moreover, nursing homes are sometimes a crucial part of the latter stages of Parkinson's disease, we will be discussing the new approach and how they might help as well as the disadvantages to PD patients in coming days.

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