A federal nursing home mandate from October 2010 will be changing in 2012, according to The New York Times. For the past year, residents in nursing homes have been asked each quarter whether they'd like information on moving back into the community. Not surprisingly, families who fought hard to convince loved ones to move into a facility where their needs could be met adequately are less than thrilled with the repeated question.
This question has always been asked of residents, and residents have always maintained the right to leave a facility. The difference in the past year is that if a resident (or family member or guardian in cases in which the resident isn't mentally competent) answers, "Yes," the facility must make contact with an outside agency that can provide information on returning to the community. In the past, the question was asked, but no action had to be taken regardless of the response.
Changes in April 2012
In April 2012, however, residents will be asked if they want to continue to be asked each quarter. If they say no, they'll be asked annually instead of quarterly. These changes will be welcomed by families who worked long and hard to convince loved ones a nursing home was the best place for them, although the annual (or quarterly, depending on the person) problem will still persist.
New views on long-term care
The New York Times says these changes reflect a fundamental shift in how the government looks at long-term care, moving towards a person-centered model where care is provided -- and paid for -- in a place the individual chooses to age, such as their own home. Some states, author Paula Span says, are spending the majority of their Medicaid budgets on maintaining the elderly in their own homes, in senior apartments or in assisted living, a trend rapidly spreading across the entire U.S.
Nursing homes are the most expensive form of long-term care, so the move makes sense for states struggling to balance their budgets. However, there's a flip side to this argument: Moving residents from a facility back into the community doesn't always make sense. For instance, some nursing home residents are too frail or too advanced in a disease process, such as dementia, to be able to function independently, even with the help of personal care aides and home nursing services. Further, moving some residents back to the community means moving them into isolation, especially when the individual doesn't have close family or friends.
The issue of whether to ask if a resident wishes to move back into the community, like many delicate health care debates, has no clear answer. As the U.S. attempts to re-balance its health care delivery systems and budgetary concerns, some seniors tend to fall through the cracks. There's no one-size-fits-all solution, and attempts at making a standard rule that applies to -- and works for -- every individual are sure to fail.
What's the solution? Let us know what you think in the comments below.