Tag Archives: skilled nursing facilities

Critical Support: Nursing Homes Need Our Action NOW

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Alice Bonner, PhD, RN, FAAN, Senior Advisor for Aging, Institute for Healthcare Improvement

Alice Bonner, PhD, RN, FAAN, Senior Advisor for Aging, Institute for Healthcare Improvement

This editorial is the work of four authors: two registered nurses with PhDs, one of whom is a former government/public health division director and one of whom leads a national foundation; a certified nursing assistant and director of a national CNA organization; and a nationally recognized health economist and nursing home expert. Their names and affiliations appear at the end of the article.

How We Got Here

For years, extended families formed the backbone of American communities. Children and young adults grew up living with parents and grandparents, or with the grandparents of friends and neighbors down the street. So why is it that we struggle with long-term care — how to create meaningful, purposeful living environments as we age? And why is it that skilled nursing and rehabilitation facilities and skilled nursing facilities (SNFs, historically called nursing homes) are always an afterthought, or completely invisible?

The greatest success story of the 20th century is human longevity; all of us love to tell the story of a relative or friend who has made it into their ninth or tenth decade. However, as a society we have not come to grips with how to care for older people. Antibiotics, pacemakers, renal dialysis, and artificial hearts are just a part of the story that has led to longevity — not to mention the extraordinary achievements of the public health system.

Why We Do This Work

Many of us have had a career focused on supporting or caring for older adults over decades. Why do we do this work? Because we believe we can create a comprehensive system of care, a continuum of health, housing, and social services that can better support ourselves — older people and our care partners —  in social engagement and the life of communities. Due to a variety of factors, some form of nursing home care will always be a part of that continuum.

Many not-for-profit associations, for-profit companies, and government agencies focus on creating environments for optimal aging.  The John A. Hartford Foundation, a foundation devoted to improving care for older adults, is dedicated to improving care of older adults in every place they reside.  Every day the team focuses on its mission and work with national and international organizations, government agencies, universities, and all components of the healthcare system, to try to create Age Friendly Health Systems. They are sorely lacking. Continue reading →

High-Quality Nursing Homes Lower Risks for Long-Term Care Placement for Older Adults

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Journal of the American Geriatrics Society Research Summary

After being discharged from the hospital, an older person often is admitted directly to a skilled nursing facility (SNF). SNFs specialize in the skilled care we need to recover properly.  These facilities also provide the additional rehabilitation we may need before returning home. However, experts have raised concerns about the uneven quality of SNF services, the substantial differences among them, and how they are used in different parts of the country. A transfer from an SNF to a long-term care facility, for example, is considered a failure to achieve the goals of SNF care.  Most older people view a move to a long-term care facility as a step in the wrong direction.

In a new study, researchers decided to examine the role that SNFs play with regard to older adults’ placements in long-term care facilities. Their study was published in the Journal of the American Geriatric Society.

The researchers studied the role of SNF quality and how it affected older adults’ risks of transitioning to long-term care facilities. They also looked at whether any aspects of skilled nursing were linked with an older adult’s risk of entering long-term care facilities. The research team focused specifically on whether the quality ratings of SNFs (available to the public, free of charge, here) helped predict long-term care placements. Continue reading →

Hospitalized Older Adults Released to Skilled Nursing Facilities May Not Get Counseling to Help Make Informed Choices

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JAGS graphicJournal of the American Geriatrics Society Research Summary

More than 20 percent of all hospitalized older adults who use Medicare will be admitted to a skilled nursing facility following a stay in the hospital (also known as “post-acute care”). However, these men and women may be given too little information when it comes to choosing a post-acute care facility: sometimes they may receive just a list of addresses for local facilities. What’s more, hospitalized older adults typically don’t plan for care at a skilled nursing facility ahead of time. This can lead to making important decisions too quickly or during a time of particular stress.

We don’t have much information about how people select skilled nursing facilities or what information they’re given to make informed choices. So a team of researchers recently studied how hospitalized older adults make decisions about choosing a facility, who helps them decide, what they think about the process, and what they consider as they make decisions. The researchers published their study in the Journal of the American Geriatrics Society.

They interviewed 98 older adults who had just been admitted to a skilled nursing facility. In 90 interviews in five cities across the country, the researchers spoke only to the older adult. A family member participated in the other eight interviews. Continue reading →