Introduction
The role of Nursing Homes (NHs) in the healthcare system cannot be underrated. NHs, thus, are essential in healthcare deliveries because they are infrastructures used to care for the aged and frail population and individuals who need short-term rehabilitative services. Recently, the quality of care within NHs has fallen short, with patients failing to get the required services. As such, it is high time that the NHs be restructured to move from the traditional acute-care, curative model to a more holistic, bio-psycho-social model of care, which will be capable of rendering quality services to all patients admitted to the NHs.
The arguments in this paper will be anchored on Dr. William Thomas and the initiative of the Pioneer Network’s ideas to develop solid approaches to improve the future NHs to serve as a truly nurturing environment. This essay explores the significant problems plaguing the quality of NHs, addressing the demands of caring for the chronically ill. Moreover, the paper will address the availability of family and other sources of informal care, labor and staffing issues, and the role of social policies.
The Complex Care Needs of Chronically Ill Patients in Nursing Homes
Chronically ill patients require complicated care that poses significant challenges within the existing nursing homes. According to Gandhi et al., the population served by NHs continues to age and experience complex health conditions, and the demand placed on care providers has intensified (389). Other researchers have also found that chronic illnesses require long-term management and specialized care, encompassing many facets of individual well-being.
The implications of these intricacies in the existing NHs necessitate a shift from the traditional acute-care, curative model to a more modern, holistic bio-psycho-social approach that will render quality services to the patients in the NHs. Caring for chronically ill patients also demands that care providers consider a person’s directed values. Nurses and caregivers need to recognize the importance of relationships, choice, dignity, self-determination, respect, and living purpose to effectively render quality services to their patients. As such, this means that care providers in the NHs must go beyond the purely medical aspects of care to embrace more comprehensive and person-centered care to render quality services to chronically ill patients effectively.
The Role of Families and Informal Care in Enhancing Patient Well-Being
The quality of NHs also depends on the availability of family and other informal care. According to Faronbi et al., the aged, among other chronically ill patients, rely on the support and involvement of their close relatives or circles to enhance their well-being (10). Moreover, Faronbi et al. found that many patients worldwide trust their families and close friends to provide additional care and companionship while in NHs (11).
However, when families and friends are restricted from being involved in the NH’s care, many challenges may arise that, in the long run, affect the quality of the NHs. According to the Pioneer Network, for a culture change in the NHs, care providers need to recognize the importance of meaningful relationships among patients and care partners. Therefore, NHs must embrace an environment that values and encourages patient families’ involvement in their care to harness many benefits such as resident satisfaction, emotional support, and continuity of care.
Several factors often affect families’ involvement in the patient’s care. For example, societal norms, geographical distances, and time constraints are the major impediments (Faronbi et al. 13). Research has shown that long distances from NHs, busy schedules, and pressures to meet daily life demands significantly influence families’ involvement in patients’ care.
Furthermore, a lack of communication and collaboration between staff and families also affects the exchange of vital patient information, which makes it challenging for the continuity of care. Therefore, NHs need to implement practices and policies that promote the engagement and involvement of families in their loved one’s care. This could include flexible visiting hours, open communication channels, and active collaboration. With families’ participation, NHs will be capable of creating a more supportive and person-centered environment that understands the family and close friends’ involvement in one’s care.
Labor and Staffing Challenges in Nursing Homes
NH’s quality is also dependent on labor and staffing issues. According to Gandhi et al., staffing ensures that NHs effectively render patient services (385). With the demand for skilled nursing care, the community pressures the NHs to have the best workforce to give patients and society the services they seek. Gandhi et al. found that inadequate staffing, high turnover rates, and insufficient training impact NH’s quality deliveries and lead to a fragmented system (387).
One of the key elements of Dr. William Thomas’s work is the role of nursing staff (Thomas). The emphasis is to empower and support the caregiving workforce through training, resources, and opportunities for professional growth. In the long run, investing in the workforce will enable NHs to enhance the quality of care and create sustainable staff members.
The current NHs still have staffing challenges due to several factors that NHs need to address to render services effectively. According to Gandhi et al., labor issues persist in NHs because of low wages, physically demanding work conditions, and a lack of training for career advancement (390). The result of these challenges is burnout, which negatively affects nurses and caregivers and hinders continuity of care. To completely address the challenges of labor and staffing shortages, the NHs need to offer competitive wages and benefits to lure care providers and retain the existing ones.
Moreover, NHs should put in place advancement opportunities through staff training and prioritize the well-being of workers. Additionally, Pioneer Network (n.d.) suggests collaboration between NHs, educational institutions, and policymakers can address staff issues by creating an innovative workforce model. Therefore, by combating labor and staffing issues, NHs can create a stable and competent workforce capable of rendering quality care.
The Impact of Social Policies and Medicaid on Quality of Care
Social policies also play an important role in shaping the future of NHs. For instance, Medicaid is considered the main public funding source for long-term care in the United States. This program gives financial assistance to individuals who require nursing home services but cannot pay for them. However, the existing Medicaid structure and limitations have significant quality implications in NHs.
One of the major concerns is the Medicaid reimbursement rate, which often falls below the actual care rates (Diamond). The result is budget constraints, understaffing, and cost-cutting measures instead of giving appropriate care. Moreover, the fragmentation and profit-driven NH care, as found by Diamond, further communicates the challenges affecting NHs, thus contributing to a commodified approach that thwarts holistic person-centered care. According to Diamond, the reasons for NHs’ fragmentation and commodification are love for money and greed, as many private sectors are profit-driven and do not focus on the well-being of their patients. Therefore, improving the quality of NHs demands that the deficiencies in the Medicaid program be addressed.
Conclusion
In conclusion, the improvement of NHs’ care requires the adoption of person-centered approaches and the integration of ideas formulated by Dr. William Thomas, The Pioneer Network. Emphasizing individual preferences, autonomy, and meaningful enjoyment, as formulated by Williams, fosters a sense of home and belonging for residents. Moreover, nurturing an environment that prioritizes privacy, comfort, and personalization is important for improving NHs’ facilities. Additionally, staff training and support have been found in this paper to be one of the significant steps that NHs can take to improve their quality further. Finally, remedies for Medicaid reimbursement discrepancies will also enhance NHs.
Works Cited
Diamond, Timothy. Making Gray Gold: Narratives of Nursing Home Care. University of Chicago Press, 1992.
Faronbi, Joel Olayiwola, et al. “Caring for the Seniors with Chronic Illness: The Lived Experience of Caregivers of Older Adults.” Archives of Gerontology and Geriatrics, vol. 82, 2019, pp. 8–14. Web.
Gandhi, Ashvin, et al. “High Nursing Staff Turnover in Nursing Homes Offers Important Quality Information.” Health Affairs, vol. 40, no. 3, 2021, pp. 384–91. Web.
Koren, Mary Jane. “Person-Centered Care for Nursing Home Residents: The Culture-Change Movement.” Health Affairs, vol. 29, no. 2, 2010, pp. 312–17. Web.
Pioneer Network. “Defining Culture Change.” Pioneer Network. Web.
Thomas, William H. What Are Old People For?: How Elders Will Save the World. Vanderwyk & Burnham, 2004.