The character Dorothy said in The Wonderful Wizard of Oz, “there is no place like home” (Baum, 1960, p. 45). Sadly, many of our elderly live in Long Term Care Facilities (LTCF). The transition from living in their own homes, to living in a LTCF, can be a traumatic experience. Poor adaptation to a LTCF may cause depression, malnutrition and significantly reduce the lifespan of the elder. Thus, it is imperative, that nurse’s recognize this promptly. According to Agnes and Guralnik (2008) adaptation is “a gradual change in behavior to conform to the prevailing cultural pattern (p. 15).” When elders are placed in a LTCF, whether it be voluntarily or involuntarily, they must give up certain liberties that are taken for granted. This includes independently bathing, cooking their meals, and having the freedom to come and go. In most LTCF’s there are scheduled routines of activities, to include meals, bathing, a few physical activities and a lot of down time. The down time can be especially hard for the elders. It is in this period of time, when they may think about family, friends, and other activities they have had to give up. Parker (2013) mentioned to me in an interview, she is very fortunate to have family members that still care for her since moving into the nursing home. Her daughters and sons come multiple times throughout the day and evening checking on her. She goes on to say that, many of the other residents do not have family or friends. They just sit in their chairs, and stare off into space, wasting away. Nursing homes have been looked at as institutions, rather than homes for the elderly. This leads to more negative thoughts about LTCF’s and the care provided there. As Whitaker (2009) mentions, LTCF’s enc... ... middle of paper ... ....). Skilled nursing facilities and convalescent homes. Retrieved November 20, 2013, from http://www.helpguide.org/elder/nursing_homes_skilled_nursing_facilities.htm Ackley, B. J., & Ladwig, G. B. (2011). Nursing diagnosis handbook: an evidence-based guide to planning care (9th ed.). Maryland Heights, Mo: Mosby. Agnes, M., & Guralnik, D. (2007). Webster's New World college dictionary (4th ed.). Cleveland, Ohio: Wiley. Baum, F. (1960). The wonderful wizard of Oz. New York, NY: Dover Publications. Bergland, A., & Kirkevold, M. (2005). Thriving in nursing homes in Norway: Contributing aspects described by residents. International Journal of Nursing Studies, 43, 681–691. Retrieved November 20, 2013, from the Ebsco database. Whitaker, A. (2009). Family involvement in the institutional eldercare context towards a new understanding. Journal of Aging Studies, 23(3), 158-167.
I will discuss how LTC contributes to the U.S. Healthcare System, the targeted clients, employees that work within the long-term setting, the benefits and services offered within LTC, and the expected outcomes for individuals in a long-term facility. I will discuss the legalities and regulatory issues faced within the LTC setting along with ethical issues that may impede successful facilitation of a long-term facility.
Touhy, T. A., & Jett, K. (2012). Toward healthy aging: Human needs & nursing response (8th ed.). St. Louis, MO: Elsevier/Mosby.
Simpson, J. A., and E. S. C. Weiner. The Oxford English dictionary. 2nd ed. Oxford: Clarendon Press; 1989.Print.
Long-term care (LTC) covers a wide range of clinical and social services for those who need assistance due to functional limitations. These limitations usually result from complications associated with age related chronic conditions, from disabilities related to birth defects, brain damage, or mental retardation in children; or from major illnesses or injuries suffered by adults (Shi L. & Singh D.A., 2011). LTC encompasses a variety of services including traditional clinical services, social services and housing. Unlike acute care, long-term care is much more complicated and has objectives that are much harder to measure. Acute care mainly focuses on returning patients to their previous functional level and is primarily provided by specialty providers. However, LTC mainly focuses on preventing the physical and mental deterioration of an individual and promoting social adjustments to suit the different stages of decline. In addition the providers of LTC are more diverse than those in acute care and is offered in both formal and informal settings, which include: hospitals, physicians, home care, adult day care, nursing home care, assisted living and even informal caregivers such as friends and family members. Long-term care services have been dominated by community based services, which include informal care (86%, about 10 to 11 million) and formal institutional care delivered in nursing facilities (14%, 1.6 million) (McCall, 2001). Of more than the 10 million Americans estimated to require LTC services, 58% are elderly and 42% are under the age of 65 (Shi L. & Singh D.A., 2011). The users of LTC are either frail elderly or disabled and because of the specific care needs of this population, the care varies based on an indiv...
Ackley, B. & Ladwig, G. (2010) Nursing diagnosis handbook:an evidence based guide to planning care. Maryland Heights, MO: Mosbey.
Whereas, Australian families tend to keep assistance to a minimum by having care brought from a culturally and linguistically diverse (CALD) approach, which accommodates older adults based on their cultural background (Yeboah, 2015). A point often overlooked is that regardless of the quality of care the older adult receives, they prefer to be located close to family. More importantly, a nursing home produces an environment that shows little consideration for family values, which is the main aspect older adults strive for when considering a nursing home. Therefore, participating in a nursing home can be disputed because it is the defining line between a good or poor quality of life if the older adult fails to make it their home. Quality of life refers to the perceptions people have of their position in life based on their goals, expectations, values, and concerns (Cavanaugh & Blanchard-Fields, 2015).
With over 1.5 million elderly and dependent adults now living in nursing homes throughout the country, abuse and neglect has become a widespread problem. Even though some nursing homes provide good care, many are subjecting helpless residents to needless suffering and death. Most residents in nursing homes are dependent on the staff for most or all their needs such as food, water, medicine, toileting, grooming- almost all their daily care. Unfortunately, many residents in nursing homes today are starved, dehydrated, over-medicated, and suffer painful pressure sores. They are often isolated, ignored and deprived of social contact and stimulation. Because of insufficient and poorly trained staff commonly found in nursing homes. Care givers are often overworked and grossly underpaid that often results in rude and abusive behavior to vulnerable residents who beg them for simple needs such as water or to be taken to the bathroom.
Assisted living is an effective type of care facility programmed towards helping older individuals with their increasing disabilities. “The fit between individual capacity and the availability of satisfying activities within an environment is an important aspect of positive aging and an especially salient issue for ALF [Assisted Living Faculty] management, given the role of activities in the consumer selection of assisted living”.2 This isolation of this quote is “positive aging”. Positive aging is important since it leads individuals to have a happier and more fulfilling life, and it can be supported through everyday activities and through the living environment. In nursing homes, each individual needs help with making sure that they are given care that meets their needs. This varies through different states and also communities. The purpose of the quote is to show that each person should be evaluated individually, meaning everyone needs a different approach to deal with the aging process.
St. Louis, MO: Elsevier Ackley, B.J., Ladwig, G.B., & Flynn Makic, M. (2017). Nursing diagnosis handbook (11th ed.). St. Louis, MO: Elsevier University.
...rcise, social activity, and proper nutrition are important in keeping the patient healthy as well. Any steps toward producing a calm, safe, and well-structured environment may help the patient. Helping the patient and the family with the legal aspects, supporting the family through care giving, and assisting with decisions about long-term care placement are also crucial to help the patient.
The New International Webster's Pocket Dictionary of the English Language. Naples, FL: Trident International, 2002. Print
Spark Ralph, S. & Taylor, C. M. (2011). Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Pearsall J (1999) The Concise Oxford Dictionary Tenth Edition page 286 by Oxford University Press in Oxford New York, America
Gordon, M. (2007). Manual of nursing diagnosis: including all diagnostic categories approved by the North American Nursing Diagnosis Association (11th ed.). Sudbury, Massachusetts: Jones and Bartlett.
Limited mobility is a factor that creates a situation where people once social butterflies become home bound, creating a need for increased care (Berger, 2014). As age increases, more support may be needed creating a situation where a nurse would need to support my aunt in the care for my grandmother. Respite care and/or some form of assisted living may be on the horizon; however, as of right now my grandmother is in her home where she wants to be with the ability to stay for the unforseen