Care for the Elderly

Rebirth in Care of the Elderly

The Denver Post just published this great article about patients whooping and hollering through swimming classes rather than sitting parked in wheelchairs. Steak and lobster grace the dinner plates instead of chipped beef and fish sticks. Plastic plants have given way to the Zen garden.

As a generation of retirees resists the fate of nursing homes they’ve grown to dread, supporters of a cultural revolution say they are reforming an industry long tainted by images of neglected patients languishing on soiled sheets.

The overhaul is happening room by room, from sprawling state-run homes to transformed ranch houses hidden on suburban cul-de-sacs.

Reforms in long-term nursing care will likely quicken in the next year as Colorado begins a “pay-for-performance” plan, sending higher Medicaid payments to homes that make changes ranging from reducing bed sores to giving residents a peanut-butter sandwich on demand.

“We’re at that tipping point for a major cultural change in nursing homes,” said Shelley Hitt, the ombudsman who is the independent advocate for better patient care in the state’s 212 nursing homes. “Our standards are higher; our expectations are higher. Twenty years ago, it was just a place where sick, older people went to die.”

Critics of traditional nursing- home care are not ready to declare lasting success. Reforms at a given home too often depend on the energy and dedication of a few key staff members, and those changes are difficult to replicate in more than 16,000 nursing homes nationwide.

“In general, the quality of nursing-home care is really bad,” said Charlene Harrington, a professor of sociology and nursing at the University of California at San Francisco who has studied national reforms. Truly improving care almost always requires increasing staff, she said.

“There’s some basic merits to the idea of the culture-change movement,” Harrington said. But “the nursing-home industry is trying to promote the idea you don’t need the staff; you just change the culture. That’s why I’m bruce mccandless colorado state veterans nursing home, florence. Park Beatty gets a kiss from Gladys, his wife of 63 years. The couple met in the Navy during World War II. (Joe Amon, The Denver Post )skeptical of the whole effort.”

Still, from one home installing a live cow outside the window of an animal- loving patient, to a sharp statewide decrease in chronic-pain measurements, the humane fixes have upgraded some of the most vilified institutions in American life.

“The heart of it is just treating people the way you want to be treated,” said Barbara Moore, administrator of Bruce McCandless Colorado State Veterans Nursing Home in Florence. Once entrenched in a notorious state nursing system, McCandless has won kudos for trying everything from consistently matching staff with the same patients to parking a Patton tank outside for grandkids to climb on.

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