January 30, 2003

Fixing long-term nursing care
By Shirley Cohen

Our country's long term care system is tragically flawed. What more evidence do we need than the high profile failure of San Mateo County's largest nursing home, the Burlingame Healthcare Center, which now look like it will be closed for good after the state failed to find a buyer for the long-troubled facility.

Who wants to live in a nursing home anyway?

Given the choice, wouldn't we all rather stay in the comfort of our own homes? Sadly, the long-term care system in the US has grown overly reliant on nursing homes, and unless something is done to reverse this trend, roughly one out of four of us will wind up in one ourselves.

Nursing homes came into prominence about 30 years ago as a way to ease the burden on US hospitals, which back then were responsible for nearly all long-tern care services.

It seemed a reasonable enough solution at the time - to place a dozen or often hundreds of seniors together under one roof in an effort to consolidate their care.

But the system was then and is now extremely impersonal and clinical, caring mostly for the patent's physical health and failing to adequately address their emotional or spiritual well-being.

Many industry experts will admit that nearly one out of three institutionalized seniors don't need to be there in the first place, that they would be better off living at home and cared for by the community.

The good news is that some efforts have already been made to fix the system. For instance, adult daycare programs are more widely available today than before.

San Francisco was the first city in the country to form an alliance of adult day services, a network that now includes 13 agencies and 23 community -based centers. These centers provide seniors with basic Healthcare and therapies as needed, plus social and recreational activities.

Another prime example is the Family Caregiver Alliance, a statewide organization founded in San Francisco to address the needs of families and friends providing long-term care at home.

The FCA recognizes the contribution of family caregivers to the health of our country's elderly and champions their cause through education, research and advocacy.

In 1990, my mother suffered a paralyzing stroke. The doctors told me she would need around-the-clock care, recommending that I look into nursing homes. But I didn't have the heart to do it. I felt she deserved better than to live out her dying years in some cold, anonymous residence.

So I set out to find reliable home-care help, a task that proved to be much more difficult than I could've imagined. Back then, our country's home-care system wasn't nearly as formalized as it is today.

There were very few agencies facilitating the type of care my mother needed, so it was left to me to hire and manage aides to watch after her.

This forced me to take off several weeks from work and spend hours interviewing candidates, checking their references, arranging for medical visits, etc.

Today it is much easier to find dependable alternatives to nursing homes than it was in 1990. But we still have along way to go.

We must find better ways to finance the care of low-income seniors by prosecuting elder abuse more severely. We must increase the pool of professionals qualified to care for seniors in their homes.

But most of all, we must stop relying so heavily on nursing homes to care for our elders.

Otherwise we all run the risk of ending up in one.

For more information, contact:
shirley@eldercarexperts.com
(415) 776-7337

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