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As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
Written by leading international experts, this book discusses the latest advances in the field of dementia in nursing homes. The topics and findings covered are based on their survey and on a scientific literature review. Dementia is spreading worldwide, placing a growing burden on healthcare systems and caregivers, as well as those affected. With increasing and complex care needs, nursing home admission is often necessary. Globally, over half of nursing home residents suffer from dementia. The book provides essential information on the most important issues in dementia in nursing homes today, including meaningful activities, patient-/person-centered care, psychosocial interventions, challenging behavior, inclusion and support of family members, pain, staff training and education, communication, polypharmacy, quality of life, end-of-life care and advanced care planning, depression, delirium, multidisciplinary approaches, physical restraints and care dependency. Each topic is covered by an international expert in dementia. As such, the book will appeal to professional nurses, nursing scientists, nursing students, other healthcare professionals, and to a broad readership, and will provide a valuable resource for those working in nursing homes, as well as researchers in the field.
At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Get the vital clinical information you need with this comprehensive handbook!In the decade since the first edition of this book, dramatic changes have taken place in the field of geriatric psychiatry. Psychiatry in the Nursing Home, Second Edition, presents timely information on the newest trends in law, culture, and medications, while still offering essential advice on the fundamental concerns of caring for elderly patients with mental illnesses. The new edition of this essential handbook presents up-to-date information on psychiatric issues involving nursing home patients. Featuring helpful case histories and diagnostic criteria, Psychiatry in the Nursing Home, Second Edition, helps you effectively treat such difficult problems as noisy patients, sexual acting out, and incontinence. In addition, it offers help with such administrative concerns as financial issues, absent or warring families, and staffing problems. Psychiatry in the Nursing Home, Second Edition, presents incisive discussions of the changes in the field since the publication of the first edition, including: the effects of the new Prospective Payment System the use of newly released psychotropic medications the altered nomenclature of the DSM-IV the rise in assisted-living facilities the rapid development of the specialty of geriatric psychiatry With its comprehensive scope and practical advice, Psychiatry in the Nursing Home, Second Edition, is a must-have for nursing-home administrators and staff. Policymakers, mental health professionals, and geriatricians will be fascinated by the book’s wider considerations of the problems of housing and caring for the mentally ill and its provocative suggestions for future policy.
Long-term care services include a broad range of services that meet the needs of frail older people and other adults with functional limitations. Long-Term care services provided by paid, regulated providers are a significant component of personal health care spending in the United States. This report presents descriptive results from the first wave of the National Study of Long-Term Care Providers (NSLTCP), which was conducted by the Centers for Disease Control and Preventions National Center for Health Statistics (NCHS). This report provides information on the supply, organizational characteristics, staffing, and services offered by providers of long-term care services; and the demographic, health, and functional composition of users of these services. Service users include residents of nursing homes and residential care communities, patients of home health agencies and hospices, and participants of adult day services centers.
Nursing homes are where some of the most vulnerable live and work. In too many homes, the conditions of work make it difficult to make care as good as it can be. For the last eight years an international team from Germany, Sweden, Norway, the UK, the US and Canada have been searching for promising practices that treat residents, families and staff with dignity and respect in ways that can also bring joy. While we did find ideas worth sharing, we also saw a disturbing trend toward privatization. Privatization is the process of moving away not only from public delivery and public payment for health services but also from a commitment to shared responsibility, democratic decision-making, and the idea that the public sector operates according to a logic of service to all. This book documents moves toward privatization in the six countries and their consequences for families, staff, residents, and, eventually, us all. None of the countries has escaped pressure from powerful forces in and outside government pushing for privatization in all its forms. However, the wide variations in the extent and nature of privatization indicate privatization is not inevitable and our research shows there are alternatives.
The care home sector is large, with over 400 000 residents in the UK and a similar number employed within the homes. It is therefore an area of considerable economic importance. Care home residents are often very old, and many have multiple physical and mental health needs, meaning that their care poses particular challenges. They are also a distinctly and profoundly marginalised group who are often invisible in the wider debates on quality of care including those about care homes. Mental Health and Care Homes is a coherent and evidence-based text exploring these issues. Bringing together both clinical and research perspectives it will help those working in the care home sector to deliver high quality care and support to both residents and staff. This important, yet neglected, area is thoroughly reviewed by a range of experts including residents, family carers, staff, researchers, and clinicians. The book has four sections: 'the inside view' which includes several first-hand accounts of care home life; 'the outside view' which discusses the regulatory, funding, and legislative context in which care homes operate; 'mental health and care', a detailed review of the major mental and other health issues that arise in care homes, as well as interventions and services to offer support; and a section exploring the 'promotion of health and wellbeing' including examples of good practice. It concludes by synthesising key themes and setting an agenda for further enquiry. The book is written in a style that encourages engagement, with the inclusion of contemporary case studies and examples, making it topical and readable. It will be valuable for a broad professional and vocational audience across both health and social care, as well as students and researchers.
Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.