Nursing Homes
From Wikipedia, the free encyclopedia

A nursing home or skilled nursing facility (SNF) is a place of residence for people who require constant nursing care and have significant Activity of Daily Living (ADL) deficiencies. Residents include the elderly and younger adults with physical disabilities. Adults 18 or older can stay in a skilled nursing facility to receive physical, occupational, and other rehabilitative therapies following an accident or illness. In the US, nursing homes are required to have a licensed nurse on duty 24 hours a day, and during at least one shift each day, one of those nurses must be a Registered Nurse. In April, 2005 there were a total of 16,094 nursing homes in the United States, down from 16,516 in December, 2002. Some states have nursing homes that are considered NF or nursing facility, these homes do not have beds certified for Medicare patients, but can only treat patients whose payments source is Private Pay or Medicaid.

Consumer choices

Current trends are to provide people with significant needs for long term supports and services with a variety of living arrangements. Indeed, research in the U.S as a result of the Real Choice Systems Change Grants, shows that many people are able to return to their own homes in the community. Private nursing agencies may be able to provide live-in nurses to stay and work with patients in their own homes.

When considering living arrangements for those who are unable to live by themselves, it is important to carefully look at many nursing homes and assisted living facilities as well as retirement homes, keeping in mind the person's abilities to take care of themselves independently. While certainly not a residential option, many families choose to have their elderly loved one spend several hours per day at an Adult Daycare Center.

New trends

Nursing homes are beginning to change the way they are managed and organized to create a more resident-centered environment, so they are more "home-like" and less "hospital-like." In these homes, nursing home units are replaced with a small sets of rooms surrounding a common kitchen and living room. The staff giving care is assigned to one of these "households." Residents have far more choices about when they awake, when they eat and what they want to do during the day. They also have access to more companionship such as pets. Some organizations working toward these goals are the Pioneer Network, the Eden Alternative, and the Green House Project. Many of the facilities utilizing these models refer to such changes as the "Culture Shift" or "Culture Change" occurring in the LTC industry.

Resident- Oriented Care

Resident oriented care is where nurses are assigned to particular patients and they have the ability to develop relationships with the patient. Patients are treated more as family as, oppose to random patients. Using resident oriented care nurses are able to become familiar with each patient and cater more to their specific needs, rather they be emotional or medical.

Scientific Findings

According to various findings residents who receive resident-oriented care experience a higher quality of life, in respect to attention and time spent with patients and the number of fault reports after the introduction of Primary Nursing. Although resident-oriented nursing does not lengthen life, nursing home residents are able to connect with someone, which allows for them to dispel many feeling of loneliness and discontent.

“ Resident assignment” refers to the extent to which residents are allocated to the same nurse. With this particular system one person is responsible for the entire admission period of the resident.

In coming to this conclusion three guidelines must be assessed: structure, process and outcome. Structure is the assessment of the instrumentalities of care and their organization; Process being the quality of the way in which care is given; Outcome being the usually specified in terms of health, wellbeing, patient satisfaction, etc. Using these three criteria find that are strengthened when residents experience resident oriented care.

Communication is also heightened when residents feel comfortable discussing various issues with someone who is experienced with their particular case. In this particular situation nurses are also better able to do longitudinal follow up, which insures the implementation of more lasting results.

Task-Oriented Care

Task oriented care is where nurses are assigned specific task to perform for numerous residents on a specific ward. Residents in this particular situation are exposed to multiple nurses at any given time. Because of the random disbursement of task, nurses are declined the ability to develop more in depth relations with any particular resident.

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