by Debra K. Carey

Created on: January 02, 2009

I have worked in nursing homes for twenty years and have seen many changes in how they are operated. The trend used to be to care only for those who were dying. No thought was given to making these facilities home like or pleasant. With the aging of the population and changes within the healthcare payment system, nursing homes have had to begin providing various services to the community that once were provided only by clinics and hospitals.

Some of these services are physical therapy, speech therapy and occupational therapy. Many nursing homes now have a wings dedicated to patients who plan to return home after they are rehabilitated and fully healed. Hospitals stablize the patient and then they are discharged to a nursing facility to rehabilitate and recuperate. Some nursing homes employ physical therapists and other therapy professionals in house, some hire an outside agency to come in and provide these services.

With the aging of the population also comes more incidences of age related dementia. Alzheimer's can set in as early as mid forties or fifties with the individual expecting to live some twenty or more years. Our social structure does not always allow for adult children to care for aging parents with Alzheimer's or other types of dementia. Often both husband and wife have to work or have obligations that prevent them from being available 24 hours a day to care for an aging parent with dementia. These types of situations are reasons for placing an parent in a nursing facility. They are not there to die but to receive help with the daily activities of living such as bathing, eating, dressing and for safety issues. Many patients with dementia live for more than ten years before passing on. The nursing home truly does become their home. Other residents with dementia come only for the day and return home to family in the evening.

State regulatory angencies also now require facilities to operate more in line with how people actually live. No more institutional regimines of getting up at 5am, the same meals served at the same time to everyone. No more are baths scheduled and given only on certain days. Residents are allowed to choose when and how they are cared for. Gentle awakenings provide the opportunity to "sleep in" and eat in your room. Menu's are provided and choices can be made within the framework of their medical diets. Residents are allowed to refuse to follow their proscribed diets at will. The idea is to make the resident's stay more home like. The benefits of making nursing homes more "home like" are less stress and depression for those living there, which means less medication and less cost to the system.

Many nursing homes even provide another option in assisted living apartments. Medical staff is on hand in an emergency and for medication assistance but not intrusive in daily living. Residents are able to shop for and cook their own food and care for themselves in such things as bathing and dressing. Many services are provided such as house cleaning and laundry.

Gone are the days when being admitted to a nursing home meant you were dying.

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