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.

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.

"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

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.

After caring for his mother at the end of her life, Thomas Gass took a job as a nursing home aide in a for-profit long term care home. This graphic, poignant & chilling book details his experiences in this 'warehouse' for the elderly & asks fundamental questions about care in American nursing homes.

What has become known as the Schiavo affair-the death of a brain-damaged woman in Florida in 2005, and the controversy that surrounded it-was a revelatory moment in American society. For the first time, the nation got a clear view of both the fanaticism gripping the religious right and the political power it could bring to bear even when the vast majority of the country disagreed with it. But it was also a turning point: a moment when America seemed to glimpse a dangerous radicalism, and began to pull back. Eleanor Clift witnessed this event from a unique vantage point. At the same time that Schiavo was dying in her Florida hospice, Clift's husband, Tom Brazaitis, was dying of cancer at home; the two passed away within a day of each other. Two Weeks of Life alternates between these two stories to provide a moving commentary on how we deal, or fail to deal, with dying in modern America.

This first hand report on the work of nurses and other caregivers in a nursing home is set powerfully in the context of wider political, economic, and cultural forces that shape and constrain the quality of care for America's elderly. Diamond demonstrates in a compelling way the price that business-as-usual policies extract from the elderly as well as those whose work it is to care for them. In a society in which some two million people live in 16,000 nursing homes, with their numbers escalating daily, this thought-provoking work demands immediate and widespread attention. "[An] unnerving portrait of what it's like to work and live in a nursing home. . . . By giving voice to so many unheard residents and workers Diamond has performed an important service for us all."—Diane Cole, New York Newsday "With Making Gray Gold, Timothy Diamond describes the commodification of long-term care in the most vivid representation in a decade of round-the-clock institutional life. . . . A personal addition to the troublingly impersonal national debate over healthcare reform."—Madonna Harrington Meyer, Contemporary Sociology

Since the introduction of Medicare and Medicaid in 1965, the American health care system has steadily grown in size and complexity. Muriel R. Gillick takes readers on a narrative tour of American health care, incorporating the stories of older patients as they travel from the doctor's office to the hospital to the skilled nursing facility, and examining the influence of forces as diverse as pharmaceutical corporations, device manufacturers, and health insurance companies on their experience. A scholar who has practiced medicine for over thirty years, Gillick offers readers an informed and straightforward view of health care from the ground up, revealing that many crucial medical decisions are based not on what is best for the patient but rather on outside forces, sometimes to the detriment of patient health and quality of life. Gillick suggests a broadly imagined patient-centered reform of the health care system with Medicare as the engine of change, a transformation that would be mediated through accountability, cost-effectiveness, and culture change.

Most people fear the idea of living in a long-term care facility. Yet, there is potential for joy and meaning in these settings. This book highlights expanded roles and services that mental health professionals can provide in long-term care for older adults, offering the potential to improve the quality of care for residents. Beyond assessments and individual therapy, the authors make a case for mental health providers to help improve the long-term care environment for both residents and staff, thus having a greater impact on systems, culture, and ultimately, patient well-being. Readers who wish to add or expand their services for older adults will find helpful guidance, including detailed instruction on Medicare policies and reimbursement practices. The authors also present an innovative model of wrap-around care that involves the array of staff and family members who are present to the individual all day, every day. This comprehensive approach, called the Eldercare Method, positions the mental health professional to serve in the roles of teacher, consultant, role model, advocate, and clinician. With numerous case examples to illustrate common scenarios and ethical dilemmas, this practical resource will help readers envision new ways to apply their skills in the rapidly growing field of long-term care for older adults.