Ramsey 1

Jordan Ramsey

Mrs. Cook

English Composition II

11 April 2021

Choosing Nursing Homes should be a Careful Decision

Over three hundred times. That is how many times it took for ninety-eight-year-old

Yvonne Grant to successfully get the attention of the staff. In December 2012, at a nursing home

in the UK, her family set up a secret camera in her room to figure out what was going on when

they were gone. The footage shows two nurses finally coming in after she calls out for an hour.

She asks them to help take her to the bathroom, and they tell her to wait five minutes so that they

can help other residents. This becomes ten, then fifteen, and then twenty minutes. When they

return, they try to make her walk with them to the bathroom, even though they should be using a

hoist. When they realize she is unable to walk, they act annoyed. They also refuse because she is

wearing a pad and leave her alone until another worker comes two and a half hours later. On

other nights, some caregivers take her to the bathroom sooner, but others are also rough with

transporting her. Yvonne’s granddaughter later told Yvonne that she had put the camera in and

had seen what was happening to her. Less than a month later, Yvonne ended up passing away.

One of the caregivers from the first night was charged and found guilty of assault. Figures that

have been released showed that since 2011, 1,260 other facilities have been issued warnings for

elder abuse across the UK. Most of the complaints are related to care, welfare, and staffing

issues. Nursing homes are important to society because they can serve senior citizens better than
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other alternatives, however, they should be carefully selected so that they are the most beneficial

option to them and their family.

Instead of living at home, many senior citizens around the world are placed into nursing

facilities. Some families try their best to keep them at home, but how often is this really

practical? Family members may try to care for family members themselves, but is this best for

everyone involved? Does it fulfill the needs of the seniors? How about their families? Caregivers

can provide in home care, but is that a better alternative?

Figure 2 A study by the CDC shows the use of Advance Directives, or ADs. ADs are

written statements used to specify desired medical treatment to make sure that they are carried

out. The figure shows how often they are used by age and the age differences by population

(Jones et al).
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Before nursing homes in the United States, there were almshouses which provided a

place to live for the poor and needy. After the Social Security Act of 1935, the use of these began

to decline because they charged the elderly and needy. The government began to understand that

the amount elderly members of society was rising, and they knew it would be harder for them to

compete against their younger counterparts. According to “History of Nursing Homes in

America”, states, “Under the SSA, the Old Age Assistance program made federal money

available to the states to provide financial assistance to poor seniors. The law specifically

prohibited…institutions such as almshouses (poor houses,) thus spawning the creation of the

private nursing home industry.” (Michaels 6). The first listing of nursing homes began in 1954

and were usually built in close proximity to hospitals. There were about 9000 in existence with

270,000 people listed as residents. Today, this number has risen to about 1.4 million residents in

the U.S. (Michaels).

One factor that often determines why seniors are often placed into nursing homes is that

families are not able to meet the demands that seniors have. Seniors may need help with mobility

and with taking certain medications. It can often be a bigger burden than what families initially

expect. This can be a lot on families trying to care for them and deal with their own daily

responsibilities. Nursing homes are commonly seen as an easy alternative that will cater to all of

their needs. For example, “Palliative and Nursing Home Care: Policy Challenges and Quality of

Life”, by Samuel E. Plunkett, explains, “Nursing homes are now seeing increasing numbers of

obese… providing care for obese patients in hospital settings reveals that obese patients often

have complex medical profiles with multiple co-morbidities, unique care needs, and greater

health care resource utilization.” (Plunkett 117). Many residents need extensive care that applies

to daily living aspects such as “…bathing, dressing, toileting, transferring, and eating.” (Plunkett
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118). Certain factors such as obesity, often create more issues in receiving these necessities. This

frequently requires complex medical assistance and leads to higher rates of health care

application.

Another issue with ageing and remaining healthy is that behavioral health disorders such

as Alzheimer’s and dementia begin to develop in the brain for some. The initial cause of

Alzheimer’s is uncertain, but it is thought to progress from protein build-up in the brain.

Currently, over 5 million Americans are living with Alzheimer’s, which makes caring for seniors

even more demanding because symptoms include difficulty with thinking, poor judgement,

memory loss, confusion, and even aggression (Bond-Nelms). Aggression can be a significant

issue because this symptom often leads to seniors rejecting help and becoming increasingly

hostile as the disease intensifies. Eventually, it will come to the point where they will have to be

placed in a facility. Depression and withdrawal from daily activities are also common.

Withdrawal means that seniors may have tasks that they used to enjoy or need to be able to

perform in order to live independently or with family, but they begin to distance themselves from

them. This statistic is increasing because elderly members of society are living longer in general.

Research shows that about 65% to 90% of residents are affected by some behavioral health

disorder. Psychiatric care is often required for the patient’s health, meaning that it may not be

suitable to choose in home services. Caregivers may perform in home service, but a lot of

patients need to be cared for 24/7 (Orth et. al).

There are also seniors who live alone, away from their families, and then eventually enter

nursing homes. Sometimes this is due to issues with physical and mental health, and the

hardships that come with this become problematic over time. Usually, what leads to this situation

involves families living far away and not being readily available. Some choose to abandon older
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family members because either because there is no relationship, or it is easier to disregard them

altogether. The BBC News article, “Loneliness is 'Hidden Killer' of Elderly”, asserts, “A lack of

social interaction can make old people more vulnerable to depression and to problems such as…

poor diet and a reduction in exercise. More than half of people over the age of 75 are living

alone.” It often leads to cardiovascular and immune system ailments. Living alone increases the

chances that seniors will have to eventually enter a nursing home. If families took time to move

close to their seniors or invite them to live with them, then these issues would decrease

(Coughlan).

These statistics are based on studies of seniors with depression when living alone.

Research shows that more than 50% show signs of poor interaction. Results say that 47% were in

the age group of 60 greater than or equal to 70 years. Only about 17% were older than 80 years

old. This is shown when living with and without family. 45% of respondents were found to be

widows or widowers (Singh). The deaths of family members such as spouses, is a common

trigger of depression is senior citizens as well as loneliness. Nursing homes are an excellent way

to introduce isolated seniors to relatable people in their age range so that they can avoid issues

that come with these triggers. Nursing homes are able to get them involved in activities that are

beneficial to their mental and physical health. Social activities on schedules may include group

bingo, card games, chess, checkers, etc. Physical activities may include balloon fights, yoga,

even karate. Overall, nursing homes are an effective way to solve this issue.

However, stigma of nursing homes often derives from issues involving elder abuse.

Families may fear what happens in nursing homes when they are not around because there are so

many cases of it occurring. One study done in Michigan found that about 24.3% of nursing home

residents report experiencing elder abuse. A random sample was taken of four hundred fifty-two
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adults over the age of sixty-five. “Physical Abuse of Older Adults in Nursing Homes: a Random

Sample Survey of Adults with an Elderly Family Member in a Nursing Home” confirms,

“Limitations in activities of daily living (ADLs),… and previous victimization by nonstaff

perpetrators were associated with a greater likelihood of physical abuse.” This means that harm

caused by malpractice in nursing homes can lead to individuals becoming more physically

challenged by any injuries they may have received. It is more likely that abuse will create more

challenges over time. It is important to check the background of any nursing home being

considered and whether or not it has a history of elder abuse. Because seniors’ body are frailer

with age, it will take longer for them to heal from injuries they may receive from incidents

involving falling, not using a hoist/wheelchair when necessary, or being handled roughly.

Ailments may also occur when proper medical treatment is not implemented. For example,

diabetic patients may need to have their blood sugar taken or insulin shots given to them at

certain times of day. When caregivers are fall behind with this system, it can be deadly. Another

factor in this is that caregivers have to be able to understand when their patients are not feeling

well. Some patients will not be as vocal as others, so caregivers need to understand how deal

with this when the situation arises.

The pie graph found on MSMC’s website lists common types of elder abuse and the

percentage that each one occurs. Neglect, physical abuse, and financial exploitation are the top

three most common forms (Rolfe).

Currently, COVID-19 is a major worldwide threat to seniors which has changed how a

lot of people view safety and security in nursing homes. Families cannot be certain how safe

their family members will be when the death rates among seniors are so high. The pandemic has

led some families to be more cautious about choosing nursing homes because of the risks that

COVID-19 pose to seniors. Elderly members of society have been shown to be most affected by

symptoms such as neural, cardiovascular, and respiratory damage, high fever, pneumonia, dry

coughing, chills, and loss of smell/taste. Facilities have taken precautions to prevent the spread

by limiting visitation, allowing family members to communicate from behind glass windows, use

of face masks, sanitation, and restricting group activities. The truth is that seniors are way more

limited in their time than their younger counterparts are expected to have. Even though most of

the precautions negatively affect how they carry out the rest of their lives, it is what maintains
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their lives. COVID has taken face to face interaction with family. Some who have died have had

to die alone to prevent spread to family and other seniors. Vaccines have changed the direction

of this trend since seniors have been vaccinated first because they are most at risk.

Figure 2 A study by the Kaiser Family Foundation shows a small fraction of nursing

facilities is deficient. Almost every nursing home met the targeted inspection by March 2020

(Musumeci).
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The map is based on the Kaiser Health Foundation study of COVID-19 related deaths

being connected to nursing homes. It shows that in seventeen of these states, half of COVID

deaths are associated with nursing homes. implications of this data show that seniors have a

higher risk of dying from the disease in nursing homes in most states. This data is as of October

2020 (Harder).
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The map by the Kaiser Health Foundation represents the number of care facilities by

state. It relates to the first map because there is a correlation between the number of deaths and

the number of facilities respectfully. This data is as of 2019 (Harder).

Perhaps the best solution in providing care for senior citizens is nursing homes. Adults

are living longer, and families struggle to maintain their own daily lives. Nursing homes provide

mental, physical, and medical care when seniors are too frail, lonely, or otherwise worse off. The

concept of nursing homes within itself empowers them to continue living healthily. They are

important to society because they are beneficial in providing the care that seniors need as they

age when they themselves or their families are unable to properly care for them. They have been

around for a long time and serve the purpose of being a better alternative. However, there are

some risks that come with them. Elder abuse remains an issue that families are fighting in every
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shape and form. COVID-19 is a recent dilemma for families because it affects what may be the

safest option for their seniors. When adequate care is provided, it is best in dealing with the

physical and mental issues that seniors tend to face as they age. Nursing homes are convenient

because they have specialists that can handle issues such as dementia and Alzheimer’s. In cases

where seniors are forced to live alone, entering nursing homes can combat depression and

loneliness as well as prevent health issues that would stem from lack of exercise, poor dietary

habits, medical issues, and isolation. While there is no perfect care option, it remains important

that families make rational decisions about what is best for their family members.
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