Forms of Care
Home Health Care vs. Nursing Homes and Assisted Living
Caring for the elderly is seemingly becoming an enormous challenge to the U.S healthcare system. It has become a significant public health issue whereby the elderly population requires extensive care from their families. Currently, the population of persons aged 65 years and above is estimated to be 39.6 million, which is equivalent to12.9% of the total U.S population. Research indicates that the percentages of elderly persons have increased significantly in the last decade. In 2000, the percentage of the elderly population was found to be 12.4%, so it has increased by 0.5% within a span of 10 years, and this is predicted to reach as high as 19% by 2030. This implies that the population of older persons will be about 72.1 million which will be more than twice their population in the year 2000 (Administration on Aging, 2013).
In this context, care for the elderly will serve as the most principal approach in enhancing their health and social wellbeing. Caring for the elderly people involves numerous aspects, which require comprehensive evaluation to ensure that people at old-age enjoy a high quality of life. Ordinarily, elderly people are faced with health challenges owing to their aging bodies which are susceptible to illnesses. For instance, most old people experience mental degradation leading to memory loss. In addition, some people develop loss of vision and hearing abilities while others suffer from mental disorders such as Alzheimer’s and dementia. In theory, care-giving serves as the most principal requirement for the elderly for improved health. However, care-giving is usually faced with challenges owing to the complexity of decision making, availability of resources and experiences of care-givers. Ideally, elderly persons are supposed to be taken care of in a safe and healthy environment (Boehlke, 2010). Therefore, this paper will provide an overview of caring for the elderly in which it will focus on caring for elderly at home verses nursing homes and assisted living.
Forms of Care
In practice, care for the elderly persons can be provided in three different forms which differ significantly with regard to the level of care, facilities and care-givers involved. The principal care forms include home health care, nursing home care and assisted living. In most cases, home health care is used in offering care services to the elderly persons (Boehlke, 2010). It is the oldest form of care, but advancements in the nursing field have led to the emergence of nursing homes and assisted livings which have gained unprecedented popularity in the U.S owing to their reliability and availability of a wide range of care resources.
Nursing home care involves skilled nursing facilities and medical attention to elderly persons, especially those who experience medical issues such as cognitive impairment or chronic illnesses. Ordinarily, nursing homes are meant for providing care to patients to ensure efficient monitoring of their health needs, and it requires extensive nursing skills which are offered by nurses and other medical staff. In the U.S, nursing homes fall under the government health system in which Medicare and Medicaid programs are extended to cater for medical health needs of the elderly persons.
Assisted living care is a new approach in caring for the elderly population which emerged in 1990s to address challenges of nursing facilities. They are designed to provide home-like care services to the elderly persons who require custodial care. Ordinarily, assisted living facilities involve private apartments in which laundry, catering and housekeeping services are provided to the residents in an atmosphere characterized by autonomy and independence (Stevenson, 2013). It is worth noting that, assisted living facilities are not included in the national health programs which are extended to the elderly for addressing their medical challenges. However, assisted living facilities receive state licensing, and they involve State Ombudsman Programs and Private Accreditation Programs for quality monitoring in accordance to the federal Older Americans Act of 2000 (AHRQ, 2006).
Currently, there are 6,315 assisted living communities in the U.S which comprises of 475,500 apartments. These facilities are estimated to hold an elderly population of 733,000 with an average length of stay in the facilities of 28 months. On the other hand, there are 50 federal states which regulate assisted living facilities.
Home Health Care vs. Nursing Homes and Assisted Living
It is believed that home care offers numerous advantages to the elderly and care-givers compared to nursing homes and assisted living facilities. However, it has its drawbacks especially with regard to the availability of care resources and medical attention.
One of the most significant benefits of home care is that it promotes recovery, primarily when the elderly person is experiencing some illnesses. Research indicates that the confinement of elderly persons in the hospital environment causes traumatizing experiences, which interfere with the process of healing. In most cases, traumatizing effects are associated to medical procedures, which are involved in nursing homes and hospital facilities during the treatment of a given medical condition of the elderly persons. Therefore, the rehabilitation of elderly persons in their own homes enables them to reduce treatment trauma and realize efficient recovery from their unhealthy status. Ideally, home care provides social support, which plays a pivotal role in improving cognitive capabilities of the person’s mind and body. Wilding (2012) reports “research shows home care expedites healing – demonstrating older adults heal more quickly at home versus in a hospital or nursing home setting” (par. 7). It is also reported, that home care reduces chances of re-hospitalization for elderly persons with medical problems because healing is sustainable compared to the case in nursing homes or hospitals where healing is compromised when trauma develops.
Secondly, home care has been found to be cost-effective because it saves money. Financial reports indicate that, home care costs for the elderly persons in the U.S accounts for one-third whereas nursing homes and assisted living cost three-thirds of the total cost of care. It is reported that home health care costs $37,440 annually compared to the cost of private and semi-private rooms in nursing homes which cost $85,775 and 75,555 thousand, respectively. Therefore, home health care is the most cost effective of all other forms of care. As such, it is ideal for addressing the issue of healthcare costs, which has led to immense crisis in the U.S healthcare system. In practice, it is quite easy to provide home care to the elderly persons by virtually all income groups because it is affordable compared to nursing homes care and assisted living which involves a hefty price tag (Wilding, 2012).
On the other hand, home health care offers individualized care services to the elderly persons because it is personalized. Ideally, home health care is based on individual preferences and needs, and it plays significant roles in persons with long-term illnesses because there is a high level of continuity where a unified team of care-givers provides a wide range of services to the elderly. In contrast, the element of continuity is entirely absent in nursing homes and assisted living facilities because patients stay in these facilities for a limited duration. In addition, the type of staff, environment and lifestyle are always the same in nursing homes and assisted facilities compared to the diverse social environment experienced at home care set-up.
Fourthly, home health care is associated with an advanced level of personal dignity and independence. Ordinarily, home health care allows the elderly persons to exercise maximal control and freedom because it is not restrictive in any way. This is probably the principal reason as to why 90% of the elderly population prefers aging at home. It is believed that home setting provides the elderly with opportunities to remain in the community and engage in their daily activities without hindrance. They are also able to choose their care-givers, and this allows them to experience an environment characterized with mental comfort. In addition, senior adults are not subjected to rules and regulations in their homes unlike the case in nursing homes where rules and regulations govern their daily living. As a result, their aging health problems are minimized; thus, their quality of life is improved.
In contrast, nursing homes and assisted living facilities do not provide honor to the elderly, especially with regard to personal dignity and independence because their freedom is restricted by rules and regulations in nursing homes and assisted living facilities. However, assisted living facilities are designed to provide the home-like environment to the elderly persons. Stevenson (2013) states “assisted living helps seniors care for themselves while also offering access to an active and rewarding lifestyle. At the same time, when families no longer bear sole responsibility for meeting all of their loved ones’ needs, it can reduce everyone’s stress level and even improve family relationships” (par. 10).
Moreover, home health care anchors the family together and it is safe compared to nursing homes and assisted living. In practice, family bonds serve a fundamental role in maintaining emotional, mental and physical fitness in patients and elderly persons. It also allows elderly persons to receive care from their loved ones, in which they can choose their therapeutic environments which guarantees safety. As such, home health care helps in reducing some of the challenges facing care-givers including feelings of guilt. In addition, one-on-one attention aspects of home health care ensures the safety of the elderly because their needs are met adequately in a more efficient manner than it is the case in nursing homes where procedures are followed in providing care to the elderly. Moreover, home health care does not involve increased risks of infections. In most cases, confinement of elderly persons with infectious illnesses enhances the development of complicated infections. Research indicates that, 20% of patients hospitalized experience health complications associated to infections (Stevenson, 2013).
However, home care encompasses several drawbacks including the lack of supervised nutrition and intellectual stimulation. These services are provided more conveniently in nursing homes and assisted living facilities than home care setting. Nutrition plays a pivotal role in the health of elderly persons. Therefore, the aspect of providing nutrition supervision in accordance to individual health needs make nursing homes ideal for elderly persons (Stevenson, 2013).
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- Patrick Kimuyu (Author), 2016, Caring For Elderly at Home versus Nursing Homes and Assisted Living, Munich, GRIN Verlag, https://www.grin.com/document/381255