Re: long-term care is all too often long term abuse or neglect (today at 3:00 PM)

[Memo To Me]

Some time ago I reviewed a study on Nursing home long term care in the
USA. It's in our archives. If and when we are able to buy insurance,
overall the care that we presume will be available later when we need it
is spotty and more often than not substandard even when meeting state
and local inspections. I personally have found those associated with and
near a good hospital to be a good long term care facility.


In my experience as Director of a Florida County Health Department,
excepting sanitation inspections which were done well, government
regulations and oversight of these facilities is mostly an expensive
exercise in enforcing bureaucratic rules with too little relation to
good nursing care.


That a facility newspaper is published at least once a week, that an
adequately stocked bookmobile is wheeled from bed to bed daily, that
frequent entertainments in a well equipped ready room are provided may
be indicative of a well run nursing home, but are ancillary to the care
itself.


Generally information re the frequency and quality of physician visits
is gleaned from nursing notes that often are nicely written, sometimes
before the recorded event takes place. Same with the number and quality
of bedside staff visits. I once observed an aide throwing a patient's
watch and jewelry out a window to be picked up later by an accomplice.
Unusual? It happened and like crime generally, may not be all that
unusual.


Just as having health insurance, medicare etc. requires patients and
families to be informed and vigilant, so it is with long term care even
if we do have insurance. This is a major family/friend/societal
responsibility, not always available.


I hope our member's experience differs, but too often being insured for
long term care is not the same as being assured of good long term care.
Be careful out there!


Best, Arch

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