Forecast: the "sociable" nursing home.Report from the American College American College is the name of:
There was a time not long ago when nursing home owners and managers might have been considered to be among the last of a breed -- the good old American rugged individualist in·di·vid·u·al·ist
1. One that asserts individuality by independence of thought and action.
2. An advocate of individualism.
in . They provided "rest homes" for those who could afford it, and the service offered was limited only by their own business ingenuity and sense of decency. For the most part, nursing home operators answered only to their residents, residents' families and their own consciences.
Obviously, those days are fading fast Fading Fast is a rare EP by country music singer Kelly Willis. A&M Records originally released the CD as a promotional item, then later issued a limited number of copies for sale only in Texas. It features recordings with Jay Farrar of Son Volt, and with the band 16 Horsepower. . Aside from their well-known, and steadily accumulating, burden of regulation, nursing homes are being pushed into a new environment of social cooperation and responsibility -- so social, in fact, as to be almost chummy chum·my
adj. chum·mi·er, chum·mi·est
chummi·ly adv. . More and more, it seems, they will be working with other providers in the so-called "continuum of care." More and more, they will be faced with having to respond to demands for more personalized resident services. And, more and more, they will be be lining up and comparing themselves with each another in quality-of-care follow-up audits.
These "more and more's" were the trends that almost everyone agreed upon Adj. 1. agreed upon - constituted or contracted by stipulation or agreement; "stipulatory obligations"
noncontroversial, uncontroversial - not likely to arouse controversy among those who presented at the American College of Health Care Administrators' recent "National Futures Symposium." For example, Dennis Codner, Study Director of the futurist "Project 2010," discussed the predictions offered for that year by "Delphi panels" of academics, government officials, providers and businessmen. What did they foresee for long-term care long-term care (LTC),
n the provision of medical, social, and personal care services on a recurring or continuing basis to persons with chronic physical or mental disorders. ? Aside from an increased burden of illness among the elderly, continuing labor difficulties and constantly tight budgets -- nothing earthshaking earth·shak·ing
Of great consequence or importance.
earthshak there -- they saw:
-- a new generation of seniors -- better educated, more well-off financially, more "consumerist," but with less family support -- demanding high-quality service;
-- more "public-private" partnerships, starting with some growth in private long-term care insurance, but evolving to an expanded Medicare-type social insurance program, i.e., the "public" becoming the senior partner;
-- more coordination of long-term care services of all kinds, including but not limited to nursing homes;
-- more accountability for cost-effective care, with capitation being the primary mode of payment, case management greasing the wheels, and managed care running the show.
Dr. Robert Kane Robert Kane may refer to:
1. of, pertaining to, or characteristic of plants.
2. concerned with growth and nutrition, as opposed to reproduction.
3. ). This would involve, for nursing homes, an uncoupling of the concepts "nursing" and "homes." Residents would receive whatever specialized health care services they needed while living in environments meeting their personal standards of quality of life. For many of today's cognitively intact living in nursing homes, he said, having to share facilities with the cognitively disabled represented a severe decline in quality of life.
This comment prompted rumblings from the audience, and one administrator responded that, in his view, nursing homes' mission was to serve as a community for all those in need. To Dr. Kane, this was propagating the "mythology of happy togetherness"_most cognitively intact residents, when asked, would not choose to live in this way. "We have to begin to think about the configuration of the sites in which we treat these people."
Dr. Donna Infeld, a professor at the George Washington University George Washington University, at Washington, D.C.; coeducational; chartered 1821 as Columbian College (one of the first nonsectarian colleges), opened 1822, became a university in 1873, renamed 1904. School of Management and Policy, served as an official commentator on Dr. Kane's remarks. She broadened the issues -- and raised serious questions about them. "What about AIDS patients? Those with tuberculosis? Pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children.
Of or relating to pediatrics. cases? The developmentally disabled? The mentally ill? Can we in long-term care specialize our care for these groups? Or will we end up with so much fragmentation and redundancy?"
There were other potential problems -- for example, there could be more competition for funding, rather than coordination of it. Also, attempting to integrate a variety of long-term care services could produce more headaches than it resolved. For example, she noted, hospitals that own nursing homes have often felt frustrated in attempting to manage this unfamiliar mode of care, and have had availability problems, as well (as she put it, "full is full, whether you own it or not"). Furthermore, under managed competition, might not nursing homes be relegated to providing specialized post-hospital care, with their more social service aspects being farmed off to other providers? And, with "bundling," will reimbursement be adequate for all levels of care?
Dr. Infeld, in short, sounded like someone who has had experience with public policymaking pol·i·cy·mak·ing or pol·i·cy-mak·ing
High-level development of policy, especially official government policy.
Of, relating to, or involving the making of high-level policy: .
Still, if youth is any guide to the future, there's little for futurists to worry about. A pre-conference "Young Leaders The Young Leaders' Programme is run alongside the main Explorer Scout Programme. It is a formalisation of what was happening in many Groups and Districts across the country where older Scouts were returning to help the younger sections. " meeting involving 32 long-term care administrators with less than 5 years' experience, issued its own report. All in all, the participants seemed very comfortable with the predictions of the 2010-Kane scenario. Indeed, the youngsters were so broad-thinking that they reported failure in coming up with a common definition of "long-term care." They were anxious, they said, to avoid the connotation con·no·ta·tion
1. The act or process of connoting.
a. An idea or meaning suggested by or associated with a word or thing: of simply caring for the chronic needs of the elderly. There was much more to long-term care than that, but in attempting to define that "much more," they had found that commonly agreed-upon terms eluded them.
Some of the experienced administrators in the audience found their report frustrating. Were the kids thinking too much and overcomplicating things? Or was their uncertainty a sign of recognition of the wider, but still ill-defined, mission of tomorrow's nursing home?