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Few people voluntarily consider going into a nursing home. They are usually seen as a last resort for the elderly and their history has been fraught with neglect and abuse. There is now a growing movement to eliminate nursing homes and replace them with home and community-based care, or assisted living residences.

As people grow older, the choice of aging in place should always be an option. However, there will also always be those who will have to turn to nursing homes for 24-hour care. There is much
documented evidence that nursing homes beds are decreasing (see Kaiser Health News) . At the same time the number of assisted living facilities has increased.

Alternative options such as assisted living residences or community-based care often appear more desirable but can be financially out of reach for those who are not eligible for Medicaid. Many
assisted living facilities offer more amenities, greater freedoms and additional activities. However, they are not always equipped to handle the health problems of aging older adults. Assisted living is fine for early onset conditions, but as a resident’s health deteriorates and eventually requires more specialized care, he/she will need 24-hour services primarily provided by skilled nursing facilities .

Another important factor is oversight. While nursing homes are regulated by the state and
federal government, most assisted livings facilities are not. With a few exceptions, the government does little to monitor or regulate assisted livings, leaving little recourse for residents.

This brings us back to the case for nursing homes. Nursing homes still have a crucial role to play in long term care. They are the primary resource for intensive care that is regulated by the
government. We cannot ignore the need for nursing homes or for watch dog organizations that monitor the care nursing homes provide. It is time to direct attention towards improving the quality of care and quality of life in skilled nursing facilities by ensuring safe staffing ratios and by focusing on
person-centered care to create more home-like atmospheres.

FRIA has been working with caregivers since 1976, offering them information on long term care options in New York, alerting caregivers to their rights, and working with the Department of Health to improve conditions. If you have questions or concerns regarding long term care, contact FRIA’s free Helpline at 212-732-4455. (Mon-Fr. 10 am-5 pm) or visit our website at www.fria.org.
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