Putting the Home Back in Nursing Home
Redesigning nursing home care for the future
The pandemic has triggered a national conversation about where and how people want to live as they age and need increasing assistance.
Now is the time to redesign nursing home care. The model that's been in place in America for roughly 70 years needs a contemporary and forward-looking set of changes that are responsive to older adults.
A new poll commissioned by The John A. Hartford Foundation found striking results related to this issue. We learned that 57% of older adults say COVID-19 has affected their willingness to live in a nursing home and nearly everyone (89%) says changes are needed to make nursing homes acceptable and inviting to them.
This overwhelming desire for change calls all of us to help create a shared vision for the future of care of older adults as they age. What new, innovative long-term care options will address the needs and priorities of older adults and their family caregivers?
Fortunately, the public and private sectors are already thinking about how and where America can best care for older adults in the future. Here are a few examples:
- The American Rescue Plan that passed Congress incentivizes states to work with nursing homes to enhance infection control, provide training and support for staff and create lasting partnerships between public health organizations and long-term care facilities.
- The Geriatrics Workforce Enhancement Program provides strategic training and information to primary care clinicians, direct care workers and patients and families themselves to ensure an age-friendly workforce is able to meet the changing needs of older adults.
- An updated ‘Teaching Nursing Home’ model pairs skilled nursing facilities with nursing schools to identify innovative ways to improve the care of older adults by enhancing skills of the nursing home workforce and the faculty and students who participate.
- A renewed examination is underway of hospital rehabilitation wings to create space for older adults to stay in hospitals for specialized care after serious procedures like a hip replacement, rather than being discharged to separate skilled nursing facilities where they run the risk of spreading hospital-acquired infections to older, sicker residents.
- Alternatives to traditional nursing homes are becoming more popular, including programs like GRAYCE, which helps family caregivers support older adults, or smaller, community-oriented facilites like Greenhouses that serve fewer than a dozen residents and have a comfortable, easy-to-navigate design.
- New nursing homes are being created for residents who share critical aspects of their identity, like Spanish-speaking communities or facilities that appropriately serve LGBTQ+ adults.
I'm confident that within the next several years, nursing homes will look far different than they do today.
Older adults can expect to see programs and options for long-term care that focus on what matters most to them, especially since our polling shows 71% of older adults are currently not willing to live in a nursing home in the future. But, as with most major societal shifts, real change will take public and private resources and consumer demand.
What can you do? Talk about this with friends and family, speak with state and federal lawmakers and share your thoughts with your community. As COVID-19 showed the world, there is nothing home-like about today's nursing homes, and we have the power to change that. And change is coming.
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The John A. Hartford Foundation is a private, nonpartisan, national philanthropy dedicated to improving the care of older adults. The leader in the field of aging and health, the Foundation has three priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care.
