JustCare

Tag: Nursing care

  • If you need long-term care services, how will you get them?

    If you need long-term care services, how will you get them?

    The majority of older adults will need long-term care services at some point. But, caregiving costs for older adults are super high, stemming from significant labor and facility costs, along with high demand. If you need long-term care services, how will you get them?

    More and more people are looking for adult day care, assisted living facility care and nursing home care. For many of them, relying on volunteer caregivers, such as friends and family, is not possible. But, the cost of paid care is prohibitive, swallowing up years of savings quicly. Caregiving costs increased more than 20 percent between 2012 and 2019 and continue to rise.

    Medicare does not pay for long-term care services. At best, Medicare will cover 100 days in a rehab facility or nursing home for people who need daily skilled nursing or therapy services. And, most Medicare Advantage plans inappropriately deny coverage for rehab and nursing care beyond a few days.

    But, a stay in a rehab or nursing facility can cost thousands of dollars if you have to pay out-of-pocket. The average cost of a nursing home stay is now more than $9,000 a month. The average cost of a stay in an assisted living facility is more than $4,500 a month.

    Caregiving costs are a lot higher in some states than others. In Massachusetts, average costs for a nursing home stay can be more than $15,000 a month. An assisted living facility stay can cost well over $8,000 a month.

    More than four in five households with someone over 65 need some type of care. Almost a quarter of them have significant care needs, including round the clock care. Almost two in five need help, though not round the clock. Only about one in five of them need minimal care, such as help getting groceries and cooking.

    Here’s more from Just Care:

  • Does your hospital have enough nurses?

    Does your hospital have enough nurses?

    Nurses represent the largest health profession in the United States. But, we have been experiencing a nursing shortage. Having enough nurses is critical for patient care. A new study published in the British Medical Journal reveals an increase in deaths the greater the number of hospital patients whom nurses must care for.

    Specifically, of the 137  British hospitals studied, those with six or fewer patients per nurse in their medical wards had a 20 percent lower death rate than hospitals with 10 or more patients per nurse. Higher levels of health care support workers taking the place of nursing staff did not make up for fewer nursing staff, but rather led to higher death rates. The researchers could not prove cause and effect because this was an observational study, but they did see strong evidence of an association between nurse staffing levels and patient death rates.

    Does your hospital have enough nurses? It’s hard to know. National data is not easily accessible, if it even exists. Massachusetts appears to be at the forefront of states collecting and reporting data on the quality and safety of hospital care, including nurse staffing. If you or someone you love is going into the hospital, you should consider looking into the adequacy of nursing staff. (No matter the nursing situation, it’s always helpful to have a health care buddy with you at the hospital and to prepare for your hospital stay. Here’s a checklist. It’s also good to know which hospitals Medicare has rated poor on patient safety.)

    On a positive note, the supply of nurses is growing to meet significant demand.  A  report by the Department of Health and Human Services’ Health Resources and Services Administration (HRSA) finds that we are educating many more nurses. Consequently, we are seeing a dramatic increase in our supply of both registered nurses (RNs) and licensed practical nurses (LPNs), which HRSA projects will outpace national demand by 2o25. However, some states will still see serious shortfalls in RNs and LPNs.

    There were just shy of three million registered nurses in the U.S. in 2012.  By 2025, the number is expected to grow by one-third to almost 4 million registered nurses. Yet, the demand is only expected to grow by one-fifth to 3.5 million RNs.  However, there is still expected to be a shortfall of RNs in 16 states, 10 in the west, four in the south and two in the northeast.  Arizona, North Carolina and Colorado will experience the greatest need for RNs.

    There were almost three-quarters of a million licensed practical nurses in the U.S. in 2012. By 2025 the number is expect to grow by more than one-third to almost one million LPNs. And, as with RNs, the demand is not expected to grow by quite as much. There will still be a shortfall of LPNs in 22 states, 10 in the west, five in the south, five in the northeast and two in the mid-west. Maryland, North Carolina and Georgia will experience the greatest need for LPNs.

    NB: HRSA’s models rely on an assumption that use of nursing care and patterns for delivering nursing care will not change. With new emerging health care delivery systems they could very well change. And, if they do, an increased reliance on nurses is very possible.

  • Cutting edge small nursing homes: Green Houses

    Cutting edge small nursing homes: Green Houses

    If you’re looking into nursing homes for yourself or someone you love, consider a Green House.  Green Houses, conceived by Dr. William Thomas, are non-traditional nursing homes that transform long-term care, focusing on person-centered care.  They are small nursing homes that are designed to look and feel like a real home. And they promote caregiver relationships based on mutual respect and empowerment to make the lives of their residents meaningful.

    Green Houses are for older adults with or without disabilities. Studies show that they improve quality of life for residents, with higher resident satisfaction and as good health outcomes.  

    Green Houses are designed for between 10-12 residents.  Each resident has his or her own bedroom and bathroom, and there is a shared living room, dining room and kitchen.  The residents design their own daily routines.  

    Caregivers, nurse assistants, and social workers work together as a team to provide personalized care for residents. They provide four times more personal and social contact with residents than a traditional skilled nursing home. Staff are happier with their work than traditional nursing home staff.  

    Studies show that the costs to Medicare and Medicaid are as much as $2300 less than a traditional nursing home.  And, data show fewer hospitalizations for residents relative to people in traditional nursing homes.  

    Green Houses can be established as part of a traditional nursing home or independently. They began operating in 2003.  Today, there are 175 Green Houses, with about 1700 beds, in 27 states.  More than half the residents have Medicaid.  There are 16,000 nursing homes in the U.S., with about 1.5 million beds.

    Click here to learn why community matters in later life.

  • Medicare begins rating home health agencies

    Medicare begins rating home health agencies

    Much like surgeons, home health agencies are not created equal. To help people better compare Medicare-certified home health agencies, Medicare just launched Home Health Compare. It’s a web site that helps you see some quality differences among home health agencies in your community rates.

    There are a lot of factors that go into whether a home health agency is good, bad or great. So, you should talk to your doctor and other people you know and trust about home health agencies in your area as well as look at Home Health Compare. The Informed Patient Institute provides good information about health care quality, patient safety and health care costs as well as the usefulness of report cards.

    Right now, Medicare is rating agencies for the quality of their patient care based on nine of 27 process and outcomes measures.

    • Process measures include how quickly the patient received needed care, whether the patient got a needed flu shot and whether the agency educated the patient about his or her medications.
    • Outcomes measures include whether the patient got better at walking, bathing, and getting into and out of bed, as well as whether the patient experienced less pain and shortness of breath.

    Some home health agencies may not offer the full range of Medicare-covered services you need. On Home Health Compare, you can find out which services different agencies provide, including nursing care, physical therapy, speech therapy, occupational therapy, social services, home health aide services.