Any family member who has had a loved one go to a rehab facility (aka nursing home) after being in the hospital may have encountered this problem. Anyone with an aging parent who has to stay in one of these facilities for more than a few days is sure to have seen it. Understaffing is the problem. There are not enough aides and of even greater concern, not enough Registered Nurses. Of course this endangers residents who have inadequate supervision.
Sufficient staff is needed to watch our elders
The New York Times recently reported on this and the piece was commented upon by a trusted resource advocating for elders, The Long Term Care Community Coalition (LTCC). The article and commentary by LTCC emphasized that many facilities do not comply with the legal requirement that an RN must be on duty eight hours a day seven days a week. Why aren’t there enough staff and what can families do about it?
As for aides, I can personally testify from experience that it is a very tough job, very physically demanding and that the salaries are low compared with other, probably easier jobs. I found it rewarding to work with mainly older people in these homes but not everyone gets satisfaction from doing this kind of work. The turnover rate of aides is generally very high. RNs can often find better paying jobs elsewhere. These facilities then use “licensed practical nurses” or “licensed vocational nurses” (LPNs/LVNs) who are significantly less educated than RNs. Less skill can mean limited ability to correctly diagnose problems and communicate effectively with physicians, other nurses, families and providers. While many LPNs/ LVNs are very good at their jobs, they cannot legally substitute for an RN, whose training is more rigorous and extensive. Adding to the problem is the fact that our aging population is growing, the need for long term care such as is provided in these homes is also growing and the number of available, quality aides is not keeping up with demand.
We can’t always predict when a family member will need to go to such a facility. For example, after a stroke or heart attack, an elder may be briefly hospitalized to address the immediate problem, the next step is to send the elder to a place for longer term rehab services, such as physical, speech and occupational therapy. Medicare will not pay for any patient to remain in an acute care hospital for long when rehabilitation is the next step. If your loved one needs any of these therapies, expect that he or she will be discharged from the hospital, sometimes on short notice, and you will