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DAY FIFTY-THREE: Who lives in nursing homes?

Tennessee is experiencing growth in under 60 institutional population.

By Tim Wheat

Often nursing homes are considered a home for elderly people. Age, however, has nothing to do with being admitted to a nursing home, it is a disability that creates a need for long-term care services and poverty that triggers payment from Medicaid. Most people in nursing homes are seniors, but young people often find themselves at this dead-end to this nations healthcare system. 

Chart showing the growth in Tennessee nursing homes 1990 to 1999In fact, the population in Tennessee Nursing Homes less than 60 years old has expanded more than 34% since 1990. That makes the growth rate of residents under 60 years old more than four times the total nursing home population growth rate of 8% over the same period of time. The most recent figures from the Tennessee Department of Health show that as an overall percentage of the nursing home population, the under 60 age group has grown from 4.4% in 1990 to 6.1%.

Although the general population of Tennessee over the age of 65 has increased 13.5%, that increase has not seemingly translated into a corresponding increase in the nursing home population. The population in nursing homes under 60 has comparatively expanded dramatically growing by over a third.

The fallacy promoted by the Tennessee Nursing Home industry is that a facility is the ONLY long term care option for people with disabilities. "My husband requires round-the-clock total care,” states the wife of a nursing home resident on the Tennessee Nursing Home Lobbies website. “Nursing homes can and do provide this needed service.” 

The fact is that Nursing Homes do not provide 24-hour care. The US Department of Health and Human Services found that nursing facilities provided residents on average less than three hours of direct care a day. The Nursing Home lobby however seems to want citizens to believe that being locked in a facility, stranded in bed, medicated to submissiveness, or restrained is some kind of around-the-clock care.

Nursing homes are the most expensive and least desirable form of long-term care.“I will always be grateful to the nursing home for the care they give my husband,” the same spouse of a nursing home “patient” continues on the Nursing Home Lobbies website. “I truly don’t know how we would survive without nursing home care."

There is nothing exclusive about the services provided in the institutional setting that cannot be provided in a persons home. The Nursing Home Industry uses statements like “I don’t know how we would survive,” to play on people’s ignorance of what the facilities actually provide.

The Center for Medicare and Medicaid Services recently released a report titled: "Nursing Home Data Compendium 2000." It found that for 2000, the percentage of the total number of nursing home residents with ZERO/NO Activities of Daily Living (ADL) impairments in Tennessee was 28.9%. That means that nearly a third of the people currently in Tennessee Nursing Homes had no impairment to accomplishing routine tasks like bathing, eating or toileting.

Why are many of these individuals in a nursing home when they don’t require institutionalized long-term care? The Tennessee Nursing Home Lobby’s website gives a clear indication that the Industry considers confinement to be “care.” “I kept [my mother] at home for as long as I could,” another family member states on the Nursing Home Lobby’s website, “but she cannot be left alone and requires 24-hour care."

But there are alternatives to inappropriate institutionalization. Nursing Homes are the most expensive and least desired form of long-term care. Americans should have the choice to live in their own homes and receive long-term care.

Obviously, people cannot depend on the Nursing Home Industry for reasonable information of alternatives. The industry apparently wants to sell the idea that confinement to a facility is the place for citizens that need long-term care; out of sight, out of mind.

Consider Medicaid reform that will end the current bias for institutional care. Consider MiCASSA, the national legislation that will offer real choice to Americans with disabilities.

No longer should parents be forced to incarcerate their children with disabilities because the state will only provide long-term care services in expensive facilities. And no longer should adult citizens with disabilities foresee spending their entire life in a nursing home. The following alarming excerpt was taken directly from the Tennessee Health Care Association website to sell the importance of institutionalizing family members. 

"We needed to get our son in some place. Our health had deteriorated to the point where we just couldn’t take care of him at home. We had some home health care, but we had to end up doing most of his care ourselves. We searched around for a place that would take care of him. A big stumbling block was the fact he is on a ventilator to breathe. The staff at King’s Daughters and Sons Home has been very helpful ever since day one. They’re just helpful in every way.

Mr. And Mrs. McCarthy, parents of nursing home patient 
King’s Daughters and Sons Home, Memphis 

- Tim Wheat

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