Saturday, November 5, 2011

Persuasive Research Paper


                                                                                                                                          
Francis O Nyachae
11/05/2011
Thomas Maltman
Persuasive Research Paper
Homecare versus Nursing Home Care and Group Homes

Care for the elderly and disabled individual has been a matter of heat debate for many decades, as every family sooner or later confronts a dilemma concerning the future life of an elderly family member or relative who is no longer able to lead independent life and fend for oneself.  I would like to think that we would do onto others as we would expect done on us  since our moment of truth is a few days away.There exist several options, like placing an elderly in a nursing facility or bringing in home care services. First of all it is necessary to conduct patient`s needs assessment, results of which are able to determine which variant is more appropriate (Diamond 1996). It is crucial to conduct such assessment before making any decision. A healthcare professional, making an assessment is able to determine the level of care required by the elderly person. In case an elderly is assessed to have high level care needs one may be recommended to move into the nursing facility to ensure medical safety. In case care needs of a patient are assessed to be of a low level, possibility of homecare should be considered (Diamond 1996).
Home healthcare is defined as a system of care, provided by a qualified practitioner to a patient in his or her home, being supervised by a physician. Services provided by the home healthcare include: physical, medical and occupational therapy along with nursing care (Centers for Medicare & Medicaid Services 2006). Homecare aims to help elderly or disabled individuals to live more independently and promote their level of well being as much as possible. Homecare allows patients to stay at home, avoiding admission to the long-term care facility or hospitalization (Shaughnessy, Hittle, Crisler et al. 64).
In spite of a common opinion that the majority of elderly people live in nursing homes, the U.S.A Census Bureau claimed that in 2000 only about 4.4 % of people older than 65 reside in nursing facilities (U.S.A. Census Bureau 2001). These figures have declined since 1990, when 5.1 % of those dwelled in nursing homes (Foner 73). Such reduction may be partially explained by governmental bills, which increased financing for nursing facility alternatives, such as homecare services, adult day care, family caregiving, and by the general decrease in disabilities for the elderly population. This fact witnesses for homecare to be recognized by the government as an effective and beneficial option for elderly and disabled care.
Long term care for elderly and disabled patients has undergone multiple changes during the past few decades. There appeared much more options in comparison to those previously available.  However, this kind of care is usually divided into two categories: institutional or facility care and non-institutional or homecare.  There have been numerous debates and researches on which type of care should be considered more beneficial (Fuller, 13).
Facility nursing care is usually provided by large organizations comprised of healthcare professionals, nurses, nutritionists etc. The most common types of nursing care facilities include nursing homes, facilities of assisted living care along with housing services.  Institutional care is developed for elderly and disabled patients who need constant assistance with their daily activities. Nowadays, institutional care is claimed to be the most common type of care. The elderly and disabled patients are provided with the opportunity to interact with each other while having a 24 hour care performed by professionals (Centers for Medicare & Medicaid Services 2006).
Homecare, on the contrary may be given by the non-licensed caregiver with assistance of a healthcare professional. Though a patient may not always receive constant assistance and care like in an nursing facility, one feels more convenient in the security and comfort of one`s own home. 
There are numerous benefits of having a loved one person cared for in one`s own home instead of in a group home or a facility. In the majority of cases such care is performed by a primary caregiver – a relative, spouse, friend with assistance of a homecare professional. Agencies involved in homecare provide various services for older individuals.
Convenience is one of the main reasons why people prefer homecare over institutional care. Having a medical care team come out and care for the patient means that the patient does not have to leave home frequently. This is especially useful for patients in wheelchairs or unable to move at all. Providing a homecare staff visit is considered to be a cost-saving practice, alternative to placing the elderly into a care facility which may appear very expensive (Fuller 13).
Qualified homecare nurses invited to care for the patient usually work under the supervision of a physician. They provide such services as taking vitals, drawing blood, inserting catheters, administering medications and making overall assessment of the patient`s health.
A proper hygienic care is crucial for a homebound individual. Taking into account the fact that a patient may find it hard to bath or shower oneself, homecare representatives can be invited several times a week to provide necessary services. Qualified aids can also assist with dressing up or changing catheter bags. Wound care professionals can perform skin and wound care (Centers for Medicare & Medicaid Services 2006).
The majority of agencies, providing homecare offer respite care service. It consists in caring for the elderly or disabled patient when the primary caregiver is not available or needs rest or respite. This service includes monitoring the patient and spending some time entertaining him or her. Housekeeping is another useful service given by the homecare. A housekeeper may be invited to make the bed for the patient, help with laundry, vacuuming, dusting and making sure that everything inside the house is safe for the patient (Fuller 13).
Both, institutional and homecare are very different types of care.  However, they both have the same objective - to promote a proper care for disabled and elderly patients (Foner 44).  Since both kinds of care have pros and cons, choosing one of them should be based on one`s individual preferences.  Placing a close person into a nursing home may become overwhelming.  In such a case one should choose homecare service, that would produce a less significant impact on one`s daily life.
According to the annual "Cost of Care" survey conducted by Genworth Financial, the recent years have witnessed an increase in costs for the long-term care in nursing institutions (Genworth Financial 2011). This survey has found that rising costs are now forcing 65 % of Americans to stop making long-term care plans. The average annual cost of living in a private nursing home varies from $70 to $194 per day, which still remains the most expensive care option. On the other hand, home care average hourly rate is about $25 for qualifies aid and about $17 for uncertified assistance (Genworth Financial, 2011). The daily fee for care in a nursing facility may include all available services, but sometimes it includes only room, and some basic services. Physical therapy and other additional services are billed additionally. In this respect homecare is much more beneficial.
There exist many benefits of having a close person cared for in one`s own home instead of placing one into a nursing care facility. Nowadays, thousands of people living in nursing facilities would rather prefer to dwell in their own houses. However, they remain in rehabilitation centers or nursing homes, because of the previously formed bias towards care in facilities. Institutional care is much more expensive, but it does not seem to matter.
A Community Choice Act, co-sponsored by Barack Obama is legislation that aims to give individuals receiving Medicaid an opportunity to have equal access to their own community’s services without forcing them into facilities like nursing homes (Community Choice Act, 2011).
Demand for long term care services is expected to increase in the coming decades. People will always continue to age, along with new technological improvements allowing more individuals to survive serious diseases and injuries. These factors add to growing demand for nursing homes alternatives and without any doubt, homecare in the most beneficial and convenient option.






Works Cited
Centers for Medicare & Medicaid Services. What is home health care? Retrieved from: http://www.medicare.gov/HHCompare/Home.asp?dest=NAV|Home|About|WhatIs#TabTop.
Community Choice Act (CCA). A Community-Based Alternative To Nursing Homes And Institutions For People With Disabilities. 2011. Retrieved from: http://www.adapt.org/cca
Diamond T. Making Gray Gold: Narratives of Nursing Home Care. Chicago: University of Chicago Press. 1995.
Foner N. 1994. The Caregiving Dilemma: Work in an American Nursing Home. Berkeley, CA: University of California Press.
Fuller C. Home care what we have what we need. Canadian Health Care Coalition. p. 13, 1995.
Genworth  Financial. Cost of Care Across the United States Survey. 2011. Retrieved from: http://www.genworth.com/content/products/long_term_care/long_term_care/cost_of_care.html
National Association for Home Health Care & Hospice. Basic statistics about home health care. Retrieved from:  http://www.nahc.org/04HC_Stats.pdf.
Slobac S. Disabled World: Costs of Home Health Care. 2010. Retrieved from: http://www.disabled-world.com/disability/caregivers/home-care-costs.php
U.S. Census Bureau. The 65 Years and Over Population. 2000.

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