Caring for elderly parents or grandparents in a private home setting requires patience, love and a strong will. Unlike children, though some are like children, adults have a sense of independence, yet are dependent on the caregiver. Once strong and self-sufficient, they are vulnerable and helpless, in need of care from family members. It causes not only the caregiver grief, but the one being cared for is often confused and can’t accept their condition.
In-home elderly care usually falls on the shoulders of one family member. In the beginning, other family members may assist and give the initial caregiver time off, but as time progresses from weeks to months and possibly years, other personal activities tend to override the importance of sharing in the task, often leaving no other choice but putting the loved one in a nursing home. Without family support, it is nearly impossible to spend twenty-four hours, seven days a week meeting the needs required for the elderly person.
Until the early 1900’s people managed to take full responsibility of elderly parents or grandparents. However, many of the caregivers were less fortunate, living in impoverished conditions. Thus, almshouses and poor farms were instituted. Many thought it best to place their loved ones in such a place in order to get the care they needed.
The almshouses were supported strictly by charity donations, and were for those who were no longer productive and needed a place to stay. On the other hand the poor houses, or at times referred to as poor farms, were in the beginning established to house paupers who were caught stealing. The poor house is not to be confused with paupers prison. The farms were supported by tax payers, similar to the modern day welfare system. Amongst the residents of such institutions were thieves, mentally ill, orphans, and elderly. Eventually the government decided that housing those with an array of distinct needs together was inappropriate and the farms soon became known as “old folks homes.”
Not until 1935 were changes made in favor of the elderly when President Franklin D. Roosevelt signed the bill for Social Security benefits. Those who were already housed in one of the facilities, however, were not eligible for the benefits. The benefits were only for retired individuals and did not include the poor. Soon after the signing of the bill, homes were opened for those who had income, such as Social Security, with the mindset that the home’s proprietors could benefit from the payments.
In the mid-1950’s, the government took a stand against those homes which were taking money from the residents, yet care was rated very poor. The government passed a bill that required all such facilities be licensed through the government. In that case, not only did the proprietors make a substantial income, the government would benefit from the cost of licensing a vast number of “old folks homes.”
During the 1960’s the government passed the Moss Amendment, after a mass nursing home scandal broke out in New York State. The Moss Amendment was to prohibit below-level standards of care and stop fraudulent activities. After several years of investigation Medicare was initiated in 1969, a program established to assist those who were on Social Security, met the low income standard, and were either elderly or handicapped.
Again, in 1971, the government became involved with the nursing homes, which were no longer a welfare system but, due to the licensing process, considered to be part of the health care system, and modeled after a hospital setting. The care received in nursing homes was supposed to be the same quality that a patient receives in a hospital. However, due to the many scandals that once again took place in the seventies, it seemed that government involvement had not improved the establishments’ bad habits, but simply gave them an even greater opportunity to play a fraudulent game with the residents Medicare and Social Security benefits.
Today, in modern nursing home facilities, the government has cut the Medicare pay to homes, allowing them only a percentage of the patients income. The homes are paid according to the Balance Budget Act. The patient by no means gets the greater part. The residents are permitted to have $1,500.00 in their personal accounts that are in the nursing homes banks. Should that amount exceed that which is permitted, the patient’s family must do a “spend-down” in order to bring the account back to an allotted amount of that mentioned.
It is often difficult to spend a large amount of money on those who are confined to a nursing home. However, if the money is not spent on the resident, with receipted proof, the state acquires the money at the time of the patients death.
Over the years, since the poor house syndrome, many things have changed as far as modern day care, building appearance and food. However, even though there have been stricter laws applied, the nursing staff does not give much better care in the days past. The rate of nursing home abuse and neglect is astronomical. Most modern day facilities are understaffed, and lacking in heartfelt compassion.
To many who work as nurses and nurses aides, it is nothing more than an eight hour job. Constant observation from family members is imperative. Notice any unusual behavior the patient may have. Check their skin for bruises. It is our responsibility to report unusual “falls” or bruises that happen to often. Reporting incidents to the nursing home is not always the best option. It may become necessary to report to a local Ombudsman organization if mistreatment is suspected.