New directions in nursing home ethics

bibliography) (Special Supplement)

Authors: Collopy, Bart; Boyle, Philip; Jennings, Bruce

Citation: The Hastings Center Report, March-April 1991 v21 n2 pS1(15)

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Long-term care facilities_Moral and ethical aspects

Nursing homes_Moral and ethical aspects

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Full Text COPYRIGHT The Hasting Center 1991

New Directions in Nursing Home Ethics

Nursing homes can be frightening and depressing places. They remind us of our own mortality and of the inevitable time when most of us will face the frailty, ailments, and incapacities of old age. At the same time, nursing homes are places of refuge and respite; essential places to which exhausted families turn when they can't manage at home and when adequate community support is unavailable or unavailing. For some residents, too, moving to a nursing home represents escape from the loneliness, isolation, and danger of a solitary house or apartment. It means return to a social setting and a community of care and concern. Nursing homes are places to go home fromùand many do. They can also beùand areùplaces people go home to.

How can we best make sense of the deep ambivalence, even the antipathy, that so many in our society feel toward nursing

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are not acutely ill. A large policy issue hides here, one that affects the basic mission of nursing homes and the very definition of institutional care of the frail elderly. Cost containment policies in acute care could in fact transform nursing homes into "subacute care" institutions. If the present pattern of escalating care continues, it is quite possible that nursing homes will, in the future, offer very little "intermediate" and domiciliary care. In short, they will be transformed from long-term care homes into long-term care hospitals. This would, of course, further erode the already thin continuum of care between hospital care and home care, leaving the health care system with few institutions providing assistance in daily living rather than high-level medical and nursing care. Deinstitutionalizing care to this extent would drastically narrow the mission of nursing homes. It would also massively increase the burdens on families, many of whom would have very limited access to formal home care services. Such reduction of institutional care, while it might produce fiscal savings in the health care system, would also bring disheartening social costs. "Being a Resident": The Constraints of the Institution The
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Some common words found in the essay are:
DRGs Medicare, Vulnerability Restraint, Medicare Medicaid, Regulation Nursing, Moral Agents, Social Security, United Despite, Ethics Nursing, Cultural Image, Medicaid Facing, nursing home, nursing homes, home care, long-term care, health care, acute care, nursing home care, nursing home residents, home residents, health care system, care system, elderly families, care elderly, nursing home regulation, nursing home setting,
Approximate Word count = 10004
Approximate Pages = 40 (250 words per page)

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