as could not care for a disabled elderly person. People have to go to work, and no one could stay home to care for the patient. (p. 264)
The fact that most elderly persons were put into nursing homes prior to the last decade meant that nursing homes grew in number with the growth of the elderly population. By the late 1980s, if trends toward institutionalism of the aged had continued, the number of elderly Americans in nursing homes could have reached 4 million by the year 2018. In 1988 about 2.3 million Americans were in nursing homes, and the rapid increase in those aged 85 and up, meant that nursing homes were building to meet the demand.
Patients are transferred from hospitals into nursing homes much more quickly today than in the past. As Horne (1989) observes, "in today's streamlined world of health care, it is not uncommon for a hospital to provide care until the patient is stabilized and then transfer that patient to a nursing home for the kind of rehabilitative and convalescent care once provided as part of a hospitalization" (p. 3). Horne goes on to maintain that "these days, persons who are taking up permanent residence in nursing homes are older, sicker, and more frail than such residents were in the past" (p. 3).
Today, the community is more able to provide services which allow older persons to stay independent and be cared for outside of an institution for a much longer period of time. Those elderly persons now in nursing homes are much more likely to have severe medical conditions than those in the past. This has been one of the reasons that nursing homes have found it increasingly difficult to sustain profitable operations; as a consequence, nursing homes have sought ways of cutting corners, which is never a good practice when it comes to health care.
Although nursing homes have been the only alternative for many elders, their families, and the social workers who assist them, there exist may m...