Opinion — The Big Picture: Fair critique or cheap shots?

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There's a familiar rant coming from state legislatures, federal policy-makers and other self-proclaimed defenders of the elderly. Boiled down, it goes something like this: Nursing homes need to be replaced because bad things happen in them.

There certainly seems to be a collective push to eliminate as many facilities as possible, and replace them with something else, anything else. You'd think from the sound of this fury that the nursing home sector is on its rightful deathbed. What rubbish!
I strongly believe our older, frail seniors should reside in the place where they can receive the highest level of care possible. Preferably, it's at home. Perhaps a community-based option makes sense. Sometimes an assisted living community or other eldercare-specific option works best.
But let's face it: Nursing homes exist because they fill a need. No other setting has proven as effective or efficient at providing 24/7 care for people who happen to be very old and very sick.
Certainly, nursing homes are not perfect. Some are run by disreputable owners and managers. Most could use more staff to provide care and literally do the heavy lifting. Working conditions at many are far from ideal. And on the best days, running a long-term care facility is no picnic.
But the clarion call for the demise of nursing homes is not just off-tune. It's a bad tune. Under the same logic — put nursing homes out of business because bad things happen in them — hospitals for children should cease to exist, particularly those for children with cancer. Would any sane person present such an argument?
Yet, nursing homes continue to be fair game. The general sentiment among critics seems to be that other options will be better and cheaper. That remains to be seen. So far, the choice has been better or cheaper, not both.
Among people whose jobs depend on accurately predicting the future, the death-to-nursing-homes sentiment is notably absent. Kalorama Information analysts examining the eldercare market through 2009 predict that nursing homes will continue to dominate. A separate report from the government's own actuaries sees nursing home outlays essentially doubling between now and 2014, reaching $400 billion along the way.
Nursing homes must adapt to changing conditions and new competitors. And those that are not strategically aligned or offer bad care may already be living on borrowed time.
But the idea that nursing homes are the problem is simplistic and wrong. Such a view impedes constructive dialogue and insults the profession.
John O'Connor
Vice President
McKnight's Long-Term Care News
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