History of Nursing Homes Essay

Today, there atomic number 18 approximately 16,100 suck up crustal plates in the U. S. with approximately 1. 5 million residents (www. cdc. gov). However historic in ally, the sick, disabled, and olden were caveatd for at home by family members. Changes in applied science and accessible changes have created a shift in how we feel for for our fourth-year and disabled, and there is evolution in geriatric flush that continues at once (Morris, 1995). Nurses have had a huge role in revolutionizing the concern for our immemorial and for creating what is the modern breast feeding home.Caring for the old age, or geriatric treat, is practically not viewed as beingness as prestigious as former(a) specialties in treat. Despite the growing time-honored race and the fact that 46% of all Registered Nurses entrust be providing direct c atomic number 18 to the decrepit, the majority of treat students silent do not receive any specialize cognitive content in geriatric nurs e (Ebersole & Touhy, 2006). Later on, we will discuss the increment of geriatric nurse as a specialty and as it relates to the explanation of long-term care. In the sixteenth century, we began to see institutions unquestionable to care for a variety of people in need.This did not just include the elderly or disabled, tho any dependent poor, sick, orphaned children, widows, insane, and even belittled criminals. These institutions could be considered a predecessor to the nursing homes that eventually followed (Morris, 1995). Poor laws in Europe gave rise to these institutions referred to as workhouses, almshouses, or poorhouses. They take into accountd actually minimal nursing care, and the care was oft entrustd by pauper nurses who were not trained and usually inmates themselves, practically alcoholics. Agnes Jones, a Nightingale trained nurse visited a Liverpool Infirmary in 1864 and reported deplorable conditions.She was forced to dismiss 35 pauper nurses for drunkenness and say that bed clothes had not been washed for months (Ebersole & Touhy, 2006). These poorhouses were common in the united States as easy and much had the same deplorable conditions. Carolyn B fraudlett Crane, the hot seat of Charity Organization Department of Womens Civic Improvement confederacy of Kalamazoo, MI attempted to address these problems first-year with the Michigan State Nurses joining in 1906 and again with the Nurses Associated Alumni of the United States in 1907 with pleas for nursing care in these almshouses.In her 1907 paper, Almshouse Nursing the Human Need the Professional Opportunity, she expound the county almshouse as a hospital with the hospital part unexpended out. She went on to talk almost how the specialization of institutions for certain groups, such as asylums and orphanages, left the elderly and infirm to be the majority of those left with no separate options besides the poorhouses (as cited in Ebersole & Touhy, 2006 p. 8). Little progr ess was made. In 1912, the American Nurses tie Board of Directors appointed an Almshouse Committee to oversee housing in these institutions. relegate continued to be slow. From 1910 to 1920 focus was taken away from elder care due to the war (Ebersole& Touhy, 2006). An article published in the American daybook of Nursing in 1930 by Munson, R. N. discussed the conditions in the almshouses and lack of quality nursing care. She states, Modern nursing in England and in this country was started with the purpose of clean up just such conditions in hospitals as are still found in almshouses. She proposed that these small almshouses be consolidated into larger facilities that are better managed (1930).Morris describes the factors that have led to the need for the care that nursing homes provide today. They describe an area of healthcare when a person is not sapiently ill and in need of hospital care, but is perhaps inveterate ill and cannot return independently to live in his or her ho me. This center is ever changing and is affected by two factors technology and social change. As we discussed earlier, care for the elderly and infirm had largely been done by individual families. Poorhouses and almshouses arose to meet the need for anyone who did not have family to care for them or means to care for themselves.The need gaind in the U. S. as the immigrant community rose and there was a shift from extended to nuclear families. A child born in 1900 had a life expectancy of solitary(prenominal) forty-seven years old. As medical technology, for example, infection control, rapidly create, the state of elderly people increased. With the rise in aged population, there was an increase in chronic disabilities associated with age (1995). In the nineteenth and twentieth centuries, hold standards increased. The poorhouses began to become a thing of the past as there was a movement to specialize care for certain groups.For example asylums for mentally ill, TB sanatoriums, veterans hospitals, and orphanages. There was homecare provided by ordinary health nurses, but many refused to care for the chronically ill (Morris, 1995). As mentioned earlier, the elderly and infirm were among the last left in the poorhouses. Thanks to the efforts of many, including many nurses, there was a push to provide better care and bring trained nurses into these almshouses. By 1940, increased expectations for care and the Social Security Act led to the rise of the modern nursing home.The Social Security Act provided a means for elderly who could no longer work and widows to have financial means to pay for care. Entrepreneurs speedily took advantage and homes for the elderly were oftentimes as much for profit as for care. By the 1960s, scandals and patient neglect led to increased regulation and public control over expansion (Morris, 1995). Medicare and Medicaid provided more money for care of the elderly and also further increased government control. Rapid increases in technology and new treatments led to a further rise in the aged and vulnerable population and change magnitude costs.Nursing homes became linked to local hospitals and rectify referrals. Some homes specialized their services to include services for cognitive trauma or active rehabilitation. Government reimbursement and regulation became more complicated. Nursing homes became little homes and more medical facilities. They operated with a limited nursing provide and very little physician presence. It continues today that nursing homes face contradictory pressures to let sicker and more difficult patients while at the same time maintaining a home- give care atmosphere.All this while limiting costs (Morris, 1995). As more specialized care for the elderly developed, it was apparent that the needs of the elderly were not as simple as taking the principles of nursing care and applying them to the aged. Geriatric nursing has only become recognized as a specialty inside the past fifty years. However, the origins of gerontological nursing can be traced all the way back to Florence Nightingale who once was a superintendent in an institution we would call a nursing home today.The clinical hold of the aged can be traced back much further to Hippocrates. A Viennese physician, Ignatiz Nascher coined the word geriatrics in a 1909 New York medical examination Journal article. In 1935, a physician named Marjorie Warren established an elderly concentrated practice with a concentration on environment, rehabilitation and motivational methods (Ebersole & Touhy, 2006). Geriatric nursing is a unique specialty in that it was developed by nurses themselves. Other nursing specialties were first developed in medical specialty and then carried over to nursing.The reason for this difference is that medicine so often concentrates on curing illness and prolonging life. As Ebersole states, Old people often have little life left and therefore are unseductive subjects. Nurses, in co ntrast, have always sought to prevent illness and placate suffering (Ebersole & Touhy, 2006). It seems fitting that nursing, and not medicine, would give birth to this specialty and that is something that nurses should take pride in. However, as mentioned earlier, geriatric nursing is often considered the least prestigious of nursing concentrations.With the continued rise of the elderly population as the baby-boomer generation ages, nurses should be prepared to care for elderly in some capacity no matter which specialty they choose. It is unfortunate that nursing schools often provide little material on geriatrics as a unique population. Care for the elderly has continued to mother slow, but consistent progress even in more recent years. Although we are leaps and bounds from the almshouse, there has still been serious abuse and neglect in nursing homes and cries for change in the way we house and care for our elderly.In addition to more people receiving homecare services that allo w them to live at home longer, there are other movements to change the nursing home itself. William Thomas describes an alternative concept that hopes to revolutionize long-term care, the Eden alternating(a). He states, The modern American nursing home is being crushed amid the intrinsic weaknesses of the institution and the rising expectations of a new generation of elders. We are averes to its destruction. Like the leper colony, the tuberculosis sanitarium and insane asylum, the nursing home is intimately to be heaved onto the ash heap of history (Thomas, 2003 p. 42). In 1992, the Eden Alternative began as a grant project in New York. It has changed over the years, but is based on a set of principles that aim to make facilities more like homes. The focus is on treating the residents as unique individuals first and patients second. Some changes that differ from traditional nursing homes include environmental changes like carpets, plants, and allowing pets and personal items, si ngle rooms, and family style meals. Staff at Eden facilities do not dress in scrubs and whenever possible, a child day care is on site to increase staff satisfaction as well as bringing more life into the facility.Currently only about 2% of U. S. nursing homes have adopted this new format in spite of the statistics showing significant reductions in behavioral incidents, decubitus ulcers, bedfast residents, use of restraints, and staff absenteeism. There was also an increase in census (Thomas, 2003). Going a step beyond the Eden Alternative, an even more recent information has been the Green House with a focus on smaller being better. These homes aim to blend seamlessly into a community and house up to octette residents in what is more than a home-like atmosphere, but very much a home.The technology would still be utilized, but as in the authentic Eden model, it should be woven into daily life without interfering with it. So far, Green Houses have been able to meet the increasing challenges of providing state of the art care and keeping costs down while complying with state and federal official regulations (Thomas, 2003). In conclusion, the nursing home and geriatric nursing have developed to meet the needs of a changing society with ever increasing medical advances and a larger than ever population of elderly.Nurses have been a huge part in the development of what has become the modern nursing home. As the geriatric nursing specialty has grown, there has also been great understanding of the unique needs of our aging population. It is clear that despite the advances made, there is still much dissatisfaction in how we care for our elderly population and a lot of room for improvement. New alternatives are being developed and it will be fascinating to be in the field of nursing to witness the changes that are yet to come.