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Nursing Home Rating System Worrying Nursing Home Industry

Lin — Fri, 19 Dec 2008 11:00:14 +0000

The Centers for Medicare & Medicaid Services (CMS) has released a new nursing home rating system on its website to help make choosing a nursing home easier for senior citizens and their families.

The 5-star rating system used for all 15,800 U.S. nursing homes that participate in Medicare or Medicaid, similar to rating systems for hotels and restaurants, has some nursing home operators worried about how their business will fair with this new rating system.

The ratings are based on health inspection surveys, staffing information and quality of care measures, such as the percentage of residents with pressure sores. The nursing homes will receive stars for each of those categories as well as for their overall quality. Only 10% of nursing homes received the highest five-star rating, and 20% received just one star in the first round of ratings. Which nursing home is your parent or grandparent living in and what rating did it receive?

Now the general public can know which nursing homes got a low rating and which received the highest rating of 5, but of course there are those in the nursing home industry desperately trying to poke holes in the rating system from the get-go by saying the system is “is poorly planned, prematurely implemented and ham-handedly rolled out”.

“What you have with the five-star system is a very well-thought-out way of summarizing all of that information that was available on the earlier site with new information. This allows you to do a much more direct comparison in a user-friendly way” said Charles Phillips, a professor of health policy and management at Texas A&M Health Science Center School of Rural Public Health in College Station. “The old site had a lot of information, but the information wasn’t necessarily terribly usable by the average consumer. You knew if the facility was above or below the state average, but you didn’t know what that meant”.

Families caring for elderly parents have a weighty responsibility trying to deal with providing needed care and attention to elderly parents, and the struggle to find quality nursing home care weighs heavily on the hearts and minds of caring families. Many family members incorrectly assume good quality nursing care and they often don’t know what questions to ask when trying to choose a nursing home, and that’s where this rating system can be an important educational tool for families.

Alice H. Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform, said consumers should consider the star ratings, but not solely rely on them when comparing nursing facilities. “Our initial reaction is that consumers should probably avoid any facility with a one- or two-star rating and even a three-star rating unless people they trust convince them that the rating is inaccurate or unfair,” she said. Her organization also issued a press release warning that nursing homes may appear in the ratings to give better care than they actually do.

“There are other quality-of-life issues they are very concerned about: the atmosphere, cleanliness, ratio of nursing professionals, the ability to go visit. None of that is reflected in what gives this a five-star rating”, said Debra Greenberg, a senior social worker at Montefiore Medical Center and Albert Einstein College of Medicine in New York City.

The decision to put a family member in a nursing home is very stressful and emotionally charged for many families. Anyone considering placing an elderly parent in a nursing home should talk to the local nursing home ombudsman and take the initiative to physically go and visit each nursing home facility being considered several times (unannounced) in order to get a real first-hand look inside the nursing home.

Some families are intent on taking care of elderly parents themselves, with the help of programs that offset some of the financial stress and hardships, rather than placing their mother or father in a nursing home. The decision as to whether to put mom or dad in a nursing home or not is a personal one, and the general public has the right to know as much as possible about how nursing homes are rated and why each nursing home received either low ratings or high ratings in order to make the best possible decision for their parents and family.

Medicare’s Nursing Home Compare

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What Grown Children Owe Their Parents

Lin — Wed, 03 Sep 2008 15:15:14 +0000

What do grown children owe their parents? Do adult children owe their parents for what they’ve done while growing up? What does honor thy father and honor thy mother really mean? What are the duties and responsibilities towards elderly parents by their children, and how do these responsibilities relate to the scriptural requirement to cleave in a marriage relationship?

The challenges of parenting parents in their advanced years can often cause personal and financial problems in marriages and families, but it’s a shame when grown children use the word “owe” when discussing how or IF they will provide care for their aging parents, as if what parents do for their children while raising them is somehow a debt that must be repaid in full.

Some children have grown up in abusive or neglectful homes, using those past experiences and memories as an excuse not to help or assist in providing needed care and attention to their elderly parents, with the selfish attitude of “I didn’t ask to be born” or, “I don’t have to take care of my parents because of x, y, z done to me while growing up”.

Caring For Elderly Parents

Getting along with aging parents can be a challenge, and you don’t have to be part of the Sandwich Generation to appreciate the difficulties and conflicts that sometimes arise in marriages and families while taking care of mom and/or dad. There is no such thing as a perfect parent. Throughout our own lives and the lives of parents, genuine forgiveness for past hurts and misdeeds is a sign of maturity and good character as opposed to holding onto a lifelong grudge that hurts no one but you.

Jane English, a philosophy professor at the University of North Carolina, was asked the question “What do grown children owe their parents?” English’s response was “nothing”, arguing that “grown children have no filial obligations to their parents, but that there are things that children ought to do for their parents, but they do not owe them things”.

Caring for aging or elderly parents is not so much a question of whether the aged generation should be taken care of, but more of a question of who should take care of them. Isn’t caring for elderly parents just the right and moral thing for their children and families to do?

Don’t we all hope that when we are old and needing help of some kind that our children would without question or a moments hesitation be willing to come to our aid, rather than having the attitude of “owing” such help? Or worse, completely ignore the parent’s plea for help or need of help, and simply decide to let the state or society handle their care.

Honor Thy Father and Mother

The United States Catholic Catechism for Adults says “children owe their parents respect, gratitude, just obedience and assistance” as part of the Ten Commandments in the Old Testament. The commandment says to “Honor thy father and mother…that thou mayest live long on the earth.” Nowhere in the text does it say “Honor thy father and mother” IF:

If they are good parents…
If they stay together in marriage until death do them part…or
If they did everything right as parents or as individuals, etc.

Nor does it say that children owe their parents love, which is another common excuse used by adult children not wishing to provide care for their parents saying, “I don’t love my parents so I don’t need to do anything for them”. The scriptural text simply and clearly states that children are to honor their parents. To Honor means “to dignify; to raise to distinction or notice; to bestow honor upon; to elevate in rank or station; to ennoble; to exalt; to glorify; hence, to do something to honor; to treat in a complimentary manner or with civility”.

Taking care of elderly parents is primarily the responsibility and moral obligation of families and the individual needing care, and the state can assist as needed. There are state programs available that may be able to provide financial assistance by paying caregivers or family members that are having difficulty in dealing with elderly parents and the increasing need for care that can become quite costly.

Cleave

The definition of cleave is “to adhere closely; to stick; to hold fast; to cling” and, “to unite or be united closely in interest or affection; to adhere with strong attachment”. So, how do you balance “leave and cleave” with honoring your parents at the same time? “Therefore a man shall leave his father and mother and be joined to his wife, and they shall become one flesh” (Genesis 2:24)

The parent-child relationship is the temporary one…there will be a “leaving.” The husband-wife relationship is the permanent one (let not man put asunder-Matthew 19:6). When an adult child has gotten married and the parent/child relationship remains primary or the first priority, the newly formed marital union is seriously threatened.

Cleaving indicates such intimate closeness that there is to be no closer relationship than that between the two spouses, not with any former friend or with any parent. They are to become “one flesh”. When a parent deliberately or unknowingly violates the biblical principles found in Genesis 2:24, they should be respectfully disobeyed. It is necessary to distinguish real physical and emotional needs from the “felt needs” of an overbearing, meddling, controlling and demanding parent.

Whether or not there is good relationship between grown children and their parents, there is still the need to provide care for elderly parents in order to lead a truly peaceful, happy and contented life, but also because St. Peter may call your name one day as well as mine, and the choices we all make in life will determine if we’re on St. Peter’s list or not.

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