Thesis+Based+Research+Assignment

__Senior Seminar Thesis-based Research__


 * Rationale for Research/Introduction**

After volunteering at a nursing home for a whole summer, and growing up visiting elders at Saint Joseph’s Villa, I always thought that nursing homes are a great place for those who need day to day care. Not too long ago I learned that many people contemplated sending a loved one to a nursing home due to food problems, abuse, and for the fact that their loved one doesn’t get enough exercise. Volunteering let me see that all of these problems weren’t true. I decided to do my project on this project to discover how nursing homes have developed over the years and to hopefully inform my classmates of why nursing homes are great places. My driving question is why nursing homes are necessary for our society and why is there abuse within nursing homes and how can we stop this? Before answering the driving question, more specific questions I had to answer were: Do members of nursing homes get proper medical care? What kind of activities do residents do to keep in shape? And finally, are members being provided with a balanced nutrition?


 * Research**

1. Philosophies of nursing home: incorporate “person centered” or “resident-directed care;” changing the facility environment to break down nursing units into “households that have the characteristics of a home” 2. Culture Change has two goals: improving the lives of residents by giving them more choice, and giving more decision making authority to staff 3. “It’s all about giving residents more autonomy in their day-to-day decision making” (Leslie Grant)
 * A.** Zigmond, Jessica. “Just like home; Long-term-care facilities try new approaches in their operations to shed that institutional image.” __Modern Healthcare__ 39.38 (Sept 21, 2009): 28. __Expanded Academic ASAP__. Gale. Springfield Township High School. 8 Oct. 2009 .

1. The quality of nursing homes is improving 2. Our nation has 17,000 nursing homes 3. The number of violations identified per survey increased from 4.8 in the year preceding the initiative to 5.5 in the year since it began 4. The number of violations with actual harm or immediate jeopardy to resident health and safety identified per survey increased from 0.65 to 0.73.
 * B.** Hash, Michael. “The Quality of Nursing Homes Is Improving.” __Opposing__ __Viewpoints: An Aging Population.__ Laura Egendorf. San Diege: Greenhaven Press, 2002. __Opposing Viewpoints Resource Center.__ Gale. Springfield Township High School. 8 Oct. 2009 .

1. Three types of nursing homes: skilled nursing care homes, intermediate care facilities, and supervised assisted living facilities. 2. Skilled nursing care homes provide more extensive services than the other types of nursing homes. 3. Intermediate care facilities provide basic nursing services. 4. Supervised assisted living facilities provide nonmedical services.
 * C.** Kropf, Nancy P. “Nursing home.” //World Book Student.// World Book, 2009. Web. 6 Oct. 2009.

1. Medicaid pays more than 50% of the cost of nursing-home care for the elderly 2. In September 1995, President Clinton spoke out against the plan to transfer Medicaid program to the states, warning that it would have a negative effect on nursing homes. 3. Congress enacted standards for nursing homes in 1987
 * D.** “Nursing-Home Care (sidebar).” //Issues & Controversies on File:// n. pag. //Issues and Controversies.// Facts on File News Services, 29 Dec. 1995. Web. 6 Oct. 2009. .

//Injury Board//. N.p., 5 Sept. 2009. Web. 6 Oct. 2009. . 1. Having well trained direct care workers reduces the chances of nursing home abuse or neglect. 2. Direct Care Workers (DCW’s) often work as a liaison to the nursing staff. 3. Poor training about dementia and mental health issues had been identified as a factor that contributes to nursing home neglect and abuse.
 * E.** Cunningham, Billy. "Nursing Home Direct Care Givers are Essential to Good Care."

1. Approximately 5 percent of the population 65 years and older reside in nursing homes at any one time. 2. In 1995, residents were discharged after an average stay of 838 days, compared to 1,026 days in 1985 3. An average one-year stay in a nursing home costs more than $43,300
 * E.** Blair, Cornelia. //Growing Old in America//. Michigan: Gale Group, 2000. Print.

Oct. 2009. . 1. A warm, welcoming environment where residents are free to make choices regarding their care: That's the new vision of the ideal nursing home, according to a guidance issued Friday by the U.S. Centers for Medicare 2. Almost 1.5 million Americans now live in an estimated 15,800 nursing homes spread throughout the country, CMS noted, and more than 3 million will spend at least some time in a nursing home this year. 3. "Many facilities cannot immediately make these types of changes, but it should be a goal for all facilities that have not yet made these types of changes to work toward them," the guidance reads. 4. The directives in the CMS guidance aim to "transform nursing homes into environments that are more like [residents'] homes through both environmental changes and resident-centered caregiving.
 * F.** //Make Nursing Homes More Like Home: Medicare//. U.S. News, 19 June 2009. Web. 6

. 1. I n 1987, Congress enacted the Nursing Home Reform Law that has since been incorporated into the Medicare and Medicaid regulations. 2. A Few Rights: (1) Residents have the right to be free of unnecessary physical or chemical restraints. Vests, hand mitts, seat belts and other physical restraints, and antipsychotic drugs, sedatives, and other chemical restraints are impermissible, except when authorized by a physician, in writing, for a specified and limited period of time. 3. (2) To assist residents, facilities must inform them of the name, specialty, and means of contacting the physician responsible for the resident's care. Residents have the right to participate in care planning meetings. 4. (3) Residents also can get up and go to bed when they choose, eat a variety of snacks outside meal times, decide what to wear, choose activities, and decide how to spend their time. The nursing home must offer a choice at main meals, because individual tastes and needs vary. Residents, not staff, determine their hours of sleep and visits to the bathroom. Residents may self-administer medication.
 * G.** "Nursing Home Issues ." //Elder Law Answers//. N.p., n.d. Web. 6 Oct. 2009.

N.p., 5 Oct. 2009. Web. 6 Oct. 2009. . 1. Jeanne M. Hannah, a Michigan lawyer whose mother died of neglect in a nursing home, wrote, “There was a pervasive attitude among the caregivers I encountered in the long-term care facility that the patients were old and were going to die anyway, that caring for them — changing diapers, hand-feeding — was something that the workers did, not because they liked to do it, wanted to do it or were even particularly good at it, but because they needed the minimum wages that are paid for these unpleasant jobs.” 2. Ms. Hannah found that in her mother’s nursing home there were not enough aides to help patients with activities like feeding, that aides lacked adequate training and supervision and that medical attention by doctors and skilled nurses was brief and infrequent. 3. There I met Annabe Schwartz, a 94-year-old widow, meticulously groomed and well dressed, who sat in her wheelchair surrounded by plants and pictures she had chosen. “I love this place,” she told me. “It’s my home.” Although she said she was estranged from her family, at the Miami home she said she felt cared for, appreciated and respected, with prompt attention to her medical needs.
 * H.** Brody, Jane E. "Nursing Homes That Belie the Bad Image." //The New York Times//.


 * Thesis**

Based on lots of research discovering different points and views, I chose what my stance would be on this topic. Even though there have been many counts of abuse and malnutrition, etc. I believe that nursing homes are attempting to make a better living for elders. Many think that it is wrong to send a loved one to a nursing home but I see it as beneficial because it provides one to be cared for everyday, and allows them to stay active in activities rather then sitting around at home with no one to help.


 * Findings and Support for Findings**

1. The nation's toughest-ever nursing home regulations are being enforced. a. President Clinton therefore announced a major new intiative to increase protections for vulnerable nursing home residents and to crack down on problem providers. 2. Nursing homes are improving the lives of residents a."Culture Change" is a term used for the skilled-nursing industry which enhances the guidelines for surveryors for nursing facilities b. Culture change not only addresses quality and workforce issues, but it can also improve occupancy rates, operational costs and competitive position in the market place, all of which can improve the facilities bottom line. 3. Nursing homes also allow residents to feel as if they are at home and not a facility a. Practicing collaborative and decentralized decision making in the facility's organizational structure. 4. Staff of nursing homes allow senior citizens to engage in different activities to keep them active. a. Trips and tours to community activities. b. Arts and crafts programs. c. Games in which foster both one on one relationships and group activity. 5. Food prepared and served in nursing homes are healthy and made up differently for each resident a. Nursing homes are required to provide special diets, as needed. b. The nursing home must have a dietary or food services supervisor in charge of meal preparation who meets state training requirements.


 * Process Reflection**

After much research, I discovered both bad points and good points within nursing homes, whether it's activites or food. Overall, I learned that nursing homes across the world are working at becoming a better place. For all the sources I found, I analyzed it and evaluated it. When researching, I really need to start narrowing my searches and not just typing in: "nursing homes" or "why nursing homes are necessary."


 * Connections to the Overall Project**

All of my findings helped me discover why nursing homes are necessary for our society and different examples about how they are devolping. This research will help me move forward with my project for it helps me come up with different topics branching of my main topic and will, in the long run, help me support my stance on the topic.