For many elderly people, a nursing home is one of the last places they will call home in their lives. According to the Centers for Disease Control and Prevention (CDC) over 1.5 million people live in the over 16,000 nursing homes in the United States.
Some people living in long-term care facilities lack the end-of-life planning and advance directives that help determine the direction of their care. Advance directives are documents that detail the level of health care a person would like to receive in the event they are incapacitated. They can include a living will, power of attorney, health care proxy and do not resuscitate orders.
A recent report from the CDC found that 45 percent of nursing home residents did not have an advanced directive (AD) in place. By contrast, 88 percent of discharged hospice patients had at least one AD on file. Home health care patients, however, were least likely to have an end of life plan, with only 28 percent documenting their wishes.
The study also found that younger patients were far less likely to have an advanced directive in place. In home health care and nursing home settings, patients aged 85 and over were more than twice as likely to have one advance directive in place. Do not resuscitate orders (DNRs) were the most common form of advance directive among nursing home patients, with 56 percent of residents having one.
Those in nursing homes should take the time to develop an advance directive or similar document. End-of-life planning serves to clarify the wishes and care residents’ desire.
Another issue for nursing home residents to be aware of is elder abuse and neglect . We expect that the level of care provided at a nursing home will be enough to keep elderly loved ones comfortable. But far too often, instances of abuse and neglect happen. In 1996 the National Elder Abuse Incidence Study estimated that over 550,000 elderly people experienced some form of abuse, neglect or self neglect. The CDC, however, estimates that number to be much higher, noting that anywhere from one to two million elderly people may be abused by the one they depend on for care.
When the elderly are abused in nursing homes or other long-term care facilities, the effects can reach the entire family. If you notice signs of abuse or neglect in your loved one, it is important to document the injuries or behavior changes. In many cases, it may be also be helpful to discuss your concerns with an attorney. A lawyer can advise you of potential claims and advocate on your loved one’s behalf.
