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The Push For Nursing Home Reform In The Middle Of A Pandemic

Most Americans prefer to age at home, according to a 2018 AARP survey. But the need for facility-based care is not going away.
Most Americans prefer to age at home, according to a 2018 AARP survey. But the need for facility-based care is not going away.

According to AARP, at least 186,000 nursing home residents and staff have died from COVID-19.

For many, the pandemic has exposed cracks in our long-term care system — such as staffing shortages and unenforced rules. Some have seen those cracks for much longer.

From The New England Journal of Medicine:

Long-term care in the United States has been marginalized for decades, leaving aging adults who can no longer care for themselves at home reliant on poorly funded and insufficiently monitored institutions. Although major regulatory policies, including the Federal Nursing Home Reform Act of 1987, have attempted to address deficiencies in the quality of care, Covid-19 has highlighted the fact that better monitoring is not enough. The coronavirus has exposed and amplified a long-standing and larger problem: our failure to value and invest in a safe and effective long-term care system.

Indeed, long-term care has been sidelined in our federal social welfare policies since the 1960s, when Medicare and Medicaid created narrow and incomplete social insurance programs for such care. These programs adopted a medicalized model of care, prioritizing the use of licensed providers and institutions. This model made nursing homes the default provider of long-term care and made the care provided by families and others outside these licensed facilities invisible, leaving it unsupported.

Most Americans prefer to age at home, according to a 2018 AARP survey. But the need for facility-based care is not going away, especially for those who can’t afford another option.

We talk with experts about the future of nursing homes and long-term care.

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