Nursing homes dealing with more acutely ill

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I know we'll be seeing alot of this. From the Sun-Gazette: With people remaining in homes longer, nursing homes deal with ‘more acutely ill’ - News, Sports, Jobs, Community Information - Williamsport-Sun Gazette

The number of Americans over the age of 65 will double by the year 2030 due to the aging Baby Boomer population, according to the Census Bureau, but local nursing home officials say facilities already are filled to capacity with patients who are increasingly ill.

"You're seeing people come from the hospitals into nursing centers sicker and sicker and really requiring a lot of specialized care that's very clinically complex. It's something we haven't seen as recently as 10 years ago," Rose View Center administrator Blake Apsokardeu said.

At Sycamore Manor, residents with increasingly complex medical histories are on the rise as well.

"We always say we're like mini-hospitals. The hospitals don't keep them as long and then they come to us with IVs, and we can take care of that," said executive director Michele Brague.

Lee Horn, Valley View assistant administrator, said since people are remaining in their own homes longer and more services are available in the community, residents come to nursing homes later in life when they are "more acutely ill."

Short-term stays are another recent trend in skilled nursing facilities. At The Williamsport Home, "we're seeing more post-hospital care and surgical short-term admissions," administrator Don Pote said.

Increasingly ill residents and short-term care are combining to make shorter nursing home stays.

"The people that we're getting are a lot sicker. They're either in the end stage of life or they are here just because they need a rehab stay. The length of stay is shortening," said Jamie Aurand, Susque-View administrator.

That trend is seen at Kramm Nursing Home and Rehabilitation in Watsontown, too, administrator Susan Warfel said.

"We get much more in the way of clients who need short term rehab than in former years when people would come to stay long term. Our discharge rate is definitely higher," she said. Warfel added that short-term stays are increasingly common in most nursing homes across the board.

Apsokardeu doesn't think nursing homes will have decreasing enrollments any time soon.

"You're going to see a bulge in the population from the Baby Boomers as they get older. We're going to need more services," he said.

Administrators believe that the future influx will mean more personalized and resident-unique care. The industry is moving toward "person-centered care," according to Apsokardeu.

"We're accommodating the residents' needs, but tailoring them even more individually," he said. "For instance, the typical model in the past was a medical model where your meal times were at a certain time of the day. We're starting to tailor things more to people's needs and wants, like if someone would like to have their meal at 2 instead of noon."

Eating on demand is just one of the things that Aurand thinks Baby Boomers will expect. "They're going to be expecting better service, higher quality service in different settings," including private rooms.

Kramm's Warfel said a "culture change" is in the works to make the facility "more home-like."

"The focus is client-centered care," Warfel said, "meeting individual needs, residents' rights, adapting our schedules to meet the needs of the residents, rather than having the residents change to meet our schedules."
Administrators think an increased level of independence will affect care as well. "I think that baby-boomers are much more savvy and are going to be expecting different things to do here, like they do at home," Horn said.

"I think it's going to change how we're going to look at aging in the future," Pote said.

According to Aurand, future health-care consumers are "going to be well-educated and their expectations are going to be higher than we've seen before."

That change, he believes, may occur within the next five years. "Or it could be 25 (years). It's something that we need to start planning for."

Although area nursing homes are filled to capacity, there are no government agencies that can order more be built, according to state Department of Welfare spokeswoman Stacy Witalec.

Because the majority of nursing facilities are privately owned, the government "absolutely will not" direct any company to expand its services.

The administration is focused on home- and community-based care, Witalec said, adding that home-care is more "cost effective" and growing numbers of patients want to "be able to live at home. They want to age in place."

The only funding nursing homes receive from the government is medical assistance reimbursement for care.