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In today’s Email:

• Navigating the Storm: The Looming Crisis in Eldercare

• Revolutionizing Nursing Homes: A Call for Change

• Staffing S.O.S. Op-Ed: The Comedy and Tragedy of Nursing Homes in the US

NAVIGATING THE STORM

The Looming Crisis in Eldercare

As we step into a critical juncture in the realm of eldercare, a sense of urgency grips us, fueled by the imminent wave of aging baby boomers and a disconcerting decline in healthcare workers. According to projections from the U.S. Census, the entire baby boomer generation will have crossed the threshold of 70 years or older by the year 2030. This significant demographic shift is poised to unleash a surge in healthcare needs as this substantial portion of the population ages, potentially placing an overwhelming burden on and adding immense stress to the healthcare industry.

The aging population will impact the nursing profession in several ways:

1. Magnifying the forthcoming nursing shortage:

• More patients are in need of acute and chronic care management than ever before, and there are fewer experienced nurses to do the job. Due to advances in modern medicine and care management, many of these individuals are expected to be living longer with multiple chronic comorbidities; in the next 10 years, the percentage of Medicare beneficiaries living with three or more chronic conditions will reach 40%. The increased complexity of care associated with chronic care management means that not only will this large population begin requiring more geriatric services, but it will also likely require care for a longer period of time. This will demand an increase in health care providers, which will only further exacerbate the acute and post-acute nursing shortage.

2. Generating higher volumes of burnout and turnover rates:

• As acute and post-acute facilities become inundated with the ailments of an aging population, facilities will struggle to fill shifts with a shrinking workforce. Rather than operate understaffed and risk being caught out of compliance, facilities will be forced to mandate their internal nurses to work overtime to cover the gaps in their schedule. Unfortunately, this is a temporary fix, not a long-term cure. These internal nurses will inevitably become exhausted and overworked – and that's where burnout sets in and staff turnover accelerates.

The American Society of Registered Nurses reports that by 2030, one million nurses will retire. This exodus of skilled nursing professionals due to retirement is projected to occur at precisely the worst time – the nursing shortage will be at its height just as a large population segment will begin requiring care. To make matters worse, research shows that the nursing workforce is already well below the recommended amount of baccalaureate and doctoral prepared-nurses in the workforce – which indicates that it is highly unlikely these nurses will be able to fill all the shoes of their predecessors.

The convergence of these challenges paints a stark picture for the future of eldercare. As the aging baby boomer population places unprecedented demand on healthcare services, and the nursing profession faces a perfect storm of shortages, burnout, and retirements, the need for transformative change in nursing homes becomes not just urgent but imperative. The time to act is now, to ensure that our elders receive the quality care they deserve and that those providing it are supported and sustained in their vital roles.

Sources:

1. How The Aging Population Is Affecting The Nursing Shortage. ASRN.org.

2. Demand for Healthcare Grows as Baby Boomers Age. Colliers Knowledge Leader.

3. Nursing Shortage Collides with Rising Baby Boomer Population. Healthcare Finance News.

4. What The Aging of Baby Boomers Means for Nursing. Bradley University Online Degrees.

REVOLUTIONIZING NURSING HOMES

A Call for Change

In a momentous stride, the National Academies of Sciences, Engineering, and Medicine have sounded a resounding call for a transformation in the landscape of nursing homes. Their most recent report, released on April 6, 2022, presents a compelling case for a holistic overhaul of how care is delivered, financed, and regulated in nursing home settings. This clarion call is driven not just by the imperfections of the current system but by the imminent challenges posed by the aging baby boomer population and the concerning decline in healthcare workers.

The Urgency of Change: At the core of the report lies a recognition that the current system is not just flawed; it's fundamentally failing those it's meant to serve. Betty Ferrell, the director of nursing research and education at City of Hope Medical Center, emphasizes that the way the U.S. handles nursing home care is "ineffective, inefficient, fragmented, and unsustainable." The report advocates for a shift towards person-centered care, development of quality measures for palliative care and psychosocial health, and an overall health equity strategy for nursing homes. A game-changer is the recommendation to enhance transparency through platforms like Care Compare, empowering families with information and holding nursing homes accountable.

Acknowledging Past Shortcomings: For decades, nursing homes have grappled with underinvestment and a lack of accountability. The report confronts this head-on, acknowledging that implementing transformative recommendations will demand a significant financial commitment from federal and state levels and the nursing homes themselves. However, the committee recognizes a critical challenge: key partners, such as CMS, may lack the full authority or resources to enact these changes. The report hints at the need for congressional action, urging policymakers to recognize the urgency of this call for reform.

Envisioning a Future for Nursing Homes: This report serves as a roadmap for a future where nursing homes are not just places of care but vibrant communities that prioritize the well-being, choices, and dignity of every resident. As the aging baby boomer population places unprecedented demand on healthcare services, the need for transformative change in nursing homes becomes imperative.

Sources:

The National Imperative to Improve Nursing Home Quality. National Academies of Sciences, Engineering. and Medicine.

STAFFING S.O.S. OP-ED

The Comedy & Tragedy of Nursing Homes in the US

In a world that can often feel like a chaotic sitcom, there's a less amusing, more alarming plotline unfolding in the United States: nursing homes are grappling with a critical shortage of staff triggered by the pandemic. It's not a punchline; it's a pressing issue that could compromise the well-being of over a million elderly residents.

According to a report by The Conversation, more than 80% of nursing homes in the US reported staffing shortages early in 2023. To put it bluntly, if nursing homes were episodes of a TV show, they'd be on the brink of cancellation due to a severe lack of cast members.

USA Today has added its own dramatic twist to the narrative. Out of 15,428 nursing homes in the country, a staggering three-quarters fell short of the expected number of nurses and aides in 2021, as per Medicare's payment formula. To make matters more perplexing, only 589 of them faced penalties for their understaffing issues. It's like giving a standing ovation to a play with missing actors and expecting an award-worthy performance.

Now, you might be wondering, why aren't regulators putting these nursing homes in the penalty box for their understaffing fouls? The answer, it seems, is hidden somewhere in the intricate script of federal benchmarks, where the failure to penalize facilities for understaffing is an ongoing plot twist that baffles even the most seasoned critics.

In the midst of this staffing crisis, it's ironic that I couldn't find any recent news articles warning about this. It's almost as if the audience has moved on to the next big thing, unaware of the dire state of the show they once binge-watched. Unless we initiate change, we risk resigning ourselves to a quality of life for our aging population that falls far short of anything we could ever have imagined.

Sources:

1. Most US Nursing Homes are Understaffed, Potentially Compromising Health Care for More than a Million Elderly Residents. The Conversation.

2. Many Nursing Homes are Poorly Staffed. How Do They Get Away with It? USA Today.

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