Long-Term Health Care

On behalf of the members of the California Assn. of Health Facilities (CAHF), which represents more than 1,200 licensed long-term care facilities providing long-term care for patients statewide, I must clear up some inaccuracies in a recent article (“Muzzled in a Nursing Home, the Spirit Is Extinguished,” Commentary, May 6).

While we are concerned about the quality of life for the disabled and acknowledge the importance of funding for home-care services, we maintain that “robbing Peter to pay Paul” is not the answer and would simply deny funding to those elderly and disabled people who live in nursing facilities and need the care provided there.

Facility-based long-term care and home care are not alternatives to each other. Rather they serve distinctly different patient populations and degrees of disability. Facilities provide 24-hour nursing care and provide short-term rehabilitation for people of all ages. Home health care plays an important role for individuals with supportive families who no longer need facility-based care and require nursing care on an intermittent basis.

While living in a nursing facility does not provide as much autonomy as living at home, facilities do accommodate residents. For example, dietary staff work with residents and their families to provide meals that satisfy the resident’s nutritional needs as well as personal likes. Facilities offer a wide range of rehabilitative and restorative care, social services and activity programs, all with the goal of helping residents achieve their maximum potential physically, mentally and socially.

Nursing facilities must strike a delicate balance between the provision of adequate supervision and much needed privacy. Common areas in nursing facilities tend to be open, while resident rooms are considered private.

Nursing facility residents maintain all those rights guaranteed to them by the U.S. Constitution, including the right to vote. In addition, the Omnibus Budget Reconciliation Act of 1987 (OBRA) mandates specific rights guaranteed to all residents of nursing facilities. These include the right to voice concern about a facility, the right to receive visitors, the right to form resident councils, and the right to informed consent, privacy and the freedom of choice.

TED GREENBERG

Los Angeles County Vice President

California Assn. of Health Facilities

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* The commentary by Mike Ervin was excellent. If we, as a nation, are ever going to contain health-care costs we must reduce our emphasis on institutional care. This is particularly important in the field of long-term care.

We spend about $60 billion annually on long-term care, but only 18% of this is used for home-based care. This is an obvious underutilization of an important health-care resource. Most individuals in nursing and convalescent homes are not sick. They are there because they have difficulty with routine activities of daily living. These include bathing, dressing, and preparing meals. Keeping these individuals in an institution costs from four to 30 times the cost of home care.

The members of our association are pioneers in the field of home care. Many of us are severely disabled, yet we remain active in the community. We know that home-based long-term care can be both safe, and cost-effective.

RICHARD L. DAGGETT, President

Polio Survivors Assn.

Downey