Who Cares? Many Do. And More Will.
On Friday, I was lamenting a problem I was confronting after three weeks of trying to get Dan’s ears cleared of impacted wax. Harbor personnel had applied drops in them to no avail, and at my urging made an appointment for him with an ENT. The appointment, however, wasn’t until July. Not only had Dan been, for all practical purposes, unable to hear for three weeks already, but a four-week wait meant he may well would have faced an ear infection and potential hearing loss.
So Dyke and I took him to a local walk-in urgent care center. About two hours later, Dan’s ears were clear, he was feeling much better, and his hearing was fine. The whole thing cost $165 out of pocket, less than I would have expected, and likely considerably less than treatment by an ENT would have cost. We paid for the clinic visit; Medicare and Medicaid would have had to pay the ENT. It was a bargain no matter how you look at it.
The state of operations in long-term care facilities is emblematic of issues with the American health care system. It costs too much and delivers too little. It’s not the fault of the people who provide the care in nursing homes; it’s more likely to be reflective of the private interests of those who own them. According to a report by NPR, putting a premium on the cost of care needed for residents to survive can turn quite a profit for individual or corporate owners, affiliated companies, and their shareholders. Running these facilities for profit (and the CDC points out that 70% of nursing homes in 2018 were for-profit enterprises) translates to underfunding within the facilities themselves. Underfunding is directly related to understaffing and lowers the quality of life of residents because it compromises the provision of daily care, access to rehabilitative therapy and medical treatment when issues arise, food quality, and the availability of recreational activities.
As a result, as noted by U.S. News & World Report, a number of nursing homes across the country are unable to accept new residents, and many are facing the prospect of having to close their doors, due to a staffing shortage. As a result of too few staff, most nursing personnel who work in these facilities face grueling workloads; they are responsible for the care of more residents and are often required to work overtime or take on extra shifts. The result is burnout and high turnover rates—which means the care that residents receive is compromised.
The problem is only getting worse as the general population ages, increasing the need for care even as there is no comparable increase in funding or in qualified caregivers who want to work these jobs. It’s an existent and still growing crisis that already affects 1.4 million nursing home residents (and, of course, their family members) across the country. It’s a crisis that, unless there is a dramatic shift in healthcare provision in this country, is only going to get worse.
As John Donne famously said, “[S]end not to know / For whom the bell tolls / It tolls for thee.”