Essay on “The Nursing Homes or Home Care Dilemma”


Living in the developing world force young generation to face the dilemma of putting their elder relatives, parents, or people they are familiar with into the nursing houses or take care of them at homes. Traditionally, it is believed that all those mentioned must be taken care of and looked after at homes. However, the modern way of life shows that the younger generation is now more concerned and busy with their own daily routine, private life, education, job and entertainment they have the right for. This leaves too little time and resources to focus on the issues of their elder relatives and care of them by their own. However, home care not always can be provided as it is necessary because of the lack of facilities or equipment needed. For that very reason, the dilemma of the nursing houses and home care is of great importance and gains a huge attention of all those people who have the problem of the kind. This essay will aim to discuss the burning issues related to the dilemma of the nursing homes and home care. Also, it will highlight the arguments of both the nursing homes and home care for elder relatives.

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The current existing problems of the nursing homes in the United States

Being a volunteer in one of the campuses in Virginia, I was lucky to meet Jim. Sitting in his wheelchair, he seemed to me one of the most cheerful and interesting 60 years old persons I’ve ever met in my life. That is why I believe this acquaintance had all the right to be identified as a lucky chance. Jim was a local resident, and an experienced pilot in the past. I noticed a small sticker on his wheelchair titled something like “Treat your kids in a nice manner. They are the ones who choose a nursing home for you”. I was surprised and asked him about that stuffed. I was told that he had been nice to his children, which is why he was a resident of the best nursing home he could dream of. The thing is that his “kids” had no choice but put him in the nursing house to be looked after. But before they did it, there appeared to be an issue after a long research – most nursing houses are not fully appropriate and equipped with all the necessary thing to place the elder people and provide them with the healthcare they need (Sakauye KM, 1992). Not all of them are staffed appropriately and abuse their patients and a disservice to them. Such negative aspect of a poor quality the nursing home industry has, boosts to the question: is it rational to put the relatives in the nursing houses and to find a way out if there is a need to do it. Conversation with Jim pulled me to the answer: one should make a proper research before choosing a new “shelter” for the one you love when you have no opportunity to take care of them at home.

Today, almost all the existing nursing homes are understaffed, which is currently one of the biggest problem. Thus, the residents are not provided with the service they need and their needs are not taken care of. In 2001 Reuters Health made a survey among the nurses in the United States. It showed that 5,000 of the nurses out of more than 7,000 surveyed admitted the decline in quality of the nursing care in the nursing homes. The statistic revealed some shocking facts. 34 residents of the nursing home have only one licensed nurse and 12 residents are assisted by only one nursing assistant per day. HCFA (Health Care Financing Administration), which is an organization aimed to regulate the quality of assistance and care in the nursing homes shared the information that “average staffing time of nurses was 3,5 hours a day” (Harrington in “Nursing Home Residents”, 12).

The other issue that influences the quality of assistance in the nursing homes has a lot to do with hiring temporary nurses. This reveals another problem hidden in the way the nurses are trained. The thing is that the nursing homes inform all the residents that the assisting staff is trained properly indeed when in reality it isn’t so. So, the nursing homes are satisfied when there are no complaints about it. However, the issue of improperly staffed of such organizations must be revealed by a careful previous research before putting relatives in the nursing homes (Hertzberg A, 2003).

However, the major problems of the nursing care industry are not limited by all those mentioned above. The United States Department of Health and Human Services identified nursing home physical abuse as an even more frightening argument for monitoring the right home before making a choice. Up to seven categories of such abuse were revealed, including physical and emotional neglect, which is a real problem because in reality all the nursing homes promise a good service as if the residents are taken care of at homes, where they are loved.

Putting older people into the nursing homes. Pros and cons of living beyond home.

The aging population class is regarded as the major consumer of the resources provided by healthcare. Thus, the nursing homes are required to have the necessary drugs available just like the appropriate staff to take care of the nursing home residents. The lack of both resources causes difficulties in making decision whether put the old relatives into their “new homes” or not, while it is believed that the healthcare houses are much better places for living than the families.

As a matter of fact, before planning to put old people into the nursing homes one must do a research to take the right decision for the beloved ones. This fact gives all the grounds to reveal pros and cons related to this question.

Following are the facts considered as pros for the nursing homes care. Again, with the increase of the elderly population, most of us can face with the challenge to provide the members of our family with the nursing assistance in communities or stay beside them at our home. The decision itself may appear to be stressful. It is said that the nursing homes have the highest levels of service and all the appropriate equipment and resources, including a trained staff, to look after the residents. Some of them do really provide custodial care as it is required, which includes help related to getting out of bed, dressing up, feeding and bathing. This mens that the nursing staff is available for the patients around the clock and are always ready to help in case of need and giving drug therapy as required. Adequate healthcare, drug therapy and rehabilitation is promised and followed, while home care is not always possible in an appropriate way.

Though, all the existing cons of the nursing homes must be paying even much more attention to make sure that old people are taken care of at the promised level. One should note again that nursing assistance offered in the community must meet all the daily needs of the residents and help them in various activities. All that mentioned relates to the medical assistance for the patients who suffer from diseases, and meeting the needs with eating, bathing, toileting, dressing, walking around, etc. These types of so called services can be provided by a very skilled and experienced personnel, which turns out be not enough as promised by the hospital care management. Or, the staff working there is not appropriately trained to cope with the problems they face with on practice. Again, as mentioned sometimes the residents may be abused by the nurse assistance in terms of moral principles, or even physically.

From the one hand, the government is obliged to organize more funds that would observe the existing problem and develop more programs for the patients who receive healthcare or any other assistance in the nursing homes. Currently, many of the communities may not have facilities available for the separate situations occurred because of illness that may be possibly carried by the patient and the urgent attention might not be paid in due course just for the reasons of understaffed homes. Moreover, the fact that there are too many old people left alone who has no sponsorship provided by their relatives is also must be taken into account.

On the contrast, home care appears to be the alternative for the nursing homes, which also has both its advantages and downsides. On the whole, home care permits patients stay home and get an assistance in recovering from illnesses, after serious medical surgery activities or to those who are disabled to living a normal life in terms of the aging or disease as well.

Most of the patients that are taken care at home also receive all the types of treatments and services from their homes offered by healthcare facilities. These services are covering the main needs in cooking and delivering food, various works about the house like laundry and help involving washing the hair, bathing, dressing or getting out of the bed. All these services may be donated or provided for free by the government programs that cover the costs for the home care. For that very reason, most of aging people give preference to aging at their homes and staying with people they know and love. The surveys revealed that it is much easier and adoptable for aging people to be looked after at homes, which makes them much happier to be in the circle of the family members.

Even though, the positive arguments in favor of home care are met by the downsides. Globally, the rapid rise of the aged population is met by the young generation rather than negatively. Since the young people tent to rise their own families and living happy life, taking care of their oldest relatives seems too inconvenient. For that very reason most of the aging people feel lonely and have all the symptoms of depression and mental disorders (Gaugler JE, 2004). Currently, most families do not tend to spend too much time together in a warm circle of relatives and the aging members will need help from the retirement homes and nursing homes.


With the aging population issue being currently one of the most significant for the children who are looking for an appropriate nursing home for their parents or relatives, it is becoming a vital question for them. Viewing both negative and positive sides of care provided in the nursing homes and at homes by the family, one may conclude there’s no univocal answer. However, the facts gathered with the help of surveys signify that home care is far better than the one provided in the understaffed nursing homes. I am deeply convinced that there is no better place for the aging population than their home with those who love them.

Sources used

  1. Murphy E. A more ambitious vision for residential long-term care. International Journal of Geriatric Psychiatry 1992, 7 (x), 801-802.
  2. Sakauye KM, Camp CJ. Introducing psychiatric care into nursing homes. Gerontologist 1992, 32 (6), 849-852.
  3. Gaugler JE, Anderson KA, Zarit SH, Pearlin LI. Family involvement in nursing homes: effects on stress and wellbeing. Aging and Mental Health 2004, 8 (1), 70-75.
  4. Hertzberg A, Ekman SL. “We, not them and us?”: Views on the relationships between staff and relatives of older people permanently living in nursing homes. Journal of Advanced Nursing 2003, 31 (3), 610-615.
  5. Shinoda-Tagawa T, Leonard R, Pontikas J et al. Resident-to-resident violent incidents in nursing homes. JAMA 2004, 291 (5), 590.
  6. Cohen-Mansfield J, Deutsch LH. Agitation: subtypes and their mechanisms. Seminars in Clinical Neuropsychiatry 1996, 1 (4), 320-330.