Long term care facilities

Nursing homes are a type of residential care that provide around-the-clock nursing care for elderly people. Twenty-four-hour nursing care is available. Nursing homes will provide short-term rehabilitative stays following a surgery, illness or injury which may require physical therapy, occupational therapy or speech-language therapy. Nursing homes offer other services such as planned activities and daily housekeeping services. Nursing homes may also be referred to as convalescent care, skilled nursing or a long-term facility. Nursing homes may offer memory care services or have a separate area specified for memory care.

Starting in the 17th century, the concept of poorhouses (also referred to as almshouses) were brought to America by English settlers. All orphans, mentally ill and the poor elderly were placed into these living commons. These poorhouses gave a place where they could be given shelter and daily meals. Poorhouses continued to exist into the early 20th century despite the criticism they faced. Much of the criticism stemmed from the conditions of the poorhouses. The Great Depression overwhelmed the poorhouses as there were a lot of people that needed help and care but not enough space and funding in the poorhouses. Due to Muck Raking in the 1930s the less than favorable living conditions of the poorhouses were exposed to the public. Poorhouses were then replaced with a different type of residential living for the elderly. These new residential living homes were called board-and-care homes or also known as convalescent homes. These board-and-care homes would provide basic levels of care and meals in a private setting for a specific fee. Board-and-care homes proved to be a success and by World War 2, the new way of nursing homes began to take shape. As the times continued to change, the government identified the issue of people spending extensive amounts of time in hospitals. To combat these long stays in short term settings, board-and-care homes began to convert into something more public and permanent that was state and federally funded. From this, by 1965 nursing homes were a solid fixture. Nursing homes were a permanent residence where the elderly and disabled (poor elderly and disabled specifically) could receive any necessary medical care and receive daily meals. Though nursing homes in the beginning were not perfect, they were a huge step above almshouses and poorhouses in regards to following laws and maintaining cleanliness. From the 1950s through the 1970s the dynamics of nursing homes began changing significantly. Medicare and Medicaid began to make up much of the money that would filter through the homes and the 1965 amendment laws enforced nursing homes to comply with safety codes and required registered nurses to be on hand at all times. Later in 1987, the Nursing Reform Act was introduced to begin defining the different types of nursing home services and later added the Residents' Bill of Rights. Today nursing homes are very different across the board. Some nursing homes still resemble a hospital while others look more like a home. Nursing home residents can pay for their care out of pocket, others may receive medicare for a short time and some may use long term insurance plans. Across the spectrum, most nursing homes will accept medicaid as a source of payment.

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