Editorial: Dire straits of nursing home care

Tuesday, Feb. 19, 2002 | 8:58 a.m.

Anew federal study, a decade in the making, says that more than 90 percent of nursing homes in the United States don't have enough nurses and nurses' aides to properly care for their patients. According to the New York Times, which obtained a copy of the Health and Human Services' study, the report found "strong and compelling" evidence that nursing homes with a poor ratio of nursing personnel to patients were more likely to find patients receiving poor care. Patients in these homes were more prone to bed sores, malnutrition, dehydration, pneumonia and other ailments.

It is common for nursing homes to have just one aide for every eight to 14 residents from 7 a.m. to 11 p.m. The report, though, says such a staffing ratio is woefully inadequate. The study's authors recommend one nurse's aide for every five to six residents. Numbers only tell part of the story, though. The Times interviewed patients and their family members to get a better glimpse of just how bad it can get for the residents:

"Food was put in front of the residents, but there was not enough staff to help them eat," said Phyllis Moga of Detroit, who visits her mother three times a week at a nursing home in the suburbs. "Many patients have dementia or are stroke victims, so they don't have the ability to feed themselves, or even to know they should be eating." Two different times, according to Moga, "I caught a woman who was climbing out of bed and was trapped in the bed rail, screaming for help, but there was no staff nearby to help her."

The Bush administration has rejected suggestions to set mandatory nurse-to-patient ratios. Instead the Bush administration believes a directory that lists the nurse-to-patient ratios in these homes will do the trick, creating an incentive for family members to place their loved ones in homes that have better ratios. In other words, let the market decide. But it's ludicrous to believe the same market that allowed the abysmal situation to be created in the first place, now is capable of turning this problem around.

Sure, the costs to improve nursing home care are significant. It's estimated that spending on nursing home care would have to increase by 8 percent a year to meet adequate staffing levels. But we should gradually phase in minimum requirements to ensure that people get the kind of care they deserve. If we can mandate instructor ratios for children in day care facilities, then there is no reason why we can't show the same level of concern for the elderly in nursing homes.