Oklahoma Still Has A Nursing Home Problem

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A new report shows the overall quality of Oklahoma’s nursing homes is among the worst in the nation and, unfortunately, that’s an old story dating back at least three decades.

I know the timeline well because, as a former journalist, I wrote a series of articles in 1982 along with another reporter outlining the overall poor quality of the state’s nursing homes and the political forces that helped make it so.

I visited several nursing homes in 1982 as part of my research for the series and while I found there were some outstanding homes there were simply far too many with problems, including substandard care.

The new report, issued by Families For Better Care, ranks the quality of Oklahoma’s nursing homes as 49th in the nation, only behind Texas and Louisiana. A major part of the problem then and now is the lack of professional staffing. The report notes, for example, that “. . . more than 80 percent of nursing homes had middling to below average professional nursing levels.”

This is from the 1982 series about the specific staffing problem:

The reason for the shortage and high turnover stems from the nature of the job. It's an unglamorous task. Nursing aides are responsible for bathing residents, cleaning up messes, helping residents use the bathroom or, in some cases, changing diapers. Aides also must help lift heavy bodies and empty portable toilets.

The new report also notes that Oklahoma nursing homes “with severe deficiencies remained inordinately high when compared to other states . . .”.

As I noted earlier, I visited some wonderful nursing homes in the state in 1982, and there are surely some great nursing homes here now, but overall Oklahoma’s homes have consistently been ranked below the national average.

It’s a complex problem that gets intertwined with the drawn-out process of dying of old age in this country, a process that many medical experts believe needs reconsideration. Some experts believe too many unnecessary procedures are performed to sustain the lives of bedridden dementia patients, who require around-the-clock care.

According to one prominent member of a panel formed by the Institute of Medicine to study the issue, end-of-life care is “poorly designed.” This is from a recent article in The New York Times:

“The bottom line is the health care system is poorly designed to meet the needs of patients near the end of life,” said David M. Walker, a Republican and a former United States comptroller general, who was a chairman of the panel. “The current system is geared towards doing more, more, more, and that system by definition is not necessarily consistent with what patients want, and is also more costly.”

Of course, that statement is a red flag for right-to-life groups, which make the slippery-slope argument that such thinking could lead to premature or even government-ordered deaths among the elderly.

None of this solves Oklahoma’s nursing home problem, which seems chronic and everlasting at this point. Obviously, someone with enough money can find a decent facility in which to die, but many nursing home residents rely solely on Medicaid dollars. It’s a tragic situation.

This is from one of the 1982 articles:

Nursing homes scare people.

They frighten people because they offer a glimpse into almost everyone's future: wrinkles, gray hair, loss of mobility and, possibly, senility.

It’s no different 30 years later. Everyone ages. All of us could theoretically end up as nursing home patients as we near death. As a culture, we need to drastically improve our end-of-life protocols and processes. Improving nursing homes here and elsewhere should be a central component of any reform.