The rationale behind paying for for-profit or private nursing care for your loved one is that private facilities are considered to provide better individualized care. What recent studies are showing is that this may not be the case in Canada. New data has revealed that private nursing homes and assisted living Winnipeg facilities may be providing inferior care. Worse yet, the mortality rates for those who are placed in private facilities appears to be greater than in publicly owned and operated nursing homes.
“What makes it so disheartening is that
when you place a senior into a facility,
they have no voice in their own care.”
Reviews posted in a peer-reviewed medical journal are the results of studies comparing both private and public nursing homes and assisted living centers around Canada. Researchers wanted to determine whether the standard of care was less, more, or equal in the two types of nursing facilities. What they found was not what they expected. The research was carried out using various measures of “quality of care,” including things such as staffing hours and patient outcomes.
Presumably, what the researchers concluded was that the for-profit centers might have a different motive in treating an elderly population. Namely, they are run for profit, which means that they try very hard to keep costs down. That leads to lower staffing protocols and cutting costs. Although not an experiment per se, the study conducted was done using rigorous, methodical observation.
What makes it so disheartening is that when you place a senior into a facility, they have no voice in their own care. If they are at the mercy of the staff or the facility, it isn’t as if they can just get up and leave if they feel the quality of care they are receiving is inappropriate. In many cases, they aren’t even able to determine such matters. Family members, who leave their loved ones in facilities to maintain their health, have to trust that the nursing homes put their elderly relatives’ best interest at heart. Unfortunately, in for-profit centers, that may not be the case.
Why these findings are so important is that Canada has an increasingly aging population. Due to better nutrition, better access to medical care, and public health measures, people are living longer. That poses the problem of an overload of long-term care facilities, and is leading to the need for growth in the nursing care and assisted living communities. That has led to a trend in more “for-profit” centers being built to handle the overflow of those seniors who can’t find placement elsewhere.
Where the study may go wrong
The problem with the results is that because they are observational only, and not conducted on an experimental basis, there is no way to discern causation. Just because something coincides, that does not mean that one causes the other. For instance, it may be that those who are put into private facilities are there because they were in dire health that their families couldn’t deal with but wanted to make sure that they had the best care. Since there’s a widespread public conception that private facilities are better, they may have chosen the option of housing them in a private nursing home.
The other measure that they used is modeled after the dose-response method. In essence, that means that the greater the correlation you find between two measures of dose amounts, the more likely it is that there is causation. Because they saw so many inferior care incidents in those centers operated for profit, they tried to determine whether the for-profit model was the cause of the inferior quality of care.
Currently, 37% of all nursing beds occupied by seniors are privately held, making the findings extremely significant for the health of Canada’s citizens. Although the number of private facilities in Canada is lower than in other industrialized nations such as the US and the UK, it poses a severe problem if the care being provided is not appropriate enough for good outcomes.
“One thing is for sure: with more Canadian elderly
individuals entering long-term care facilities,
the public health agencies have an obligation
to ensure that everyone is being treated with
the utmost care and concern.”
These findings at least call for better regulations of privately run institutions around Canada. Better safety measures and legal requirements could help to make the centers more equal. Other things that are certainly called for are more investigation to ensure that the findings are real, and further research to determine what it is about the profit vs. not for profit centers that is causing the differential outcomes in the inhabitants who occupy the beds.
One thing is for sure: with more Canadian elderly individuals entering long-term care facilities, the public health agencies have an obligation to ensure that everyone is being treated with the utmost care and concern.
Are you concerned about the quality of care loved ones received in private nursing homes?
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