Nursing Homes: Working, Living, and Dying in Long Term Care

A physician with half a century experience takes you behind the brick walls, beyond the guided tours, brochures, and Internet sites, to reveal what it's really like to work, live, and die in a nursing home. His stories are of real people in an unnatural environment of diminished freedom and little personal privacy, and those who care for them. His observations are unique, but typical. Through them, he shows how our system of nursing home care fails, and the reasons why. Along the way, you will learn about overregulation, laws and their consequences, fear-based management obsessed with compliance, managerial isolation, minimum standards condoning mediocrity, counterproductive inspections called surveys, misleading ratings, meaningless deficiencies, artificial prolongation of life and death, polypharmacy, underfunding, overfunding, the bizarre Prospective Payment System, the subacute-care codependence of hospitals and nursing homes, physician extenders, auditors called consultants, intrusive committees, gaming the system, and much more. It is a system that is deeply flawed, but can be changed.