It has now been many years ago that I began my first job working with the elderly and my perspective is some what unique in that my first job in a nursing home was with the same company that I work for now. Although I did not spend my entire career working for the same corporation, nor did I work in long term care facilities exclusively through out my career, and in fact spent ten years working as a home maker and raising my children, I still have had a birds eye view of the progress we have made in how we care for our nursing home population. During the 1990s when I worked as a nurse manager, we always would joke that the nursing home industry was more heavily regulated than nuclear power. Indeed, even now as a floor nurse, when state or federal inspectors walk through the front doors I feel a bit of stress. Nevertheless, with my interest in history, I have explored the path we have followed to get to the place we are now, and understand why it is necessary to have these inspections. While there is still much progress to be made, when I look at how far we have come, I take heart that we can continue to improve. My work with the elderly began in what I have dubbed the Pre OBRA Era and HERE is a chart that outlines reforms from 1987 when the Omnibus Budget Reconciliation Act was passed to 2007 - its 20th anniversary. An excellent extensive online book of the history of long term care can be found HERE http://www.elderweb.com/book/history-long-term-care. I have explored some of it's pages and photos and time lines and find it a fascinating resource. And in closing I would like to share two videos with you from The Kaiser Foundation. Please pay especially close attention to minutes 2:56-3:43 in the first video for truly, unless an elderly person has an advocate in a family member or a friend, they do not have strong enough of a voice to fend for themselves in a free unregulated healthcare market place.
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