Understaffed Healthcare Workers in Elderly Nursing Homes

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A nursing home is place where people who do not need a hospital but cannot be cared for at home either. Most nursing homes have a nursing aides and skilled nurses on hand 24/7. Some of the issues affecting the nursing home are cost of living, staff to resident ratio, and nutrition. Community Needs Assessment are performed to determine current situations, identify issues to determine a course of action, and establish the foundation for vital planning. The target population for this community needs assessment is 70+ elderly individuals in Tennessee specifically Jefferson City who cannot be cared for at home. The objective of this need’s assessment is to identify barriers and gaps that prevent residents from accessing resources and services, come up with strategies to improve quality of patients care, how to use resources more efficiently, and to assess the coming challenges of caring for large numbers of frail elderly as the Baby Boom generation ages.

The types of data needed for this assessment are statistics comparing Jefferson City to Tennessee and studies on the effects of under staffed healthcare workers. The average median household income for seniors in Jefferson City is “$32,702 with 8% below the poverty level” (ACS) whiles the median household income in Tennessee is “$51,340” with 16.7% below poverty level respectively’ (datausa.io). “There are a little over 10 nursing homes in Jefferson City which comes with an array of preferences suitable for the loved ones needing assistance” (sc.org). The average life expectancy for individuals in is 76.4, 79.3 for females and 73.6 for males individually. There are 3,348,795 in the labor force, 3,243,693 employed and 105,102 unemployed in Tennessee. The utmost waged jobs in Jefferson City are “Health Diagnosing & Treating Practitioners & Other Technical Occupations ($51,875), Healthcare Practitioners & Technical Occupations ($51,146), and Computer, Engineering, & Science Occupations ($49,063)” (ACS).

The Life Care Center Nursing home operates by assigning roles to specific skill criteria such nurses administer medications and record vitals of the residents, etc. The demographics of the nursing home is relatively diverse, there are just about the same number of women to men ratio, different races such Native Americans, Hispanics, African Americans, and Caucasians. There are two residents per room with a curtain divider for some privacy. The facility tries to accommodate every diversity as closely as they can by respecting each their religion, dietary needs, etc. Some of the existing community services and programs that addresses problems and issues are Elder Rights and Long-Term Care Ombudsman program. This advocates for the protection of older Tennesseans from abuse, neglect, exploitation, and discrimination. The Tennessee Vulnerable Adult Coalition (TVAC) was established in 2008, to bring the state’s public and private agencies together to promote the collaboration necessary to prevent abuse, neglect, and exploitation of vulnerable adults.

Long-Term Care Ombudsman program consists of a State long-term care ombudsman, along with 11 district long-term assisted by 200 volunteer ombudsman representatives. The Long-Term Care Ombudsman program is responsible for supporting for the rights of those living in licensed nursing facilities, assisted living facilities and homes for the elderly. The chief concern of this program is to resolve complaints that impact the health, safety and welfare of residents of long-term care facilities, as well as informing residents of their rights. The Ombudsman’s advocacy role takes two forms: 1) to receive and resolve individual complaints and issues by, or on behalf of, these residents; 2) to pursue resident advocacy in the long-term care system, its laws, policies, regulations, and administration through public education, consensus building, and policy or legislative action. The services of the Ombudsman are free, confidential and statewide.

The program accepts complaints and or concerns from anyone including, but not limited to, the residents of any nursing home, assisted living or residential homes for the aged, family members or friends of a nursing home resident, nursing home and administrators, employees of the facility, or any other concerned citizen. This program will also assist individuals and families interested in and considering long-term care placement.

Some of the political, social economic status, and environmental factors that are impacting understaffing in nursing homes are the Advanced Center for Nursing and Rehabilitation and the state Department of Public Health (DPH), the state’s Public Health Code, income and education level, insurance status, access to care, and patients’ health beliefs. The DPH makes sure health facilities such nursing homes have a minimum nurses and staff ratio per shift required to run a successful business and comply with the law. With SES, sometimes individuals who cannot afford, have insurance that does not cover treatments, etc. sometimes hinder them from getting adequate care and treatments. Most individuals that reside in the nursing home have out grown most of their family members, have no children or have family members living far away.

With the facility I gathered information in particular, families have a special day they come and spend with their loved ones, volunteers from neighboring schools and the communities come whenever they can to help out, it they offer equal employment an equal pay for employees, and the Abuse Policy ( this helps to identify and properly report any form of abuse. This in place it helps ease the load on healthcare workers, help protect the elderly, and healthcare workers work better if they get paid better.

Comparing Jefferson City to Tennessee

  • 13% of the population of Jefferson City, TN are seniors 13% of the population of Tennessee are seniors.
  • 31% of those seniors living in Jefferson City, TN are living alone. 27% of those seniors living in Tennessee are living alone.
  • 11% of Jefferson City senior households have an annual income of less than $10k and 41% less than $20k 8% of Tennessee senior households have an annual income of less than $10k and 29% less than $20k.
  • 24% of Jefferson City, TN residents 60 and over received food stamps in the last year. 26% of Tennessee residents 60 and over received food stamps in the last year.
  • The average Social Security Income in Jefferson City is $14,629/year. The average Social Security Income in Tennessee is $16,841/year.
  • The median household income for a Jefferson City senior is $23,180 The median household income for a Tennessee senior is $32,702.
  • Compared to other states, Tennessee ranks 45th for Long Term Care and 44th for America’s Health Rankings Compared to other states, Tennessee ranks 45th for Long Term Care and 44th for America’s Health Rankings.
  • There are 110 working seniors in Jefferson City. There are 126,939 working seniors in Tennessee
  • 26% of the seniors in Jefferson City are veterans. 22% of the seniors in Tennessee are veterans.

Comparing Jefferson City to Tennessee there was not much of a difference in evidence supporting the issue but then the information I could find was generated few years back. Nationally, there is a much recognition to the issue and talks have been engaged in coming up with solutions. The outcomes of nursing home understaffing are many and may vary according to patient needs. Neglect and abuse become more common as the patient to staff ratio increases. The neglect and abuse suffered by patients can cause physical ailments, psychological disorders, and even death. Nursing home understaffing may also contribute to psychological disorders among staff members, as stress increases.

Nursing home understaffing may also result in patients being physically and emotionally abused. Abusive staff members report stress from understaffing issues as a primary factor in becoming abusive. Having a limited amount of time to care for each patient can also cause staff members to become intolerant and use excessive force when caring for patients. Nursing home understaffing is a societal problem that may benefit from increasingly strict laws, policies and penalties, as well as increased public awareness. Many nursing homes have been held accountable for understaffing issues by paying fines and with lawsuits. While this may temporarily halt some nursing homes from practicing unethical hiring and staffing, there is much to be done to rectify the problem.

References

  1. (n.d.). Retrieved October 12, 2019, from https://www.truthaboutnursing.org/faq/short-staffed.html.
  2. (2016, September 11). Retrieved October 14, 2019, from http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0400/Sections/0400.23.html.
  3. (2017, June 24). Retrieved October 13, 2019, from http://www.leg.state.fl.us/statutes/.
  4. Jefferson City, TN Senior Guide. (n.d.). Retrieved October 10, 2019, from https://www.seniorcare.com/directory/tn/jefferson-city/#census_footnote.
  5. Tennessee Senior Guide. (n.d.). Retrieved from https://www.seniorcare.com/directory/tn/#acs_footnote.
  6. A Tennessee Department of Health Fact Sheet Life … (2013, November). Retrieved October 26, 2019, from https://www.tn.gov/content/dam/tn/health/documents/Life_Expectancy_in_Tennessee_2009_to_2011.pdf.
  7. Tennessee. (n.d.). Retrieved October 26, 2019, from https://datausa.io/profile/geo/tennessee.
  8. Yurtoğlu, N. (2018). http: www.historystudies.net.pdf. History Studies International Journal of History, 10(7), 241–264. doi: 10.9737/hist.2018.658
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