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Most nursing homes in this country
were built with a different population in mind than the population that
currently lives in them. The current health care financial environment is
driving changes now and will continue to do so in the near future. When they
were originally built, most nursing homes were intended to house cognitively
intact but medically ill individuals who would convalesce there in hopes of
ultimately returning home. As a result, most nursing homes resemble
hospitals, with high, hospital-style beds, long corridors and visibly
prominent nursing stations. Over the last 25 years, however, nursing homes
have become home to a million or more individuals with dementia and related
conditions, requiring 24-hour supervision and "custodial" care.
Almost two thirds of all nursing
home residents are cognitively impaired and, overall, the prevalence of
mental disorders, (including dementia, delirium and psychiatric illness),
among nursing home residents is over 90 percent. These buildings were,
unfortunately, never intended to house these individuals. The physical plant
was tailored to an entirely different purpose. As a result, these elderly
nursing home residents often have difficulty conforming to the nursing home
environment and their illness puts them in contact with a number of
environmental hazards. Crowded public areas, slippery floors, and dim
lighting increase the risk of falls, while hard floors and high beds
increase the risk of injury. |
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