The Right to Safe Social and Health Care for Seniors in Nursing Homes


With more than 46 million Americans over the age of 65, the issue of quality elderly care has never been more pervasive. The Baby Boomers, as the world’s largest historical population segment, will be in need of long-term healthcare and in-home health support within the next five to ten years. Like every other age and stage in life, the boomers are expected to change the way we look at, and participate in long-term care. That is a good thing, as a report from the Population Reference Bureau predicts that the number of seniors who may require assistive care, is likely to double to 98 million by the year 2060.

Demand for high-quality care for elders is a concern that is growing in tandem with the aging population in the United States. Finding medical support and access to affordable residential or institutional care is important, but ensuring that the care provides for a good quality of life, and safety for elderly family members, can be difficult. As institutions cost costs and stretch budgets, lapses in care can result in negligence and abuse; instances that are growing at an alarming rate.

Why the Increasing Costs for Elder Care Is a Problem

In virtually any community across the United States, the demand for institutional care of the elderly exceeds availability in licensed long-term care facilities. When you look at the demand for nursing home care and consider that there are over 46 million Americans currently over the age of 65, the fact that there are only 15,600 licensed care facilities is dismaying. The Centers for Disease Control and Prevention estimated that there were only 1.7 million beds available for Americans total, within the long-term healthcare system.

The CDC also indicated that almost 70% of nursing homes are privately owned, for-profit facilities. While costs vary depending on the institution, the average semi-private nursing home accommodation can cost up to $81,0000 per year. The average retirement income, based on data from AARP, is $31,472. Social security benefits pay (at current rates) roughly $1,300 per month for single individuals.

Given the rising cost of institutionalized care, many families try to accommodate elder relatives at home, with part-time or full-time day care from a healthcare aide or nurse, depending on circumstances. While the cost of in-home care is roughly 50% less than residence in a licensed nursing home, families can expect care at an expense of $3,500 to more than $5,000 per month. Part-time care costs in-home average about $200 USD per day.

What Rights Do Patients in Long-Term Care Legally Have?

Regardless of conditions like dementia, or other cognitive impairments that can make care coordination difficult for a patient, in the United States there are laws that direct the dignity that all long-term care patients should be treated with, which include:

  • Access to medically related social services
  • Accurate healthcare, including primary and dental care
  • Special services for mentally ill or cognitively impaired patients
  • The provision of material, financial or personal privacy, when requested by the resident
  • Nutritional dietary needs that are met and tailored to each individual patient
  • Clinical or social engagement that does not violate the resident’s dignity

The rights of nursing home patients include safety, social activation, and a medical patient care plan that addresses health needs. Patient rights must be advocated for by family members, who must remain active in the life of their family member, regardless of medication conditions or cognitive degeneration. It is residents who are not able to articulate on their own, who represent some of the most vulnerable patients in a nursing home facility; they can’t explain what is happening, or why they may be afraid or unhappy with the staff and care providers.

The National Council on Aging reports that 1 in every 10 Americans aged sixty-years and up, have experienced elder abuse. Other estimates are as high as five million seniors who may be abused every year. Unfortunately for a variety of reasons, only 1 in 14 cases of abuse are reported to the appropriate authority or escalated to legal action, in defense of the senior.

Why Intervention and Immediate Action is Important

Intervention can take months, and may involve the transfer of the senior to another facility. However, with wait-listing and diminished availability, getting a family member away from a potentially abusive environment is frequently difficult. This is true most for individuals who require hospice, or significant healthcare assistance and supervision daily. Bringing the family member home for intermediary care is sometimes possible (depending on resources), but frequently not an option for average families, who cannot shoulder the cost of private 24-hour care in their home.

Do some research on the nursing home, using the Medicare review site. It will help you search for nursing homes, or read comments and reviews about different aspects in local long-term care facilities (including previous instances of misconduct or lapse in patient care). If you suspect that your family member is being systematically abused (psychologically or physically) or mistreated, consult with a lawyer.

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