By Bel Weyble
In my freshman year of high school amidst the COVID-19 pandemic, my family finally recognized the glaring truth: my grandmother had dementia. She was quite lonely during the lockdown, even though we lived right next door to her. When I visited, she would tell me the same stories over again, her once extraordinary cooking became inedible, and she forgot how to use her sewing machine. Her personality was changing, and it was obvious that the isolation from her community was detrimental to her health.
Once we realized what was going on, we began seeing more concerning signs regarding her mental state. She would misplace items and find them in obscure places, she permanently locked herself out of her iPhone because she could not remember the password, and she refused to take her medicine, so we had to hand deliver it to her twice a day. Eventually, we would find her wandering through our neighborhood, showing up at our door or in our yard at random times of the day. She forgot who my mom was, calling her “that woman” who was married to my father, and accusing her of stealing. The most heartbreaking decline of all, she forgot who her own son was.
This was a breaking point: as much as we hated to see her placed in a nursing home, we knew we could not take care of her the way she needed. We began searching for nursing homes in the area that could provide her with the extent of care she deserved, and that we could afford. Upon entering the world of nursing homes, we found most had major flaws in their operations. In my family’s experience, these flaws can often be linked back to a lack of nursing staff.
The Costs Do Not Outweigh the Benefits
Nursing homes are known for outrageous prices, taking complete and utter advantage of families with no other choice. Most public nursing homes receive funding from the government in the form of Medicare and Medicaid. This makes the individual price lower for families, but it comes at a cost: staffing. Even with the funding provided by the government, the costs of running a nursing home are quite extensive—especially when attempting to comply with all the standards of quality. So nursing homes must cut down on both staff, and staff hours. Or they must increase the price for families like mine, forcing us to liquidate my grandmother’s 70 years’ worth of belongings just to be able to afford a few years of mediocre care. When examining the distribution of payment sources for nursing homes, most of it comes from Medicare, but the next largest contributor is straight from your family’s pocket.
Is It Neglect If It’s Not on Purpose?
During the process of researching, touring, and interviewing with potential homes, we discovered that the industry of elder care left a lot to be desired. Homes appeared outdated, care was wildly expensive, and they never seemed open about the truth. The nursing homes we visited felt dark, dingy, and overall, not a happy place to be. The experience worsened once we finally placed my grandmother in a home, and she was not given the attention or care she needed. We soon moved her to a different facility in hopes of her receiving the care she deserved, but her mental state worsened there. She fell while unsupervised and broke her hip, refusing to get up. She later died in her nursing home bed.
Lack of supervision as a leading cause of injury is quite common in nursing homes, and attributed usually to their poor staffing. Without proper staffing, gaps are left in the day where patients are unattended or waiting for help. Like Michelle Welliver explains in “Nursing Homes: Good Intentions, Sad Realities,” a 99-year-old woman had an appointment within the home but had trouble walking. She pressed her bedside call button and waited for a nurse to assist her. However, she ended up waiting for almost an hour, and had to hoist herself out of bed. Falling and injuring herself was extremely possible, but she had no other choice (Welliver). Nurses are spread thin in this demanding line of work, but this puts patients at more risk than ever. My grandmother, for example, was a victim of such harsh neglect that she ended up dying from complications due to a completely avoidable accident. Wouldn’t you be unimaginably angry? Imagine your mother falls out of her bed, slips in the shower, or walks into a doorway, and with her physical resilience depleting, she cannot recover, all because there wasn’t a nurse there to help her.
My grandmother was going to do what she wanted when she wanted to. She was determined to drive herself to the mall every week, despite having terrible vision and poor reaction time, all because she simply could not wait for someone to take her there. We had to take away her car keys out of fear that she would get lost, or worse, due to her memory problems. My grandmother was a strong and independent woman, and above all she was stubborn, as most elderly people are. Isn’t this reason enough to have extra hands on deck in nursing homes? No person should be left helplessly waiting for someone to assist them.
Nursing Homes Turned Deadly
Especially during the pandemic, a lack of proper staffing in nursing homes led to an excessive spread of disease to elderly patients: “The pandemic turned nursing homes into a death trap for more than 170,000 long-term care residents and staff members who have lost their lives to Covid-19” (Khimm). Because the excruciating work that is involved in caring for elderly residents is undervalued, the search for extra financial stability left workers and patients with increased exposure to the virus. Suzy Khimm even stated in “America Now Knows That Nursing Homes Are Broken. Does Anyone Care Enough to Fix Them?” that the first outbreak in a nursing home in Washington state was attributed to the staff traveling between multiple facilities (Khimm).
Luckily for my grandmother, the height of the COVID-19 pandemic had passed by the time she was placed in a home. Regardless, her time in a nursing home was spent without proper care or dedication to her well-being. Nursing homes do not meet federal standards. CMS recommends 4.1 nursing hours per resident, per day, and with over 80% of homes in 2023 reporting staffing shortages, there is no way this minimum can be met (Travers). The chronic understaffing of nursing homes, due to a variety of issues, has led to neglect and death for our elderly family members.
So, What Should You Do?
An issue like this can’t be solved overnight, as it needs serious consideration and federal involvement. CMS offers loan reimbursements for nurses who work in underserved areas, to even the playing field for poorer nursing homes (Travers). President Biden proposed offering $400 billion towards home care in his American Jobs Plan to make end of life care more accessible (Kohn). Deciding to place a family member in a nursing home is a very personal decision, and some people, like MalTheGentleman on Reddit think that “it is inhumane to keep human beings in the conditions of a nursing home… Once someone is past basic functionality, I think it should be the best option to provide comfort measures and end of life care in a respectful and compassionate way that doesn’t prolong their life in a state of mere existence and suffering” (MalTheGentleman). Although it seems extreme, maybe morbid, this comment highlights some common views surrounding nursing homes, and prompts an important discussion about what families can do in this situation.
As families, we can urge the U.S government to intervene and solve the shortage of staff members. But that takes time, and your loved one needs care now. So, all that can be done is sufficient research before placing them in a nursing home. A reliable source for nursing home quality is the Medicare.gov Care Compare page, which highlights nursing homes in your zip code, and gives them a rating based on national standards of care. Five-star rated homes are considered to have quality well above average, meaning it’s far more likely that your loved one will be properly cared for.
Without many viable options, you might feel trapped with nursing homes as your only choice. Nursing homes are meant to be places of safety, comfort, and compassion. Without enough nurses however, those ideals become out of reach. When a nursing home is stretched too thin, the caregivers are often overwhelmed and exhausted. No one wants to think of their family members being neglected or forgotten, but with staffing shortages rampant, this can become an everyday struggle for residents. In the end, it is up to you and your family to decide what is best for your elderly loved ones. When considering nursing homes, it is important to look past the façade of brochures, and promises, and think about the quality of care this facility will be able to provide. Your family deserves not just a place to stay, but a place where they are seen, valued, and cared for.
Works Cited
Basset, Erica. “Abuse and Neglect against Elderly Adults in Nursing Homes in the US.” Ballard Brief, https://ballardbrief.byu.edu/issue-briefs/abuse-and-neglect-against-elderly-adults-in-nursing-homes-in-the-united-states. Accessed 7 Nov. 2024.
Find Healthcare Providers: Compare Care Near You | Medicare. https://www.medicare.gov/care-compare/?redirect=true&providerType=NursingHome. Accessed 20 Feb. 2025.
Khimm, Suzy. “America Now Knows That Nursing Homes Are Broken. Does Anyone Care Enough to Fix Them?” NBC News, 7 Mar. 2021,
https://www.nbcnews.com/politics/politics-news/america-now-knows-nursing-homes are-broken-does-anyone-care-n1259766.
Kohn, Nina. “It’s Time to Care about Home Care.” The Hill, 31 May 2021, https://thehill.com/opinion/healthcare/556178-its-time-to-care-about-home-care/.
MalTheGentleman. “Nursing Homes Are the Worst Possible Way to Treat the Elderly.” R/Unpopularopinion, 2020,
https://www.reddit.com/r/unpopularopinion/comments/l2dc2s/nursing_homes_are_the_w orst_possible_way_to_treat/.
Travers, Jasmine. “Most US Nursing Homes Are Understaffed, Potentially Compromising Health Care for More than a Million Elderly Residents.” The Conversation, 22 Aug. 2023, http://theconversation.com/most-us-nursing-homes-are-understaffed-potentially compromising-health-care-for-more-than-a-million-elderly-residents-211398.
Welliver, Michelle. “Nursing Homes: Good Intentions, Sad Realities.” American Nurse, 10 Feb. 2018, https://www.myamericannurse.com/nursing-homes-good-intentions-sad-realities/.