Geriatric nursing may soon look very different than it has in the past. Previously, those in the field of geriatric nursing could expect to find employment in nursing homes and home health care facilities. However, with recent changes to Medicaid and Medicare, the home health care model may soon become much more prominent. Policy officials are now beginning to feel that full time medical assistance within a nursing home facility is not warranted for many of the patients who would have previously been candidates for these services. Instead, they are looking to the home health care model, where only specific services are provided within the home of the patient.
Impact on Families
At first, it is likely that the greatest impact of this change will be on the family members of the elderly patients who are no longer going to be placed in nursing home facilities. They will now need to find additional funds to pay for the home and daily care of these family members. Many of these patients will still require extensive care, even if the cause is not strictly medical. The patients that had been sent to nursing homes may have non-medical reasons for needing extra care, such as age-related frailty or mental decline. The end result will still be that family members will need to find the extra time to care for these family members themselves or the extra resources to pay for someone else to care for them.
Impact on Nurses
At first glance, it may appear that the greatest impact would be in the loss of the jobs that were previously supplied by the nursing home facilities. Those facilities that have closed, as well as those that will likely be closing in the future, seem to promise a reduction in the need for the services of geriatric nurses. This may not necessarily be the case. The nurses that were serving these facilities were responsible for multiple patients at any given point of the day or night. Now each of those patients will need individual care in their own home or in the home of a family member. The care they require could be as little as a few hours a day or may be as extensive as overnight care. This may actually result in an increase in the number of positions, with home health care firms and positions offered by individual families.
Positions with home health care facilities will likely require a great deal of travel, but will probably still provide benefits and a comparable salary. Those nurses who decide to offer extended services to individuals or their families may need to work as independent contractors, which can seem intimidating to many workers who are used to working for companies.
As a geriatric nurse, are you concerned about the upcoming changes? Have you already seen the effects of changing insurance policies? What do you see as the future of your career?