A nursing home is a facility for the residential care of older people, senior citizens, or disabled people. Nursing homes may also be referred to as care homes, skilled nursing facilities (SNF) or long-term care facilities. Often, these terms have slightly different meanings to indicate whether the institutions are public or private, and whether they provide mostly assisted living, or nursing care and emergency medical care. Nursing homes are used by people who do not need to be in a hospital, but cannot be cared for at home. The nursing home facility nurses have the responsibilities of caring for the patients' medical needs and also the responsibility of being in charge of other employees, depending on their ranks. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day.
In the United States, while nearly 1 in 10 residents aged 75 to 84 stays in a nursing home for five or more years, nearly 3 in 10 residents in that age group stay less than 100 days, the maximum duration covered by Medicare, according to the American Association for Long-Term Care Insurance. Some nursing homes also provide short-term rehabilitative stays following surgery, illness, or injury. Services may include physical therapy, occupational therapy, or speech-language therapy. Nursing homes also offer other services, such as planned activities and daily housekeeping. Nursing homes may offer memory care services, often called dementia care.
History
From before the 17th century to modern day, many families care for their elders in the family's home. While this is still common practice for many communities and families around the world, this has become increasingly more difficult over time as life expectancy increases, family size decreases, and increased expertise in caring for a person with a chronic disease is needed. In the 21st century, nursing homes have become a standard form of care for most aged and incapacitated persons to account for those complexities. Nearly 6 percent of older adults are sheltered in residential facilities that provide a wide range of care. Yet such institutions have not always existed; rather, their history and development reflect relatively recent demographic and political realities that shape the experience of growing old.
In the 17th century, poorhouses (also referred to as almshouses) originated in England as municipalities were expected to care for their poor. Orphans, people determined to be mentally ill, and elderly people were often placed into these living commons while able-bodied individuals were expected to work and could be imprisoned if they refused. This model was brought to North America by English settlers. Before the 19th century, no age-restricted institutions existed for long-term care; elderly individuals, who needed shelter because of incapacity, impoverishment, or family isolation, often ended their days in an almshouse. Placed alongside people deemed insane, people who were inebriated, or people who were homeless, they were simply categorized as part of the community's most needy recipients. Poorhouses gave a place where they could be given shelter and daily meals.
In the 1800s in the US, women's and church groups began to establish special homes for elderly people. Often concerned that individuals of their own ethnic or religious communities might die alongside the most despised society, this led to the creation of private care facilities for the elderly in these communities. Poorhouses continued to exist into the early 20th century, despite the criticism of the poor conditions of the poorhouses. In the US, the Great Depression overwhelmed the poorhouses, leading to not enough space and funding. Due to muckraking in the 1930s, the less-than-favorable living conditions of the poorhouses were exposed to the public. This led to the provision of the Social Security Act (1935) to only give people their pension if they did not live in poorhouses, but could live in private institutions.