AOL had an article equating nursing homes with prison.  This may sound harsh but the people I speak to at nursing home typically feel that way.  The residents do not feel like the nursing homes want them to get better because they will lose money if the residents return home.  The most interesting aspects of the article are the comments under the story.

The article talks about Charles Todd Lee, a 67-year-old photographer who has been confined to a nursing home for five years, the victim of a stroke that paralyzed his left side.

"Most of the people come here to die, so you want to die," he said. "It is a prison. I can’t escape it."

Lee is a Medicaid recipient challenging the nightmare of the old and disabled: to be forced from comfort and familiarity into a nursing home.  Residents say the state is illegally forcing them to live in nursing homes when they should be able to live where they choose. Advocates charge that nursing homes, afraid of losing money, have successfully pressured politicians to make qualifying for community care more difficult. They have filed a federal lawsuit seeking class-action status on behalf of nearly 8,500 institutionalized Floridians.

Whether the litigation gets Lee and others moved out of nursing homes remains to be seen. But at the very least, it has illuminated the frustration experienced by older people or those with disabilities who say they’re shuttled into nursing homes when they are healthy enough to live at home, with relatives, or in other less institutional settings.

Americans who qualify for Medicaid and get sick or disabled enough to require substantial care typically have little problem gaining admission to a nursing home. But obtaining Medicaid-supported services at home, such as visits from an aide, is substantially harder and often involves a long waiting list, even though it may cost the government less.

Advocates for the elderly and disabled had hoped a 1999 Supreme Court case would change that. The Olmstead decision, as it is known, involved two Georgia women, both Medicaid beneficiaries with mental retardation who wanted community-based services, but were refused and were treated in institutions.   The high court ruled unjustified isolation of the disabled in institutions amounted to discrimination under the Americans with Disabilities Act.   It said states must provide community services if patients want them, if they can be accommodated and if it’s appropriate.

States have been putting more money into community services, but not nearly enough to meet the demand of people who would rather stay at home than go to a facility. Nationally, state Medicaid payments for long-term community care have skyrocketed since the Olmstead decision, from $17.4 billion in 1999 to $42.8 billion last year, though spending on nursing homes and other institutions is still substantially higher.   A total of $59.5 billion was spent last year on institutional care through Medicaid.

The article also mentions John Boyd, 50, who has been in a nursing home for the last nine years. He hates them. He became a quadriplegic 36 years ago when he fell off a wall and broke his neck.
"I can’t choose what meal I want, I can’t have a visitor after 8 o’clock — it’s just like a prison without bars," he said. "People are making decisions for and about me that don’t even know me or even care about me. All they care about is the money they’re getting for me."

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