What Is the Biggest Problem in Nursing Homes?

The biggest problem in nursing homes is often the lack of enough staff to care for all residents efficiently and in the manner necessary. According to the American Health Care Association (AHCA), 87% of nursing homes face moderate to high staffing shortages. Of those, 48% face high levels of staffing shortages. This has a major effect on the care provided to residents, leaving less time for staff to spend on each resident and increasing the staff-to-patient ratio.

This can paint nursing homes in a negative light when the lack of staff creates several other problems as well. Without enough staff, response time to calls and social interactions suffer, and this can put residents at risk and lead to difficulties in providing the level of care needed. Currently, the solution to the staffing shortage is assigning overtime or extra shifts to employees and hiring temporary agency staff. However, the AHCA reports that 53% of nursing home providers cannot sustain current operating paces for more than a year.

Nursing homes often implement call lights that residents can use when they need help outside of times a staff member would normally be caring for them. However, as nursing homes get busier and staff numbers decrease, response times slow. These systems rarely have any way to prioritize who needs urgent help and who needs something that can wait a little while longer, making it difficult for staff to assess who needs assistance first.

Seniors enter nursing homes requiring extensive, round-the-clock care for a range of conditions, and when that care can’t be provided, the senior’s needs will not be met. As slow response times increase, several problems can arise. Residents may fall and injure themselves trying to get up alone after not receiving assistance in a timely manner. Some may have accidents in bed when they can’t be assisted to the bathroom. Some may miss time-sensitive medications, and some medical emergencies may be missed entirely. Residents who are dependent upon staff for movement may also suffer from bed sores as time spent in one position increases.

Nursing home staff provide more than just care to residents; they also offer the lifeline of social interaction with staff and other residents. Without that interaction, residents are left in social isolation, which can increase the risk of dementia and depression and also worsen overall well-being. Positive social interaction is a measure of nursing home quality that takes a major hit due to staffing shortages and directly impacts the residents.

Staff members cannot spend as much time with individual patients as the staff-to-patient ratio increases, nor can they spend as much time assisting residents with social activities and transportation around the community. As a result of the shortages, often the most social interaction residents receive comes from their loved ones visiting.