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" Priority 1: Quality and Discontinuity of Care <br />The Consequences of Doing Nothing <br />■1 I n 1990, 7 M i I I i on peopl e used some form of I ong term care, by 2040 the number <br />will i ncrease to 18 rri I I i on <br />*The people who are most likely to be institutionalized are those who are <br />extremely difficult to sustain in the community <br />♦ 1% of persons 65 to 74, 6°/o of persons 75 to 84, and 220/0 of persons age 85+ <br />resi de i n nursi ng homes (45% have been there more than two years) <br />*There i s al most no i nstructi on i n nursi ng home care duri ng medi cal school and resi dency <br />♦ M any of the problems resi dents suffer f rom i n a nursing home requi re sped al di agnosi s <br />and treatment: i Iecti ons, i nconti nence, fal I s, depressi on, conf usi on, mal nutri ti on and <br />pressure ulcers <br />M any hospi tal admi ssi ons of nursi ng home pati ents are a resul t of : I ack of adequatel y <br />trai ned staff, a I ack of di agnosti c sere i ces, phyd ci an cony eni ence, and pressure f rom staff <br />and f ami I y to "transf er" of der persons w i th "di ff i cul t" compl i cati ons <br />• T ransfers back to nursi ng homes are f requently a prod em due to: del ayed or i ncorrpl ete <br />transfer of information from the hospital <br />• Readrni ssi on to the hospi tal w i thi n a short ti me occurs i n 30- 4010 of the cases <br />• H i gher hospi tal i zati on rates hav e been f ound among resi dents of f or- prof i t nursi ng homes <br />• 8810 of nursi ng home residents are white (US figure) <br />• C.N.A. turnover rates are 9010 <br />Source:: Williams, Mark (1995). The American Geriatric Society's CoMlete Guide to Akins and Health <br />Hooyman, N.. & Kiyak, H.A., (1999), Social Gerontology. <br />N <br />