American Journal of Nursing: The Politics of Caring
By Sue Whittaker and Margaret Kay
The ANA strongly supports the following recently introduced legislation that will enhance the lives of seniors and their families. The Positive Aging Act of 2004 (S 2572 and HR 4694) would help seniors receive much-needed mental health services. Although approximately 10% of the elderly population suffers from dementia and 25% from clinical depression, seniors’ access to mental health services is compromised by limits on health care benefits coverage, gaps in how mental health services are delivered, and shortages of mental health practitioners who serve the geriatric population. Supporters hope the bill will improve senior access to care by integrating mental health services into primary care, community settings, and geriatric care facilities. Additionally, it will include geriatric mental health professionals in existing grant programs and will establish advisory boards to ensure that the mental health needs of the elderly are not overlooked.
The Ronald Reagan Alzheimer’s Breakthrough Act of 2004 (S 2533), introduced by Senators Kit Bond (R-MO) and Barbara Mikulski (D-MD), will invest in Alzheimer research, with the goal of reducing the number of cases of the disease by more than one-third by the middle of this century. An estimated 4.5 million Americans suffer from Alzheimer disease—a figure expected to increase dramatically as the population ages. If enacted, the bill will also ease some of the financial burden on family caregivers by assisting with the costs of medication and care, as well as providing families with respite care, counseling, and training. This financial burden on families is substantial: 10% of Americans have a family member with Alzheimer disease, 70% of people with the disease live at home, and the average cost of nonreimbursed care for these patients is $12,500 per year.
The ANA also has put its weight into promoting the Family Caregiver Security Act of 2004 (HR 4095). This bill would offer hope to the more than 50 million Americans who provide care for chronically ill, elderly, or disabled loved ones by allowing qualified family caregivers to receive reimbursement for assisting with activities of daily living, such as bathing, transferring, dressing, and assisting with toileting. The nonreimbursed services these family caregivers provide are estimated conservatively at a market value of $166 billion annually. Furthermore, because 54% of these caregivers are between the ages of 35 and 64—prime wage-earning years—their efforts to tend to friends or relatives take an enormous toll on their own financial well-being and earning potential.
More information is available at the ANA government affairs Web site at www.anapoliticalpower.org.
Staffing. The ANA and state nurses associations are working together to promote legislation that would hold hospitals accountable for developing and implementing valid and reliable nurse staffing plans. These plans are based on the ANA’s Principles for Nurse Staffing, which provides recommendations on appropriate staffing and requires that nurses be deeply involved in developing plans and making decisions on staff issues. The plans give hospitals the flexibility to tailor nurse staffing to their patients’ specific needs based on such factors as the seriousness of the patients’ illnesses and the experience of the nursing staff.
In 2004 Florida, Hawaii, Illinois, Massachusetts, Rhode Island, and Washington introduced legislation that would require health care facilities to develop nurse staffing plans. These bills require:
Nurse-to-patient ratios. Another approach to address nurse staffing is to mandate specific nurse-to-patient ratio legislation, such as that introduced this year in Hawaii, Iowa, and Tennessee, which would require specific ratios in hospitals and other health care facilities. These bills assign a numeric ratio to specific patient care units, such as pediatric recovery rooms, trauma units, and psychiatric units. Connecticut legislation calls for the commissioner of public health to adopt regulations establishing minimum nurse-to-patient ratios. Strict enforcement is another hallmark of these bills, with violations leading to any combination of the following: loss of hospital licensure, fines, termination of Medicaid reimbursements, private right of action, and civil penalties.
Sue Whittaker is associate director of government affairs, and Margaret Kay is the manager of periodicals at the ANA. Search Contact ANA Join/Renew Membership Members Only Online CE NursingInsiderSpecial Offersnursesbooks.org © 2008 The American Nurses Association, Inc. All Rights Reserved Copyright Policy | Privacy Statement
About AJNANA Columns in AJN Questions/ConcernsAbout AJNANA Columns in AJN Questions/Concerns
