As individuals age, they may require ongoing support with everyday activities of daily living or to help manage the symptoms of chronic disease. For many older adults, nursing homes help to meet these care needs. Common reasons for admission to a nursing home include dementia, incontinence, mobility limitations, and challenges with common activities of daily living (e.g., feeding themselves, bathing, dressing).
The federal government sets requirements and quality of care standards for nursing homes to participate in the Medicare and Medicaid programs. An important component of these requirements is reporting on quality measures. The Alliance for Aging Research has advocated for the inclusion of meaningful patient-centered metrics in the Five-Star Quality Rating System for nursing homes. The Five Star Ratings help consumers, state regulators, and insurers evaluate the quality of a nursing home. These ratings also impact the payment that nursing homes receive from the Medicare program.
Nursing homes also help care for patients with dementia. Dementia symptoms can include behaviors such as acting inappropriately, being physically or verbally abusive, or wandering. Effectively managing or preventing behaviors that disturb or cause harm to patients and others is highly important. However, there is currently a significant unmet medical need in long-term care settings to diagnose and manage these neuropsychiatric symptoms (NPS). For this reason, the Alliance for Aging Research is one of the convening organizations of Project PAUSE (Psychoactive Appropriate Use for Safety and Effectiveness), an ad hoc coalition of national patient and professional organizations advocating on clinical regulatory and legislative issues in long-term care. Project PAUSE aims to educate policymakers and the public on effective solutions to improve clinical care in long-term care settings by advocating for streamlined clinical surveyor training, improved quality measures that accurately assess inappropriate use of antipsychotic drugs use in long-term care settings, and other solutions aimed at improving the diagnosis and management of NPS.