Our elder-care approach is a policy failure

THANK YOU for your piece on cuts to elder care ("Fiscal woes already mean wait, worry for ailing elders," Page A1, Dec. 31). I am a nurse practitioner in gerontology, and am distressed about the cuts in services and the penny-wise, pound-foolish policies that dictate how we care for elders. As reporter Kay Lazar points out, the state reimburses nursing homes about $158 per patient per day as opposed to less than $9 a day to maintain elders in their own homes. As a result of shrinking services, more elders end up with hospitalizations that could be prevented through vigorous home care programs. Typically the hospitalization will result in a nursing home stay for rehabilitation, a transfer process that I unfortunately see so often in my practice. Hospitalizations and rehab stays take a toll on the overall health of the elderly, and often result in a decline in status that makes it impossible for them to return home. The result is long-term placement.

The great majority of elders want to remain in their own homes, and are devastated by the prospect of nursing home living. By developing individualized care plans along with the elder's primary care physician, nurse practitioners can accomplish this goal in many cases.

Peg Ackerman
Nahant