FAR EASTERN UNIVERSITY

Institute of Nursing

Nicanor Reyes St. Sampaloc Manila

Position Paper in “Recommending Nursing Home as an Alternative Choice

for Filipino`s Geriatric Problem”

In Partial Fulfillment for the requirement in

College Academic Skills English

Presented to

Ms. Edu Lou Ochangco

By:

Samielle Alexis G. Garcia

Jailyn Eve B. Patricio

May 18, 2020

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ABSTRACT

The aim of this paper is to give an idea to people regarding the benefits and services of

the nursing home facility. Also how it differs from other facilities that provide long term-care

and assistance for elderly people. Nursing Homes are a significant component of health care

system. Its main objective is to carry out and meet the physical, emotional and social needs of an

elderly. Most families choose to take their loved ones to the nursing homes because they wanted

them to get adequate and specialized care that they cannot provide because of their personal

affairs. The literatures gathered and analyzed were used to formulate evidences and proof on the

effects of nursing homes in the lives of the elderly. The paper also discusses the elderly new

enhance identity closer to its former by continuing their independence and mobility while living

in the nursing home. In addition, the authors wanted to show to the readers that it is important to

consider the ways and means of improving the conditions and the lives of elderly. This paper

will provide a brief, precise and concise information regarding nursing home`s individualized

care and benefits given to the elderly.

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INTRODUCTION

Geriatric Care in the Philippines (Issue)

In today’s corporate world, the increase of aging is rapidly increasing especially aged 65

and above which we refer to as old age and also known as the elderly. The elders are the ones

that are much older than us or an individual that is mostly holds the superiority and authority.

They are the one that teaches the catastrophe of life because though they are old enough they

have the wisdoms to convey to the young ones. But now, most people become uncomfortable

with their elders because of the mood swings while aging and tribulations of the golden years

which is the time that they become weak and contributes to ageism that defined as the debilitated

or unworthy of attention to the elderly people.

We Filipino`s takes pride in our traditions where in it centered mostly on our family

values like taking care of the elders of our society. The idea of taking care and living with the

elderly in their old age is a custom that is rooted to every Filipino family. Some are askance to

those families overseas who choose private residential facilities which are called Nursing Home

—to take care for their elders. It is a place where they take the responsibility in caring the health

and living of the elders that cannot provide from their homes. Some families prefer to take their

elders and their parents here in these facilities because they cannot provide the vulnerability and

commitment in providing the needs and attention to the elderly people. As the saying says “it

takes a village to raise a child as well as to look after an old person”, having a better perspective

towards this manner sometimes give our cultural assumptions a second look and be practically

wise as a person.

The Filipinos deepest respect for the elderly has been incorporate in the Philippine

Constitution which is the Article 15, Section 4 which states that “it is the duty of the family to
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take care of the elderly members while the State may design programs of social security for

them” (Antonio, 2016). It is the value system of “utangnaloob” (debt of gratitude) that deeply

ingrained in the Filipino thinking and that is why it might be unthinkable for Filipino families to

commit the elderly to residential homes or any institutions even if they are falling short to their

duties and responsibilities, unless circumstances proved to be extreme such as some phenomenon

that cannot be avoided. For others, aging in place has been the most favored approach for them

because as this allows for the latter to care for them or be taken care in areas where they lived as

they can freely move and do the things that they want to. It is evident that this is a cultural

imperative and is firmly upheld our virtue of cultural beliefs, while many elders who lived in the

nursing home facilities are brought there by their relatives or social workers who found them in

the streets roaming around and has no place to go.

Contrary to what has been stated above, “The future seems brighter for the providers of

care towards their elder member of the family to the country’s growing populace who are in their

twilight years, but the family-oriented culture of Filipinos somewhat hinders them from reaching

their full potentials” (Abad, 2016). Mostly Filipino`s felt the spasms of guilt and shame thinking

that if they brought their elders to nursing homes they will be violating their practices even

though on the other hand that it would help them and brought ease in their family. Besides, as

much as their family wanted to help them they didn’t know if they are receiving the care that

they are really needed. If we broadly look what a nursing home has to offer, it is typically staffed

with a variety of medical professionals. In the Philippines, the growth of the elderly population

from 2000 it reaches 4.6 million which represents 6%. After a decade it grew to 6.5 million

which is converted into 6.9% of the total population. Then in the year 2030 the National

Statistics Office (NSO) says that their population will probably increase into 11.5%. With these
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the demands and services for the elder people increases as same as they suffer from different

degenerative and communicable diseases due to the ageing of their body`s immune system.

(Villaverde, n.d.)

Nursing Homes brings you and your loved ones peace knowing that their medical needs

are being addressed and being cared for by professionals 24/7. We could see in a way that

actualizing this concept of a localized residential facility for the elders is in anticipation of the

eventual aging of our society, which should take place within the foreseeable future, considering

the foreseen decrease in fertility rates about 15 years from now and an increase in life expectancy

among every Filipinos.

Long-Term Facilities for Elderly People

Nowadays, this issue is often discussed within the family due to the sensitivity and

importance of the topic. It is about deciding where you will be taking care of a relative and their

loved ones at the current state of their lives. Nursing homes, takes care of the people that has

special needs which is mostly for elderly and disabled people. Assisted living facilities provide

assistance, including help with medicines and private hygiene to the elderly people. “Nursing

homes have never had a consensus. It's called upon to produce variety of various things, often

contradictory: from post-acute stays, provision of rehabilitative care, providing homes for those

within the last days of their life, for those with dementia and other behavioral conditions. He

further noted that they need not been staffed, financed or organized to try and do of these

things.” (Vladeck, 1989) Nonetheless, home care is very important because it's a more personal

and intimate type of care and it is also the one that usually elder people prefer too or they called

it “aging in place”. The professional caregiver provides the patient with customized care that
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specifically satisfies the requirements of the person. Home care is the simplest place for several

people, so patients feel far better when taken care of reception. It provides a warm and safe place

and a reminder of comfort and love to the people who need care especially to the elderly people.

Unlike in health care facilities, home care is more personalized and readily available to the

sufferer.

The most common issues surrounding of this subject is that the conflict between family

member's opinion, lack of financial, and capacity of nursing homes and residential care.

However, making the decision on home care placement will include some challenges. It becomes

an emotional time and some opinions may disagree between the individual requiring care and

other members of the family. Different issues occur when this happens, that affects and leads

them to the decisions that they know would be best for them and their loved ones. However, on

the other hand, several families chose home-health care because it is safe and affordable solution

for them that support the family, while allowing your loved ones to remain within the comfort of

their own homes and communities.

This subject is relevant to students because it can help them become active during

decisions and talks regarding the issue. For Filipinos and citizens, they must be made aware and

educated about the topic because the voices and concerns of the few can influence the

government which can elevate the health care that we have.

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Review of Related Literature

Nursing home is a facility that provides care for older age outside the hospital. It provides

custodial care that meets the quality needs of every patients and residents inside the facility.

There are a license physician and other practitioners that supervise every patient. Also a skilled

nurse that is always in the premises and available in 24 hours a day. As time goes by, our

population ages and more of us are facing this stage in life. Deciding in this matter could be

stressful but by acquiring knowledge and learning can be at ease and make a decision that is right

for you and your older family member.

Life in a Nursing Home

According to Hindawi Nursing Research and Practice Study, the lives of elders change

when they entered into the nursing home facilities, from their habits, activities, status, as well as

their identity. “Identity is subject to more or less considerable changes throughout the course of

an individual’s life. These are changes includes the alteration of living environment and bodily

changes, particularly those due to age”, according to the Identity Theory of Petzold.

Based from the study, elders’ stories from their everyday lives was their way to balance

their identity, to produce their sense of living and prove that a person`s identity is constantly

changing throughout their lives. Concerning this mater, the researchers conducted an interview to

the residents of the nursing home to know the different experiences of the elders that seems so

different from one another. Some responded in their interview that even though they prepared for

the day that they will be moved out to the nursing home they still undergo with a huge self-

adaptation process. They become emotional, seek out for an attention, and looking for the right

person that they can share their problems, in order to cope up positively and draw enough
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strength. Mostly, an elderly also generate their sense of life through reflecting from their

memories in life and as they live longer in the facility, they also come up to establish their new

identity which is closer to their original identity and with that they live confidently, satisfied and

it gives them a new hope for a good and positive future.

The Perspective in Nursing Home

Nursing homes provide the most comfortable and efficient care for people who are no

longer capable of taking care of themselves, particularly those who have dementia or severe

physical limitations. However, due to increase of admissions, maintaining a professional,

secured, and comfortable nursing home is becoming more challenging. As per the Journal of

Aging Research, "In the near future, the demand for care of nursing home residents will increase

as residents deal with the effects of dementia or severe physical limitations. At the same time,

there is a trend towards small-scaled and homelike accommodations."

In lieu of this anticipated challenge, the researchers performed a systematic literature

which focuses on the elder's perspective on the concept of home in order to understand which

factors should be improved in nursing homes to make it feel more like 'home'. The questions are

mostly consists of the keywords 'meaning of home' or 'sense of home' and 'care home' or 'nursing

home'. Through the study that was conducted the researchers were able to come up with three

main themes which are:

1. Psychological aspects

2. Social aspects

3. Environment
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The Psychological aspects were about the sense of acknowledgement between staff and

patient, sudden or gradual change of old habits (things used to be done at home but no longer in

home care), autonomy and control - unlike at home you can do whatever you want, now there are

certain rules to be followed, and last but not the least coping - sudden change of a home may be

unbearable to some patients. Social aspects focus more on relationships between staff, patients,

and pets wherein some find it more challenging to interact, especially with the added influence of

their diseases and disabilities. Lastly, the environment which it is covers areas such as privacy,

public spaces, storage and exposure of personal belongings, location, and overall feel.

Conclusion

In conclusion, while the nursing homes are designed to be the second home for elderly

people and those who have disabilities and diseases, a sudden change in environment and living

conditions can make it challenging for patients to recognize home cares as their new homes. As

stated in the Hindawi Nursing Research and Practice Article "The change in social status, the

impact on autonomy, the feeling of having no place to call home, the change in social contacts,

and the reduction of habitual activities rank first in the presentation of the results and endanger

the people’s identity which they had before." It is with this unconscious denial of recognition

which can lead to a question to one's identity (especially those who have dementia) and a much

harder phase at adapting and acknowledging the importance of this home figure. In the context of

the journal of aging research, "This study has shown that the sense of home of nursing home

residents is influenced by a multitude of psychological and social factors, as well as the built

environment of nursing homes."

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Pro-Argument

Argument/Stand: Nursing home helps to develop a new identity close to the person`s

individuality by continuing their freedom and support on their independence.

Skilled Nursing Care in the Nursing Homes

Nursing Homes are served by different licensed health care practitioners and is also

known as the skilled nursing facilities.These living facilities vary widely known in the levels of

care available. They provide health care for the people that truly needs and attention that requires

a higher level of medical care that can be provided. Today as our economy increases, the demand

of life also increases. Due to that fact, families prefer to bring their elderly in a nursing home

because no one to take care of them in their private homes. Their health is being monitored by

professional nurses and as well as doctors whereas at home family members are often too busy to

devote their time to their needs. In fact, the article of Neufeld (2017) states that in 2015 the

National Institute of Aging has a total of four million senior citizens whose apply home health

care, next is seven hundred thirty thousand in the assisted living facilities then in the nursing

home there are 1.4 million senior citizens. With these, there are more of them that truly need the

type of care that a nursing home can only provide. Nursing home aides and nurses provide high-

quality care to every resident that have different needs especially those in their dementia-related

symptoms. They increase their assistance with such activities that would help the residents

continue their daily living and make them feel that they are being taken care of in an

environment that make them feel at home.

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Advanced Patient –Care Facility

According to the National Institute on Aging (2015), there are four million senior citizens

in home care and seven hundred thirty thousand in assisted living facilities and there are about

sixteenth thousands in nursing homes nationwide.Nursing homes offer nursing-care services with

professional nursing aides and professionals. It is a place where you don’t need to be in a

hospital and cannot be taken care at home too. New technologies were adapted that reduces the

workload of nurses and be able to do a potential quality and efficiency in health care. They see to

it that they received sufficient treatment and fast recovery from their illnesses and conditions.

Contrary to what other people tell, a family that settles their elders in the nursing home does not

mean that they are abandoning them. In fact, they wanted to help them to socialize physically

and mentally and be active unlike when they are at home and no one could take care of them as

well.

Conclusion

In conclusion, nursing and residential care facilities provide a range of health and

personal services for elderly that needs assistance for care. Nursing facilities continue to serve a

long-term care system for the needs of elderly, even as they battle to manage various issues

ranging from delivering quality care services to adequate compensation. The frenetic pace of

progress is driven by the dynamic condition in which they work,it seems destined to continue to

bring more uncertainty to the job they will play in the long term care service in the future.

Whatever the future holds for nursing facilities, one thing seems certain: if they are to keep up

and suitable, they will have to continue to meet the needs of the residents they serve and to find

right to adequately support the services they provide.

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Anti-Argument

Argument/Stand: Options why family value their culture and choose to age in place home care.

Assisted living facilities and the home based technologies

As our world reach in the modern age, new technologies that could be use for medical

advances are being found that will make our lives easier and convenient. This means more and

more ways could be considered in getting the right treatment for our elderly. Because of the

newly found medical advances, people get to live longer and make people decline nursing home

offers and prefer to install the modern devices and technologies at home.

Today there are more like to have more options when it comes in providing care for our

elderly members. As the invention of medical advances aging in place is not a problem anymore

for it is cheaper, useful and more convenient in every family. With this, caring for the elderly

with home based digital technology could be more effective in the families with elderly and with

the increasing support to improve care and convenience in life. In fact they prefer to continue

living in their own place because of their personal possessions, and the familiarity of the

community and surroundings. According to McKnights Long-term news article, the average age

of an assisted living resident has risen to 87 years; it increased the overall senior population.

Reverence of the Filipino to the Elderly

Traditionally, Filipinos are living in a multi-generational household or in a extended

family structure. It is because for them family support is important especially in that particular

age. According to Anderson (2010), “they maintain that independence of the elderly for them to

feel that they are worthy and help them promote their physical and mental well-being.” For the
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Filipinos the idea of looking and caring for the older people is the responsibility of their children

and is rooted as firmly in Filipino culture. For them sending elders it is not still a custom they

choose to practice because of their high respect to the elders. Since then their tradition and

cultures are strong and willing to take care their aging parents and provide the care they needed.

It may be a burden and problem to other people but for the Filipinos it is a respect for their

elders.

Conclusion

In conclusion, Filipino elders living abroad would still prefer to return home and living a

simple and having a good life, which is the only other way that many Filipinos do choose after

retirement. However aging in the Philippines is not always easy, with lack of advance health care

and health practices and also health facilities, returning in the Philippines can also be very

dangerous for sickly senior. Seems that getting old with the care from their own children,is the

best solution for Filipinos who are aging. In traditions and cultures holding among many

Filipinos, they are still very willing to take care of their aging parents and provide a better

healthcare.
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Critique of Argument (PRO)

While nursing homes have become an essential, effective, and reliable care facility for

both families who can no longer afford to take care of their loved ones and patients who are in

need of extensive medical care, there are still some lapses and improvements needed to be done

on nursing homes before patients can easily and quickly adapt and recognize them as their

second home.

Factors that Influence a Patient’s Perspective of Nursing Homes

In a research called ‘The Factors Influencing the Sense of Home in Nursing Homes’

(2016) the study or review was taken from the resident’s perspective and there it was seen that

there are a lot of factors that influence a patient’s perspective of nursing homes. With regards to

your premise that nursing homes can provide a wide range of health and personal services to

residents, these factors, especially when highly influential to a resident’s perspective, can make it

difficult for nursing homes to achieve that goal of providing quality physical and mental living

conditions for residents. And this is only at the beginning, depending on a resident’s willingness

to adapt, cooperate, and keep an open mind, a nursing home’s goal to provide quality service

may take a longer time before being accomplished – and this is not fully certain.

Lack of Long-term Quality Service

In addition to this, it also mentioned that nursing homes are struggling to give quality

care due to the large demand of quality service from residents. In an article, Challenges in

Nursing Home Care (2002), it was seen that many factors contribute to a nursing home’s struggle

with providing service; this can range from high number of residents, lack of training and

experience of staff, to lack of quality and essential equipment. Through this, it can be quite for
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both the staff and residents of nursing homes to expect consistent and long-term quality service.

As demand and supply changes constantly on both ends, immediate solution is needed to certify

that nursing homes can meet the expectations of residents.

Conclusion

While many rely and find convenience on nursing homes, many factors influencing

resident’s experience and perspective and external factors affecting the services provided by

nursing homes can make it difficult for both parties to create an ideal environment. This is why it

can be quite difficult for some to perceive and find assurance that nursing homes as a second or

new home for their loved ones and can are capable of providing the quality services that they are

looking for.
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Critique of Counter-Argument (ANTI)

While it may be true that due to medical advances and new technologies that are arising,

it has become easier for families to stay at home and care for one another. However, technology

cannot easily replace the expertise of an experienced, trained, and well-versed medical

professional in providing the right and adequate care for patients.

Medical Technologies is Capable for Health Conditions

While it has been a tradition for Filipinos to have grandparents get taken care of by their

children at home, when it comes to health conditions and concerns, Filipinos will always resort

to going to a health care professional, even with a health machine present. While health

machines certainly made things easier for some households, they can never truly replace a person

on the field. In an article of health care finance, while some technology – especially AI are

becoming more advance and capable of performing medical tasks, they lack the empathy and

reasoning that nurses can do. Machines can provide perspective but it is the health care workers

that make sense of the information that they provide. According to Sappern (2020), AI is more as

an empowerment tool.

AI and Advance Medical Technology

Other than this, in a survey conducted with health professionals on whether they believe

that AI and advance medical technology is capable of replacing them over the next years,

majority of the respondents answered no. According to Richards (2020), AI is simplifying those

things it requires a little more training. This is because there are still a lot of skills that medical

technology is not capable of such as analyzing patient information for diagnosis and prognoses,

creating treatment plans, and showing empathy.

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Conclusion

While tradition plays a strong role among Filipinos, many will choose over prioritizing

health over practiced traditions. Which is why despite grandparents being taken care of by their

children with the help of the advancement of technology, many still resort to getting consultation

and opinion from a health expert.

Health experts can give the right consultation, empathy, and treatment plans for patients

which it is safer and more accurate compared to self-medication. In addition to this, machines are

programmed to do several tasks but they are not able to construct information from the data they

receive.
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Conclusion

Many depend and discover comfort on nursing homes, numerous components impacting

occupant's understanding and point of view and outside variables influencing the administrations

gave by nursing homes can make it hard for the two gatherings to make a perfect domain. This is

the reason it tends to be very hard for some to see and discover affirmation that nursing homes as

a second or new home for their friends and family and can are equipped for giving the quality

administrations that they are searching for.

While the facts may confirm that because of clinical advances and new innovations that

are emerging, it has gotten simpler for families to remain at home and care for each other, in any

case, innovation can only with significant effort supplant the aptitude of an accomplished,

prepared, and knowledgeable clinical expert in giving the privilege and satisfactory consideration

for patients. While custom assumes a solid job among Filipinos, many will pick over organizing

wellbeing over rehearsed conventions. This is the reason notwithstanding grandparents being

dealt with by their youngsters with the assistance of the headway of innovation, many despite

everything resort to hearing discussion and point of view from a wellbeing master. Wellbeing

specialists can give the correct discussion, compassion, and treatment plans for patients which is

more secure and increasingly exact contrasted with self-prescription. Furthermore, machines are

modified to carry out a few responsibilities however they can't develop data from the information

they get.

Elderly age is considered as the time of retirement, pension and finding ways to enjoy life

till death. Thinking that this stage is the later part of the normal life, it is also the time that the

body cells changes because of the aging process and one-self becomes depressed, disorganized
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and alone. (Elderly Care, n.d.) The care they need becomes more demanding, complex and

complicated especially to time and attention because they are prone to different illnesses and

diseases. There is situation for the elderly are more serious as with the growing age and last

phase of life because they prefer to live in their own house with their lovable family members

and cared by them rather than unknown nurses of a hospital. But as most of our generation today,

are now busy with our career we unintentionally neglect the duties towards our old members

most of the time. Because of this families needed to think of a way in order to help themselves

and their loved ones. Making tough decisions and possibilities is needed to think of, considering

the things that you’re responsible of and the highest standard of care that you wanted your loved

ones to receive. Today, there is now reliable facility where the elderly can be able take care

fulltime and be able to cope up with their old lives. Nursing homes or skilled nursing facilities

are known to serve the people that need care and attention. Mostly they tend to help the elderly

since they are the ones who are mostly prone in illnesses and require the skilled nursing level of

care. They do exist to care those who cannot look for themselves and who has no one to look for

them.

The form of care in nursing home offers skilled nursing care that is given by skilled

practitioners and that includes medical monitoring and treatments. Nursing home provides an on

hand services that is ready to deal with their medical problems and to help with their task that

they are having difficulty with. Trained staff is provided, ensuring that they serve the efficient

and effective care that an elder needs. (Advantages & Disadvantages of Nursing Homes, n.d.)

Here there are trained people who take care of the person’s physical comfort as well as their

medical needs and know immediately when and what medications is needed to be adjusted.

Caring for people is hard work especially when you are at this stage because unlike toddlers,
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most adults cannot be convinced or reasoned with and that makes everything difficult on

everyone’s part.

Nursing facilities will continue to serve and provide care no matter what, even as they

struggle to deal with the uncertainty and number of issues due to providing the right quality of

care to their patients. The proponents wanted to show that despite the disadvantages that people

hear and think against the nursing home they could at least see the bright side of this facility

before formulating any decisions and judgments. Because regardless of what the others think,

there will be time that the safety and well-being of your loved ones that will override. We might

not like it neither he nor she but sometimes you don’t get what you want because the reality

doesn’t match up. It is unsafe for an elderly person to live alone or with their family that cannot

really care for them and a nursing home would probably the best option left. Furthermore, the

proponents sincerely hope that this paper would make the readers think critically on how to

provide care to their elders and knowing that the advantages of the nursing homes would be a

great help on both parties. Nursing homes will carry on providing and serving the ever changing

needs of every elderly and will try to achieve funds to support and improve the services.
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