Nursing Homes

BEAUTIFUL COUNTRY ESTATE IDEAL FOR

REST HOME.

Such ads are a familiar sight on the real-estate pages of U.S. newspapers, and every year more private houses are converted into small nursing homes for oldsters and invalids. There are now about 7,700 such homes in the U.S., caring for nearly 150,000 people. But many of the "beautiful country estates'' are firetraps, inadequately adapted for hospital use. Grim evidence of that fact was furnished last week in Puxico, Mo. There, in a 50-year-old wood-frame house. Mrs. Bertha Reagan, 53, a practical nurse, ran a convalescent home that technically conformed to state laws even though there was neither full-time nurse nor night attendant nor fire alarm. One night last week fire swept through the hallways of the three-story home. Twelve people were killed: Mrs. Reagan, her seven-year-old grandson and ten patients, including one who could not walk.

Last year the Missouri legislature had passed a law providing for fire protection in convalescent homes, only to have it invalidated by an attorney general's ruling. Missouri, however, is not alone in its neglect of convalescent homes. To find out what sort of people are in such homes, what they pay and what kind of care they get, the U.S. Public Health Service collaborated with the Commission on Chronic Illness in a detailed study in 13 representative states. Results: P: More than 80% of Connecticut's homes have registered nurses on their staffs; in several states only 40% to 50% of the homes have R.N.s, while in Wyoming and Oklahoma "the home with a registered nurse is practically nonexistent." P: The inmates desperately need care. Only 10% are under 65, and the median age is 80. About half cannot walk, or can do so only with help; 20% are confined to bed; more than half are mentally confused, and one-third cannot control bladder and bowels. More than a third are suffering from the aftereffects of heart attacks or strokes. Yet in half the states studied, one-sixth of the inmates had not seen a doctor in six months. P: Despite the label "proprietary," these homes are supported largely from public funds paid out of welfare coffers. In Connecticut a private patient pays an average of $230 a month, but public authorities will pay only $160. California ponies up $120 for welfare cases, against a private charge of $210; Georgia gets by with $55 public, against $125 private.

Overall conclusion to be drawn: most U.S. convalescent homes are not medically oriented--or, indeed, safely oriented.

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