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I grew up watching my mother care for aging adults and their families with deep compassion. As a gerontologist and care manager, she dedicated her life to helping older adults and their families find the right support, no matter how complex the situation.
My mother’s joy came from finding solutions that improved quality of life for seniors and their families. Sometimes that meant building a loving home care team, and sometimes it meant finding quality care at a nursing home that gave both the older adult and their family peace. There was no shame or stigma in needing help, only love in finding the right kind.
Now, years later and in a role where I represent nursing homes, I too often encounter the misconception that home care is about love and nursing home care is not. Nothing could be further from the truth. The reality is that nursing home care is simply the best, most loving option for many seniors and their families, and that New Jersey’s nursing homes provide skilled, loving, compassionate care to tens of thousands of residents every day.
Nursing homes exist because people need them.
New Jersey’s nursing home residents are among the most medically complex individuals in our state. Many require 24/7 skilled nursing, assistance with every aspect of daily life, management of chronic conditions, and constant monitoring for changes in health status. No matter how loving, committed, or determined a family may be, this level of care cannot be delivered in most home environments.
Nursing homes are where these medically complex people are best cared for. Nearly 70% of nursing home residents have moderate to severe cognitive impairment, and 60% are physically frail. Many residents need wound care, medication management, IV therapy, rehabilitation, and close monitoring of conditions like dementia, Parkinson’s disease, or heart failure. Nursing homes are where these people get the best possible care from the most qualified professionals, and where many of these people can find their absolute best quality of life in their most difficult times.
The Reality For Families
Families across New Jersey are living this reality right now. Caregivers are trying to manage medications, lift loved ones in and out of bed and the tub, handle unpredictable dementia-related behaviors, and respond to medical emergencies—often completely alone. Families are also juggling caregiving with careers and children, along with the demands of everyday life. The toll is brutal. Sleepless nights, bodies pushed to the brink, emotional burnout, jobs sacrificed, and lives put on hold. Some are barely hanging on.
Eventually, for many, the only viable option is a skilled nursing facility. That decision is never made lightly - and is ultimately made out of love, concern, and the need to keep loved ones safe. Choosing a nursing home doesn’t mean stepping back from a loved one’s life. In fact, it often allows families to step more fully into the roles only they can fill—those of sons, daughters, spouses, and friends. When professional caregivers handle the medical and day-to-day tasks, families are free to focus on what really matters: love, connection, and emotional support.
Nursing homes also allow caregivers the ability to work when needed, balance the care of other family members, and to take care of themselves.
An Effective System of Long-Term Care Must Include Quality Nursing Homes
Of course, both home care and nursing homes can and should coexist within a broader care continuum. But we must resist narratives that frame institutional care as outdated or unnecessary. That kind of thinking dismisses the needs of the very people our system is meant to support.
Moreover, underfunding nursing homes - whether to divert money to home care or based on the assumption that home care can reduce nursing home demand - does real harm to seniors and caregivers. It results in staffing shortages, fewer available beds, and reduced access to high-quality care, right as New Jersey’s aging population is growing at record speed. In other words, these policies reduce access to quality care for our state’s most vulnerable residents.
We Owe Seniors and Families Quality Nursing Home Options
We owe it to our seniors—and to the families who love them—to build a care system rooted in reality, not wishful thinking. As our population ages rapidly, let’s allow them to do so with dignity, quality, and compassion. It starts with acknowledging a simple truth my mother understood and compassionately shared with her clients and with me: nursing homes are essential in delivering the round-the-clock, complex care many older adults truly need. New Jersey needs to devote the funding necessary to pay nursing homes fair Medicaid rates that support the high level of quality that our seniors and their families deserve.
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