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OUTLOOK ON DAY CARE The message conveyed in "Creating an Adult Day Care Center" (Jan.-Feb. 1988) is both inaccurate and mislead- ing. The inaccuracies include the idea that a for-profit operation is somehow superior to a not-for-profit operation and that the social model of adult day care is "babysitting." It is misleading to state that public money for respite care will cause adult day care centers to emerge and then disappear. Public money for respite care is for respite care. The real issue is public policy, which will provide fund- ing for adult day care. The most misleading statement in the article concerns the author's need to visit adult day care centers unan- nounced, implying that centers are somehow different when visitors arc expected. Centers that have high re- gard for the confidentiality of clients usually do not permit unannounced visitors-it is curious that the author was admitted without prior planning. The Salvation Army provides adult day care in four centers in Ohio and Kentucky within 200 miles of Ms. Korhumel's center. It is unfortunate that she did not visit our centers , which havea history of 11 years ofcar - ing for frail, disabled elderly in a not- for-profit, publicly-privately funded, psychosocial health care model that clearly is not babysitting . ALICE SKIRTZ, ACSW/LISW Director. Social Service The Salvation Army Cincinnati. Oll Author Eileen Korhumel, RN, BA, re- sponds: The comments are welcome, but I hasten to say that it was not my intent to imply that for-profit centers are superior to not-for-profit centers. Indeed. most of the successful centers I listed are not-for-profit. The thrust of the article is what I personally experi- enced and observed in myyear-long re- search and what my own reasons are for operating afor-profit center. While I visited 6 centers in the 200 - mile Cincinnati area. I regret these didn 't include the excellent ones oper- ated by The Salvation Army. THE OTHER SIDE OF THE COIN I read "Support for Nursing Shortage Reforms Builds" (News Watch, Jan .- Feb. 1988) with a mixture of agree- ment and disappointment. Agree- ment, in that we do have a nursing shortage problem , especially in the long-term-care setting. Iam disappointed that Barbara Cur- tis, a member of the ANA board of di- rectors, believes the solution is to fed- erally mandate increased nurse staff- ing and wages. That solution assumes that there are sufficient nurses to hire, while in the same breath declaring a nursing shortage. She also assumes that long-term-care operators have the financial wherewithal to offer salaries and benefits that are competitive with hospitals and otherhealth care provid- ers. From my 18years of experience , I believe this assumption is incorrect. Private pay clients oflong-tcrrn-care providers have long been subsidizing the public pay clients. Until public funding matches the outcry for more competitive wage packages in long- term care, we will continue to be at a competitive financial disadvantage when it comes to recruiting. In addition, competitive pay is not the total answer. The public in general must come to realize and accept that working in a long-term-care facility is a "class" act. Without that kind ofatti- tude, hospitals and other health care providers will always have the upper hand in recruiting, regardless of wage. LEE J. GARBER, Administrator South Hills Health Care Cent er Eugene. OR REVIEWING THE REVIEW Normally, I think it a waste of time to respond to negative reviews of one's work; however, Kathleen McGuirk's review of AIDS Public Policy Dimen- sions (Mar.-Apr. 1988), a book I edited for the United Hospital Fund, contains a serious misstatement that requires correction. M.D. Anderson Hospital in Hous- ton, which Ms. McGuirk reports "closed in the summer of 1987 for a variety of reasons-none of which were mentioned in this book," is a ma- jor United States cancer center, affil- iatcd with the University ofTexas, and is very much still in operation. Ms. McGuirk was undoubtedly thinking of the Institute forImmunological Disor- ders in Houston, which did close in the summer of 1987, well after the book was published and naturally preclud- ing any mention of the reasons for its demise. While one naturally regrets even one bad review, fortunately there have been overwhelmingly positive re- sponses to the book from other review- ers and from others involved in coping with the problems of the AIDS epi- demic. JOHN GRIGGS, Editor AIDSPublic Poli cy Dimensions Author Kathleen McGuirk, RN, MA, CS, CNA, responds: Indeed. it was the Institutefor ImmunologicalDisorders to which I was referring. since the book was dealing with the immunological deficiency syndrome. LET'S MAKE NOTE I would like to clarify one notion con- tained in "A Recovery Group For El- derly Alcoholics" (Mar.-Apr. 1988). Alcoholics Anonymous, which does publish many books, booklets, and pamphlets, does not publish "Thought and Meditation for the Day." The au- thor is probably referring to Hazel- den's publication (Crater City, MN), "Twenty-Four Hours a Day," which is used by some AA members. A complete list of all AA publica- tions is available by writing AAWS, 468 Park Ave. South, New York, NY 10016. RUTH JAGODZINSKI, RN, CSAC Las Vegas. NV CORRECTION: Book reviewer Nina J. Argondizzo, RN, MA, was incorrectly identified as director. School ofCont inu- ing Education in Nursing, New York Hospital, NY, NY. She is now retired. Geriatric Nursinc May/June 1988141
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Transcript of Reviewing the review
OUTLOOK ON DAY CAREThe message conveyed in "CreatinganAdult Day Care Center" (Jan .-Feb.1988) is both inaccurate and misleading. The inaccuracies include the ideathat a for-profit operation is somehowsuperior to a not-for-profit operationand that the social model ofadult daycare is "babysitting."
It is misleading to state that publicmoney for respite care will cause adultday care centers to emerge and thendisappear. Public money for respitecare is for respite care. The real issue ispublic policy, which willprovide funding for adult day care.
The most misleading statement inthe article concerns the author's needto visit adult day care centers unannounced, implying that centers aresomehow different when visitors arcexpected. Centers that have high regard for the confidentiality of clientsusually do not permit unannouncedvisitors-it is curious that the authorwas admitted without prior planning.
The Salvation Army provides adultday care in four centers in Ohio andKentucky within 200 miles of Ms.Korhumel's center. It is unfortunatethat she did not visit our centers ,which havea history of 11 years ofcaring for frail, disabled elderly in a notfor-profit, publicly-privately funded,psychosocial health care model thatclearly is not babysitting .
ALICE SKIRTZ, ACSW/LISWDirector. Social Service
The Salvation ArmyCincinnati. Oll
Author Eileen Korhumel, RN, BA, responds: The comments are welcome,but I hasten to say that it was not myintent to imply that for-profit centersare superior to not-for-profit centers.Indeed. most ofthe successful centers Ilisted are not-for-profit. The thrust ofthe article is what I personally experienced and observed in myyear-long research and what my own reasons arefor operating afor-profit center.
While I visited6 centers in the 200mile Cincinnati area. I regret thesedidn 't include the excellent ones operated by The Salvation Army.
THE OTHER SIDEOF THE COINI read "Support for Nursing ShortageReforms Builds" (News Watch, Jan .Feb. 1988) with a mixture of agreement and disappointment. Agreement , in that we do have a nursingshortage problem , especially in thelong-term-care setting.
I am disappointed that Barbara Curtis, a member of the ANA board of directors, believes the solution is to federally mandate increased nurse staffing and wages. That solution assumesthat there are sufficient nurses to hire,while in the same breath declaring anursing shortage. She also assumesthat long-term-care operators have thefinancial wherewithal to offer salariesand benefits that are competitive withhospitals and other health care providers. From my 18years ofexperience, Ibelieve this assumption is incorrect .
Private pay clients oflong-tcrrn-careproviders have long been subsidizingthe public pay clients. Until publicfunding matches the outcry for morecompetitive wage packages in longterm care, we will continue to be at acompetitive financial disadvantagewhen it comes to recruiting.
In addition, competitive pay is notthe total answer. The public in generalmust come to realize and accept thatworking in a long-term-care facility isa"class" act. Without that kind ofattitude, hospitals and other health careproviders will always have the upperhand in recruiting, regardless ofwage.
LEE J. GARBER, AdministratorSouth Hills Health Care Cent er
Eugene. OR
REVIEWING THE REVIEWNormally, I think it a waste of time torespond to negative reviews of one'swork; however, Kathleen McGuirk'sreview ofAIDSPublic Policy Dimensions (Mar.-Apr. 1988), a book Iedited for the United Hospital Fund,contains a serious misstatement thatrequires correction.
M.D. Anderson Hospital in Houston, which Ms. McGuirk reports
"closed in the summer of 1987 for avariety of reasons-none of whichwere mentioned in this book," is a major United States cancer center, affiliatcd with the University ofTexas, andis very much still in operation. Ms.McGuirk was undoubtedly thinking ofthe Institute for Immunological Disorders in Houston, which did close in thesummer of 1987, well after the bookwas published and naturally precluding any mention of the reasons for itsdemise.
While one naturally regrets evenone bad review, fortunately there havebeen overwhelmingly positive responses to the book from other reviewers and from others involved in copingwith the problems of the AIDS epidemic.
JOHN GRIGGS, EditorAIDSPublic Poli cy Dimensions
Author Kathleen McGuirk, RN, MA,CS, CNA, responds: Indeed. it was theInstitute for Immunological Disordersto which I was referring. since the bookwas dealing with the immunologicaldeficiency syndrome.
LET'S MAKE NOTEI would like to clarify one notion contained in "A Recovery Group For Elderly Alcoholics" (Mar.-Apr. 1988).Alcoholics Anonymous, which doespublish many books, booklets, andpamphlets, does not publish "Thoughtand Meditation for the Day." The author is probably referring to Hazelden's publication (Crater City, MN),"Twenty-Four Hours a Day," which isused by some AA members.
A complete list of all AA publications is available by writing AAWS,468 Park Ave. South, New York, NY10016.
RUTH JAGODZINSKI, RN, CSACLas Vegas. NV
CORRECTION: Book reviewer Nina J.Argondizzo, RN, MA, was incorrectlyidentified as director. School ofContinuing Education in Nursing, New YorkHospital, NY, NY. She is now retired.
Geriatr ic Nursinc May/June 1988141
