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The other side of the coin
OUTLOOK ON DAY CARE The message conveyed in "Creating an Adult Day Care Center" (Jan .-Feb. 1988) is both inaccurate and misleading. 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 funding for adult day care. The most misleading statement in the article concerns the author's need to visit adult day care centers unannounced, implying that centers are somehow different when visitors arc expected. Centers that have high regard 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 ofcaring for frail, disabled elderly in a notfor-profit, publicly-privately funded, psychosocial health care model that clearly is not babysitting .
THE OTHER SIDE OF THE COIN
I read "Support for Nursing Shortage Reforms Builds" (News Watch, Jan .Feb. 1988) with a mixture of agreement and disappointment. Agreement , in that we do have a nursing shortage problem , especially in the long-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 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 other health care providers. From my 18years ofexperience, 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 longterm 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 ofattiALICE SKIRTZ, ACSW/LISW tude, hospitals and other health care Director. Social Service providers will always have the upper The Salvation Army hand in recruiting, regardless of Cincinnati. Oll wage.
Author Eileen Korhumel, RN, BA, responds: 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 ofthe successful centers I listed are not-for-profit. The thrust of the article is what I personally experienced and observed in myyear-long research 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 operated by The Salvation Army.
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 AIDSPublic Policy Dimensions (Mar.-Apr. 1988), a book I edited for the United Hospital Fund, contains a serious misstatement that requires correction. M.D. Anderson Hospital in Houston, 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 major United States cancer center, affiliatcd with the University of Texas, and is very much still in operation. Ms. McGuirk was undoubtedly thinking of the Institute for Immunological Disorders in Houston, which did close in the summer of 1987, well after the book was published and naturally precluding any mention of the reasons for its demise. While one naturally regrets even one bad review, fortunately there have been overwhelmingly positive responses to the book from other reviewers and from others involved in coping with the problems of the AIDS epidemic. JOHN GRIGGS, Editor AIDSPublic Poli cy Dimensions
Author Kathleen McGuirk, RN, MA, CS, CNA, responds: Indeed. it was the Institute for Immunological Disorders 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 contained in "A Recovery Group For Elderly Alcoholics" (Mar.-Apr. 1988). Alcoholics Anonymous, which does publish many books, booklets, and pamphlets, does not publish "Thought and Meditation for the Day." The author is probably referring to Hazelden's publication (Crater City, MN), "Twenty-Four Hours a Day," which is used by some AA members. A complete list of all AA publications 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 ofContinuing Education in Nursing, New York Hospital, NY, NY. She is now retir ed. Geriatr ic Nur sinc May/June 1988141
THE OTHER SIDE OF THE COIN
I read "Support for Nursing Shortage Reforms Builds" (News Watch, Jan .Feb. 1988) with a mixture of agreement and disappointment. Agreement , in that we do have a nursing shortage problem , especially in the long-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 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 other health care providers. From my 18years ofexperience, 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 longterm 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 ofattiALICE SKIRTZ, ACSW/LISW tude, hospitals and other health care Director. Social Service providers will always have the upper The Salvation Army hand in recruiting, regardless of Cincinnati. Oll wage.
Author Eileen Korhumel, RN, BA, responds: 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 ofthe successful centers I listed are not-for-profit. The thrust of the article is what I personally experienced and observed in myyear-long research 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 operated by The Salvation Army.
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 AIDSPublic Policy Dimensions (Mar.-Apr. 1988), a book I edited for the United Hospital Fund, contains a serious misstatement that requires correction. M.D. Anderson Hospital in Houston, 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 major United States cancer center, affiliatcd with the University of Texas, and is very much still in operation. Ms. McGuirk was undoubtedly thinking of the Institute for Immunological Disorders in Houston, which did close in the summer of 1987, well after the book was published and naturally precluding any mention of the reasons for its demise. While one naturally regrets even one bad review, fortunately there have been overwhelmingly positive responses to the book from other reviewers and from others involved in coping with the problems of the AIDS epidemic. JOHN GRIGGS, Editor AIDSPublic Poli cy Dimensions
Author Kathleen McGuirk, RN, MA, CS, CNA, responds: Indeed. it was the Institute for Immunological Disorders 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 contained in "A Recovery Group For Elderly Alcoholics" (Mar.-Apr. 1988). Alcoholics Anonymous, which does publish many books, booklets, and pamphlets, does not publish "Thought and Meditation for the Day." The author is probably referring to Hazelden's publication (Crater City, MN), "Twenty-Four Hours a Day," which is used by some AA members. A complete list of all AA publications 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 ofContinuing Education in Nursing, New York Hospital, NY, NY. She is now retir ed. Geriatr ic Nur sinc May/June 1988141