A Policy Analysis of WISH Act Implementation and Nursing Integration Strategies.
The Well-Being Insurance for Seniors to be at Home (WISH) Act proposes universal social insurance for long-term care through activities of daily living (ADL) assistance. While this legislation addresses basic personal care needs, it overlooks the clinical complexity of aging adults who require both...
| Published in: | Policy, Politics & Nursing Practice Vol. 27; no. 2; pp. 134 - 143 |
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| Main Authors: | , |
| Format: | research tables/charts Journal Article |
| Published: |
Sage Publications Inc.
May2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192633387&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192633387 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15271544 FMO jtl: Policy, Politics & Nursing Practice issn: 15271544 maglogo: Y pubinfo: dt: May2026 vid: 27 iid: 2 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 192633387 189449196 192633387 192633387 10.1177/15271544251396105 192633387 ppf: 134 ppct: 9 formats: tig: atl: A Policy Analysis of WISH Act Implementation and Nursing Integration Strategies. aug: au: Kyei, Evans F. Mumba, Mercy affil: Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL, USA sug: subj: Policy Making Health Policy Legislation and Jurisprudence Activities of Daily Living Economic and Social Security Legislation and Jurisprudence Insurance, Long Term Care Legislation and Jurisprudence Long Term Care United States Human Qualitative Studies Chronic Disease Accidental Falls Functional Status Pressure Ulcer Adverse Drug Event Readmission United States Descriptive Statistics Health Services Accessibility Legislation and Jurisprudence Health Services Needs and Demand Health Care Delivery Workforce Implementation Science ab: The Well-Being Insurance for Seniors to be at Home (WISH) Act proposes universal social insurance for long-term care through activities of daily living (ADL) assistance. While this legislation addresses basic personal care needs, it overlooks the clinical complexity of aging adults who require both ADL support and ongoing health monitoring. This policy analysis examines how strategic nursing integration can enhance WISH Act effectiveness by addressing the gap between ADL-focused services and the complex care needs of beneficiaries with multiple chronic conditions. Using Russell and Fawcett's Conceptual Model for Nursing and Health Policy, this qualitative analysis evaluated policy sources, components, and four outcome levels. The study analyzed legislative text, congressional reports, and peer-reviewed literature on long-term care policy, nursing coordination, and international social insurance models. Analysis reveals that 85% of WISH-eligible beneficiaries will have multiple chronic conditions requiring clinical oversight beyond basic ADL assistance. Personal care workers encounter medication management challenges in 78% of cases, while falls, declining functional abilities, pressure ulcers, and adverse medication events frequently result in unplanned hospitalizations when clinical changes go unrecognized during routine personal care. Strategic nursing integration targeting the 35% highest complexity cases could reduce emergency department visits by 32% and hospital readmissions by 25% while achieving cost neutrality through prevention-focused interventions. Strategic nursing involvement in complex case identification, care transitions, chronic disease monitoring, and family caregiver support could bridge the clinical complexity gap while complementing existing Medicare services. This targeted approach maintains the WISH Act's core ADL focus while ensuring comprehensive community-based care for aging populations with complex health needs. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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