Will You Go to a Nursing Home?

images-1In a recent AARP study, nearly 75% of adults 45 and older said they strongly desire to stay in their current home as long as possible if they have a chronic illness or need long term care. Many baby boomers state that they would never cross the threshold of a traditional nursing home. But what happens if a spouse is not able to take care of you or you can no longer get around your home?

Many assisted living residences have replaced nursing homes to provide care to those who are chronically ill or have lost their mental capacity. But Increasing numbers of baby boomers will seek out new alternatives for independent living where care can be provided.

Intentional communities for philosophical, religious, and lifestyle groups are emerging. Wikipedia describes an intentional community as “a planned residential community designed from the start to have a high degree of social cohesion and teamwork. The members of an intentional community typically hold a common social, political, religious, or spiritual vision and often follow an alternative lifestyle. They typically share responsibilities and resources.”

Alex Mawhinney (jamlll@charter.net) , a developer of retirement communities for over 25 years, reports that “intentional elder neighborhoods are becoming the new paradigm for elder living.” He states that boomers will no longer be interested in “the older generation of elder living options that were available to our parents that follows this model:

  • Age in place — in a home not designed for aging in place, and eventually aging alone
  • Move in with children or other relatives
  • Move to an institution — and pay dearly for care delivered by strangers, under their rules and according to their schedules. The institution might be a nursing home, an assisted living facility, a rest home, a retirement hotel, or a continuing care retirement community with multiple levels of care.

There are SOTELs (service-oriented technically enhanced living—like an upscale Embassy Suites); ecovillages; senior cohousing; and the new lifestyle communities like those being developed by Canyon Ranch.These elder neighborhoods are taking many different forms.

The common traits of these new alternatives are that they are:

  • Human scaled (not large and impersonal)
  • Relationship-based
  • resident managed/centered, with an overlay of lifelong learning, later-life spirituality
  • giving back to the community

Dr. Bill Thomas, came up with an alternative that he describes as “Green Houses”  in the 1990s,  based on “a really radical idea: Let’s abolish the nursing home.”

Thomas, a geriatrician from upstate New York, had patients then who lived in nursing homes, and he realized “that the medicines I was prescribing were not treating the true source of suffering, which was loneliness.”

He also realized that traditional nursing homes were going to have to be replaced soon anyway. “Most of them were built in the 1960s and ’70s, and, you know, their time is done. So I got to asking the question: What comes next?”

What came next were the first Green House homes, which opened in Tupelo, Miss., in 2004. Now, with 148 Green House homes nationwide, there’s enough research to get an idea of how they’re working.

And they’re doing pretty well.

Each resident has their own private room. There are no strict schedules at Green House homes, so while many of the residents gather at the table for lunch, they can have their meals sent to their room. David Farrell, director of the Green House Project nationwide, explains that those private rooms aren’t a luxury — they’re safer than a traditional nursing home, where two or even three people might share a room and also share a bathroom with the two or three people in the room next door.

Research also shows that Green House residents maintain their independence longer than residents of traditional nursing homes, where hallways are long and schedules are tight. “So people really are kind of relegated to a wheelchair in order to efficiently move them around,” Farrell says, “and they quickly lose their ability to walk.”

This program of private rooms and personal service sounds like it could be much more expensive than the traditional nursing home, but Green House home costs have shown to be about the median for nursing homes nationally.

There are now about 150 more Green House homes in development, where residents will be able to enjoy the privacy of their own rooms or the company of the communal table. It’ll be their choice.

Caring for your elderly parents, are you doing it?

Dad and StephIt’s a fairly universal assumption that at some point we’re going to have to think about how to look after our parents when they get to an age when they’re less independent than they want to be. When that time comes, we have to consider the options against the time we have available to give them and the cost implications of an increase in service or utilities. Here are some of the ways we can make sure we’re all doing the best we can for our family and other elderly people we know.

Time

Giving your time to your elderly family is priceless when trying to make sure they get the best life possible. In the not-so-distant past, and in many other cultures, it’s expected that elderly men and women would live with their children or younger relatives when they are no longer capable of living independently. This is fantastic for keeping a family together, but it’s simply impossible for some young families to dedicate that much time if they are both working and have lots of commitments- consider that, when this was popular in the past, it was generally accepted that women would stay at home while men worked- alternatives must be used, even if they don’t necessarily want to use them.

Money

If the financial responsibility may fall on the younger members of the family and if that’s the case then private carers and expensive retirement homes may not be feasible. If this is an issue for you then check what kind of organizations are offering the retirement homes to give you a clue on what price and quality of services they will provide. Some charitable trusts offer residential ‘communities’ that focus on building an active and friendly environment for the elderly, and have the charitable status to back them up. These offer fairly reasonable prices and ensure that time and attention will be given where it’s needed, which is great if the problem is a lack of ability to spend time with the older family.

What sorts of things are available in retirement communities?

As these retirement villages are focused on activities and building communities, there is generally a lot to do in them. More conventional things like book clubs are obvious, but there are also more contemporary activities such as tai chi, and if people aren’t quite up to speed with IT skills like email and Microsoft Office programs, there are plenty of classes to help there too.

Make sure they’re happy about where they’re going

Everyone is aware of the negative connotations surrounding some of the more dingy retirement homes, so your elderly family will obviously be included in that. Retirement villages, especially when run by charities dispel those worries, by having an already bustling community that people can see and reference to, meaning that if you really can’t afford the time or money to have your family at home with you, they are by far the best options available.

Moving Mom to Assisted Living

Four weeks ago my mom contracted a stomach virus and was sent to the hospital to recover. While she was there the Doctors discovered that she also had a urinary tract infection. After a week in the hospital she was sent to a nursing home for rehab. When I visited her there I noticed that her memory had deteriorated dramatically. She thought I was my Dad (who died 10 years ago) After three weeks in rehab. she had gained enough strength to return to her independent Living Retirement home. But we were told that she would need round the clock aides for a few weeks.

A week has gone by now and it looks clearer that she will need extensive care for some time. Using aides from a service firm is costing her $400 a day. Her memory has improved somewhat but she is still confused and gets up several times during the night to see if the door is locked and to go to the bathroom. We cannot continue to pay for private aides because it will end up costing $12,000 a month.

Unfortunately we live 3 hours away from Mom’s home. We have decided we have to find a facility closer to us, possibly an assisted living facility that helps those who are memory impaired. The most difficult step now is to convince her to make that move. She has a number of friends in her community. But the real question is will she miss those people? Will another move cause her fragile memory to deteriorate even more? Do we need to tell her what to do or get her approval.?

We are meeting with her doctor on Friday. Out of that meeting we may convince her that the doctor recommends that she move close to us. I am very anxious about telling her she’s got to move. I don’t know how she will respond and what the result will be. I know one thing. The current situation cannot go on for very long or her assets will disappear and she will have no choices.