Good Medical Care for the Elderly and How to Get It

Choosing a good nursing home for your loved one

Charles Duhigg reports in the New York Times Health section on September 23, 2007 that private investors have purchased groups of nursing homes, reduced staff (often below minimum requirements), and cut other expenses. As a result, profits for the owners have increased, but quality of care is down, mobility and health of nursing home residents is compromised, and complaints to regulatory agencies are higher.

Families of patients who have died as a result of alleged negligence in such nursing homes increasingly find that complex corporate structures are like mazes and act to insulate the real owners of the facilities from any negligence that might be proven.

Read More Profit and Less Nursing at Many Homes

For help in choosing a safe nursing home for your loved one, see the resources in Appendix A of Good Medical Care for the Elderly and How to Get It. This and other appendices are online and yours to use without charge.

New report criticizes government oversight of nursing homes

The New York Times revealed on April 21, 2007 that the Government Accountability Office (GAO) will release a report this week about the failure of federal health officials charged with oversight of nursing home regulations to impose penalties upon nursing homes repeatedly cited for “poor quality of care.” The net result is that nursing homes that should have been closed remain open and residents of those nursing homes continue to be abused.

The report notes that federal investigators found that a Michigan nursing home (unidentified) was still open even though it had repeatedly been cited for “poor quality care,” poor nutrition services, medication errors and employing people who had been convicted of abusing patients.

The US has about 16,400 nursing homes in which about 1.5 million people live on any given day. Annually, more than 3 million people receive nursing-home care. Medicaid and Medicare pay for more than two-thirds of this care. The cost is significant. In 2005, the most recent year for which figures are available, $122 billion was spent on nursing home care. 60% of that was paid for by Medicaid and Medicare.

I’ll be watching for this report and will post a link to it when it is released.

Read the NY Times article Oversight of Nursing Homes is Criticized

Technorati tags: caregiving, caregiver, family caregiver, nursing homes, nursing home, GAO, Government Accountability Office,

Remote monitoring for Boomers

As we continue to look at ways that baby boomer may safely age in place — comfortable in their own homes, benefiting from the continuity of care provided by spouses or other family caregivers and from their regular primary care physician — another new idea comes to the forefront to assist them.

On Friday the Boston Globe described a new kind of home healthcare service called “remote monitoring.” Companies providing these kind of services schedule personal visits from a nurse and a pharmacist at the outset. Then the companies install a small computer monitor that is hooked up to their phone line. This monitor serves as a hub for a network of devices. Weight and blood pressure may be monitored daily by the system. The numbers are then transmitted to the company’s office where nurses scan the results and call the senior citizen or schedule a visit if there appears to be a problem. The idea is to provide boomers with a safety net — a means of daily tracking of vital signs.

You can read more about this type of care on the Boston Globe website. Access a personal medical record that you can use to monitor your own care in Appendix H of Taking Charge: Good Medical Care for the Elderly and How to Get It. You can print this form and keep update it regularly.

Beacon Hill Village: Another Model for Senior Communal Living

I've been interested in recent articles about alternatives to institutionalized living for the elderly who live alone and don't have adult children to look in on them and/or to take them to doctor's appointments, grocery shopping, etc. Recently, the New York Times published an article by Jane Gross about an experiment in Boston. There, elderly residents became members of Beacon Hill Village, a unique non-profit organization created by and for neighborhood residents in the Back Bay and Beacon hill neighborhoods. This organization's goal is to keep seniors out of nursing homes and allow them to grow old in their own homes.

Here’s an example of the types of services the elderly members of Beacon Hill Village can expect to have—services that allow them to stay in walk-up apartments and homes—services that are only a phone call away:

Intentional Communities

Leave it to the Baby Boomers to come up with some pretty unusual alternatives to nursing homes and assisted living! I first heard the phrase "intentional community" last winter while spending a month in Hawaii with friends.

Later, upon returning home, I was fascinated by an article in the New York Times about an intentional community in California. Opting for old age on their own terms, the "charter members" of Glacier Circle were starting a new chapter in their lives as the country's first self-planned housing development for the elderly — a community they had conceived and designed themselves, right down to its purple gutters.

Over the past five years, the residents of Glacier Circle have found and bought land together, hired an architect together, ironed out insurance together, lobbied for a zoning change together and existentially probed togetherness together.

This community reminds me of the old saying "You can choose your friends, but you're stuck with your relatives." And that's sort of how Peggy Northrup-Dawson describes the Galcier Circle:

"Here you get to pick your family instead of being born into it," said Peggy Northup-Dawson, 79, a retired family therapist and mother of six who is legally blind. "We recognized that when you're physically closer to each other, you pay more attention, look in on each other. The idea was to share care."

A Model for Senior Living - Staying Out of a Nursing Home

I've been interested in recent articles about alternatives to institutionalized living for the elderly who live alone and don't have adult children to look in on them and/or to take them to doctor's appointments, grocery shopping, etc. Recently, the New York Times published an article by Jane Gross about an experiment in Boston. There, elderly residents became members of Beacon Hill Village, a unique non-profit organization created by and for neighborhood residents in the Back Bay and Beacon hill neighborhoods. This organization's goal is to keep seniors out of nursing homes and allow them to grow old in their own homes.

Jane Gross writes:

"ALONE in his row house on Beacon Hill, with four precipitous flights of stairs and icy cobblestones outside the front door, John Sears, 75, still managed to look after himself after he was hit by a taxicab and left with a broken knee.

That is because Mr. Sears was one phone call away from everything he needed to remain in his home, the goal of more than 80 percent of the nation's elderly as they confront advancing age, according to consistent polls.

Mr. Sears required both practical assistance and peace of mind: Transportation to and from the hospital. An advocate with him at medical appointments. Home-delivered meals from favorite restaurants. Someone at his side as he hobbled to the bank and the barber. Someone else to install grab bars in his bathroom. A way to summon help in an emergency. People to look in on him.

All these services were organized for Mr. Sears by Beacon Hill Village, an innovative nonprofit organization created by and for local residents determined to grow old in familiar surroundings, and to make that possible for others. Community-based models for aging in place designed by the people who use them are the wave of the future, experts say, an alternative to nursing homes and assisted living centers run by large service providers. "

Aging at Home: For a Lucky Few, a Wish Come True