Nursing home checklist. How does our county run facility stack up?

A recent Article in US News and World Report lists four steps that will help you make sure you find the best possible facility to meet your needs and the needs of your loved ones. Included in that article is this checklist to bring on your tour of the facility.

How would the Albany County Nursing Home stack up?

Do you know what is in the fine print?

From this article:

A bill has been reintroduced in the United States Senate and House which would prevent nursing homes from forcing residents to sign an agreement to waive their right to file a lawsuit in court if they suffer bedsores, dehydration or another injury caused by nursing home negligence.

The legislation would invalidate mandatory arbitration provisions which are found in the fine print of many nursing home admission agreements, requiring that any dispute between the facility and a resident be resolved through a private arbitration process which is insulated from the public view.

The reason why? Because according to this article, arbitration usually favors the facility over the victim.

Urge your representatives, Paul Tonko and Kirsten Gillibrand, to vote for the Fairness in Nursing Home Arbitration Act of 2009. It is bipartisan bill that was introduced in the U.S. Senate on March 4, 2009 by Senator Herb Kohl (D-WI) and Senator Mel Martinez (R-FL). The bill was introduced last week in the U.S. House by Rep. Linda Sanchez (D-CA).

Albany County Executive Michael Breslin delivers the state of the county today.

From the Times Union article:

In addition to economic conditions, Breslin will renew his commitment to long-term care services and alternatives for residents who prefer to remain at home rather than go into nursing homes or assisted living facilities, Witkowski said.

In this economy, baby boomers who may need this care are seeing their 401Ks shrink. With an aging and crumbling County run nursing home available to those who can’t afford private pay facilities, will we continue to ship the ones who cannot be cared for at home out of the state away from their family and friends?

Albany County can buy a rail trail in Bethlehem, build a shiny new judicial center, support a convention center, and spend millions fixing and repairing county office buildings but we are not one step closer to securing a place for our seriously ill residents who cannot be cared for at home.

We will be listening to your speech Mr. Breslin. Let’s hope the Albany County Legislature will address this soon.

Building a new nursing home means new jobs!

Here is an interesting story out of Madison, WI. A new nursing home in Verona means 200 new construction jobs for that area. While Albany and its suburbs seem not to be hit as hard as many communities due to the fact that state and local government seem to be the main employer for the area, construction is an area that is seeing a decline.

The other question our community should be asking is why is this nursing home costing only 22 million and is incorporating  the latest in “green” technology when the estimates the Family Council has been given for a new Albany County home are tens of millions of dollars more?

If the Eddy can do it for less in this area, why can’t Albany County?

Here is the story in its entirety.

New nursing home means 200 jobs

Posted: March 5, 2009 07:08 PM

VERONA (WKOW) — A new nursing home project in Verona will mean 200 construction jobs for the area.

Dane County Executive Kathleen Falk was at the Badger Prairie Health Care Center this afternoon. She announced the county will be accepting bids for the project starting on March 16. The project will cost $22 million.

“While it was already very important for us to be building a new facility, given that this will bring up to 200 good paying jobs for the next year and a half, the timing of this, I think, is very helpful for the entire community,” Falk said.

Falk said the current facility in Verona is outdated, specifically in terms of energy efficiency. The new building will incorporate cutting edge green technology.

She said “We’re doing something that isn’t very normal and that is using geothermal technology to help fuel both cool and warm this new facility and we are very excited about that.”

Falk explained that senior citizens are the fasted growing segment in southern Wisconsin’s population. Even though there are other new facilities in the area, the one in Verona will fill a specific need.

“We take here patients that no one else will take. They are high need, special need, high risk, particularly challenging patients. If there were other nursing homes that were able to take these we would not be needing these kinds of facilities, but there is no one else,” she explained.

The facility should be open by the end of 2010. It will be staffed by current Badger Prairie Health Care Center workers and will not require any additional hires.

How to choose a nursing home.

Here is a great video that stresses one factor in choosing a nursing home for your loved ones.

Are the residents there happy?

The 2030 problem: Is the Capital Region Ready?

This spot was featured on News Channel 13 last year.

WNYT Newschannel 13, February 26, 2008

The 2030 problem: Is the Capital Region ready?

By Lydia Kulbida

The year 2030 is when the last of the baby boomers is expected to retire, doubling the number of older Americans to more than 70 million. The Centers for Disease Control says the aging of the U.S. population is one of the major public health challenges we face this century. The question now – is the Capital Region ready?

Capital Region seniors are living longer and better.

Locally, Colonie has the largest population of people over 60. That age group will explode by 2030.”Colonie, which is our primary concern, is expected to grow a whopping 48%,” says Ed Neary of the Colonie Senior Service Center.The organization’s mission is to help seniors stay in their homes as long as possible and it has nearly 400 independent living apartments for when they need a little help, but, he says, eventually many seniors need more help than a family or home care can provide.

“At some point in time skilled care is necessary and we need to be sure we have that plan in place. Even today we need it. We have shortages today,”adds Neary. When the Berger Commission’s report came out in late 2006, protests focused on hospital cuts, but Capital Region nursing homes also took a hit.

The Albany County Nursing Home merger with the Ann Lee Home came with an order to downsize by at least 345 beds.In Schenectady County, the merger of Dutch Manor and The Avenue and downsizing at Glendale meant a loss of 200 beds.

If Capital Region seniors can’t afford a private home, where will they go?

“I talk to family members who are nurses. The hospitals have waiting lists, they’re sending our residents out of state. Why? They belong here,” says June Maniscalco.Maniscalco cared for her mother at home for seven years. Her mother had Alzheimer’s and Maniscalco knows, even with help, it’s not an easy alternative.

“I had reached a point where I couldn’t stand my mother and I love my mother dearly, but I couldn’tdo it. I was burnt out,” says Maniscalco.

Her mother has since passed.

Now her mother-in-law has Alzheimer’s, but was able to get a bed at the County home before admissions were suspended. As for her own future, this boomer voices the fears many have, but no one wants to talk about. “The average person in our generation, as I say,no, I don’t want to go to a nursing home, what are my odds?,” says Maniscalco.

The harsh reality of more elderly boomers is more people with age-related diseases like Alzheimer’s and Parkinson’s, diseases with long term decline that need long term care.  With boomer’s smaller families and higher divorce rates, the family safety net is shrinking and the number of elder orphans, those with limited resources who have outlived family and friends, could reach 2.5 million nationally by 2030.

Courtney Burke says providing long term care is one of our biggest challenges.The Director of the Rockefeller Institute’s New York State Health Policy Research Center says the nursing homes of the future will look very different.

The trend for elder care will take it’s cue from the movement for people with disabilities,smaller group homes instead of large institutions. “Transforming a system takes a long time, so we really need to start now, if we’re thinking about the year 2030, we need to start thinking about what we can do tomorrow,” says Burke.

There are no quick and easy answers to where we will care for the elderly or who will care for them with projected shortages in home health care aides and nurses and doctors who specialize in elder care.

Courtney Burke says the State needs to invest in the workforce and future facilities but a revenue shortfall and competing political interests make that difficult.

Putting the “home” in Nursing Homes…

What a novel idea! Let’s make our seniors feel as home!

Featured in the Business Lexington in Lexington, KY.

Putting the ‘home’ in nursing homes
Central Kentucky retirement village wants to be first in state to build “deinstitutionalized” nursing homes

by Dan Dickson

March 05, 2009

Lexington, KY – When Jude Rabe flies around the country for her consulting business, she often sits next to a passenger who asks her what she does. When she reveals she’s in the nursing home business, her seatmate immediately goes silent. It’s a subject they clearly don’t want to discuss. But if she tells them she’s a nursing home reformer, “the other person is immediately intrigued and wants to talk about the issue,” said Rabe.

What has propelled Rabe, a former nurse and gerontologist, on this life mission is a concept called small homes. It is a nationwide attempt to deinstitutionalize nursing homes by moving residents from traditional, hospital-like facilities to specially designed, cozy homes where 10 seniors live together with staff. Wesley Village Senior Living Community in Wilmore wants to build the first such homes in Kentucky.

The small home is designed to feel like a real home. That means a private room and bath for each resident. “People have their privacy restored,” said Rabe. There’s a home configuration with a front hall, living room, den, hearth, and most importantly, an open kitchen and dining area featuring a large dining table for residents and staff to eat together and interact. Residents are encouraged to help prepare meals or do light chores, if they choose. Seniors also have much more freedom in the house than in a traditional nursing home and can visit the kitchen any time for a snack or a drink. There is easy access to a fenced patio. “When people hear about this model, they give a sigh of relief,” said Rabe. “The American Association of Retired Persons (AARP) has studies on how people feel about nursing homes, and more than 90 percent say they would rather die than go to one. It’s not a hard sell.”

Administrators at Wesley Village feel up to the challenge. “We hope to build six homes that would handle 60 residents, ten in each home,” said Glenda Creech, president and CEO of the Village, a retirement community affiliated with the United Methodist Church. “Right now, projected cost is about $2 million for six homes.” At about $330,000 per home, Rabe believes the small homes would be no more expensive to run than nursing homes and that Medicaid reimbursement per patient would be the same.

Creech said the small homes at Wesley Village would be for people with memory impairment all the way up to those in the final stages of life with Alzheimer’s. “What they’re finding is that people are coming alive in these small homes, even though they may have been bedridden or were only bed-to-chair,” said Creech. “Some are starting to walk and talk again. They’re interacting. I don’t know if you’d call it a miracle, but from what I’ve seen and the research, these people are stimulated rather than stuck in a bedroom isolated from life.”

Creech said her goal is for everyone who receives healthcare on campus to eventually move to a small home. The staff to elder ratio in a small home is about one to five, half that of a nursing home. Plus, there is less staff turnover. Employees seem to enjoy the work more and feel empowered, said Rabe.

There are only two groups in America that continue to be institutionalized for the remainder of their lives, Rabe said — “That’s murderers and frail elders. Everyone else has a home in a community. No one wants to end their life in an institution,” she explained.

Rabe is helping guide Wesley Village through the tangle of bureaucracy in order to launch this ambitious project in Kentucky. There are clearly obstacles. Nursing homes are the third most regulated industry in the United States, according to Rabe — first are nuclear power plants, and second are coal mines.

Rabe said small homes retain the licensure and certification of nursing homes. Critics say it would be cost prohibitive to build small homes that meet safety regulations, but Rabe is lobbying for revisions in the regulations, which would decrease the cost. Funding models for small homes have already been created, and with small homes now up and running in places like Ohio and Mississippi, there is solid performance data available to judge results.

Although the Wesley Village campus is relatively new, just 13 years old, 30 to 40 percent of nursing homes around the country are over 35 years old and badly in need of major renovations or replacement. Now may be the time for some operators to consider a whole new approach to senior care. Wesley Village is ready to take the plunge.

“Realistically, a lot of it depends on what happens economically and with fundraising,” said Creech. “Our goal is to go public with our fundraising campaign in the fall and we hope to break ground by the end of 2010 and have occupancy by 2011.”

If the goal is reached, Wesley Village will have fulfilled its dream to turn the sterile environment of a nursing home into a warm and dignified home.

County to buy locally for jail, nursing home

This is an older story, but it concerns the nursing home.

County to buy locally for jail, nursing home
Albany County Legislature approves measure to get food from area farmers

By CAROL DeMARE, Staff writer

First published: Tuesday, February 10, 2009

ALBANY — County lawmakers, in what was described as a first of its kind policy in the region, approved a measure Monday night to buy locally-grown food for the jail and nursing home.

Latham Democrat Tim Nichols, the lead sponsor, said if the “county dedicates just 10 percent of its food purchases” for the two facilities, “local farmers would share some $270,000 in county dollars annually.”

Not only does the proposal support local farmers but ensures that much of the food consumed at the jail or by nursing home residents would be fresh produce and meats, Nichols said.

“It behooves all of us to make sure people in our care receive fresh produce and other goods to help them stay healthy,” he said. He estimates it costs $3 million annually to feed inmates and nursing home residents.

The plan also has a “green” benefit because food from local farmers — Nichols suggested from as far as 100 miles away — doesn’t have to travel long distances, thus, less fossil fuel is coming into the county.

“It takes a great deal of energy to move food thousands of miles around the planet and across the country,” the legislator said. “This policy means that Albany County is doing its part to reduce harmful emissions that hurt us and contribute to global warming.”

Albany County may be the first in the state to enact such a policy, Nichols said, and it should be in place in time for this summer’s growing season. Several Democrats co-sponsored the measure.

One of them, Gary Domalewicz of Albany took issue with another resolution — one that gives a contract to Rudnick’s in Schenectady for the purchase of uniforms, accessories and equipment for Sheriff’s Department members, both deputies and jail correction officers.

In addition to Rudnick’s bid, the county also received a bid from Rosen’s Uniforms on Central Avenue, which has supplied local police agencies for decades. A breakdown shows that in one section of the bid, mostly for uniforms, coats, hats, insignias, Rudnick’s came in at $83,559 and Rosen’s at $84,060. In another section, involving accessories such as shoes, holsters, gun belt, Rudnick’s came in at $16,240 and Rosen’s at $19,140.

“Rosen’s came in at $3,000 more than the vendor in Schenectady County because Rosen’s is paying $3,000 more in property and school taxes in the city of Albany,” Domalewicz said.

Douglas Bullock, an Albany Democrat, said he considers Rudnick’s a local store.

“Anything in the Capital District is considered local,” he said. His concern dealt with where the clothing was made. The county should buy only goods made in America, he said, “and not produced in sweat shop conditions. The resolution passed unanimously.

Carol DeMare can be reached at 454-5431 or by e-mail at cdemare@timesunion.com.

Mass. elder abuse on rise (article from the Boston Globe)

The Boston Globe
Mass. elder abuse on rise (link to article)
Economy adds to family stresses; Budget cuts limit options for care

By Kay Lazar, Globe Staff | February 9, 2009

More of the state’s elderly are being abused or neglected, as economic stresses push family caregivers to the breaking point and the social service programs that once helped them are cut back.

Confirmed cases of financial, physical, emotional, or sexual mistreatment of elders more than doubled in each of the first four months of this fiscal year, compared with monthly averages the previous year, according to a Globe analysis of state figures.

“Many of the issues we are dealing with are simply related to overload,” said Dale Mitchell, executive director of Ethos, a Boston nonprofit agency that handles the city’s protective services program under a state contract.

Mounting job losses, shrinking investments, and unrelenting foreclosures have caused a new level of stress for families taking care of elders, say Mitchell and other officials on the front line of elder care.

At the same time, programs designed to help ease the burden – such as home care services and a training and stress management program for family caregivers – are being cut, they say. That fuels a rise in abuse allegations.

The reports cover a range of mistreatment by family members, who make up a significant portion of caregivers. In one case, a son demanded money from his 84-year-old father and when the elder refused, he shoved him, causing a serious head injury, according to the neighbor who alerted authorities.

In another, a daughter failed to keep tabs on her 82-year-old confused mother who was found wandering at 3 a.m. in Dedham.

Mitchell said his office received 134 reports of alleged elder abuse and neglect in January, the highest for any month in the agency’s 32 years of running the program. Because of the caseload, workers are more frequently “triaging” cases, investigating only the most serious ones, Mitchell said.

Mitchell’s program is one of 22 in Massachusetts that, under a contract with the state, investigate reports of mistreatment of elders and refers parties to community programs that can help resolve the problem. In past years, about 30 percent of allegations were confirmed. That number soared to more than 60 percent in the first quarter of this fiscal year, state figures show.

Like Mitchell, directors of protective services programs in Worcester and Bristol counties said they have been increasingly forced to triage because of the rapidly rising number of abuse and neglect calls.

At Elder Services of the Merrimack Valley, investigators are seeing a spike in financial exploitation cases, where, typically, a family member has drained a senior’s life savings.

These cases often require detailed forensic accounting, taking longer to resolve than other forms of abuse and hampering staff members’ ability to handle additional cases, said executive director Rosanne DiStefano.

“What I fear,” DiStefano said, “is that as the economy gets worse, we are going to see more of these cases.” Deborah Fogarty, director of the state’s protective services program, said her office is closely monitoring the issue.

In several areas, directors of protective services agencies say one of the most critical cuts has been in state-subsidized homecare services, which sends an aide to an elder’s residence a couple of hours a week to help with bathing, dressing, grocery shopping, and other chores – providing a much-needed breather for family caregivers.

Nearly $4 million was cut from the homecare program in October. The waiting list is now 675 people.

“We can do a great job in doing an investigation, identify the underlying cause of abuse, and put together a great plan, and that plan can fall apart or not be as strong as it should be if we don’t have those services,” said Gregory Giuliano, who directed the state’s protective services program from 1997 through 2007. Giuliano, who now runs Montachusett Home Care Corporation in northern Worcester County, said the number of abuse and neglect reports coming in to his agency recently hit a 34-year high.

Among those who know, first hand, the stress of caring for a parent is Janice Williams. Her mother Eleanor, a once-independent octogenarian, emerged from a hospitalization for pneumonia last spring frail, confused, unable to feed herself, and forgetful.

Williams, who lives in Roslindale, hunted for affordable help through state-subsidized agencies for her mother, who lives in Milton. She finally found South Shore Elder Services, and then waited six weeks, she said, for someone to determine whether her mother’s pension made them ineligible.

Eventually, Williams hired a part-time personal care aide, but the stress of caring for her on nights and weekends was intense.

Williams joined a support group in December and realized she needed to ask for more help from other family members.

“To be able to talk about it is an enormous help because the stress is not going to go away and you have to learn to deal with it the best way you can,” Williams said. When her mother’s responses are frustrating, Williams says, “I work hard at biting my tongue. It’s not going to change anything and it may make her feel bad.”

Not all family members are so caring. Abusive behavior by family caregivers toward elders with dementia is common, according to a new study by British researchers.

Half of the 220 family caregivers surveyed acknowledged “lashing out and other similar acts,” toward the elder, said Claudia Cooper, a psychiatrist at University College of London and lead author of the study. The vast majority of the admitted abuse, she said, was verbal.

More baby boomers are opting to care for their frail parents at home instead of placing them in a nursing facility because it is less expensive and is often preferred by the elder.

But with that comes an increase in families seeking help from community-based programs, said Leslie Ahern, who runs support groups for family caregivers at Ethos in Boston.

Ahern notes that dementia among the elderly is increasingly common, making care even more challenging. She works to defuse potentially volatile situations by teaching caregivers how to manage seemingly “stubborn” behavior.

Said Cooper, author of the London study: “Anybody who needs lots of personal care and support is inherently more vulnerable to abuse.”

Kay Lazar can be reached at klazar@globe.com.
© Copyright 2009 The New York Times Company

Why so much progress on the Nursing Home in Schenectady?

This article was printed in today’s Gazette.

There seems to be a desire by the Schenectady County Legislature to move forward. What is happening in Albany County?

Daily Gazette article
Tuesday, March 3, 2009

http://www.dailygazette.com/

Facility ordered to be downsized
By Michael Lamendola
Grant to help reduce home’s beds

SCHENECTADY COUNTY — The state will provide Schenectady County with $3 million to help defray costs to downsize Glendale Home to 200 beds by the end of the year.

The $3 million is separate from the county’s plans to build a new 200-bed facility by 2011.

County leaders said the state Department of Health approved the $3 million grant last month. The money will help the county comply with mandates of the Commission on Health Care Facilities in the 21st Century, also known as the Berger Commission.

Schenectady County Legislator Brian Gordon, D-Niskayuna, said the grant will offset costs the county would have had to absorb itself in meeting the mandate. The county-owned nursing home has 210 certified beds, down from its one-time high of 528 beds.

“As Glendale downsizes, we will lose more money initially until fixed costs come back into line with the census population,” Gordon said.

County Manager Kathleen Rooney, in a memo to county legislators, said the county still has to pay costs associated with staffing and maintaining skilled nursing units at Glendale until residents of that unit are relocated. But now the grant will cover these transitional expenses.

Gordon called the $3 million grant “a bridge until we can achieve equilibrium. This will help defray the county’s expenditures for Glendale and as a result will help defray taxpayers’ expenses.”

County Attorney Chris Gardner said $1.4 million of the grant will be used to cover retiree health insurance and $1.4 million for nurse staffing.

To downsize Glendale, the county is closing beds as they become vacant, Gordon said. “We are not transferring patients to other facilities to downsize. We are just closing vacant beds,” he said.

The county is also reducing staff at Glendale through attrition to match its census, Gordon said. The number of employees at the facility is now about 230.

The county received approval from the state in December to build a $51 million, 200-bed nursing home to replace Glendale, considered obsolete. The county must begin construction by Nov. 1 to keep state approval.

The county hopes to obtain additional state and federal funding to defray construction costs for the new facility.