Gerontologist, Author and Activist
“7 Actions You Can Take to Stay Out of a Nursing Home”, at the Bainbridge Library meeting room (on the left when you enter.) Hosted by the VIPs (Visually Impaired Persons). Of course you need not be visually impaired; Wednesday, July 8 at 1 pm. This is for those of you who missed SWERVE. Or for anyone who wants to stay out of a nursing home. Although of course there are excellent nursing homes. And I know which ones they are!
What makes a skilled care institution a place where people want to live and where people want to work? What puts the home back into nursing home?
Almost 25 years ago when I was a grad student I did a single case study of the Mt. St Vincent, a long-time Seattle skilled care community in the midst of transformation. The “Mount” was among the first to identify and implement culture change; indeed they were literally one of the first pioneers.
Current administrator Charlene Boyd was working there at the time and many staff are also still there—an impressive achievement in an industry where the turn-over tends toward 50% a year rather than the average of 10% at the Mount.
The administrator in the early 1990s was Robert Ogden, who was generous with his time explaining the process to a student (me) who knew little about long-term care. He described his epiphany when one day he dragged his feet to work, pondering why they spent millions of dollars on an institution where few people wanted to work and even fewer wanted to live.
We will always need nursing homes, now more than ever. But they have changed in many ways. What was usually a long-term living situation can now be short-stay rehabilitation post-hospital after you get your amazing new hip (I love mine!).
What was once impersonal, institutional, rigid, regimented, and really not a lovely place to live or to visit can now be person-centered, homey, flexible, thoughtful and delightful—especially if it’s like the Mt. St. Vincent, a model of ‘culture change’.
More about this very soon!
Are all nursing homes bad? Of course not.
Are there exemplary nursing homes? Absolutely!
The question is then, why would so many people with major disabilities and illness prefer almost anything else to a nursing home, perhaps even a hastened death?
Obviously there is no one answer to this. I again use the Person-in-Environment fit model. The highest quality of life is promoted by the right person in the right place. I once interviewed an older man living in a mediocre nursing home who liked it quite a bit. For one thing, he was not particularly disabled and therefore was a bit of a nurse’s pet. He was president of the resident association. He had a private room. He found the regimentation reassuring, probably because he had spent his career in the military. Plus, as retired military, he could not afford expensive home care or an upscale Continuing Care Retirement Community (CCRC)
Our long-term care system is cruelly dominated by the funding, primarily Medicare and Medicaid. Many nurses complain they are taking care of data, not people.
Next I will explore with you what can promote a higher quality of life in what we call nursing homes, licensed as skilled care.
Savvy Women Exchanging Relevant Views (SWERVE) is superb.
Thank you all for an engaged, experienced, and lively audience. More signed books are available at the Waterfront Community Center, University Bookstore, and Eagle Harbor Books.
Remember, I’m honored to speak to your book group and happy to provide at least one free book. Plus there are 2 at the Bainbridge library. I’m also happy to donate one to any public library that wants my book “To Move or To Stay Put.”
The next SWERVE speaker is the beloved Shakespearean Tom Challinor. If you’ve never heard him, you’d be doing yourself a great service to come on Tuesday July 14 at 10:30.
Here’s a recap of what was covered in my talk June 9:
7 ways to minimize the possibility of spending the last year of your life in a nursing home:
http://www.vtvnetwork.org to better understand the Village Concept. National Conference will be here is Seattle Oct. 5 through 7.
I was out of town when this appeared on tv, but here it is–nice and short.
I would be delighted to see you at my talk at the Seattle University Unitarian Church on Monday, June 15 at 11 am. Talks r us!
Check out kcts9.org/programs/in-close/life-culture/it.takes-village#
I thought they did a good job
Jeannette from Sicily (with iffy WiFi)
Money isn’t a dirty word
Money isn’t a dirty word, although in my family it was considered impolite to bring it up, mention how much something cost, or say how much daddy or mommy earned (and the huge discrepancy between those two earnings).
I came of age in the 60s and valued love, peace, music, and anti-war politics much more than money. The Raccoons, my college cohort, were known to proclaim, “@#%* money; I hate money!”
I was both a Peace Corps volunteer and a VISTA volunteer and lived on $200 a month for years at a time. Yes, I am bragging.
When I started working at my first social service job, at Community Services for the Blind, I began to realize the importance of money. The majority of clients were older women who had lost vision due to age-related causes. If you are a woman, visually impaired, old, poor, and perhaps without a partner, you are in dire straights indeed. Those keeping the wolf from the door owned their own home. I started saving immediately.
Rich people don’t die in nursing homes. If you have money, you can purchase home care and other home-delivered services. You can afford to remodel and have a place to live made comfortable for aging in place because of Universal Design.
Having money makes it easier to get good nutrition, health care, and have access to a good gym, trainer, and exercise classes. Money makes transportation options such as taxis, available.
How much will you need? First of all calculate your income and expenditures. Know exactly how much you earn and how much you spend and what you will have in retirement http://www.kiplinger.com/tool/retirement/T047-S001-retirement-savings-calculator-how-much-money-do-i/
Also calculate how long you will live. My favorite is geriatrician Thomas Perls’ site https://www.livingto100.com Then do the math. You will probably discover that you will live longer and need more money than you ever thought possible.
Since you are thinking about ‘7 Ways to Ways to Avoid Spending the Last Year of your Life in a Nursing Home’ we might guess that you are thinking of downsizing. A great way to start doing that is frequently buy nothing. I don’t think I’ll live long enough to wear out all my t-shirts. When I see a great shirt and covet it, I think of my crowded shirt drawer. If I get a new one I will need to get rid of an old one. And those that I already have all ‘spark joy’, the criteria of the minimalist guru Marie Kondo.
At least once a week have a ‘buy nothing’ day. If I avoid the supermarket, I find myself making better use of what’s already in the fridge and pantry. Wasting food is a dreadful sin, especially after all the hungry Africans, Chinese, and East Indians I’ve seen in my travels.
Budget thoughtfully, and I would suggest that a thoughtful budget also includes gifts to charitable organizations. No matter how poor you may be, there is great meaning and satisfaction in helping others.
Since this talk is sponsored by the NW Universal Design Council, you could rightly guess that one factor that can contribute significantly to aging in place (i.e. staying out of a nursing home) is Universal Design. Universal Design is often defined as products and environments that are usable by all people to the greatest extent without the need for adaptation.
A good example is a single lever faucet, the opposite of two separate faucets for hot and cold. Now there are even touchless faucets for homes, like you’d find in an airport restroom. But the most typical examples are a lever that can be worked for both temperature and flow with an elbow or closed fist.
7 ways to minimize the possibility of spending the last year of your life in a nursing home
Jeannette Franks, PhD