A Better Kind of Nursing Home

[elleng]

'Lots of things look different when you step into a small Green House nursing home.

The bright living and dining space, filled with holiday baubles at this season. The adjacent open kitchen, where the staff is making lunch. The private bedrooms and baths. The lack of long stark corridors, medication carts and other reminders of hospital wards.

I was visiting the Green House Homes at Green Hill, a continuing care facility in West Orange, N.J. Dorothy Bagli, who’s 91, showed me her room, looking out onto the garden and filled with artwork from home and photos of her grandchildren. (Her son, it turned out, is a reporter at The Times.)

“I’ve gotten to know most of the people that live here,” she said — an easier task when there are only 10 residents.

“It’s very intimate,” agreed Eleanor Leonardis, who declined to give her age and is recuperating from a nasty fall. “It feels a lot like home.”'>>>

https://www.nytimes.com/2017/12/22/health/green-houses-nursing-homes.html?

[CaliforniaPeggy]

1. Sounds interesting! Thanks for the post, my dear elleng.n/t

[lordsummerisle]

2. Interesting

how there was no mention of the patient costs...

[elleng]

3. There was a slight mention,

'More expensive than most,' I think.

Not particularly 'interesting' that it wasn't a major aspect of the article, imo, but pretty much a given.

[pnwmom]

10. Most of the people in them are on Medicaid, but they cost about the same or somewhat higher

than other standard nursing homes for private pay patients.

My relative entered on full pay and when her money ran out, they accepted the same standard Medicaid payment that other nursing homes take.

[enough]

4. $450 per day, according to comments on the article. NT

[pnwmom]

14. They take the standard Medicaid reimbursement for those who qualify.

And their prices are in line with other area nursing homes. I have a relative living in one who's on Medicaid and it's been a wonderful place for her.

[sheshe2]

5. Yet the GOP is taking that all away.

At least for the poor middle class that have paid into medicaid their entire life.

The place in your article is only for the rich. No others need apply. Nice place...sad the rest of us are not rich enough.

The rest of us will be taking care of our loved ones at home. Those caretakers will be doing that at a huge cost to their own health. Many caretakers die before their loved ones do.

Thirty Percent of Caregivers Die Before The People They Care For Do

Rough statistics show that 30% of caregivers die before those they are caring for. Some studies show deaths higher. Illness that doesn't lead to death is rampant, as well - depression and auto-immune diseases are high on the list. Caregivers often don't find time to go to their own doctor appointments. They put them off, because they are too busy, or are just plain sick of sitting in clinics with their loved ones. Then things like breast cancer, which could be caught at an early stage, aren't found until the illness is much worse or even life threatening.

Caregivers are as important as the people they care for. If they abuse their bodies, minds and spirits while caring for others, no one wins.Support for caregivers means we must tell our stories and know we are heard. I hope we'll hear many stories on this site.

https://www.agingcare.com/Discussions/Thirty-Percent-of-Caregivers-Die-Before-The-People-They-Care-For-Do-97626.htm

I am on my second round Ellen. Second parent with home care and it is killing us, my sister and I. Dad finally ended in a home that medicaid finally paid for. He was indigent and after two strokes we were no longer able to do home care. We tried for over a year. Now it is mom.

Thanks for the article for a posh place for the rich to languish in. Good for them...hope the GOP did not take their nice place away from them as well. The GOP hate old people and that is a fact.

[elleng]

6. As these better places, clearly are not for the POOR middle class, what repugs do not relevant.

Likely not 'rich,' as you suggest, and not 'posh' either. I won't add to class hostility here.

Fortunately we, my family, did not have to struggle, costs for both parents were covered, by medicare, VA, and maybe savings (I don't recall details.) Nothing like 'posh.'

[sheshe2]

7. My dad was treated kindly in his nursing home.

You do realize that to admit a family member needs to have less than 3K before Medicaid covers the costs, correct?

As these better places, clearly are not for the POOR middle class, what repugs do not relevant.


Likely not 'rich,' as you suggest, and not 'posh' either. I won't add to class hostility here.

Well, if I understand your correctly and the article itself...anyone that can afford 450 a day is on the rich end.

Fortunately we, my family, did not have to struggle, costs for both parents were covered, by medicare, VA, and maybe savings (I don't recall details.) Nothing like 'posh.'

You mean Medicaid or Medicare...because Medicare covers shit for nursing homes. 450 a day? That is rich.

We are keeping mom at home, not because of the money right now. We do it because we love her and it is the right thing to do at this time. Yes, the 24-7 is killing us, yet for now it is what we will do.

[pnwmom]

12. The poor middle class can and do go to Green House nursing homes

because they accept the standard Medicaid reimbursement.

However, a person has to run out of their own money first (though allowances are made for a spouse who still needs to live in the home, etc.)

https://en.wikipedia.org/wiki/Green_House_Project

[elleng]

13. Glad to see this (I guess.)

Thanks.

[pnwmom]

15. I have a relative in one, have visited her there, and she's much happier

than when she was in her home with an aide. These places really do exist and they're working. They've even begun to convert some standard nursing homes into this model. I heard about one conventional older home in NY that decided to make each floor into a separate "cottage." The people doing the basic care stayed with their handful of patients on their floor, and the skilled staff (nurses, etc) rotated around the different floors as needed.

Some of the changes just involve training staff to be more respectful and flexible -- and that doesn't cost anything at all. For example, my relative had been in another home where she wasn't allowed to have ice cream -- her very favorite, favorite, food -- because some other patients couldn't have it. At her home now, she has brought her weight back up from a precarious 90 pounds to 120, where it should be -- because they let her eat what she wants, including a snack at bedtime. Her daughter can even bring her favorite ice cream in and they'll keep it in the freezer for her. Other people's relatives can come in and bake cookies or some favorite family dish. Grandchildren and dogs can come to visit (and the kids have had little performances there.) Once children from a nearby school interviewed the residents, and then stood up in front of the group and gave a little speech about the things they had learned about the resident's lives. Things like this make it seem so much more "homey" and contribute so much to the resident's happiness. And don't cost anything.

They don't have to run a nursing home like an institution, and they're finally figuring that out.

[elleng]

16. I'm very pleased to hear about how well they're run.

My only 'caution' was/need to run out of their own money first before medicaid kicks in.

[pnwmom]

17. That caution would apply to anyone in a nursing home, Green House or not.

If an adult child wants an inheritance, they might try to save their parent's money by keeping their parent at home.

But my relative on Medicaid is living as comfortably at the home as she was when she was on private pay -- in the same room, with the same everything -- so she feels no loss in not having a bank account anymore.

My advice to anyone who thinks a relative might need nursing care eventually is NOT to drain all their resources in high levels of assisted living care or on round-the-clock aides; but to enter a nursing home while the elder still has enough assets (for example, a house that can be sold) to qualify for private-pay at a nursing home. The good ones all have waiting lists, so if they wait till they're desperate, they might not have any good choices.

[elleng]

18. Thanks

[pnwmom]

11. Not true. In the typical Green House, about 1/2 to 2/3 are on Medicaid. The full payment

paid by the private pay patients helps support those who aren't (along with standard Medicaid reimbursement.) And if you have been on private pay and your money runs out, you just switch to Medicaid and everything stays the same.

My relative did that in a Green House home. It's been wonderful.

[rwsanders]

8. I've always had the idea that nursing homes and day cares should be co-located. Better for both...

I did see that there was a documentary on a place built on this model, but haven't watched it.

[elleng]

9. Yes, have seen a few of these.

It's a great idea, and shouldn't be rare.