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mickeyd

Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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At a Tupelo, Miss., retirement facility, nurses don't just walk in: They must ring the doorbell and wait for elders to admit them.

In Milwaukie, Ore., retirement-home residents choose their daily menu, distribute paychecks and have a say in ousting the chef if the food is not to their taste.

Elders at a Bradenton, Fla., continuing-care retirement community form committees to plan their daily activities and discuss current events.

News headlines often detail abusive or neglectful nursing homes, and many other facilities simply push the standard fare of bland meals, a controlled environment and directed activities.

But there are innovators who believe changing the way we treat elders will extend the length of time residents remain active and independent -- and delay the need for costly medical interventions.

Fewer wheelchairs, happier residents

At the Green Houses, in Tupelo, a traditional nursing home was transformed into homes housing 10 people each.

Residents furnish their private bedrooms, decorate common areas, get up when they choose, eat their favorite foods and hold house meetings to decide, for instance, the rules concerning visiting grandchildren -- an issue now that more relatives visit.

"We have more people visiting their loved ones who never would visit them in a nursing home because they felt guilty about it," said Alan Brown, chief operating officer with Mississippi Methodist Senior Services, which operates 10 senior housing facilities in the state, including the Green Houses.

In their new setting for just one year, patients with dementia are acting-out less and have "life in their eyes again," Brown said.

Some residents stopped using wheelchairs: The absence of long nursing-home hallways and tight meal schedules often renders them unnecessary.

And, the eating is better. "In the nursing home, they wouldn't eat food because it wasn't the food they liked. But here, where they picked the food, they can smell it cooking, they sometimes help with the cooking, the elders are gaining weight," Brown said.

Happier = healthier = less costly

"We've done a good job in the current nursing home system in providing good quality of care, but at the end of the day elders suffer from loneliness, helplessness, and boredom," Brown said.

"Your decisions are made for you: When you get up, when you take a bath, what you eat, when you eat, your visitation hours. When you take away choices in life, you take away meaning in life."

More facilities may undertake similar innovations as the ranks of older Americans swell -- the number of Americans 65 and older will double to 70 million in the next 25 years -- and the costs of medical care rise.

"Last year we spent $1.4 trillion (on health care) and 36 percent of that went to a population that constitutes 13 percent of our population, that over age 65," said Dr. Roger Landry, a physician and director of Masterpiece Living, a program being tested at two retirement communities that aims to keep retirees active and engaged.

"From a fiscal-responsibility standpoint, we must do something. The research is telling us we can," he said.

And baby boomers may not be willing to settle for less, said Sandra Timmermann, a gerontologist and director of the MetLife Mature Market Institute.

"As more boomers begin to age and think about what they want in their retirement, we'll see more changes," Timmermann said. "This is just the tip of the iceberg. They're used to having more independence and wanting to direct what they're doing in their life. I don't see this stopping when they reach 65 or 70."
 
What a wonderful development!

My sister spent her last weeks in a wonderfully-run nursing home (The Washington Home, in D.C.), but I've never been in one remotely as nice. And it cost, of course.

But these descriptions even make the Washington Home sound old-school. I hope that more nursing homes and elder care facilities adopt this type of approach. It doesn't seem like it should be necessary for them to be as awful as they tend to be. I'm thrilled to hear that someone is making a substantive change!

Annd
 
My wife has worked in nursing homes ever since we
met. The differences, one to another can be stark.
Sometimes reflective of the cost, but not always.
Some stories I have heard I could barely believe.
My wife's experiences will help a lot when and if my folks
have to go in.

John Galt
 
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