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Ginni Ryan
  - Joined on 12-14-2007
- Posts 3
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Super Article about Residential Care Homes!!
Residential care homes provide more intimate setting for frail seniors
Nov 27, 2007 - Knight Ridder Tribune Business News
Author(s): Bob Moos
Nov. 27--When Lynn Piccola's elderly parents couldn't care for themselves anymore, she began searching for a better place for them to live. She quickly passed over large assisted-living centers in favor of a more intimate place that resembled her parents' own house. "No matter how many chandeliers and silk flowers the big communities had, they still looked like institutions to me," she said. Then Ms. Piccola heard about a residential care home in North Dallas where 10 seniors live much like a family. "When I walked in the front door, I felt like we had come home," she said. At Lexington Place, residents share stories about grandkids, opinions of Cowboys games and, on many evenings, a bowl of popcorn and a DVD. Two nurse aides help the seniors bathe, dress and take their medications. The caregivers also serve meals, lead household members in exercises and have been known to host a spirited karaoke contest or two. Like the Piccolas, a growing number of people looking at senior living communities are deciding that bigger isn't necessarily better and are choosing smaller homes such as Lexington Place. "They're a good alternative for families who have vowed never to put Mom or Dad in a nursing home," Dallas geriatric care manager Carol Franzen said. "They ease the adult children's pangs of guilt." Because residential care homes vary in quality, consumer advocates urge families to consult senior care professionals and visit a number of homes. But the research and legwork can pay off. Ms. Franzen said she often recommends such homes for frail seniors who require constant care but don't want to trade the comforts of a home for the sterile surroundings of a nursing facility. The Dallas area now has about 150 residential care homes, usually serving eight to 10 seniors each, said Lynn Heinle, who owns CARE, a housing referral service for older adults. That's up from about 100 such homes two or three years ago, he said. Though many homes are mom-and-pop businesses, a growing proportion are owned and operated by gerontologists or registered nurses motivated as much by a sense of mission as by profit, he said. "We'll see more residential care homes as time goes on because no one wants to die in a nursing home," said Cathy Wasserman, the assisted-living ombudsman for the Senior Source in Dallas. Blending in From the street, Lexington Place looks like any of the other stylish homes in its upscale North Dallas neighborhood, except for the three cars and a van parked in the cul-de-sac. The home originally had three bedrooms. When registered nurses Michael and Cristina Tobias bought it, they enlarged the common room, installed the state-required safety systems and added seven bedrooms. "As much as our residents appreciate each other's company, they also occasionally want their privacy," said Carrie Reid, Lexington Place's director of operations. "All of our seniors have their own room." Fern Piccola, Lynn's mother, enjoys showing visitors how she has decorated her room with furnishings she brought from her own house and with dozens of family photos. The affable 93-year-old has earned the reputation as unofficial head of Lexington Place's welcoming committee, introducing newcomers to the household's other members. "I teach them the ropes and make them feel at ease," she said. "After all, it's now their home, too." Like many other residential care homes, Lexington Place can accommodate seniors with almost any chronic condition, Ms. Reid said. Before a resident moves in, staff members assess the person's medical needs and draw up a care plan that may include calling in home health care aides several times a week. Lexington Place operates six homes throughout North Dallas and works to place new residents where they will have the most in common with the household's other members, Ms. Reid said. At each home, there is one certified nurse aide for every five residents. The company also has two registered nurses who travel among the six properties. The staffing ratios at the higher-quality residential care homes are often better than at larger senior living communities, where there may be one caregiver for every 10 residents, Ms. Franzen said. The hands-on care pays dividends, senior care professionals say. "I've seen people who had languished in larger facilities thrive when they move into smaller homes," Mr. Heinle said. "They eat better, require fewer medications and become more sociable." Sometimes, the residents' improvement springs not only from the personalized care, but also from the camaraderie among the household members, he said. Residents at Family's Choice laughingly liken themselves to the cast of The Golden Girls, a 1980s TV sitcom about four ladies of a certain age who share a house in Miami Beach. The ladies at the North Dallas home play a mean game of dominoes, occasionally try out their favorite recipes in the kitchen and, when they're feeling especially spunky, write a letter to The Dallas Morning News' editorial page. 'Next best thing' "We spend our days comparing the notes of our lives," said Wanda Barnett, a retired teacher and principal who's 94. "I enjoyed living in my own home for 92 years, but this is the next best thing." Joy Mmbifwa, a registered nurse, opened Family's Choice after becoming frustrated with her job as a hospital manager and seeking something more emotionally rewarding. She took out a mortgage to buy the first home four years ago, renovated it to accommodate older adults with disabilities and got a state license to operate it. She now owns three homes. "I'm in business to help people keep their dignity till the day they die," Ms. Mmbifwa said. The typical senior at a residential care home is a woman in her late 70s or early 80s who lives there for the rest of her life. "Families ask when their parents must leave and move into a nursing home," said Sharon Oran Shalet, Lexington Place's marketing director. "When we tell them, 'Never,' you can see the weight fall off their shoulders." Still, senior-care professionals say residential care homes aren't for everyone. Ms. Franzen said the main shortcoming she has found, particularly at the smallest homes, is that they often can't offer the broad range of organized activities that larger facilities do. "That may be a consideration for more agile seniors, but it may not matter to others who don't want all the bells and whistles," she said. The costs of residential care homes vary widely, as can the quality of their services. Monthly charges run from $1,100 to $5,200, said Kathy Schoeneberg, director of the Texas Organization of Residential Care Homes. Most homes, especially those on the upper end of the price range, accept only seniors who pay out of pocket, although some homes will take residents on Medicaid. Some seniors who pay privately use their long-term care insurance or veterans' benefits to defray their expenses, Ms. Franzen said. Families looking at homes on the lower end of the price range need to be careful, since those homes are more likely to cut corners to keep their expenses down, industry officials and consumer advocates say. "The first thing families should do is ask whether a home has a state license," Ms. Schoeneberg said. "The second thing is to ask for the latest state inspection report." Reports typically are posted near a home's entrance, and they're also available on the state Web site at http://facility quality.dhs.state.tx.us, she said. Lynn Piccola, Fern's daughter, said she checked out Lexington Place after a physical therapist recommended it. A visit to the house and several conversations with the staff confirmed her gut instinct that it was the right decision. "It's never easy to move a parent out of her home," she said. "But now when I go see my mother and leave, I don't worry. I can say goodbye because I know she'll be fine." QUESTIONS TO ASK Before committing to a long-term care facility, ask: --May I see the state's most recent inspection report? --How many complaints have been filed against this facility in the last year, and for what? --What's the ratio of nurse aides to residents for the day, evening and night shifts? --How much staff turnover do you have? --What training do you give your staff? --How do you care for residents who become incontinent? How often do you check them and clean them? --Do you provide transportation to doctor appointments and community activities? SOURCE: Dallas Morning News research
Ginni Ryan
Market Development Coach
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