When Nursing Homes Are Not The Right Option

Nursing Homes Not The Only Option

Paul is an 86 year old man who was in a nursing home and wanted to go home.  His only living relatives were cousins who lived in the South. When Paul was able to be discharged, his cousins were referred to Ivory House by the staff of the nursing home. A geriatric care manager went to the nursing home to meet Paul and complete a needs assessment.  She felt that Ivory House would be able to care for Paul in his own home.  In preparation for discharge, the care manager made arrangements for aides to care for Paul while he was still in the nursing home. This provided a period of adjustment for Paul to begin to know the individual aides who would care for him in his home.

Paul lived in a very large home three story stone home.  Inside were various antiques he had collected through the years.  When the care manager first entered the home she noticed the paintings, some with calligraphy, which hung on all the walls. She thought some well known artist had painted them.  Paul’s cousin told her that Paul had done all the paintings and calligraphy but, due to his poor eyesight, could no longer create such detailed art.

The care manager worked closely with the cousin who was Paul’s power of attorney in getting the home cleaned and ready for Paul. A bedroom was created in the former dining room, a hospital bed was ordered along with all the other supplies that were needed. Since Paul slept during the night, the care manager arranged for a live in aide who could also sleep at night. The care manager and cousin turned the sitting room into a room for the aide.

Paul had many chronic illnesses, which included: chronic obstructive pulmonary disease, poor circulation in the legs, and osteoporosis.  His poor circulation and gait problems made walking impossible, so Paul used a wheelchair.  Prior to discharge from the nursing home, the care manager made arrangements for groceries to be delivered to Paul’s home and established a delivery system for both medications and medical supplies. Collaborating with the nursing home social worker, she arranged for physical and occupational therapy services in the home.  She also contacted a physician and podiatrist who were able to make home visits.   Through her resources at Ivory House, blood work and chest x-rays could were done at the home when needed.

When it was time for Paul to be discharged from the nursing home, he was determined to be incompetent.  His care manager arranged for an elder-law attorney to assist Paul in setting up a Power of Attorney to manage his financial and healthcare decisions.  Once discharged, Paul was very happy to be home. He immediately began listening to the radio and to his record collection. He loved classical music and would talk with his care manager about what was happening in the world.  After several months in his own environment, Paul’s health and mental state improved so much that his physician felt he was competent to manage his own affairs.

The care manager visited Paul weekly to assess his medications, medical supply needs and medical condition.  She reviewed Paul’s plan of care with him and the nursing aide.

Plumbing and heating problems with Paul’s home were handled by the care manager. Due to cost of heating the home, taxes and utilities it was decided that it would be more cost efficient for Paul to move to an apartment.  He agreed with this move and the care manager visited various apartments.  She found a lovely two bedroom apartment for Paul, which overlooked a rose garden. The care manager made all the arrangements for the move which included: deciding with the client what furniture and paintings he wanted to take to the apartment, cleaning the oriental rugs he was taking, arranging for the placement of his furniture and making arrangements for his paintings to be hung in the apartment. She assisted Paul’s power of attorney in the sale of his antiques, the cleaning of his home and getting it ready for the move.

During the years Ivory House cared for Paul he was never hospitalized. After several years, his power of attorney felt it was necessary to move Paul to an assisted living facility. The staff from Ivory House visited Paul often after his move.  They sent him cards and celebrated his 94^th birthday with a cake and gifts.  Approximately six months after his admission to the assisted living facility, Paul died.  Paul had a great life once he came home from the nursing home and he enjoyed being home with his belongings, both in his home and his apartment.