Seminar will look at options to nursing home

As the hospital begins working on a draft plan for a major upgrade in facilities that it will present to the public in the next few months, one of the issues receiving the most attention from citizens involves what will happen to the nursing home.

Ultimately, the hospital board expects to present to the voters at the end of this year or early next year a plan for an $18.7 million upgrade that will greatly expand the hospital, much of which was built 40-50 years ago.

Earlier this year, during a series of focus group meetings, the hospital presented its preliminary ideas on the proposal, most of which met with solid support. But included in the plan was a proposal to either drastically reduce or possibly eliminate the nursing home in favor of using private industry to provide those services.

And that drew the most comment, attention and concern.

On May 5-6 a two-day seminar will be held to further explore the options regarding nursing home care in the community.

The seminar will be put together by an ad hoc group, the Elder-Care Task Force, headed by Cindy Terriberry.

Terriberry is uniquely suited to organize the seminar. The former USAF colonel who commanded the Medical Group on base and ran the hospital there, her clinical experience includes nursing home care, and as an administrator she has been actively involved in policy-level decisions. She'll be making use of a facilitator from the base's active-duty personnel whose expertise is in the area that will be under discussion during the seminar.

The recommendations developed by the seminar will be forwarded to the hospital expansion planning staff and hospital board, which is waiting to make any final decisions until it has had a chance to review the task force's proposals.

"Basically," Terriberry said, "this is an attempt to bring concerned members of the community together to address how we can take care of our elderly seniors in Mountain Home.

"We're going to look at what we have today, and what we need to meet the clearly changing model of how seniors want to age," she said.

Terriberry noted that today seniors want to stay at home and remain active as long as possible. "Most don't want to go to a nursing home" if they can avoid it, she said.

"Basically, what we have right now (at the hospital) is a model that was in place 40-50 years ago for how seniors were taken care of.

"If they couldn't take care of themselves, they went to a nursing home. That was it."

But in recent years, more options have become available in the senior care industry that allows the elderly to remain independent much longer, ranging from home care services to home health to homemaking services (such as shopping and deliver services, "that let's them stay at home."

And as people seek alternatives to nursing home care, the need for the nursing home at the hospital has begun to diminish.

At the same time, Terriberry noted, during the focus group meetings held in January one of the main issues of concern involved the status of the nursing home.

"People understood there is a need for the hospital to grow. It's outgrown its ability to provide services and it needed room from primary health care services."

The hospital planning staff had looked at trends in senior care, talked to insurers, and considered ways to provide home based or community based services that would replace much of what the current nursing home does.

"We need to find services that let people stay at home," Terriberry said, and the evolving trend already is toward that model, she explained.

"Already, here in Mountain Home, we have three or four assisted living facilities, and a decline in the number of people in the nursing home."

So, she said, as a result of consumer-driven demands and insurers, "people are basically voting with their feet" and going to other types of facilities.

Today, she said, more of the elderly who are losing the ability to care for themselves 100 percent, are opting for some form of assisted living facility that helps them retain as much of their independence as possible as long as possible. Many aren't going to the "full care" nursing home until they get into their 90s, which is 10-20 years older than it was 50 years ago when the hospital was built.

Terriberry said the number of patients at the nursing home has been declining for at least ten years, and the trend began 20 years ago.

She said residents at the nursing home, which now number about 30 clients, were asked what their care needs were. One, she said, truly needed 24/7 nursing care. Five or six needed extensive nursing care, but primarily because they were recovering from recent surgery and undergoing rehabilitation therapy until they went home.

The rest, she said, "are what the industry calls long-term custodial care. They do need help, more assistance than in an assisted living facility, but not 24/7 care.

"If we had something, one or two levels down from the nursing home, but up from assisted living, the majority of those people would rather be there."

And that's one of the key areas the task force will be looking at. During the first day of the seminar, leaders in the local community involved in elderly care, ranging from private industry assisted living operators to government officials and senior advocates, will discuss just what the community currently has, and what it needs. During the second day, the 35 members of the task force will work on developing a plan to meet those needs.

There is no question the hospital would like to get out of the nursing home business. The preliminary architectural plans for the proposed expansion project don't include a nursing home.

The current hospital is getting old and will require millions of dollars just to keep in shape over the next few years if no expansion bond is passed.

"They realized," Terriberry said, "that to save the building the nursing home would have to come down. The question is, what do we replace it with," a separate facility run by the hospital district or a layered series of private industry facilities that covers each level of independence/dependance?

At the same time, the plans do envision some kind of facility at the hospital that would be able to provide 24/7 care for those few elderly that need it, but primarily for those recovering from surgery or who need special care while undergoing rehabilitation therapy. That facility would not be primarily a nursing home, however.

Terriberry said the hospital "doesn't believe it should be in the long-term care business as a business, but we need to make sure that care will be provided in the community."

The task force, she said, will hopefully be able to develop a "vision" of the future of elderly care for the community, and hopefully develop a consensus on at least the outlines of a plan for how to get there.

Terriberry is out of town currently, but said that anyone who has additional questions about the task force and the seminar should contact Betty van Ghelawe at 580-9801.