Tuesday, April 08, 2014
To the editor:
Peter Smolenski makes interesting points in his March 18 column about caring for aging parents at home.
In my position as an advocate for residents of nursing homes and rest homes, I often work with staff and families to create a safe discharge plan to go home. It is the optimal place for any of us to be whenever possible.
What was missing in the column was an understanding of the variety of circumstances that lead to someone living long-term in a skilled facility. The columnist made sweeping statements about adult children “condemning” their parents to live in a nursing home.
Over the last 10 years, I have met with thousands of residents/patients. Our health care system is financially biased to long-term care. More than two-thirds of the long-term residents (not rehab) in Hampshire County are on MassHealth. With all of the staff and overhead costs, a typical facility charges up to $9,000 per month. If someone needs skilled care around the clock, the cost would be approximately $12,000 per month to live at home.
Most people could get by with less expensive (PCA) help at home and some skilled care; however, MassHealth pays little for community-based care. Imagine if MassHealth paid even $5,000 a month to keep someone home. The taxpayers would save a bundle and the person could live at home.
Perhaps Smolenski has the means and time to support his mom to live independently. Most people do not.
Some nursing home residents have mental health issues and have no where else to go. Some are not connected to family in any way. Some residents would be homeless if not in long-term care.
Others have family members who live very far away, and they opt to stay in the area rather than to relocate.
This is not as black and white as Smolenski sees it.
Nursing homes are a product of our society. There is no “blame” here. We can work to improve the quality of life and care in facilities, and we can work to improve the healthcare system to allow people to stay home with services.