A Place to Call Home: Assisted Living Providers Focus on Specialty Care

A woman who had previously lived in a trailer with no running water, no heat, and a bucket for a toilet now has a warm and comfortable home at a Maine assisted living community. An elderly woman, who was deaf and in need of assistance that her daughter could no longer provide, was welcomed into her new home by housemates and staff who communicated in her native sign language. Then there's a man who was seriously injured in a motorcycle accident but previously had no one to help him get dressed in the morning.

These individuals have found their homes in assisted living communities, and all are supported by Medicaid and/or Social Security in some form.

The communities that support these residents and thousands of others like them are scattered across the country, from Oregon to Maine, and their missions are to offer solace, support, and a place to call home. In many cases, these individuals need care and services that do not rise to the level of skilled or long-term nursing but include some type of round-the-clock assistance.
Although the extent to which assisted living providers have opted to take on specialty care is not known, anecdotal evidence suggests that many have recently embraced the concept and carved out niche service offerings for clients with specific diagnoses or for those who simply want to stay in their homes for as long as possible.

To that end, these providers are, in many cases, meeting unmet housing needs for people who might otherwise be homeless or in a nursing facility. And many of their residents have grown to adulthood and beyond and no longer have parents or loved ones to care for, supervise, or support them.

Because these communities are filling the gaps left by housing shortages, they are often full and have long waiting lists to get in.

The individuals who are making their homes in these communities have diagnoses that range from severe mental illness, Parkinson’s disease, HIV-AIDS, acquired brain injury, multiple sclerosis, autism, and those who are deaf and deaf-blind.

In these pages, Provider takes readers into several communities for a look at how they have successfully taken the road less travelled and why they will never turn around.
Mission-focused Assisted Living Staff

Employees of specialty care homes are generally not shy about professing their love for the residents. The staff of Washington Manor, an assisted living community located in the tiny hamlet of Washington, Maine, is no exception. They don’t work there for the money; they do it for the residents—individuals with acute mental illnesses—who most likely could not live on their own in a meaningful way.

 Home to 34 residents between 20 and 90 years old, Washington Manor serves individuals with diagnoses that range from schizophrenia and bipolar disorder to personality disorder and even autism.

Before hiring someone to work at the home, owner and Administrator Janice Nelson-Kroesser preps prospective employees with what she says is her “spiel.”

“We provide services to the poor, and we don’t pay very well,” she says. “So I tell them that if they want to work here, they should do it not for the money but for the desire to help the people who live here.”

Despite the less-than-optimal wages, turnover at Washington Manor is quite stable, Nelson-Kroesser says. “We have people who have been here a long time and are dedicated to the residents. I feel fortunate to have employees who otherwise could be making a lot more money somewhere else.”

Nelson-Kroesser herself has been at the job for more than two decades, first as an employee, then as owner after purchasing the building through her company in 2003.

The community’s focus on providing homes only to adults with mental illnesses is a benefit to the residents and to the community, says Nelson-Kroesser.

Focus On Specialty Care
“Most other assisted living communities that serve mental illnesses have a ‘mixed’ population that also includes elderly individuals,” she says.

“In our case, we are able to focus on behavior modifications and interventions designed for this population. We also have a nurse on staff who specializes in psychotropic medications and conducts our medication reviews, and we have a very good rapport with the psychiatrist.”

In addition to creating an individual service plan for each resident, there is round-the-clock supervision to ensure that residents’ needs are met.

Activities are very important at Washington Manor, says Nelson-Kroesser. “We have a pool table here as well as Wii games, and the residents often have tournaments.”

The activities director also plans outings such as fishing, bowling, and hiking on their nature trail. Annual events include a “haunted trail” on the grounds each Halloween, complete with spooky music and a fog machine, to which the community is invited to enjoy.

Nelson-Kroesser is emphatic in her belief that Washington Manor is a community-based setting. “This is their home,” she says.

“They vote; they have every opportunity that anyone else would have if they lived in the actual community.”

In fact, she says, many, if not all of the residents have a better life at Washington Manor than they would have living on their own.

Nelson-Kroesser notes that the woman who lived in a trailer, in subhuman conditions, now calls Washington Manor her home.

What’s more, she adds, some of our residents are at high risk for entering the penal system without such housing and supervision. “The residents are very proud of their home.”

(Source: www.providermagazine.com)