The Bucket List and Improving Care for Seniors
I have not seen the movie "The Bucket List", but have seen the commercials and it looks worthy of a trip to the mall! I do not have a bucket list. However, as a licensed nursing home administrator, I have a professional bucket list.Tops on that list is to eliminate needless regulation that gets in the way of providing end of life care and services to residents in nursing homes. Here is my story.
We recently (within last 6 months) helped two men move to our nursing home unit, the Gregory Wing. Both were residing in a residential care setting. Both had a terminal condition and had become very ill.
In the State of Maine, anyone accessing long term care nursing home services is required to go through the State Assessment agency. This agency sends an RN out to do an on site assessment to certify that services are necessary. Both men easily qualified for nursing home services and moved to the Gregory Wing.
The Gregory Wing care team helps them improve remarkably, both physically and psychosocially over their first 90-days at the facility. Believe it or not, here is where the problem resides.
The State of Maine requires a follow up 90-day assessment to insure people continue to qualify for nursing home services. Upon reassessment, both men are deemed to not qualify!
As advocates, we appeal this decision. However, the rules of the hearing only allow a review of the exact information used by the RN assessor at the time of the assessment. We lose again!
The only possibility for each resident to continue to reside on the Gregory Wing is to have a clinical decline, generating a significant change MDS (federal level of care tool) leading to another request for a new assessment. What a great way to treat human beings with a terminal health condition!
Imagine being a nursing home resident on hospice care, just having moved to a new environment, feeling and looking better, dealing with the psychosocial aspects of death and dying, making new friends, and having to worry about another move to a new environment because the nursing home staff did too good a job in taking care of you!
We are working with our state associations and local legislators to work on providing an alternative to seniors in situations like this. Wish us luck and stay tuned in!
By the way, one of our dear friends passed away recently just before his appeal. Our other dear friend and his family desire to continue residing on the Gregory Wing and we are going to make that happen!