Changes in the industry

FREDERICK — For many people, the words “nursing home” bring to mind images of cold tile hallways, greenish room lighting, unattended seniors in distress and a sterile environment that speaks more of an outdated hospital than a home.
Some parts of the industry may have earned that reputation, but Cheryl Wright, marketing director for Homewood at Crumland Farms in Frederick, said today’s nursing homes are a far cry from the disturbing visions of yesteryear.

“There’s still a lot of education (in the community) that needs to happen,” Wright said. “The reality is, things have changed for the better.”

Homewood, one of Frederick County’s 13 nursing homes, is in the new generation of long-term care centers —-multi-staged retirement communities. In such establishments, people 55 and older can live independently in a house or apartment, and as their needs increase, move into an assisted living unit and ultimately into an advanced care unit.

As the Baby Boomers sell their homes in favor of the retirement communities, and begin to enroll their parents in nursing home care, industry experts say the expectation of service is increasing.

Today’s nursing home population has higher demands when it comes to space, privacy and patients’ rights, said Dana Cable, chairman of the Hospice of Frederick County and professor of psychology and thanatology at Hood College.

“The patients are asking, and pros are saying, that we need to do something different,” he said.

Nursing homes are responding with a more individualized approach for residents (not termed patients in today’s nursing home culture) and shifting from a focus on end-of-life care to enriching the residents’ quality of life.

The change is reflected in many ways, beginning with space. Modern nursing homes are moving toward semi-private and all-private rooms, he said, whereas 25 years ago it was common to see three people to a room.

Today’s nursing homes are geared toward making the resident “feel at home” in everything from the decor (less hospital, more cozy hotel) to providing a range of activities (jazzercise to computer classes) to catering to the residents’ desires.

“If a resident wants to leave a unit or watch a TV at 3 in the morning, you find a way for that to happen,” Wright said.

But not just the demands of service have changed —-the population itself is different than it was years ago, Cable said. The people who 25 years ago would have sought nursing home care now opt for assisted living, or part-time care in a nursing home environment.

Wright said the average age of a nursing home resident is in the 90s, whereas 10 to 20 years ago the average resident was in his mid-80s.

People are much older —-and more frail —-than previous nursing home populations, Cable said.

“That means that in nursing homes, we need more professional staff than we used to,” he said.

Eric Nichols is the executive director of Homewood at Crumland Farms in Frederick. He said insurance woes are forcing hospitals to discharge patients in weaker conditions than in years past, prompting nursing homes to step up their level of care to perform more rehabilitative work, as opposed to maintaining a level of health.

The end result is today’s nursing homes must be staffed by more highly trained employees to care for a much more frail population, Cable said. Caring for that population includes increased funding for activities and programs to enrich their lives.

With the help of a grant from Frederick resident Edgar C. Virts Jr., Homewood created a “Snoezelen room” to further the care of its most critical population —-residents with Alzheimer’s disease and related disorders. The room is a Dutch idea, Wright said, and uses tools to stimulate senses. The creamy white Snoezelen room has a massage chair, lava lamps, a bubbling fountain, light therapy and tactile objects that people seemingly “out of touch” can connect with.

“This is a great place for families, because it’s very hard to interact with Alzheimer’s patients,” Wright said.

Nena Tierney, a client services manager with the Frederick County Department of Aging, said the industry recognizes it has its fair share of problems, but is working to address them.

On average, Maryland nursing homes were cited for 12 health violations by state inspectors in the latest survey, according to the Nursing Home Compare report by the Centers for Medicare & Medicaid Services.

“Yes, there are horror stories, but there are good stories, too,” said Tierney, who is liaison to six Frederick County nursing homes. “Every place is going to have problems, but the people who are in the field are there for a reason.”

Tierney said she is encouraged by nursing home administrators’ enthusiasm for improving the level of care —-both medical and emotional — they can offer.

“Every facility I work with is open to learning and growing, which is huge,” she said.