Nursing Homes Are Getting Better (But They're Not Perfect Yet)

Maryalene LaPonsie

For many, the image of nursing homes is one of sad, sterile institutions where elderly people are left isolated by family members who stop caring.

The reality is much different, say those in the industry.

"We're embracing every opportunity to exceed expectations," says Dan Muskin, regional administrator for The Grand Healthcare System which operates five nursing and rehabilitation facilities in New York.

Elias Bonaros Jr. of Bayside, New York, would agree with that assessment. His father was transferred to The Grand after a month-long stay in the hospital for aspiration pneumonia. The infection left the 81-year-old unable to stand or even eat, and Bonaros says he had little hope his father would recover.

"I honestly didn't expect too much," Bonaros says. "My feeling was that he would never eat again. I never thought he'd be able to move again."

However, an aggressive approach to therapy at The Grand allowed his father to once again stand on his own and eat with assistance. "It's been nothing short of spectacular," says Bonaros Jr. who, as a cardiologist, understood the medical challenges his father faced.

The story illustrates how nursing homes are transforming from the stereotype of a place where people bide their time until they die. Instead, new facilities are concerned with not only maintaining, but also improving, the quality of life for residents.

Introducing iPads, Apps and Fitbits

Muskin says The Grand strives to provide a hotel-like experience to residents, both those who are admitted for short-term rehabilitation as well as those who will be long-term residents. "There is a warm, friendly face to meet and greet [residents] and introduce them to the amenities," he says of their concierge service. It's something he says goes beyond a simple check-in; a concierge walks new residents to their rooms and provides one-on-one assistance as they settle in.

Amenities include an iPad for every resident who wants one. In addition to the typical features found on an iPad, the device is loaded with an app that lets guests request everything from in-room dining to assistance getting out of bed. A concierge is available 24 hours a day to meet these needs, and an executive chef is on hand to prepare meals.

On the other side of the country, Tree of Life and Family Residential Care in San Diego, are also using technology to improve the level of service they provide. Montgomery Ostrander, founder of Tree of Life and manager of Family Residential Care, created an app that connects to a resident's Fitbit fitness band and allows loved ones to review data such as daily steps and oxygen levels. The app also includes a calendar of activities, the option to purchase medical supplies and a video call function.

Baby Boomers Driving Change

While many improvements in nursing homes help residents, Ostrander says the real drivers behind change are baby boomers. "These are people who were revolutionaries in the '60s," he says. "They don't want to put their 90-year-old mother in a prison-like environment."

To accommodate the needs of residents and the wants of their families, Ostrander has deployed a slew of techniques, both conventional and unconventional. He's brought in shamans to conduct blessings, hired Elvis impersonators for entertainment and purchased GMO-free food from a local farm. "People really want a customized [experience]," he says of family members. As for residents, "at the end of the day, what they really like most is Walker, Texas Ranger because that's what they know."

Not Every Experience Is Perfect

For all the good that can be found in today's nursing homes, there are still opportunities for improvement, according to those working in the industry and family members with loved ones in facilities.

Ostrander, who earned a master of social work from the University of Southern California, feels strongly that nursing homes should do more to treat depression among residents. "The depression level is off the chart," he says. "When [people] begin to lose their independence, they absolutely get depressed."

Diane Hamel of Lowell, Michigan can attest to that. Her parents moved into what is considered one of her region's premier long-term care facilities after her mother was diagnosed with Alzheimer's disease. While her father wanted to make the move with his wife, Hamel says it left him feeling despondent. He struggled with depression for the three years he was there until he passed away at age 89.

Hamel also experienced another shortcoming in some facilities: inadequate staffing. After her father's death, Hamel's mother was moved to a different wing of the facility. Hamel notes there were eight rooms and 10 residents in her mother's wing but only one nurse's aide assigned to the area. "The main meal was at noon," Hamel says. "I would come in and help my mom and then help the other residents eat."

Her mother passed away a year later at age 86, and in hindsight, Hamel wonders if the $8,000 a month in fees they paid would have been better spent on a home renovation and an in-home health aide.

Ostrander argues that people like Hamel's parents could have a better experience if nursing homes embraced more non-traditional methods of care. "I think we're missing the boat by focusing on Western ideals," he says. "I think a holistic approach is the next obvious move." For example, he says when his facilities began serving meals based on local, non-GMO foods, residents reported feeling better, something he attributes to them eating better.

Losing the Stigma and Filling a Need

Those working in the industry would undoubtedly prefer more people have an experience like Bonaros' than Hamel's. Even when an experience is less than ideal, they say today's facilities are a far cry from those of a few decades back.

"The face of nursing homes has changed," Muskin says. So much so that even the words "nursing home" are being shed. "The term 'nursing home' has a stigma attached to it," Muskin says. "We're providing a skilled nursing and rehabilitation center."

No matter what you call it, nursing homes aren't likely to disappear, especially as parents age and their needs increase. "There is only so much we as individuals can do for infirm parents," Bonaros says. Children shouldn't feel guilty about placing a parent in a nursing home. "You're offering your parent or loved one something you cannot provide yourself."