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By Candice Choi ALBANY, NY - Three months after Herman Schneider checked into a nursing home with severe depression, he was ready for life on the outside again - so he moved into an assisted-living facility. Schneider, a 78-year-old retired microbiology researcher, said the nursing home experience was difficult. "I've been a thinking individual all my life - it was an atmosphere that was totally foreign to me," he said. Around the country, nursing homes - once consider life's final stop - are experiencing a growing number of residents who are packing up and moving out, as more and more seniors receive the help they need through home care or in assisted living settings. The New York State Health Department, which estimates that caring for seniors in home and community settings can cost up to half as much as nursing homes, is responding to the trend: State officials hope to get a federal waiver this summer that will let up to 5,000 elderly and disabled nursing home residents on Medicaid get the same care elsewhere. Over the past several years, a majority of states have applied for similar waivers. For many seniors, the shift is welcome news. Schneider transitioned from a nursing home into an assisted- living home with the help of his daughter and wife. His life is now punctuated with weekly field trips to restaurants and historic sites around the state, organized by the facility. Occasionally, he and his wife go out for dinner. "We never did that in a nursing home. That was a restricted environment. I was anxious to get out of there," Schneider said. He's not alone. "My wife doesn't care for the idea of leaving. We built this house 42 years ago," said 76-year-old Edward Drozdowski, an Albany resident who recently moved home after spending several weeks in a nursing home while he recovered from kidney failure. While it was nice having people help him with daily tasks, he couldn't adjust to the confines of the environment. "At home, if I want to have dinner a little later than 5:30, we can do that," said Drozdowski, who used to work in the restaurant business. When the time comes, he and his 73-year-old wife plan to get a home health aide so they can stay in their home as long as possible. A recent review by the state Health Department found up to 14 percent of nursing home residents were healthy enough to be in more independent settings not currently offered to them. One problem is elderly patients who are sent to nursing homes for short-term treatment wind up as permanent residents. Also, hospitals tend to discharge patients to nursing homes rather than look for more appropriate alternative care options that might be in short supply, said Mary Kahn, a spokeswoman for the federal Center for Medicaid and Medicare Services. Under the federal waiver system, social workers and nursing home administrators work to identify seniors and people with disabilities who can thrive in assisted-living centers or at home with relatives with the help of professional aides. For some residents who have become accustomed to the fixed routine of a nursing home, the prospect of sudden independence can be daunting, said Susan Dooha, executive director for the Center for Independence of the Disabled in New York City, a group that has long helped seniors and the disabled move out of nursing homes. "It's a big psychological barrier for someone who's in a nursing home to imagine they can resume their lives in the community," she said. The waiver system smooths the transition by covering bills like moving costs and utility installation fees and training in independent living skills like bill paying. Once they're back in the community, Dooha said initial apprehensions quickly vanish. That was the case for Schneider, who moved into an assisted- living facility with the help of his family. Now, he enjoys eating and coming and going on his own schedule again. "My time in the nursing home was good for me, but I'd never go back," he said. |
