August 9, 2004 ED0809
They've all but banished the words "nursing home" at the organization that is Minnesota's largest provider of care for the elderly.
They've changed their own name, too. They were the Board of Social Ministry -- echoing their roots as an arm of the Evangelical Lutheran Church in America. As of last week, they are Ecumen (as in "ecumenical"), and they are not just for Lutherans, or for the sick and dying, anymore.
The new nomenclature reflects much larger changes that are sweeping the elder care industry, and compelling government to keep up. Old-style nursing homes -- the cramped, confining, waiting-for-death environments built in the decades after World War II -- are being phased out as fast as farsighted providers can manage. They're being replaced by a range of housing and service options aimed at maximizing choice and independence for older Americans.
Two facts about nursing homes are driving the change: They are unpopular and they are expensive. A stay in a Minneapolis nursing home last year cost an average of $140 per day, according to a Met Life survey -- for the privilege of sharing a room with a stranger and leaving most of the comforts of home behind.
Taxpayers wind up footing the bill for a majority of long-term nursing home residents -- and that means whenever government budgets get tight, reimbursement to nursing homes gets squeezed. The quality of care suffers.
"The next generation is saying, 'I'm not going there!' " says Ecumen president and CEO Kathyrn Roberts about nursing homes. A former director of the Minnesota Zoo, chair of the Metropolitan Sports Facilities Commission and acting commissioner of the state Department of Human Rights, Roberts came to her new position last year determined to respond to the market's message.
Ecumen aims to offer seniors both more varied housing options and more services to help them remain in their own homes. A housing complex going up in the shadow of the Glensheen mansion in Duluth illustrates Ecumen's expanded thinking. Lakeshore Lutheran Home is being joined by an elder living complex that, by 2007, will include 100 independent-living homes, 60 assisted-living units and 60 private rooms for recovery from surgery or illness.
Ecumen's visionaries foresee technology making greater senior independence possible, even for those in the early stages of dementia. For example, in the not-distant future, seniors' kitchens might include devices that monitor how many times a cupboard is opened per day, coffeemakers that ask to be filled with both water and grounds, or stoves that sound an alarm if they are left on too long.
Time was when home care and assisted-living services were only for affluent seniors. Running out of resources meant moving to a nursing home, at state expense. Thankfully, state government has moved to funding in-home "alternative care," allowing thousands of low-income seniors to avoid institutionalization, and taxpayers to avoid high nursing home bills.
That trend ought to continue -- and smart government ought to give it a push. Tax breaks, public-private pilot projects and greater flexibility in regulations can hasten the transformation of old-style nursing homes into something both better and more affordable.