Fla. Medicaid recipients want out of nursing homes

PLANT CITY, Fla. (AP) — Charles Todd Lee spent a lifetime going backstage at concerts, following politicians on the campaign trail and capturing iconic shots of everyone from Martin Luther King Jr. to Mick Jagger to Mickey Mantle. Today, he enjoys such freedom only in his dreams.
The 67-year-old photographer has been confined to a nursing home for five years, the victim of a stroke that paralyzed his left side. And he's angry.
"Most of the people come here to die, so you want to die," he said. "It is a prison. I can't escape it."
Lee is among the Medicaid recipients across Florida challenging the nightmare of the old and disabled: to be forced from comfort and familiarity into a nursing home.
They say the state is illegally forcing them to live in nursing homes when they should be able to live where they choose. Advocates charge that nursing homes, afraid of losing money, have successfully pressured politicians to make qualifying for community care more difficult. They have filed a federal lawsuit seeking class-action status on behalf of nearly 8,500 institutionalized Floridians.  More...

Norman DeLisle, MDRC
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Study Suggests Medicaid-Sponsored Home Care

A recently released study of Medicaid-financed nursing home use over 18 months in 2001 and 2002 finds that in states such as Oregon that have extensive community based long-term care services, Medicaid-covered nursing home stays were shorter than the national average. The numbers suggest that where seniors have alternatives, their nursing home stays are more likely to be for acute care following a hospitalization or for a shorter period at the end of life.

The study, "Medicaid-Financed Nursing Home Services: Characteristics of People Served and Their Patters of Care, 2001-2002," conducted by Matehematica Policy Research for the Office of Disability, Aging and Long-Term Care Policy for the U.S. Department of Health and Human Services, reports that over half of Medicaid-covered nursing home residents do not become eligible for benefits until after they move to a nursing home, with 29 percent obtaining coverage within six months of moving to the nursing home, 5 percent between six and 12 months, 7 percent between one and two years, and 9 percent after more than two years.

When Long-Term Care Becomes Wrong-Term Care

The term “long-term care” is revealing. Long-term care is usually about long-term loss: the loss of authority, money, health, and connections to family and community. Our system is based on an expert and medical model of passive consumption and limited choices. And because none of us really want this, we avoid talking about it or planning for it . . .

We need to begin an intergenerational discussion to redefine the issue in radically new - civic - terms . . .

We should talk about how we all age, not just about “the elderly”; about harnessing wisdom and building individual capacity, not just providing more/better services and care. We should talk about health and wellness, not just chronic illness; about taking personal responsibility for our retirement and for the economic health of future generations, not just how we pay the bills for the current troubled system . . .

Long Term Storage – Fade Out, The End

A very interesting take on LTC and community-based options:

It reminds me way too much, of moving day. That is, moving day to a Long Term Care Facility. The day that our parent or grandparent moves out of their home community and into Long-Term Storage. Dropped off. All looking alike. All gathering dust. Fade out. The end.

Long Term Storage facilities. They all look and act very similar. They are all miles out of town, have a nice long entry driveway through a pastoral setting that ends at a drop-off porte cochere that enters a massive building that houses 50 to 100 residents in a setting that is quite unlike the home these residents have left behind. It is far away from their social network. And, this is really the only option for a lot of people. The only option, by default, is the best option. Also by default, it is the worst....