Soon (maybe) at a nursing home near you
Dorothy Scott of Wauconda loved driving cars and eating at restaurants when she was younger.
It's something the 75-year-old had to give up once her health deteriorated and she moved into a long-term nursing home.
But now, Scott experiences those pleasures again through a racecar-driving video game and buffet dining at Wauconda HealthCare & Rehabilitation Centre.
"I really enjoyed it," an excited Scott said after trying the video game and dining with friends. "I don't feel like it's a nursing home. I feel like I went out to eat a buffet."
Increasingly, suburban elder-care providers are adding activities, such as interactive games, happy hour, breakfast clubs and gardening, converting traditional cafeterias into dining rooms, turning bathing into a spa experience and introducing household comforts to a sterile medical environment.
The Lutheran Home in Arlington Heights, Elmhurst Extended Care Center, Paradise Park Assisted Living and Memory Care in Fox Lake and the Wealshire in Lincolnshire are among those with such changes in place.
Experts say it signals a growing trend to offer residents more choices and fewer restrictions. While part of the aim is to stay competitive in a growing senior services market, the larger goal is a healthier psychological and social environment for seniors.
The concept is part of the Pioneer Movement, which advocates changing conventional notions of nursing homes as a place for the dying.
Lake County is a leader in the movement because some groups adopted the Pioneer philosophy and put it in practice years ago. Advocates in suburban Cook County now are making a similar push.
"I think eventually it's going to catch on," said Robyn O'Neill, the state's regional long-term care ombudsman representing suburban Cook and Lake counties. "The hope is that it should dramatically change elder care. It certainly is a growing movement, but it takes a long time because people have to rethink (traditional ways)."
Providers are trying to shift focus of care from disability and infirmity to promoting wellness and independence.
It means giving residents what they want rather than what administrators think they need, said Sharon Roberts, a Lake County Health Department gerontologist who heads Lake County's Regional Pioneer Coalition.
"It's a whole different feeling and a whole different approach," said Roberts, who talks to caregiver groups about the movement. "The elder stays in charge of their care. If you haven't been in a nursing home for a while, or you've been to one that's traditional, you won't know that these things are going on."
A culture change
The Pioneer Movement informally began in 1997 when 33 health care professionals, researchers and educators from throughout the country met for three days in Rochester, N.Y., to share their isolated efforts to modernize elder care.
It has grown into the National Pioneer Network, which brings together a variety of innovative elder care concepts under its umbrella. The coalition's recent national conference in Minnesota drew 1,100 elder-care providers from 46 states, England and Canada.
"The entry point was nursing homes, but then we realized what we were looking at here was beyond nursing home care," said Rose Marie Fagan, the coalition's founding executive director. "It's about changing the culture of what it means to be an older person in America and revolutionizing aging."
Fagan estimates roughly 1 percent -- fewer than 200 -- of the 16,000 nursing homes nationwide follow the Pioneer philosophy.
"They are changing their physical environment to actually make a home for people, and it doesn't look like a hospital," Fagan said.
Such nursing homes may have kitchens for residents' use, laundry rooms, communal areas with theater-style TVs, bistros, newsstands, jukeboxes, pets, kitchen and outdoor gardens, verandas, porches, household furniture and decor. That helps create a homelike environment and promotes a sense of neighborhood.
Dining rooms are a huge part of that culture change because they encourage residents to socialize. Residents decide what, when and with whom they eat or if they want to entertain a guest.
Changes can be as subtle as allowing residents to choose what time they wake up in the morning and catering to individual routines.
"If you like tea in the afternoon, if you like to sleep late, you do not have to regiment your life at an old age to a facility routine," Fagan said. "Instead of your having to adjust to this new environment, the people working with you should accommodate you and your routines, and who you are and how you want to live."
Staying relevant
Experts say demands will be greater for early baby boomers approaching senior age and dealing with their own parents in nursing homes.
Nonprofit and for-profit agencies have begun to recognize the need to change to be competitive in the senior-services market. Some providers see the Pioneer Movement as a means to stay relevant and fill beds.
Officials at Midlothian Manor senior apartments in Lake Zurich see change may be critical for the facility's survival.
Half of the manor's 14 apartments are occupied. It caters to low- to moderate-income Lake County seniors and is running on a deficit.
"We need at least 10 residents in order to break even," said Donna Copeland Hill, community planner for the Northeastern Illinois Area Agency on Aging that manages the Manor. "It would be nice if we had the deep pockets to provide some of the things that the other places do, but we really can't because of our size."
She said the Pioneer Movement concepts could help make Midlothian Manor more appealing and welcoming to clients.
"I would love to be able to do some of the things that other Pioneer communities have done, make luncheons a little more friendly in terms of choices," Hill said.
Officials have brought in volunteers to brighten the living area. They are considering allowing a Manor pet and creating a community garden. The facility also is starting to serve catered meals prepackaged on dishware.
"It's a small step," Hill said. "We already do breakfasts like that, but it would be nice to do lunch, too."
Yet, experts say the hardest part is getting institutions to buy into the concept of giving elderly clients control over their own care and changing the attitudes of caregivers.
That would involve changing the way nurses and social workers are trained.
"It's flipping it (the hierarchy) upside down," Fagan said. "The decisions are not made by a manager, an administrator or a CEO that people never see. The decisions are made closer, (by) the residents -- if possible -- the direct caregivers and family."
While ambitious changes, such as buffet dining, spas and home theaters have equipment costs, changing attitudes is far less expensive and improves the psychological health of elderly clients, officials say.
"Does it cost anything to smile at somebody?" Roberts said. "The ones that are really doing this, they have the beds occupied. And we're going to see more and more as the public catches on and begins to demand it."