Nursing homes have come a long way
It has long been a dread of mine: facing relocating to a nursing home when I'm no longer able to care for myself.
My memories of these long-term care facilities have been negative ones. I remember odors, small rooms populated by at least two people, privacy depending on thin pull around curtains, people lined up along the hallways in wheelchairs. These facilities seemed like warehouses for the neglected elderly who were no longer productive or needed.
For a short time in the '80s, I was the director of nursing at a large retirement center in southern Oregon. Everything was luxurious until one got to the health center where there were the efficient but impersonal and crowded rooms. Residents went from luxurious suites to smaller assisted living apartments when they needed assistance or supervision, to the health center which was reminiscent of a hospital unit or a nursing home. I had many conversations with the administrator about building a state-of-the-art health center where beauty, dignity, quiet surroundings and respect would be present. He envisioned cottages on the hillside and another skyscraper building but wouldn't budge on upgrading the health center. The residents overall could pay for an upscale health center. Why not create a model of end of life care? I wrote out my vision and dream and gave it to him when I left.
Recently I've had surgery that required more immediate post-op care than I could provide for myself living alone. "OK this is it," I thought. "I'm going to go to a nursing home even though it is disguised as a rehab center."
Down the hill from OHSU where I had surgery is a hidden jewel called Mirabella on the South Waterfront. There is a skilled nursing unit and memory care unit on the second floor and an assisted living facility on the third floor of a beautiful high-rise building.
Instead of a cramped two-person room, I was taken to a beautiful room that was like a luxury hotel. I was amazed. I was met by the head of the dietary department wearing an attractive uniform. She went over times, menus, food preferences and the availability of a beautiful dining area for meals. In an almost overwhelming parade of caregivers, I met two people from physical therapy, a social worker, an occupational therapist, a nurse, an in-house MD and a medical resident from OHSU.
The second day there, a care conference was held for me where I was able to be an active participant.
This was my vision of the future of elder care come true.
The unit has been a joint venture by OHSU and Mirabella. The physical therapy staff are employees of OHSU. Medical residents use Mirabella as a teaching opportunity.
I later found that this facility was connected to the retirement center I'd worked in over 25 years ago. I could only hope that maybe some of my words had been heeded.
Another instance of dreams being revisited happened when I was director of nurses at Ashland Community Hospital. In the late '70s home births were becoming more popular. Even though they were more natural, we were worried about what would happen in emergency situations. We developed the first alternate birth center in the state that allowed for delivery in a home-like room with all sorts of amenities. The emergency equipment was hidden behind closed doors but available.
At the time, I had the idea that if we had an alternate birth center, why not something at the other end of life? Could we have an alternate death center? This was when the hospice movement was just getting started in this country. The result of this dream was that we had a suite built in the hospital that had a place for family to stay, a stereo, small kitchenette, book shelves and a small garden outside sliding doors.
What was amazing was that over 20 years later, my husband died in that unit. I guess the moral of the story is to not give up on your dreams. One never knows the outcome.
Esther Halvorson-Hill is a member of the Jottings group at the Lake Oswego Adult Community Center.