Gene Taylor and Dana Morgenthaler found themselves in a quandary. A couple of years ago, their mother, 95-year-old Marjorie Shaw, began having trouble getting around. She couldn't keep up with her housework, but she didn't like hiring strangers to help. So Taylor and Morgenthaler tried to pick up the slack.
"It became overwhelming for us," Taylor says, "trying to keep up our homes and her home." But, she adds dryly, their mother "wasn't going to make any changes until she was older."
Eventually, the sisters managed to convince Shaw to tour a few local assisted-living facilities near her Columbia home. Their mom returned from the visits adamant about not wanting to move. "She kept saying she would do it when she really needed to," recalls Taylor.
Unfortunately, the need arose quickly. Shaw fell and broke her hip, a potentially devastating injury for the elderly. She was lucky. With rehabilitation at an area nursing home, she regained her mobility. But she could no longer live on her own. For most seniors, this would mean a permanent move to a nursing home or, at best, an assisted living arrangement. Taylor and Morgenthaler's mom had another option: TigerPlace, a unique senior apartment complex with ties to the University of Missouri-Columbia.
The facility is special because its residents get the same quality of care available in skilled nursing facilities while also enjoying high levels of independence, says TigerPlace founder Marilyn Rantz, a professor of gerontological nursing at MU's Sinclair School of Nursing.
Rantz is also executive director of the University's Aging-in-Place program, the model of care being tested at TigerPlace. "Aging in place provides services that people need in the privacy of their own [apartments] while focusing on maintaining function and abilities until the end of life," Rantz says. "In most cases, with this type of care, people wouldn't need a nursing home."
Taylor, a registered nurse, was so impressed with TigerPlace and its aging-in-place philosophy that she signed on to work at the facility. Her mom signed up soon after.
"I can do as I please," says Shaw, who gets around her studio apartment with just the help of a walker. "It's different from the nursing home. Here, you can stay in your room or you can go out. There, they wanted you to stay in. I have all my own furniture here. I have my own pictures, photographs and paintings that you can't have over there. I had a good, comfortable room over there but not like here. This is more like home."
Rantz is one of the nation's most respected authorities on elder care. She became interested in the issue in 1981 when she unexpectedly landed a position at a county nursing home in Wisconsin. As the home's head administrator, she ran the 328-bed facility and managed a $12 million budget. There she met many seniors who, like Shaw, had a real dread of nursing homes.
"I never once met anybody who came there who said, 'I want to be here,' " she says. "Nobody said that. I watched families and older people struggle at home to stay there as long as possible, and [residents] always talked about how they wanted to go back."
Bernadette Wright, a policy research analyst at the AARP Public Policy Institute, cites three key problems fueling consumer dissatisfaction with nursing homes: the institutional environment, high staff turnover rates and a lack of enforcement for quality standards.
The drawbacks of the institutional environment are obvious to anyone who has spent time with a loved one in a typical nursing home. No one wants to live in a hard-surfaced, antiseptic living space where residents must endure boredom, lack of privacy, rigid schedules, unappetizing food and the depressing spectacle of their peers' downhill slide to debilitation. "The whole institutional environment is a big problem," Wright admits. "It's certainly a big area that needs improvement."
Published by the Office of Research.
©2006 Curators of the University of Missouri. Click here to contact the editor.