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Nursing Homes And The Lutheran Home For

The Aging Essay, Research Paper


Nursing Homes and The Lutheran Home for the Aging


Recently, I had the pleasure of having a personal tour of the Lutheran


Home for the Aging located in Wauwatosa, Wisconsin. I chose this area of study


because it happened to be convenient in location for me as well as easily


accessible to a source of an interviewee that I felt comfortable with and who is


also very comfortable with myself. I find it much easier to conduct an


interview and get more relevant information from a source that I’ve already had


former contact with and also established a friendship with. I interviewed, age


48, who was a social worker at the Lutheran Home for the Aging for 12 years


until she changed career paths that would benefit herself more as well as her


family. graduated from the University of with a Social Work degree and is


presently pursing a two year Dental Hygiene degree(Associate Degree). She


explained to me that at the time she was hired at the nursing home it was not


necessary for social workers to have to take a test in order to obtain a license


and a position in the social work field, a position that she held for twelve


years explained to me how she was “Grandfathered” into her social worker


position and did not have to take a test for a license until it was required


after years of responsible and professional work in the Home for the Aging.


The Lutheran Home for the Aging was founded in 1906 by John C. Koch,


with the motivation and desire to promote residential care for his fellow aging


Lutheran constituents. Along with the supportive interests of other Lutherans,


he purchased approximately eight acres of land. A large house on the property


served as the Home’s first building and within a year of its founding, it had


reached a capacity of twenty members. Today the same desire and motivation has


increased the residential population to 313 members, age 65 and over. The


founders of the Home did more than provide a place to live for the Aging. They


founded a tradition of excellence and quality care that continues even to this


day. The mission of the home is to “take a leadership role in resident


satisfaction by providing superior services in a Christian atmosphere that meet


or exceed the expectations of each resident and his or her family” (”Lutheran


Home for the Aging” 1). Through the years, with renovations and expansions, the


facility has evolved into a nursing facility providing skilled nursing care and


related therapeutic care to all the residents 24 hours a day. The Lutheran Home


for the Aging is a non-profit organization and is a recognized service


organization of the Missouri Synod Lutheran Church. The Home is governed by The


Board of Directors, which consists of men and women from various congregations


located throughout the Milwaukee area. They constantly review and evaluate the


quality of care in relationship to the purpose of the Home and are also in


control of delegating a responsible and competent administrator who is the


leader and manager of the Home.


There is a full array of highly trained and competent staff that keep


the Lutheran Home for the Aging running smoothly and up to standard. As I


researched what quality nursing homes should offer to those in need of a variety


of daily and sometimes complex assistance, I was surprised that this Home for


the Aging met most, if not all the criteria of a “model” nursing home. Some of


the services offered include personal , dietary, therapeutic, social,


recreational and nursing services. There are also meals, laundry facilities,


housekeeping, and 24-hour medical services provided by professional nursing care


and attending physicians. In addition, as most non-profit organizations homes,


there are religious services and counseling programs provided. Some of the


daily responsibilities and individual aspects of the diverse staff include the


following:


? The activities coordinator is a trained therapist or someone designated to


help and assist residents’ individual needs and create programs that provide


recreation, entertainment and therapy for the residents.


? The social service staff consists of social workers, counselors, and , in


some nursing homes, a psychologist who assist in coping of the emotional and


psychological aspects of aging, the transitional problems that may arise when


first entering an aging home, and daily problems and frustrations.


? A food service director oversees nursing homes’ daily meal program. Many


homes including the Lutheran Home for the Aging, have a Dietitian that meet the


individual daily requirements of each resident, whether therapeutic diet or


normal, and try to ensure that meals are appetizing also.


? The Pastoral care staff consists of ordained, professional, or lay persons


trained to meet the spiritual needs of residents through worship, study, and


counseling. At the Lutheran Home for the Aging there is a Chaplain on hand that


conducts Sunday services, Bible classes, and directs a support group for family


members that meets and discusses the difficulties of adjusting to the separation


of their loved ones from the family.


? Volunteers and members of the community assist the staff by spending many


hours interacting with the residents and helping them as well as the staff


perform their daily activities. There are often groups that are well known for


their participation with the people at the Aging Home and continually come back


year after year to help and visit the new friends they have met through their


volunteer work.


Some original and surprising activities and therapies were discovered


during my research that not only entertain residents, but also rehabilitates


those with disabilities or mental deficiencies. Some therapies I found


interesting were the Pet, Music and Art therapies that are common in Aging Homes.


The Music therapy consists of a musician that sings with the residents several


times daily for entertainment purposes and is found also to be a good source of


rehabilitation for those who have slower motor skills, the easily confused


(cognitively deficient), and people that have trouble remembering things


(Alzheimer’s patients). Art therapy gives the elderly a chance to paint, do


craft work, woodworking, and explore dance and drama if interested. Pet therapy


consists of either “live- in” pets or a hired person that brings animals in to


enhance the feeling of companionship among the residents. The Lutheran Home for


the Aging has a cat, iguana, several parakeets, and a Golden Retriever named


Pawlet that s hare the home with the residents. There is also an


Intergenerational Program that involves the Child Day Care facility located


within the Home for the Aging. The child day care was built in 1991 and consists


mainly of employees children, but is also open to the public when space is


available. The children learn to benefit from the social interaction with the


residents and are included in some of the therapies and activities such as going


to the zoo, baseball games, movies , malls, and even Bible study once a week.


The residents have the opportunity to have the delightful presence of the


children and be involved in their care also by reading to them and participating


in activities especially designed for the children.


Many nursing homes, including the Lutheran Home for the Aging , are non-


profit organizations which have long been recognized as having a tradition of


serving the needs of older persons. Non- profit organizations are usually


community-based agencies and sponsored by religious organizations and fraternal


groups. As mentioned earlier, theses homes are governed by a volunteer board of


trustees who are committed to caring for the needs of older people. An important


aspect of non- profit organizations is that any income generated is put back


into the facility to either improve or expand the services they provide. As in


the case of the Lutheran Home for the Aging, the generated income from resident


pay and contributions has been used in expansion of the Home, the building of


the Child Day Care, and the coordination of special activities for the residents.


The main concern in non – profit organization is the continuum of care that


offers many options to the elderly residents of the facilities. The range of


offerings can include those who need somewhat simple care to those who need a


high level of care.


The nursing care facilities consist mainly of long- term facilities that


integrate custodial care with nursing, psychological, social, and rehabilitative


services on a continuing basis. At the time of admission, each individual’s


potential and problems are evaluated and their care and treatment is designed to


their individual needs. Regardless of the care needed and the advancements made


in therapies, nursing homes enable residents to capitalize on their strengths


and compensate for their weaknesses in an atmosphere designed to look as home-


like as possible. Nursing care facilities are licensed by the state and are


overlooked by the federal government. An interesting program that I found at the

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Lutheran Home for the Aging was the Interdisciplinary Team or often called


Resident Care Management in other nursing homes. This team consists of a social


worker, nurse, dietitian, physical and speech therapist, recreational therapist,


a resident and their family. This team reviews the residents’ status


to ensure that all the needs are being met and treatment is not lacking in any


way in any area. This work load can be very large for a social worker,


especially. As in case load, she reviewed between 96 -100 people monthly and had


to use very professional judgments in each case because of strict regulation of


the State. In nursing homes, there is a State Yearly Review in which the State


picks residents names at random and does their own evaluation of the patients as


well as of the nursing home. There are numerous interviews with residents, staff,


and even family to ensure the Nursing Home is living up to standard. If problems


are found, the facility can face financial penalties or even lose its license


unless the situation is corrected in an allotted time period.


As can be expected with all the care and rehabilitative efforts needed


by many in nursing homes just to maintain daily comfort in their lives, comes an


incredible expense to the resident or their families. In many nursing homes,


residents are required to have a need for professional medical staff and cannot


accept applicants whose basic need is custodial care or who are developmentally


disabled. Thus, payment sources must be reviewed before initial entry is


considered. I found that the costs of living in nursing homes can be incredibly


expensive, especially if the resident is in need of daily therapy and medical


attention, which increases the amount each resident pays as medical attention is


needed more often. The average daily rates can be from $90 to $140 for only


their bed – stay, not including any special treatments that are often required


by many. Costs may exceed over $4,500 monthly and from $35,000 to $45,000


yearly. There are not a lot of sources for covering such large expenses and thos


e that are offered are limited to financial need of the patient. There are three


basic methods of funding long- term care in nursing facilities that require


patients to need medical assistance. The “Private Pay” method is for residents


who are financially able and pay a daily rate from their private funds. As


mentioned before, the rate is based upon care needed and is determined prior to


admission. Another method may be through Medicare which will help pay for a


portion of an individual’s care when certain criteria are met. Some of these


requirements may include that the resident requires skilled care on a daily


basis by nursing and therapy which can only be provided in a skilled nursing


facility. Medicare will pay up to 100 days of 100% coverage in the nursing home


as long as the patient is making advancements in treatments and therapy. As soon


as the patient is at a “plateau” in their medical condition, Medicare is no


longer provided. It should be mentioned that Medicare is a federal program “that


un derwrites health insurance for persons 65 and older and some persons with


disability and also covers limited home health and hospice care” (Sager 459).


Another popular payment method may include Medicaid which is a “joint federal


and state program that helps hose with disabilities pay for nursing home care


and health care at home after they can no longer afford the expenses


themselves” (460). There are other payment methods, such as nursing home


insurance, offered to the elderly, but are rare in comparison to the payment


methods mentioned above. The role of the social worker is included in helping


the assistance of some residents find or obtain payment methods that may benefit


themselves. For instance, if a patient has no family it is the job of the


social worker to have to go and fill out the Medical Assistance papers at


designated buildings so that the residents are eligible for financial assistance


towards their stay at the nursing home. They are also responsible for


coordinating and participating in


discharge planning when a resident may return home to live in the community.


Social workers set up health care, physical therapies, or occupational


assistance for the patients if needed. They sometimes refer residents that need


psychological or psychiatric counseling to outside agencies and monitor the


results.


I found it interesting while when interviewing of the Lutheran Home for


the Aging, how much she had related the role of her work as a social worker to


what we had learned in class about the Code of Ethics. When I first asked her


for a brief description of her duties as a social worker there, she said,” I


was an advocate for Resident Rights. It was my job to protect the individual


rights of each citizen, protect their worth and dignity, and make sure they


weren’t taken advantage of.” I told her that it sounded like she was reading the


same book I had and giving me the answers I wanted to hear. Some other things


that amazed me in the professionalism of social workers to their job of working


with people and maintaining the best interest of the client became evident for


the first time during this research project. All the things I learned in class


seemed to come together after just researching one institution. Another aspect


of social work that Mrs. Hippler stressed was the importance of documentatio n


for everything . She stated, “If it isn’t written down, it didn’t happen.” This


is especially important if there is a legal problem with a resident or if the


State Review Board would like to see certain charts and documentation on a


certain patient. Also mentioned was the importance of confidentiality and the


need to provide accessible resources, especially to those in nursing homes who


cannot always care for themselves.


There are many nursing homes today that do not always meet the needs of


the residents that occupy them and often violate many ethical standards of


proper living for people. Some homes have been found to exploit people


financially, ignore proper medical care, and engage in a variety of residential


abuses. After my research, I truly believe what separates “good” nursing homes


from those who are involved in unethical practices is based upon individual


morals, community involvement, and religious guidance. At the Lutheran Home for


the Aging, I found the staff to be incredibly friendly and competent in the


performance of their job detail. I was also impressed by the professionalism of


the social worker I interviewed in regard to her job and the stress and


frustration that comes with it. The nursing home was very involved with the


community for rehabilitative purposes for the residents, and provided a learning


experience for a wide range of volunteers that take time out of their lives to


help others. The


Home has been a clinical site for interns in therapy and social services as


well. Although the institution is based upon the ” spirit of Christian caring,”


the Home for the Aging does not discriminate from other races. There is a


Chaplain available to the residents and staff for counseling and spiritual


support. Bible classes are offered as well as Sunday Lutheran services, weekly


communion, and monthly Catholic services.


I came across a good quote that would serve as an example of the unique


characteristics and motivation needed in order to maintain professional


excellence in non – profit and religious – based nursing homes. This was from a


pamphlet that stated:


“The Lutheran Home for the Aging has been blessed from its inception with


insightful leadership, a committed staff, and a supportive Christian community.


By the grace of God, we look to the continued dedication of those resources to


the tasks ahead” (”Lutheran Home for the Aging” 8).


BIBLIOGRAPHY


Applegate, William B. “Journal of the American Geriatrics Society.” Online.


Internet. Available http://www.wwilkins.com/wavcat-


bin/journals_ops/ID0856948/0002-8614/prod.


“Code of Ethics.” Online. Internet. Available


http://www.umanitoba.ca/faculties/?tml#Ethical Duties and Obligations.


Lutheran Home for the Aging. Wauwatosa: Lutheran Home for the Aging, 1996.


“Long-Term Care and Nursing Homes.” Online. Internet. Available


http://freenet.uchsc.edu/2000/senior/nurshome/menu.html.


“Nursing Home, Home Health and Hospice.” Online. Internet. Available


http://www.math.utah.edu/~c-pkse/medfile/hhh.html.


“Nursing Homes and Long Term Care Facilities.” Online. Internet. Available


http://www.medaccess.com/locator/nursehome/nsgh01.htm.


Sager, M. Measurement of Activities of Daily Living in Hospitalized Elderly: A


Comparison of Self-report and Performance-based measures. Wisconsin:


Geriatric Society, 1992. 457-462.


“Senior Care Insurance, Medicare, Medicaid.” Online. Internet. Available


http://seniors-site.com/ads/medicare.html.


Lutheran Home for the Aging:


“A warm, caring place


where life always has


quality, value and


dignity.”

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