July 21, 2005

Just like home

Charming, affordable housing alternatives for aging seniors

By Kymberli W. Brady
Staff Writer

While medical technology takes its bows for affording each generation a longer life than the last, in this day and age, it doesn’t come without a price.

After years spent searching for the right place, Diane Lawrence and her father Charlie have both found "harmonie" right down the street at Harmonie Home (pictured above). "I have never been happier," she says. "They're like a big family."

For the first time, aging baby boomers have more to consider when entering their golden years than retirement, trips around the world, or impromptu visits with the grandkids. Many are instead assuming roles they never considered until an early-morning phone call summons them to the hospital to care for parents who are no longer able to care for themselves.

Within days or hours we become the neighborhood experts on assisted living facilities, nurse-to-patient ratios, single-story floor plans, and strategic navigation that take us from the office to the nursing home in less time than it takes their nurse to make her way to their room.

This is where the age-old cliché sneaks in…

Necessity is the mother of invention
For Almaden’s Diane Lawrence, finding a facility for both of her 87-year-old parents was doubly taxing—a search that limited her options and resulted in less than satisfactory treatment. It’s a scenario that is becoming more the rule than the exception.

After a miserable experience with a large senior facility with 50 to 60 senior neighbors, each vying for the attention of a handful of overburdened nurses, she remembers all too well the lack of care that ultimately led to the heartbreaking task of separating her parents after her mother took a nasty fall. She has been hospitalized ever since.

“The ratio was 24 to 1,” Lawrence says. “And my dad wouldn’t think about when he’d have to go to the bathroom, he’d have to go right then. They might not get there for 15, 20, 30 minutes and he took some falls. My mom is where she is right now because she’d push the button and they weren’t there right away, so she tried to do things herself and hurt herself.”

Then Lawrence discovered a little known secret—practically in her own back yard. It was right about the same time another Almaden woman was making similar arrangements for her grandmother, who had been diagnosed with Parkinson’s disease seven years earlier.

Jona Romualdez owns five Harmonie Home residential care facilities, including three in Almaden, one in Willow Glen, and one in Cambrian.

Debbie Chang was facing the similar problem of trying to find just the right place for her grandparents when the time came. She liked the idea of assisted living in a home setting, but with little to no vacancy in sight, she decided to put her nursing skills to better work and started looking into one of her own.

With her husband’s blessing [he is a doctor], Debbie switched gears and instead of remodeling their second home for a future tenant, she installed graded ramps, locked medicine and kitchen cabinets, twin beds, hard-wired smoke detectors, and specialty bars in the showers.

Then came the permits, fire inspections, construction for additional doors as recommended by the fire department for increased safety, more ramps, more permits, and more inspections.

“I learned that the city will have different regulations than the fire department,” she explains. “For instance, the city wondered why there had to be a door added to one room when the existing door was just a few feet away. The fire department said it led to a hallway. It’s kind of strange. They’re sometimes a little different. It’s such a learning process.”

Acquiring a license to operate an assisted living home proved to be equally as long and comprehensive.

“Usually it takes six to eight weeks to get through the testing. Then you have to compose an admission packet, devise a plan of care for the facility, and compose a meal plan. For that I used a registered dietitian.”

After months of remodeling, preparations, furnishings, and licensing exams, Dawnview Care, located behind Oakridge Mall near Winfield and Pearl is accepting tenants, but her grandmother will not be among them.

“Unfortunately, she started to deteriorate,” Debbie says. “She’s in a convalescent home now because she has a feeding tube in her, which is prohibited in an assisted living home. That was upsetting because I really wanted to convert this place for her. It would have been nice to have her here.”

Debbie hopes that her grandfather will someday move in, but for now, he has chosen to stay in the convalescent home with her grandmother, so they can be together. In the meantime, she says there are plenty of others who need her.

“The need definitely is growing because we’re all living longer,” Debbie adds. “The aging population is getting bigger. Now you have children who are older in a sandwiched generation, where now they have to assist with mom and dad.”

A well kept Almaden secret for 18 years
Nancy Buckles admits that the adjustment has been difficult for both her and her mother, Francis Scarlotta. After living with her and her husband for nine years, the time came to move her to a place where she would get the consistent care she needed. They found Harmonie Home and Jona Romualdez, who has been operating residential care homes in Almaden for nearly 18 years.

Angelo now spends most of his time at Harmonie Home, where his wife will join him any day.

They also discovered Angelo and Luella, who just like them, are Italian.

“She’s having a hard time adjusting too,” Nancy adds. “It is just like home, but it’s not home, you know? But I think this is great. They take very good care of her and she’s always clean and tidy. Her room is always neat and she’s eating. It’s the best thing and I’m not worried about her anymore. I feel good about it.”

Nancy says it helps having Angelo and Luella around because they are Italian too. Angelo’s wife is moving in soon and they’ll all be able to speak to each other.

The foundation on which Harmonie Homes has existed is evident in the petite frame with boundless energy every when Jona walks into a room. She and her sisters now run a total of five homes, including three in Almaden, one in Willow Glen and one in Cambrian. She says it’s in her nature.

“We were one of the few who started this,” she says. Filipinos really like taking care of their elders, so this was a natural progression. It just grew from there.”

Change is in the air
Although the home on Nesbitt Court is only three months old, it filled up within the first month and Jona says there is currently a waiting list. However, she’s been at it a lot longer, having opened her first assisted care residence on Camden Avenue more than 18 years ago. Over the years, she’s seen the gradual shift in the trend, and the number of seniors caring for their parents is hard not to notice.

“When I first started in this business, the average age was 75,” she says. “Now my babies are 85 or 90, but I have some who are as young as 60.”

Expanding the roles—does Alzheimer’s and dementia fit in?

Jona has also seen how far the industry has come over the years—from a very restrictive, almost “Golden Girls” type of environment to one that today allows her to keep her residents through hospice to end of life. For many, it is less stressful and more peaceful, thanks to a gradual lift of restrictions and dramatic changes in the past five years that have more to do with demand than supply.

Alzheimer’s, according to Debbie falls within the gray area of what she is allowed to accept, although there are strict guidelines in place for treating Alzheimer’s and Dementia patients, there is very little differentiation. If the prognosis is “mild cognizant impairment” and they can be redirected back to their rooms, she can take it on.

“If they become too difficult, then they’ll have to be placed outside the assisted living environment and into more of a locked facility. We aren’t licensed to do that.”

Dawnview Care, owned and operated by Almaden's Debbie Chang, is part of a growing trend of homes specially designed and licensed to offer assisted living is licensed for six people and is located on Dawnview Court, near Oakridge Mall.

“With a smaller facility like ours, we don’t have the number of activities as others, but people are generally less active when they come her.

Activities for a population that has generally slipped somewhere between active and bedridden fit the description, but attempt to appeal to most. Dawnview offers board games, memory games, journaling, talking.

“We’re constantly following that routine, but basically it’s memory—music, reading the newspaper, talking or writing about life events, things to stimulate their minds.”

“We try to get everyone to do exercises and stretching every morning,” adds Jona. “Usually we have card games later on, but it’s hard to put everyone together for an activity, because they all have different interests and limitations. But the main thing is their walks with their families.”

The cost of convenience and custom care
Unlike nursing facilities, typical fees at Harmonie Home start at $2,700 for a private room and rise to $4,200 for a couple in a shared room. Dawnview Care has a base rate of $2,200-$2,500 per person and offers discounts for couples. Both rise from there, depending on the level of care needed.

Charming, affordable housing alternative for aging seniors
Jona is hoping that Medicare and Medicaid will catch up with the trend, as fees are privately paid by the clients from their own resources, and forces some families to take care of their parents at home, which is not always the ideal environment for someone who needs constant care.

“It’s sad,” she says. “It’s hard on everyone. And with the medication, it’s a lot of money. There are lobbyists out there now trying to change that.”

According to Debbie, there is talk of a pilot program in Southern California that will look toward Medicaid and Medicare for financial assistance, but it is still a long way off.

“The state is realizing that there is a crisis and they need to look at other avenues.” she says. “They are looking at subsidizing assisted care because there are a lot of people in convalescent homes who don’t belong there. However, it will probably be years before the program gets any approval.”

Until government assistance arrives, what Diane says she pays now, compared to the $6,400 check she shelled out every month at the former facility, has so much more bang for the buck. Their stress levels have dropped, he’s getting far better care, and he’s right down the street.

Debbie Chang RN [left], owner of Dawnview Care now offers licensed residential care for seniors like Grace Louise Patterson, with the help of nutritionist Cora Simpliaciano. “They treat me like a queen,” Patterson says.

As for Charlie, until his wife joins him, things couldn’t get much better.

“Boy these girls sure do spoil me a lot,” he says. “And I love every minute of it.”

For Diane, it’s the first peace of mind she’s had in years.

“There are always two nurses right there at all times,” she explains. “I like knowing that he’ll get the care he needs, because I know when my dad rings the buzzer, he’s going to need someone there to help him. They make home cooked meals, monitor his eating, and make sue he’s taken all of his medications on time. They call me at least ten days before a prescription runs out so I can get the refill and we’re not doing a fire drill. The other place used to call me when they’d given him his last pill. Then I’d panic and have to rush all the way across town. Here, they treat him like a king.”

“This home is absolutely gorgeous and I have never been happier,” Diane adds. “They’re like a big family. And here, they’re not giving my mom’s space away. They’re holding it for her in case she does come home, which is really nice.”

“I couldn’t give that bed away,” Jona admits. “He loves her with a passion. Every time he talks abut her, it’s with this beautiful light in his eyes. Sometimes it’s not about the money.”

For more information on residential care homes, Debbie Chang with Dawnview Care can be reached at 408.242.7459. Jona Romualdez with Harmonie Home can be reached at 408.997.7925 or by visiting www.BonHomieRCH.com.