The real world and beyond

Nursing Homes, June, 2004 by Richard L. Peck

Experienced readers of Nursing Homes/Long Term Care Management know that we take pride in our coverage of long-term care design. We have published our annual DESIGN compendium of outstanding projects for eight years and have focused on a wide array of design considerations in our regular issues for more than a decade. The issue you hold in your hands, with articles on "community-friendly" design, testing the impact of a renovation, and questioning whether we've gone too far with "homelike," is only the latest example. We like covering design; there's a lot of excitement and activity in this field.

Sometimes, though, it helps to get a perspective from "the real world" of long-term care facility management. One such arrived recently from a reader who said he was inspired to respond to the title of a DESIGN 2004 editorial I wrote alluding to the real world. This year's DESIGN publication, said Stephen P. Miller of Bridgemark, LLC, an Oak Park, Illinois, management firm, was "a delightful, informative, and inspiring experience all around. Unfortunately, I enjoyed it much the same way that I might enjoy a visit to a Mercedes showroom: Alas, I can no more foresee pursuing something along the lines of, for example, Chautauqua County Home's magnificent renovation/construction project than I can driving off in a brand-new S600. For the thousands upon thousands of skilled nursing facilities that serve a primarily Medicaid-paying clientele--facilities which themselves are often aged and aging--the prospect of spending more than $68,000 per licensed bed, as Chautauqua did, is as out of reach as that Mercedes. Rather, in our world, we too often hope we can round up enough volunteers to spend a weekend or three painting, hanging wallpaper borders (probably scrounged from the discount bin), or putting out annuals in the planting beds."

Miller continued that this type of facility is the one that "the 80-year-old with advancing Alzheimer's or with increasingly frequent falls at home is far more likely" to occupy than the ones depicted in DESIGN 2004. He requested--not at all unreasonably--that we provide more coverage of design options for facilities with limited budgets.

Facilities like these that go the extra mile for their residents are not only praiseworthy, they express the heart of long-term care, and we welcome their stories. But I've always been a big fan of the "break off a piece of the big story and put it to your own uses" approach. We don't recommend spending $68,000 per bed (although we don't mind readers being "wowed" by facilities that do). But the going rationale behind DESIGN and much of our design-related coverage during the past ten years is that readers might find something--an element, a feature, a floor or wall treatment, a bathroom or bedroom layout--that they might adapt comfortably within their own facilities' circumstances. Who knows, maybe if they're really inspired, they can put together a plan and round up the money to go more than that extra mile.

We all have to live in the real world. Our aim is to harness warm and caring spirits like Mr. Miller's and point them in the direction of "real world" improvements that they might never have imagined possible.

BY RICHARD L. PECK, EDITOR-IN-CHIEF

To comment on this editorial, please send e-mail to peck0604@nursinghomesmagazine.com.