Thursday, November 21, 2013

Improving care for people with dementia

Lutheran Services Carolinas opened its first official Alzheimer's neighborhood in 1991, and had an unofficial one around 1989. Many providers have closed or never opened space for people with dementia; they are generally low paying Medicaid recipients and it's not a profitable business model. In spite of those obstacles LSC has lived its mission: Empowered by Christ, we walk together with all we serve! LSC now has dementia or secure neighborhoods in 7 of its 8 free standing nursing and assisted living communities! Why? It's where the need is. Why? Christ said just as you have done it to the least of these you have done it to me. LSC has partnered with the Alzheimer's Association, Duke University, and others to learn how best to care for people with dementia. But LSC has always been constructively dissatisfied with its services, always looking for a better way. LSC was involved in the founding of Leadership Leading Age to raise up leadership in our organizations across the nation. LSC has sponsored two Leadership Leading Age Fellows. That program connected LSC to the Alzheimer's Resource Center of Connecticut. LSC received a state/federal grant to send 23 LSC team members to Connecticut to see first hand one of the nation's premier Alzheimer's care orgs. Many of our staff had never flown before. The visit was lifechanging for the attendees and for LSC. This week, the Connecticut people have spent the week training LSC teams from the participating LSC communities. All week I have been hearing reports and seeing pictures of phenomenal enthusiasm, change, and growth across our ministry. We've always done a good job of caring for people with dementia, but you ain't seen nothing yet. Tomorrow I get my chance. I get to go through the training with the Trinity Oaks team. Looking forward to learning personally how better to care for those who need us most. Stay tuned!

Tuesday, November 12, 2013


I am profoundly disappointed with our North Carolina state government. Our state is figuratively strangling some of the most vulnerable people in NC, specifically indigent nursing home residents! The state has not increased the rate that Medicaid pays for nursing home care in four years, that's 4 years!!! Our great nurses and nursing assistants rightly demand a wage increase every year. If they don't get more money, they can go somewhere else. The people that work at LSC aren't asking for the moon, but just enough to get by. And the price of food and electricity and gas keeps rising for LSC just like it does in our own homes. In the language of the farmers I grew up with, we are eating our seed corn. Lutheran Services Carolinas' seed corn is low turnover, quality care, and quality of life, all the things that make LSC communities a great place to live. How do we sustain what we have built for 50 years when we haven't had an increase in four years? And it gets worse. On January 1, 2014, every indigent nursing home resident in the state will be hit with a 3% Medicaid rate cut! Now, the law says that by January 1, 2015 the state is to decide on a plan to give us some of that money back in some type of "quality" incentive, but no one has decided on what that criteria might look like and if we get all, part, or none of that money back. It appears the cart is way ahead of the horse. It seems like we should have created a plan, then implemented the plan. We have implemented a plan, now we have to decide what the plan is. This rate cut is evidence of a larger problem. Nursing home expenditures are not the state's problem. Nursing home expenditures are stable. But Medicaid is rapidly expanding to cover more and more people. Somebody has to pay for that. Isn't it a shame that the poorest, oldest citizens in our state are bearing that burden? That is the disappointment!