Letter To The Editor: Los Alamos Residential Care Options Vs Overlooked ‘Inbetweeners’

By JULIE SMITH
Los Alamos
 
“Los Alamos Retirement Community” sounds like a wide-reaching organization, but do you really know which residents are helped by the live-in facilities available in Los Alamos, and which are not helped, are not eligible, or fall into the “inbetweener” category? You may think you know, but this is my ongoing experience.

Los Alamos Retirement Community’s live-in care options are Aspen Ridge Assisted Living, and Sombrillo Rehab and Nursing Home. There are vast differences in the life-stages and/or financial abilities of folks who are eligible and able to live at these facilities.

Aspen Ridge is a pretty building nestled on the canyon edge. Folks who find themselves living at Aspen Ridge are generally healthy with only minor personal daily assistance needs, such as help dressing or bathing or feeding or maintaining a medication schedule. If they need assistance with more than two basic daily personal care actions, then they usually don’t qualify to live there.

When visiting Aspen Ridge, you see residents visiting with each other and guests, enjoying card games and other activities. They have studio-style apartment rooms, a library, communal “living rooms” on each floor, and facilities for doing their own laundry. The one thing they all have in common is the $3,300+ per month it costs to stay at Aspen Ridge; whether in the form of private cash funds or an expensive insurance policy with long-term/assistive care benefits, these are the forms of payment accepted at Aspen Ridge.

Sombrillo Rehab and Nursing Home is next door to Aspen Ridge. Most folks who find themselves living at Sombrillo are at the opposite end of the personal assistance needs spectrum or the financial status spectrum. Many need supervision 24/7, or are bed-bound or wheelchair-bound, or are in various stages of Alzheimer’s or other dementia. 

Due to its certification as a “rehab” facility, one can also be there for short-term rehab from a hip replacement, for example. I’ve seen very few of these temporary rehab folks in the last three years. What most of Sombrillo’s residents have in common is a lack of funds and most rely on Medicaid to pay the $6,000+ per month, per bed (two beds to a room), that it costs to live there. Sombrillo is the only live-in care facility in Los Alamos that accepts Medicaid, which many seniors and disabled folks rely on to cover housing and care needs, regardless of their physical condition.

Let’s talk about Medicaid; before a person qualifies for Medicaid to cover housing needs at Sombrillo, or any other “nursing home” facility, they must spend all of their personal funds down to $2,000, which they are allowed to keep as a “burial fund”. They must get rid of all assets in excess of this burial fund, meaning their home must be sold, their car must be sold, everything of value that they own must be liquidated and those funds must be spent down to the $2,000 limit before Medicaid will begin to cover care expenses.

THEN, if they have a pension or Social Security, they sign over all but $69 per month to the care facility. They are allowed to keep this $69 for any living expenses such as haircuts, clothing, shoes, shampoo, toothpaste, anything else they might want or need. If the $69 doesn’t cover it, family or friends have to take care of it.

You may have seen the recent television commercials for the Beehive Homes; they are group homes offering small resident-to-staff numbers and located in home-like facilities. In February 2015, Beehive obtained a permit from Los Alamos and is in the early planning stages of building and opening such a home here. They are also a for-profit, private-pay facility just like Aspen Ridge and they do not accept Medicaid. 

I visited by phone with a gentleman at Beehive who is directly involved with the Los Alamos project; he agrees, they will be offering Los Alamos the same thing as Aspen Ridge, only on a smaller scale, and like Aspen Ridge, they will not be able to help those who fall in-between the care limits and financial limits of their facility and Sombrillo.

My mom is one of the “inbetweeners” who falls between the levels of care needed and the payment options available to her at Aspen Ridge and Sombrillo. She is paralyzed on one side due to a stroke three years ago; her mental faculties and speech were not affected, and she has the use of her dominant hand, arm and leg, but she needs assistance with dressing and personal hygiene.

She requires too much assistance to live at Aspen Ridge and she doesn’t have the cash funds to pay for it. She can’t live alone and her only family have to work fulltime jobs (non-LANL employees) to pay for their own rent and can’t afford to hire a private, fulltime nurse to care for her, much less be able to afford a wheelchair accessible apartment/home.

In a split second, she went from an active life with her own apartment, a car, friends and activities and travel, to being bound to a wheelchair, living in a facility with residents who are unable to even carry on a conversation with her. She, in her right mind, is fully aware of the yelling and crying of residents half out of their minds, of having to deal with confused residents wandering in and out of her room and getting into her personal belongings because they can’t remember which room is theirs. 

The only people she can carry on a conversation with are staff and visitors. She needs interaction with her peers, she needs to feel “normal” and vital, and she needs to live in a place where she can contribute to even the smallest of activities such as folding clothes or unloading a dishwasher. She has a few friends who visit as their schedules allow and she loves those days. She can call dial-a-ride and they can pick her up and drop her off somewhere as long as she can get around on her own while she’s there or has someone meet her there. But the rest of the time she’s held hostage in a facility where she doesn’t belong because Los Alamos does not offer what she needs. She is not the only person in Los Alamos in this situation.

The director of Sombrillo and I have discussed the situation and she agrees that Los Alamos is gravely lacking in providing an option for this growing population of “in-betweeners”. She agrees my mom does not belong at Sombrillo and that there are no appropriate facilities for her and others like her here in Los Alamos, Espanola, Taos, Santa Fe or Albuquerque.

One of Sombrillo’s nurses and her husband have been looking into the option of buying a home that can be modified and fitted for the needs of folks like my mom, and that can be approved of and paid for by Medicaid. But the scope of requirements is so wide that this is most likely just a pipe dream.

As a daughter, what do I do? As a community, when is Los Alamos going to recognize this growing population of folks in need and start planning or doing something to include them? Or, do we all know about the “inbetweeners” but just choose to ignore them? What if you were an “inbetweener”? What if you, traipsing along with your life were suddenly struck down and bound to a wheelchair with 20 or 30 or even 40 years yet to live, but with no money or family to help you? What would you do?

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