Health care reform, Dan Baum’s and his mother’s assisted living journey.

 

My father's childhood friend Daniel Jay Baum shares his mother's experience in an assisted living facility.

My father's childhood friend Daniel Jay Baum shares his mother's experience in an assisted living facility.

 

Health care reform, which has dominated domestic policy discussion for months, took a major step forward Tuesday after the Senate Finance Committee unanimously approved a bill that seems to augur substantial, if centrist, reform. 

One part of the health care reform effort that has received comparatively little attention is the Nursing Home Transparency and Improvement Act. 

Among the bill’s major elements:  improved access to information about how well nursing home providers staff their facilities; more quality-related information being made available to the public; making it easier for family members to file complaints about poor care and protect them from retaliation; and ensuring better care of the 70 percent of nursing home residents with Alzheimer’s and other dementia by requiring pre-employment training in dementia management and abuse prevention.

 Daniel Jay Baum is a retired law professor and childhood friend of my father.

His mother spent her final six years in an assisted living facility-a stint during the end of which her dementia became more and more pronounced.

Baum writes a personal, insightful account of his and his mother’s experience in Assisted Living for Our Parents:  A Son’s Journey.

The journey is a decidedly mixed one.

Baum writes the book three years after his mother’s death, and it’s clear both that he is processing the experience and has enduring misgivings his mother’s treatment at Glengrove, an assisted living facility hundreds of miles from his home in Canada.

Assisted LIving for Our Parents opens with Baum’s recognition that his mother, at age 89, could no longer live safely in her home.  

Divorced and working, Baum weighs, but decides against, his mother coming to live with him.   These realizations prompt him to encourage her subtly, and not so subtly, to sell the home in which she had lived for more than 40 years and move to an assisted living facility.

In many ways, the move seemed like a positive one. 

Baum was in the position to pay the comparatively hefty price tag for the facility, which catered to both Reform and Orthodox Jewish residents.  His mother was sprightly and had both intact mental facilities and significant mobility when she entered the home, which promoted itself as committed to helping residents’ “aging in place”-a term that essentially conveyed a belief in practices that help residents retain as much independence as possible. 

Although distressed about leaving her home, Baum’s mother instantly connected with another resident, Alice, with whom she established a close relationship, enjoyed talking with staff and the in-house deli and became a model resident for how she maintained her room. 

But the experience was far from universally positive, especially when Baum’s mother’s mental and physical decline became more pronounced.  In addition, and perhaps more importantly, Baum and his mother rapidly came to understand that the home’s rhetoric about residents’ independence was just that-a largely empty set of promises that was belied both by staff behavior and administrative practice. 

In fact, matters ranging from residents’ sexual activities to the people invited to Baum’s mother’s birthday party were deemed as to be under managerial control. 

This controlling approach combined with what Baum characterizes as inattentive and even incompetent medical care as his mother’s dementia worsens leads to some painful moments and frantic interactions between Baum and the home’s staff, doctors and administration.  

One of the book’s many strengths is Baum’s unsentimental and unsparing look both at his own and others’ conduct.  

He writes at the beginning of the book, for example, about his not so subtle advocacy of his mother’s leaving her home-a decision about which he appears ultimately to have some regret.  His sticking with Dr. Brian toward the end of his mother’s life also seems in retrospect to give him pause. 

His gaze applies to the home as well.  The technocratic actions of the home’s administrators receive some attention, as does the facility’s largely indifferent response to Baum’s mother and other residents’ experience of having some of their belongings stolen.  

Yet the book is not simply the account of a loving son working through emotional catharsis or an anti-nursing home screed.  While holding himself to account in place, Baum also appears to be sharing his experience so that others can benefit.  He writes approvingly of the presence of both Orthodox and Reform rabbis as well as of a number of staff who repeatedly demonstrate their concern for, and dedication to, the residents.  

This balanced approach gives the book intellectual credibility as well as emotional resonance.   

Assisted Living for Our Parents is a valuable work whose utility is only likely to increase as the baby boomers age and the need for assisted living and other nursing home care grows.  While Baum’s inclusion of a set of recommendations is helpful, his honest and probing recounting of the details of his mother’s final six years is even more so. 

As the most major health care reform in decades appears to gain decisive momentum, I hope that readers will consider this slender and accessible book.

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4 responses to “Health care reform, Dan Baum’s and his mother’s assisted living journey.

  1. BS 4 BlackSUN AS

    sure i m not gonna read all this but the title. and from the title a question is rising. for centuries you ve been told and you told the world, there is ONE way in life: capitalism. let us make “in god we trust” money, the “american way of life” the ” american dream ” ( note if only you could read and pick up the dictionary sometimes …the ” american DREAM* ” heim , but ok, anyway)

    suddenly just because you see a so called ” policy discussion ” on the television or in your cute house of the representatives at the tribune surrounded by 2 beautiful fasces.

    http://en.wikipedia.org/wiki/Fascist_symbolism

    so just because television shows and left and right arguments (ordo ab chaos) you suddenly turn your head 180° and now worship the opposite?
    my question is you were blind idiot bloody selfish capitalist without knowing why for years? or are you now new bloody idiots because you just believe what the show tells you on tv without never questioning yourself and think and go to the bottom of things? whatever the show is , you just believe it. is it?

    do you remember for instance when you were young who brought you the biggest lie of your childhood? your mother yes, with the help of dear government and force of habit she told you santa claus ( close to who? so easy pfffff always the same story just change the names and the ape is lost, just change the letters’ orders in fact)) was real. and you cried the day you knew he was not…

    why did your mum lied to you?
    if you mother lied by ignorance and lack of personality then do you think it is a possibility that your leaders might lie to you as well?
    now ask yourself the last question: did i believe in santa doing good for me? YES YOU DID… hard as a rock, you even beat one of your cousins or buddies older that you who told you: ” listen this is crap , i found out its’ not real, there is something occult and creepy behind it, it s just about control”

    in politics nothing happen by chance, if it happened it was meant that way. thomas jefferson i guess

    and the perfect plan is not and never coming together in one shot… this is from me. meaning there is the 1st lie then the 2nd then the 3rd and you believe hard as a rock in each of they even there are all lies and complete opposites.

    remember dream?
    ok here is the dictionary:
    dream (drem)
    noun
    1. a sequence of sensations, images, thoughts, etc. passing through a sleeping person’s mind
    2. a fanciful vision of the conscious mind; daydream; fantasy; reverie
    3. the state, as of abstraction or reverie, in which such a daydream occurs
    4. a fond hope or aspiration
    5. anything so lovely, charming, transitory, etc. as to seem dreamlike

    Etymology: ME dream, dreme: form < OE dream, joy, music dorbeetle); sense < ON draumr, akin to Ger traum, Du droom < IE base *dhreugh-, to deceive

    Etymology: to deceive??????????????

    american dream was it?

  2. My younger brother Jeff is the shame of the Degan family. He not only lives in France, he actually likes it there. He has a French wife and two gorgeous little French daughters. Honestly I think the guy is a closet commie. Back in August, in a letter to his fellow countrymen and women regarding health care, he ended it by saying:

    “In short, in the US, you pay more, get less, and die younger than we do in Europe. What part of that don’t you understand?”

    Well, hey there! That’s a danged good question! What part of that don’t we understand? Why is it that so many of us have to be dragged, kicking and screaming like half-witted little preschoolers, into the brave new world of change? What the hell is the matter with us anyway? How can it be that such a huge number of Americans cheerfully join movements of mass stupidity and salivate on cue to the sound of Dr. Glenn “Pavlov” Beck’s bell? It kind of makes you wonder, huh?

    http://www.tomdegan.blogspot.com

    Tom Degan
    Goshen, NY

    • jeffkellylowenstein3

      Thanks, Tom, for your comment. I checked out your site and can say that, while we may not agree on a lot of issues, I look forward to being part of each other’s conversations. I don’t know about you, but I feel like too often we end up speaking primarily to people who share our views.

      Thanks again.

      Jeff

  3. BS 4 BlackSUN AS

    “In short, in the US, you pay more, get less, and die younger than we do in Europe. What part of that don’t you understand?”

    both being the same stupid animals aka human resources ( and proud to be to get more papers and sometimes just number on a screen that you call monies) it might be just because one is statistically more lucky (and it has to be one or the other ain’t it?) . but if i do refer to my 32° degree most of they are dead things anyway, just they ignore it. so i m not sure it matters. i m even sure it does not matter to be honest. it s a binary issue like all the rest, either you re 1 or 0 . and it takes a lot of zeros to make a 1 big.

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