Your World ;
; Arlene Johnson wanted out of her nursing home.
; A counselor helped her overcome obstacles.
; She’s part of a growing trend.
Her new life isn’t perfect. Last winter she argued with the landlord to turn up the
heat in the Philadelphia building where she
now lives. Once, she missed a doctor’s appoint-
ment because the doorbell downstairs was
broken and she didn’t hear the shuttle driver
buzz her. And sometimes her little apartment gets lonely.
But Arlene Johnson, 67, wouldn’t dream of trading her new life for
her old one. “Not in a million years,” she says.
After languishing for two years in a nursing home, Johnson is living
on her own. She’s one of many long-term institution residents regaining
independence, their numbers projected to soon swell into the thou-
sands. This growth is happening in large part because more federal and
state programs are designed to help them do it. Between 2001 and 2007,
Medicaid spending on nursing home care rose a modest 9. 8 percent,
according to the National Center for Assisted Living. Its spending for
home- and community-based care, in contrast, soared by 81.5 percent.
And a federal program that encourages states to use Medicaid dollars to
help nursing home residents transition back to independence received
a five-year, $2 billion extension in the new health care reform bill.
But longtime nursing home residents often face big hurdles to life on
their own. Determining whether they’re capable can be a complicated
task, requiring a thorough evaluation of circumstances that may seem
Out of Control
For Johnson, life spiraled downward after she developed a serious
infection following knee replacement surgery and had to have one
leg amputated. Soon, her husband died; she was alone. Johnson tried
to stay on in the row house where she’d raised her family, but flights
of steps in front and back made it almost impossible. When she re-
turned to the hospital for another operation, she reluctantly agreed
to recuperate in a nursing home.
“I didn’t need to be there; I could look after myself,” Johnson says.
“Another woman had lost a leg just like me, and she refused to get
out of bed. All she did was eat and watch television. I didn’t want to
end up like that.”
As the months passed, however, returning to life on her own began
to seem impossible. Simply finding a place to live presented an almost
insurmountable obstacle. “I had to find a place that didn’t have steps,”
she says. Newspaper ads don’t include such details. You have to go see
for yourself. “How was I going to do that?”
Then, one day last year, she heard about a woman in the nursing
home who was leaving to live on her own, thanks to a counselor who
helps people make the transition back to the community.
The counselor’s name is Nathan Bowman-Johnston. He works for the
Philadelphia Corporation for Aging, and its Nursing Home Transition
program finds resources for people who are older or have disabilities
but want to live independently. Many people taken to a nursing home
“may not even have a wallet or an ID,” Bowman-Johnston says. “If they
end up staying more than a month or two, they may lose their home
when they stop paying rent. We often have to start from scratch, get-
ting a birth certificate or some sort of identification, setting up a bank
account, finding a place for them to live.”
Arlene Johnson had it relatively easy. Her
finances were in good order. Her Social Se-
curity checks were still being deposited into
her own bank account. Because she qualified
for Medicaid, some of the money that would
have gone to the nursing home could be used
to help pay for the services she would need—
home health aides, delivered meals, a per-
sonal emergency-response medical system.
First, she needed an apartment with wheel-
chair access. Bowman-Johnston located a va-
cant one-bedroom unit in a large senior com-
plex with an elevator. He helped Johnson fill
out the application, but after it was accepted,
plenty of complications remained. Her son-
in-law, a contractor, widened the bathroom
‘I didn’t need
to be there;
I could look