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BOULDER COUNTY BUSINESS REPORT
Millbrook's homelike setting assists
Alzheimer's patients
By Caryl Buckstein
LONGMONT -- It's taken a long time,
but Raymond Wismer, 95, seems happier now. Until two years ago, he
took care of his ailing spouse. When her condition worsened, he drove to the
nursing home each day to spend three hours by her side.
Wismer was crushed by the death of his wife. He would
never talk about it, but he began to slip, his daughter Sally Steinmetz
said. He was unable to remember things and started wandering off on his own,
becoming disoriented. He moved to a nursing home, where his spirits and his
physical capabilities began to drop off. He went from 130 pounds to 110. "He
would barely eat enough to stay alive," Steinmetz said. "He was very
unhappy."
The turning point came when he moved into a new home
that actually seemed like home. Wismer soon began to improve. The house sits
in a residential area of carefully tended homes near Fox Hill Country Club.
He joined four other people in similar straits, all with some kind of
Alzheimer's disease or dementia. "He seems so happy now. I look forward to
our visits," said his daughter.
It is part of the good life that Chief Executive
Officer Paul V. Miller and his associates hope to provide residents of
MillBrook Homes, a Denver-based corporation focusing on long-term care for
Alzheimer's and other memory impairment disorders. Whenever physically
possible, he hopes MillBrook residents can avoid placement in institutions
and remain in MillBrook home settings for the rest of their lives.
People with Alzheimer's disease begin to forget recent
events or familiar tasks. The rate the disease advances varies from person
to person, but Miller, a psychotherapist, notes, "The results are always the
same." The brain disease eventually causes confusion, impaired judgment, and
personality and behavior changes. Communication becomes difficult. If a
MillBrook resident's condition ever deteriorates to a state where they need
total nursing care, they may need to move.
MillBrook has built seven homes in Colorado, two of
them in Boulder County. Of the others, four are located in Arapahoe County
and one in Jefferson County. Miller joined with an emergency room physician,
Dr. Michael Opatowski, and a certified public accountant, Harvey Milzer, in
early 1997 to form the corporation. The trio hopes to operate 50 homes
within three years, and 100 homes within five years. MillBrook's first
out-of-state home, in Las Vegas, is expected to open later this year. Miller
and his colleagues are optimistic about the future of their business, but
realize it's a two-edged sword. "It is a very sad illness," Miller said.
The Chicago-based Alzheimer's Association estimates 4
million people have Alzheimer's. Its reach is much farther, however. A
national survey in 1993 indicated 19 million Americans had a family member
with Alzheimer's, and 37 million know someone with the disease. Blame an
aging population or other factors, but the association projects the number
of Americans with Alzheimer's will grow to 14 million in the next 50 years,
unless a cure is found.
Despite a growing need for Alzheimer's care, most
health-care providers aren't interested in offering it . "It demands a
higher level of care than required in a nursing home setting," Miller said.
"The residents need a lot of attention." MillBrook has a trained staff
member on duty around the clock.
If a patient's prognosis seems poor, the presence of
the MillBrook home stands in defiance. The house here is light and airy for
a reason. Light is particularly important to Alzheimer's patients, noted
Darren Delfino, a worker at MillBrook Homes. Each resident gets a private
room decorated by relatives to be as homey as possible. Wooden dressers,
homespun bedspreads and paintings abound.
Residents who share the MillBrook Home with Wismer
visit with loved ones in a front room that resembles the front room of many
houses built 23 years ago. A hairstylist stops by once a week. Manicures are
provided. The $3,500 monthly cost also includes clothes, incontinence
supplies, everything but medicine. The home-cooked meals have helped her
father flourish, noted Steinmetz.
Wismer is probably unaware of the front door that bolts
so securely to protect its residents from wandering alone into the daily
unknown that lurks beyond the front yard. Residents are free to walk in the
backyard to enjoy outdoor flowers and grass. MillBrook provides
residents with activities that include exercises and excursions appropriate
to the particular patient's stage of the disease. Stimulation from movie
theaters and a trip to the zoo is too much for most dementia patients,
Miller said, so most outside trips involve long drives. "They're often
topped off with a trip to the Dairy Queen," he added.
When residents are still able, MillBrook has a van to
take them to more stimulating fare.
As in other settings, the cost of care is largely borne privately by
families. Neither Medicare nor private health insurance covers the long-term
care most patients need. The cost is reasonable when contrasted with the
cost of institutional care, Miller said. The average bill per patient for
nursing home care is $42,000 per year, but can exceed $70,000 per year in
some parts of the country, according to statistics by the Alzheimer's
Association.
In the past, Alzheimer's patients often were housed in
nursing homes, with patients suffering other afflictions. Most patients with
Alzheimer's disease or dementia are healthy, said Miller, a psychotherapist
with a background in geriatrics. Their actions were often misjudged and
result in wrongful retaliation. "Here, if someone wanders into the wrong
closet and puts on someone else's clothes, it's not a big deal," Delfino
said. "Someone else has done it, too."
Copyright (c) 1998 Boulder County Business Report.
All Rights Reserved.
July 1998
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The Daily Times-Call Peace
of Mind
MillBrook Home caters to Alzheimer's patients' special needs
By Ted Nelson
LONGMONT -- The 85-year-old woman loves
the friendly, blond cocker spaniel that shares her stylish ranch-style home
in the Fox Hill neighborhood, but she can't remember its name. If someone
reminds her that the dog's name is Buck, she'll likely forget it again
within 10 minutes.
Most of the residents of the six MillBrook Homes for
people with Alzheimer's disease and dementia need help getting dressed,
bathing and preparing food because they often forget what they're doing in
the middle of a task.
MillBrook co-founder and chief executive officer Paul Miller has seen men
try to shave with their toothbrushes and a woman complain that a man's black
wingtips didn't fit her much smaller feet.
Each MillBrook home houses up to five residents who
need a lot of special attention. A caregiver remains in each home 24 hours
per day and accompanies residents whenever they leave. Groceries are
delivered to their door. Hairstylists and pedicurists make regular visits.
All stairways in the homes are closed and locked.
Stoops and sunken floors are leveled off. Bathroom lights are controlled by
motion detectors so residents will not become lost or have accidents.
Kitchen utensils are kept in locked drawers to prevent accidental injuries.
Each room is equipped with extra lighting to prevent confusion associated
with darkness.
MillBrook 's first home in Longmont opened in January,
but will have just two residents until it is licensed by the state for five
residents. Miller said the company is looking for a second Longmont house
and hopes to open one or two more within the next two years. It plans to
open up to eight additional homes in Fort Collins, Loveland and Greeley
during the same period. The chief executive officer said Longmont had only
58 beds in facilities providing specialized care to Alzheimer's patients
before MillBrook arrived. Some Longmont families drive as far as south
Denver to find care for their relatives, he said. Such distances make it
difficult for families and friends to visit as regularly as they wish.
``Our house is a home,'' Miller said. ``There are no regulated visiting
hours.'' He said the concept of small group homes for people
withAlzheimer's disease was pioneered more than 12 years ago, but really got
off the ground during the past five. It is part of a general shift from
nursing homes to assisted-living centers.
Miller said 85 percent of MillBrook 's residents are
women -- mainly because they often outlive their husbands. Many of the
residents moved to the homes after their caregiving spouses died or after
they were required to leave assisted living centers because they wandered
away or mistakenly picked up another person's things. Miller said his 14
years of work in hospital psychiatric wards and outpatient clinics helped
him understand the needs of people with Alzheimer's.
He has found they respond more favorably in a home environment than in an
institution.
``Security is the main factor,'' Miller said of the
Longmont home. Because confused wandering is common among Alzheimer's
victims, the front door of the home is secured with a magnetic lock operated
with a numerical code on a keypad. Fire alarms would open the door
automatically. Residents are free to walk out the back door and into the
roomy back yard. They may even start a garden there, but a waist-high hedge
and a 6-foot, wood fence prevents them from leaving. All other doors are
locked. ``We've never had anyone wander off,'' Miller said. Controlling
noise and stimulation is critical to preventing people with Alzheimer's from
becoming overly confused or frustrated, he said.
``They lose the ability to filter out noise they don't
need to pay attention to, and it just bombards them,'' he explained.
Classical or Big Band music plays constantly but softly on the home's
stereo. Alzheimer's sufferers can become boisterous, aggressive or loud if
they become bewildered to the point of frustration. ``We have none of
that,'' Miller said. When an 84-year-old woman asks when her parents are
coming to pick her up, he said, it would do no good to explain that her
parents have been dead for years. To avoid anxiety or agitation, caregivers
might gently tell the woman her parents are at work.
Christine Lucero, who rotates on 24-or 48-hour shifts
supervising the Longmont home, said residents can have difficulty
understanding directions unless she speaksslowly and clearly. The University
of Colorado kinesiology graduate volunteered in nursing homes throughout
high school and has been working in MillBrook homes for six months.
MillBrook homes are not staffed with nurses, because residents do not have
serious medical problems other than Alzheimer's. ``The residents don't so
much need constant attention as a little direction and help with their
activities. And they enjoy the help,'' Lucero said.
Caring for five people with Alzheimer's usually is
easier than caring for five children, she said, because they are ``nice,
calm and generally have retained their social skills so that they act
appropriately.'' On a bulletin board Lucero keeps an hourly schedule of
activities she will organize for residents. The list includes exercise
sessions, ball tossing, board games, painting, crafts, baking, ice cream
socials, tea time, clothes folding, reminiscing, occasional trips, sing-alongs
and instrumental music.
To provide mental stimulation, caregivers occasionally
open up the ``sensory box'' for residents to explore. It contains items that
may trigger pleasant memories or activities, such as a toy tractor, dolls,
knitting needles and yarn. ``It would never occur to me to be in any
other place,'' said a well-dressed resident, Ada Mary. Ada Mary's daughter,
Barbara Lavender of Boulder, moved her mother to the home when dementia made
it impossible for her to remain in her own house or in a large
assisted-living center. At the time, she said, her mother was forgetting to
eat, wandering outside in her housecoat and slippers and not allowing anyone
to clean her house.
Lavender sees the home as a wonderful, comfortable,
safe and personable alternative to the busy, institutional atmosphere of a
nursing home, which she finds ``really depressing.'' She said her mother's
mood noticeably improves when she is taken on outdoor walks. Terry Zamell,
who administers personal care home inspections for the state Health
Facilities Division, said MillBrook 's five other homes are safe and
well-run and obtained licenses without significant problems. The Health
Facilities Division has not yet inspected the Longmont home.
Julie Medearis, who lives on the same block with the
home, said she knows of no problems caused by the facility in her
neighborhood. She said she will be interested to see what happens when the
warmer weather draws residents outside.
The cost for a room, board, basic supplies and all care in one of
MillBrook's homes is $3,500 per month. The company does not accept Medicaid
clients.
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