For Senior Care, Smaller is Better

When I worked in nursing homes, I routinely cared for 8-to-14 residents, and even more during the frequent staff shortages, which by the way are still common today.

I’ve learned that one thing just about everyone dreads as they age is the possibility of ending up in a nursing home. Sharing a room with strangers, sitting slumped in a wheelchair all day, strict schedules, bad smells, and waiting “forever” for someone to answer your call bell…

For more than 1.3 million Americans, this is home.

But in Washington State (and other States) there’s an effort to change that – it’s known as the Adult Family Home program.

Today, there are more that 2800 of these adult family homes in Washington State, and Joseph Spada, LPN (Spada Homes, Inc./Spada Care Homes) was one of the earliest adopters who became an AFH provider to offer this type of nursing home care alternative to seniors in Seattle.

It’s midday, and no one is on the sunny back patio. That’s because it’s lunchtime. In the open suburban home’s kitchen, Peter Makosi is preparing a meal that would have the savviest cook salivate: baked Tilapia fish, fresh string beans with butter and garlic, and boiled potatoes with fresh parsley which was just harvested from the outdoor herb planter.

But Peter isn’t just a cook. He’s also a Certified Nursing Assistant, and like other Spada Care Homes nursing assistants, he is certified and trained to provide personal care to residents.

Peter takes his job seriously. He says this isn’t anything like the job at the nursing home where he used to work.

Since gaining employment at Spada Homes, I have experienced and learned a lot. The quality of care and attention given to each resident is remarkable. Individual preferences and care are extremely important and the management and staff go the extra mile to exceed expectations and provide top-notch care. I am so happy to be a part of the team that makes Spada Homes so great. We cook, provide care, and do daily activities and exercises with them – we get to spend a lot of quality time with our elders,” Makosi says.

One of the reasons Makosi and the other nursing assistants can spend quality time with the residents, as they’re called here, is that there are never more than six residents living in any one of Spada Care Homes, and often two staffs on duty. Every resident has a private room and bath that’s close to a common area, which includes the kitchen, sitting room, living room and a communal dining table that has enough space for residents and staff to eat together.

If you can’t be in your own personal home, this is truly the next best thing. Familiar, familial, and competent care round-the-clock.

Let’s Abolish Nursing Homes

Jack shared that he came to Spada Homes after being unsafe and socially isolated at home, but a nursing home was out of the question; his daughter insisted that he could no longer live on his own.

Joseph Spada started up the care homes in 1991, when he realized and understood that the institutional system was broken and unsafe. There was a real need for quality, personalized care in real homes, “let’s bring seniors home,” he said.

Dr. Darrell Owens, DNP, a geriatrician in Seattle, Washington, has several patients who live in Joseph Spada’s care homes; he – or one of his Advanced Registered Nurse Practitioner (ARNP), visits them on a regular basis – no need to travel and sit in waiting rooms for hours.

Spada says the traditional nursing homes are slowly being replaced. “Most of them were built in the 1960s and ’70s, and their popularity and use is waning. So what next? What’s better?”

What’s next is adult family care homes such as Spada Care Homes. Now, with more than 2800 homes in Washington alone, there’s enough research to get an idea of how they’re working, and to see that consumers prefer them over large, institutional settings such as nursing homes.

And they’re working well. Studies show that residents are happier and stay healthier longer.

Joseph Spada, President of Spada Homes, Inc., explains that those private rooms aren’t just a luxury — they’re safer than a traditional nursing home, where two or more people share a room and a bathroom with other people in the room next door.

Research shows that residents living in these small settings maintain their independence longer than residents in traditional nursing homes, or assisted living facilities, where hallways are long and schedules are tight.

“Residents are often confined to wheelchairs in order to efficiently move them around,” Spada says, “and they quickly lose their ability to walk.”

Dee Dee Rainbow showing her artfuly painted nails.

Dee Dee Rainbow showing her artfuly painted nails.

Here, there are no strict schedules. While the residents gather at the table for lunch, Dee Dee Rainbow stays in her room, finessing her colorful and artistic fingernails. The 72-year-old is not in the mood for lunch right now, but she’s not worried about missing out. “Whenever I am ready, they’ll bring me poached eggs, lamb chop, and fresh spinach, my favorite,” Rainbow says.

Personal services, private rooms, and high staff-to-resident ratio — it all sounds expensive, but Spada Homes costs are about the median for nursing homes nationally. In fact, Spada Homes serves mostly middle-class people.

At Spada Homes, residents are able to enjoy the privacy of their own rooms, the company of the communal table, and all the personal care they might ever need. It’s their choice.

References

PubMed: J Am Geriatr Soc. 2007 Jun;55(6):832-9.
Books: Author, Joseph Spada, LPN, 2014, “How To Find The Best Adult Family Home Care For Your Elderly Parent.”

About The Author

Joseph Spada

Joseph Spada is a geriatric nurse of 33 years with extensive experience in long-term care and adult family homes. He is the Founder of Spada Care Homes and author of a #2 Bestseller, "How To Find The Best Adult Family Home Care for Your Elderly Parent" (Amazon). Joseph is also a Faculty instructor at North Seattle College, teaching the 52-hour AFH Administrator Certification.

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