Specialty home for Parkinson’s patients finds government hurdles
Hope Specialty Healthcare staff, seated from left, Kabou Xiong, RN, and Suzie Chao, Marketing Director. Standing from left, David Splittstoesser and Mark Joplin, investors, and May Lo, Director of Administration. (AAP staff photos by Tom LaVenture)
By TOM LAVENTURE
AAP staff writer
Elders, especially those with special health needs, would be better served and have better quality of life in an assisted living situation if they have more personal attention from staff and live in a home setting.
That is the idea put forth by Hope Specialty Healthcare (hopespecialty.com), a series of homes designed to offer more personable quality of life care for clients with Parkinson’s Disease or other neurological disorders. They have opened two 6-bed facilities in Prior Lake and Maple Grove and recently identified a 30+ bed facility in Maplewood.
May Lo, Director of Administration, has 13 years of dental administration background with Quan Family Dentistry, and decided to follow her dream to work more closely with elders and their families. The project took off when she and Suzie Chao, Marketing Director, put the pieces in place and looked for staff and investors.
“There was no hesitation,” said Lo. “I took a leap for this project, inspired by my grandmother Zhong Yang, who is 89 years old, and full of whit. However, with aging and arthritis, daily activities has been a struggle these last few years.”
Chao, describes Lo as the heart and backbone of Hope Specialty Healthcare. She said that the immigrant-refugee Southeast Asian community also has its aging baby boomers, and that veteran of the War in Southeast Asian are aging and many suffer from war-related neurological disorders.
“There has been a rise in the number of people in our society that have become afflicted with Parkinsons’ Disease,” said Chao. “Individuals with this disease require special cares and assistance in their daily lives.
“We, at Hope Specialty Healthcare saw this need and thus decided to provide environments and homes to care for these individuals,” she added. “We want our residents to have the best of individual cares as well as be able to live the most fulfilling lives possible in a place they can truly call home’.”
Kabou Xiong, RN, came on board after earning her degree in Nursing from St. Catherine’s University in 2009. She began working with May Lo and Susie Chao last September to structure a working care plan for a Parkinson’s care facility. She supervises the care staff at all three locations.
She began by taking additional nursing training for Parkinson’s patients to better understand the neurological disorder and how it affects the body in order to design a care facility where the can see a better daily impact with clients and their families.
The advantage to Hope Specialty Healthcare, said Xiong, is that it offers more personal care with the client than is possible in a hospital or nursing home setting.
“We get to know them as a whole person and hear their stories, rather that just getting to know what’s wrong with them, and taking care of what’s wrong and then leaving the home,” said Xiong.
A facility like this would have three shifts to manage therapies, medications and basic life support services – following instructions from physicians, respiratory therapists, and other health care professionals.
“Its kind of creating a safety boundary for them; knowing that if anything happens they have professionals that are around whether at home or by themselves,” she added.
With fewer clients in a home setting, the personal care assistants are trained and have the time to work on “assistance cues” of Parkinson’s symptoms such as freezing, falling back, or forgetting, she added. In addition, there are other Parkinson’s related health problems and aging conditions from chronic pain to heart conditions.
“They need someone to be there to remind them to take a step, or remind them to move, or to remind them to use some of their therapy techniques to prevent them from falling,” said Xiong.
“Parkinson’s is a neurological disorder that affects the dopamine distribution of the brain,” she added. “So it affects mobility and coordination and so that is why it is important to get them their meds on time.”
A potential client would get an initial assessment to determine how much care they need and what stage they are at with their Parkinson’s or other neurological health issues. Then it can be determined if they would qualify for an assisted living situation. The staff is in constant communication with physicians and updating health and treatment records.
As an Asian run home the staff are also sensitive to traditional Chinese medicine and other modalities.
“I personally honor the holistic and the whole ethical aspect,” said Xiong.
Culturally appropriate care is mostly about respect for clients needs, where honoring and providing what is right is at the root of everything. When this is incorporated into training staff about the different cultures in the home she said it would impact on care with sensitivity.
“I believe that morals and values are what a lot of people hold dear to their life and respecting that would definitely increase their quality of life,” said Xiong.
Most traditional Asian families like to keep the elders in the home for as long as they can. When special needs are required appropriate care becomes an issue to working households – she said families would then look for a home that can provide the type of care that they would like to provide in their own family.
It is all part of quality of life care and the staff goal to ethically responsible for vulnerable people that are entrusting their care and personal information to them. They are careful to honor privacy and allow family access at all times within the client’s wishes.
Parkinson’s is a life condition that when manageable may help delay the onset of secondary chronic health problems that make overall health deteriorate. Xiong said if the staff can become more involved in the daily life of the client and help them to keep doing what they like to do – in addition new challenges – then it is preferable to being institutionalized.
“With Parkinson’s patients, their ability to process is much slower and they need a lot more time to get what they are thinking across,” she added.
Response time can depends vary and it might take 5 to 10 minutes to respond to a caregiver if the neurological connections are slower. The brain responds right away, said Xiong, but it takes longer for the rest of the body to speak or to react.
A Parkinson’s patient may have once been a very energetic and outgoing person, and they still are inside, but it is not apparent in their exterior. A staff that knows their patients and works closely with the families will know what to say or do to improve their quality of life.
Lo said that from the beginning, the group learned quickly that each county has its own rules and processes, which complicates the process to open several facilities around the metro area.
“We had originally wanted to start the assisted living project in Ramsey County,” said Lo, who said she learned that small facilities have larger hurdles to determine a need for services.
Scott County and Hennepin County also presented Hope Specialty Healthcare with additional contracting or licensure hurdles. They argue that there is a waiting list for persons with Parkinsons’ Disease needing the care they can provide better than a larger public facility.
“Our hands are tied,” she said. “Residents had to be turned away because we do not have the Elderly Waiver contracts. A large number of them need EW to cover expenses. Not everyone can do private pay.”
Kia Xiong, Contract Manager, Ramsey County Human Services, said there are currently four other homes for Asian elderly in Ramsey and Hennepin County. She said the county requires that specialty care homes with 5-beds or fewer beds require a foster care license and to show need before development.
“That was the road block for them,” Kia Xiong.
Hope Specialty Healthcare identified a facility for a 30+ bed unit in Maplewood. They will also need to work with the city to ensure code compliance before the county will consider its Requests For Proposals for the Elderly Waiver Companion and Assisted Living contracts.
“Right now there is a moratorium on corporate foster care licenses,” she said. “The moratorium doesn’t effect homes for people over (age) 55, but we need to make sure that the concentration of homes is not too close to each other.”
The concentration area for smaller homes is in part identified by need, such as the number of units in the surrounding area – whether they meet other criteria such as an ethnic facility or providing other needed resources, but the concentration is also maintained to prevent an overabundance number of units in any given neighborhood.
Contracts come from the county to handle their cases and also from health care providers. Kia Xiong said people would be pleased to know that specialized homes are available to provide for their needs and that the county is not the only provider – adding that the county only handles about 10 percent of those services.
The Elderly Waiver is about eligibility for people age 65 and over that are on medical assistance and qualifies for supportive services. The waiver might be just for in home services or with other housing options.
If a patient is not eligible for assistance and they don’t have the money to pay for private care – they end up not receiving the care they want.
“If these waivers are not passed or we don’t get them, then we won’t be able to provide care for the ones that need it most,” said Kabou Xiong. “I think that the ones that need it most are the ones that are already getting assistance from the county – but then they cant afford to come into a home and pay for it out of their pocket and receive professional health care on a daily basis.”