Nov 4, 2009

Pending Tragedy of our Broken Healthcare System --Lakeview Ranch

Lakeview Ranch located in Darwin MN, specializes in caring for the "hard to place" and "high cost" population of elderly with Alzheimer's. These sufferers evidence challenging, aggressive behavior. Many of these elderly, have come from a life of repeated discharges from other long term care facilities and dementia units....

Pending Tragedy of our Broken Healthcare System

By Judy Berry
Alzheimer's Reading Room

Economic downturn and healthcare cuts threaten to take away "equal access" for low income elderly to necessary and appropriate specialized dementia care at Lakeview Ranch in rural Minnesota.

Lakeview Ranch located in Darwin MN, specializes in caring for the "hard to place" and "high cost" population of elderly with Alzheimer's. These sufferers evidence challenging, aggressive behavior.

Many of these elderly, have come from a life of repeated discharges from other long term care facilities and dementia units. They have been subjected to repeated stays in geriatric behavior hospitals or psych units, and are over medicated. This causes untold trauma and stress to these elderly patients suffering from Alzheimer's and their families.

If you have experienced these angry -- often violent-- behaviors first hand, you understand how families with this problem live in a constant state of worry, angst, confusion, and live with a feeling of hopelessness.

The 2009 Alzheimer's Facts and Figures report healthcare costs for this population (elderly with dementia and significant behavior) are nine (9) times higher than for elderly without dementia and behavior.

The Lakeview Ranch Model -- focuses on pro-active disease management and prevention.

We accomplish our mission by using high staff ratios, ongoing specialized training, mentoring of support staff, and in house RN coverage.  We successfully provide the specialized level of care necessary to meet the physical, emotional,  and spiritual needs of these unique residents. Our approach results in the elimination of the most challenging problem -- aggressive behavior.

St. Cloud State University research has shown this model has proven to reduce behavioral hospitalizations by 93.3% while reducing psychotropic medication use by 36.1% in this high risk population.

This unique model of pro-active care works.

Residents at Lakeview Ranch are treated with dignity. Their feelings are continuously validated, and they are provided with choices. Each resident receives personal assistance from loving staff, and this allows each resident to live out their lives with the highest quality of life -- possible.

The Lakeview Ranch raises scholarship funds for these residents through the Dementia Care Foundation. This allows Lakeview Ranch to provide the appropriate level of care to all persons regardless of financial ability. This allows low income seniors on Medical Assistance to have "equal access" to Lakeview Ranch and their specialized model of care.

Our current healthcare system funders and case managers doing assessments for Medical Assistance clients do not recognize this added value approach or fund -- Pro-active Disease Management and Prevention as an effective way to enhance quality of care while significantly reducing healthcare costs.

In fact, Lakeview Ranch endures repeated cuts to low income residents Medicaid payments simply because they manage to do a better job, and are successful in reducing the aggressive behavior of their residents. Significantly higher payments are available for residents with ongoing aggressive behavior.

In a nutshell, under our current Healthcare Delivery System, the better care you provide, using appropriate higher staff ratios of specially trained staff, and the more pro-actively you manage disease and "prevent" other acute medical emergencies that require high cost hospitalizations, ER visits and unnecessary testing, THE LESS YOU GET PAID.

The economic downturn has significantly impacted donations to the Dementia Care Foundation scholarship fund. This along with the recent significant cuts in Medicaid funding, and changes in 24 hour customized living caps, is likely to result in these vulnerable elderly sufferers of Alzheimer's being placed back into inappropriate care settings where over medication is viewed as the answer to the problem.

The overuse of medication and reduction of staff per patients is not the way to address this very real problem.

Lakeview Ranch and this specialized model of care are under attack and at a critical crossroad. The Lakeview Ranch model is designed to give all seniors, regardless of financial ability, an opportunity to obtain the necessary level of care they need.

This critical issue -- how to maintain financial viability for residents getting significantly better and more cost effective care -- must be aired to the general public if we are to effect change.

Recent cuts in Medicaid payments due to the economy, and  the cuts made solely because of the refusal of the current system to recognize the value of pro-active disease management and prevention are responsible for this crisis.

The right to equal access to this specialized model of care for low income seniors, which has been an integral part of the mission and development of this model over the last 10 years -- is at risk.

There is an acute need for the public to know that it is possible to pay a little more up front to save billions of dollars in unnecessary wasteful healthcare spending.

The refusal to provide adequate funding for a model that re-appropriates funding to prevention and proactive disease management is the real reason our elderly with dementia are being robbed, daily, of their basic human rights in understaffed nursing homes and dementia units around the country.

For the past 9 years the Dementia Care Foundation has tirelessly raised money for scholarships for these low income elderly to provide alternative funding for the Medicaid gap for residents at Lakeview Ranch. The Dementia Care Foundation has provided low income seniors on Medicaid with over $1,000,000 in scholarships since its inception.

This Medicaid gap for this model of care has gone from an average  of $1500 - $1800 per Medicaid recipient per month to an average of $2800 per month. This resulted because of a changes in assessment criteria that reduce payments as acute symptoms are reduced with more appropriate and higher quality care.

  • A Medicaid recipient and resident of Lakeview Ranch, had a facial sore that he continually picked open, then because of the higher staff ratios and more effective monitoring of this resident, the sore was allowed to heal, his Medicaid payment was then reduced by over $700 per month.
  • Several other residents, with significant challenging/aggressive behavior and a history of multiple prior in-patient behavior hospitalizations, were admitted to Lakeview Ranch. As a result of the high staff ratios and specialized staff training, the aggressive behavior was prevented by discovering and meeting the underlying need of the resident. Medicaid payments were significantly reduced, since now the resident no longer had the behavior.
In the past year the economy has had a huge impact on donations to the scholarship fund of the Dementia Care Foundation.

Your help is needed now. You can access the Dementia Care Foundation at to see ways you can help!

For more information you can contact Judy Berry at 1-800-546-5175.
Contact Judy Berry via Email
Or, visit the Lakeview Ranch website.

Please consider airing this story.

The quality of life of seniors with Alzheimer's and dementia is at stake.
Lakeview Ranch was established in February 1999, in memory of Evelyn Holly for the sole purpose of developing an alternative high quality specialized model of dementia care.

Lakveview Ranch focuses on meeting the emotional and spiritual needs of persons with Alzheimer's and dementia. Special hands on attention is paid to the physical needs of each resident.

Lakeview Ranch provides a model of specialized dementia care that meets the needs of persons with Alzheimer's and dementia that are at high risk of repeated hospitalizations for the common challenging behavior that accompanies most forms of dementia.

The Lakeview Ranch model of care includes high staff ratios of specially trained staff. This allows us to provide the highest level of quality care while maintaining the dignity and basic human rights of persons with dementia.

The unique activities available at Lakeview Ranch contribute directly to the quality of life of residents.

The Lakeview Ranch model is cost effective.

Judy Berry is the founder and CEO of Lakeview Ranch. Lakeview Ranch provides a unique model of specialized dementia care for those with aggressive behavior.
The model focuses on prevention, rather than treatment to manage behavior. Judy is also the Executive Director and founder of the Dementia Care Foundation. Judy Berry is a winner of the Robert Wood Johnson Foundation Community Health Leaders Award.

Original content Judy Berry, the Alzheimer's Reading Room