Over half of Wyoming’s nursing home residents currently have moderate to severe dementia…and that number is expected to rise steeply in coming years. By 2020, there may be as many as 13,000 people who are experiencing serious memory loss in Wyoming. And there’s not enough space for all them in Wyoming’s nursing homes. Wyoming Public Radio’s Melodie Edwards reports.
MELODIE EDWARDS: It’s not easy to find your way to the memory care unit in Spring Wind Assisted Living in Laramie. You have to wind your way through a maze of hallways. And then there’s a locked door. Marketing director Denise Deem keys in a code and the doors pop open. The locked door is a safety measure.
DENISE DEEM: We actually have a resident that’s very young—she’s only 69. She’s a flight risk. That’s why she’s here. She would leave her home and get lost and have no clue where she is. And as winter sets in, that’s not safe for her.
EDWARDS: Spring Wind decided to build the secured unit a couple years ago when they saw that more and more of their residents needed the locked door and higher skilled staff.
DEEM: We have been full since we really opened memory care. We have two spaces open right now, but it’s only by chance because we just lost two of our residents. You know, they passed away. And so we’ll fill those units very quickly.
EDWARDS: Spring Wind is not the only place where the waiting list is an issue. The secured units in almost all of Wyoming’s nursing homes have them. And many of the nursing homes don’t have secured units at all. Which makes for some hard decisions for Wyoming families. …Sue Zappa-Palmer’s husband was diagnosed with Alzheimer’s seven years before he died. And the disease brought out violent behavior. Which led the family to find long term care for him.
PALMER: Usually, my sister could wag her finger at him and say, now you behave, and he’d behave. And he didn’t that day—he shoved her. And she said herself she kind of dramatized it a little bit to make sure I understood that it was…over. And I couldn’t change my mind. So we talk about that a lot. I don’t know what I would have done without my family.
EDWARDS: But just because they made the decision to send him to a nursing home doesn’t mean they were able to get him in.
PALMER: At Mountain Towers, they wouldn’t take him because he was too violent. When he was at the nursing home in Cheyenne, he just looked regular and people would hold the door for him, so he’d just walk out.
EDWARDS: So her husband ended up at a secured unit in Fort Morgan, Colorado, three and a half hours away. She tried to visit him every other week, but in the winter, she could only make it once a month. Steve Bahmer is the director of Leading Age Wyoming, an advocacy group for Wyoming’s 29 state-run nursing homes. He says that Palmer’s difficulties are pretty typical in Wyoming.
BAHMER: In an urban environment, you’re likely to have more options closer together. And in our state, you have fewer options and they’re farther apart.
EDWARDS: Bahmer says the reason there isn’t more space in secured units has to do with money.
BAHMER: So 7 out of 10 people in a nursing home are on Medicaid. And Medicaid reimburses the nursing home at about 80 cents on the dollar. And so, Medicaid doesn’t reimburse at a level that even covers the cost of providing the care.
EDWARDS: And that means nursing homes—even private ones--can’t afford to add more beds to their secured units. Bahmer says pressure on the problem could be eased if Wyoming chose to expand Medicaid. As part of the Affordable Care Act, states have the option to use federal money to provide Medicaid to more people.
BAHMER: Expanding Medicaid in Wyoming could save the state as much as $47 million over six or seven years. And that’s money that could potentially be reinvested into some of these programs.
EDWARDS: And, Bahmer says, some of that money could be used to expand memory care services. But the Governor and the legislature are against expanding Medicaid. Senator Charles Scott, who co-chairs the Legislature’s Labor, Health and Social Services Committee, opposes the federal plan.
SCOTT: First, it depends on the federal government keeping its promise, and they have a very poor track record on that. I don’t think you can get the savings that they’re claiming. I think that’s a ploy by the bureaucracy to expand their empire. And I don’t think we can afford it.
EDWARDS: But money is only part of the problem anyway. Wyoming has a statute that says new construction of state-run nursing homes is not allowed unless the existing nursing homes are over 85-percent full. But Wyoming’s nursing homes themselves haven’t tipped that mark—it’s only their secured units that are filled to capacity. And, in coming years, that may leave a lot more Wyoming families facing hard decisions and long drives. For Wyoming Public Radio, I’m Melodie Edwards.