Rochelle Riley: Detroit’s aging population on collision course with nursing home shortage

(Detroit Free Press) Marylyn Thurmond had been a registered nurse at Detroit Receiving Hospital for 13 years when she was diagnosed with arthritis. She has had both hips replaced. Six weeks ago, she was diagnosed with lupus. She also suffers from hypertension, diabetes and coronary heart failure.

Marylyn Thurmond is 57 years old.

Novella Walker-Page was a registered nurse at Hutzel Hospital in high-risk labor and delivery for 26 years before becoming a home care nurse and then a contract nurse for the Detroit Public Schools. One day, she fell from the bus that took her around for student care. During that same doctor’s visit, she learned that she had sarcoidosis, an inflammatory disease. She also suffers from hypertension, high cholesterol and atopic dermatitis, a skin condition.

Walker-Page, who cares for her 95-year-old mother at her northwest Detroit home, is 60. She doesn’t think she’ll live as long as her mother or her grandmother, who died at 116.

Thurmond and Walker-Page are among a fast-growing part of Detroit’s population — the new elderly, people who are 50-59 years old but more like 60-74 in terms of their health. Neither, for now, wants or needs nursing home care. But as that need is growing among their age group, their chances of finding it are in decline.

Detroit, a city that once had 50 nursing homes, has lost 20 — 16 of them in the past 13 years. And many are struggling to remain open. Nineteen Detroit nursing homes must upgrade or install sprinkler systems by next summer to be certified and continue to receive the government funding they need to stay open.

The new elderly and the looming nursing home crisis are documented in a Detroit Area Agency on Aging report that was released Monday. Based on a three-year study of illness and death rates in Detroit, Highland Park, Hamtramck and the Grosse Pointes, the report shows that in addition to accelerated aging, the elderly in the Detroit study area die at a rate 131% higher than their peers around Michigan.

The percentage of older residents in the Detroit study area (particularly those 50 and above) increased significantly between 2000 and 2010 as younger people, especially those with school-age children, moved out of the city.

“We have not built a brand-new nursing home from the ground up since the1960s,” said Paul Bridgewater, CEO of the aging agency. “There used to be 50. But they face a lot of challenges primarily because they get Medicaid reimbursement.

“Detroit loses out on 120 million in (federal) Medicare dollars that they could potentially charge, but do not charge because they do not have Medicare certification,” Bridgewater said. “The Medicare certification is an intense process, and many of the facilities are comfortable with just Medicaid reimbursements.”

Todd Johnson, administrator of Law-Den Nursing Home in Detroit, said he could barely make ends meet.

“Everything goes up,” he said. “Food is out of control. … I hope we survive. But the city will lose some nursing homes.”

For some of the new elderly, their houses have become both nursing home and prison. Thurmond, for example, can barely leave her residence because the front porch is crumbling and she has no ramp.

“I have a seat-based walker, and I take it and they hold it on each step and I kind of crawl, take one step at a time to get down,” she said. “The way I get up is by my husband lifting the walker up to the top part of the step. We have five steps.”

Her husband is 80 years old.

“I sleep downstairs on the first floor in my den because we have 15 stairs to go to the bedroom, but I can’t walk up my steps,” she said, adding that she’s on a waiting list for community aid to build a ramp and fix the porch.

And Novella Walker-Page? She said she was stunned to learn of the health problems facing her generation, until she thought about it.

“My sister is a nurse at Sinai-Grace, and we see so many people come in in this age group,” she said. “I live in northwest Detroit. And lots of young men over here are sick now in that age group, and they can’t go to the doctor. They go to the ER and then get a $1,000 bill.”

She said it is clear what needs to be done.

“First, they need to have insurance. Everybody needs insurance,” she said. “Next, we need to have more primary care physicians and more nurse practitioners to help people navigate the system. They don’t know where to go. They don’t know what to do.”

Everything she cites is something that Detroit doesn’t have. Most of its residents live in a medically underserved area. Medical students are choosing lucrative specialties, such as surgery, over primary care.

But the problem is critical, and no solution is possible until it is taken seriously.

“We need something done now, not long-term,” Walker-Page said.