Individual treatment and a high regard for human dignity mark the best nursing homes.
In 1965, the u.s. Congress passed Medicare and Medicaid legislation, and the nursing home industry boomed overnight. Motel chains snapped up independent pursing homes in large numbers, and stocks issued by nursing home chains rocketed on Wall Street. Financial analysts advised their customers to jump in, and they issued profit predictions of 20 percent or more. From 1960 through 1976, nursing home expenditures rose from $500 million to $10.6 billion, and the number of homes soared by 140 percent.
The rest, as they say, is history. Throughout the seventies, newspaper after newspaper carried scandalous tales of financial fraud and horrible mistreatment of nursing home residents, the result of unscrupulous owners trying to increase profits by cutting corners. Even before the Medicaid era, old-age homes were not generally regarded as gracious places to be. In many minds that image still endures: one of a large, white, ramshackle house converted for the purpose, with old folks whiling away the hours on the front porch, watching the world go by.
It’s scant wonder, then, that many people are nervous at the prospect of what lies ahead when they can no longer care for themselves, or that children feel guilty to find themselves even thinking that a nursing home might be the best place for an aged parent. This situation is a tragedy in itself, for across the country, Christian organizations, mostly church denominations, are running nursing homes and retirement centers that are models of love and devotion, and exemplify the best of what Christians are called to do here on earth. Most of these enterprises belong to the minority of homes that function on a not-for-profit basis.
Marvin Johnson operates Fairhaven Christian Home in Rockford, Illinois, owned by the Evangelical Free Church, in a modern, clean, pleasant-looking building. Said Johnson, “People say to me time and again: ‘Marv, if I had known it was going to be like this, I would have come here five years ago.’ ” Johnson and the administrators of other such homes are unanimous in their belief that the public, Christians included, have woeful misconceptions about what their enterprises are really like—both because the unsavory images from the past still linger, and because some homes are still far short of what they could be. Said one director of a well-regarded home: “I don’t remember ever reading an article saying that a retirement home is a good thing. Not ever.”
The fact is, many nursing homes are no longer just nursing homes. The trend is toward “continuing care,” especially among the nonprofit homes ran by Christian organizations. If you enter when you’re healthy—and the cost is considerable—you’re cared for when you’re sick, even if you can no longer afford it.
The Calvary Fellowship Homes of Lancaster, Pennsylvania, is one such continuing care center. It is basically a retirement community of apartments and cottages, as well as a nursing facility. The administrator, George Baumgartner, left a career in research chemistry to manage the center, because he saw it as a ministry to which he was called. He said, “People are gradually learning that retirement homes aren’t just places you go to when you’re sick and need help.… Most of the people who enter retirement homes want a place where they can live and be happy and perform volunteer service for the Lord and still be healthy, but have the assurance that should they need [nursing care] assistance, they’ll be taken care of.”
Like Marvin Johnson, Baumgartner is convinced that it makes a difference to run a retirement home as a Christian ministry, not simply as a business. “I have people who walk into our home who can sense a difference, and the only difference is the Christian influence,” he said. “The building itself is certainly not elaborate, and we [administrators] all hire the same types of people.” He recalls a meeting of the state nursing home board where a speaker said, “All of you here look upon this as a job, as a way of making a living.” That struck Baumgartner: “I had to say to myself. No, that’s not the case. I and one other person on the board at the time entered this not to get jobs, because we already had jobs, but as a ministry. That’s the difference.”
A lot can happen when that attitude is brought to nursing care. The president of a large construction company recently wrote a letter to Franklyn Dyrness, president of the Quarryville (Pennsylvania) Presbyterian Home, just after the contractor had visited the home. The man wrote: “I was much impressed by your personal concern for all your guests. You knew each and every one by name, and you were able to communicate with them in some kind of personal pleasantry.” The man then said that his mother-in-law had once been confined in a nursing home, and he and his wife visited her weekly. “When I saw the desperate condition of some of my dear, old adult friends, it upset me tremendously.” He confessed, “In fact, I became fearful of growing old.… For some reason, the kindness you shared with your people that day has changed my attitude considerably. I feel now that there will always be someone who will care. Just maybe, there is not anything too bad about growing old. In fact, I think maybe it can become very peaceful and rewarding.”
The Quarryville Presbyterian Home is widely respected, and Dymess has run it ever since it opened 33 years ago (he recently turned over the administrator’s title to his young assistant, G. Keith Mitchell, Jr.). The home is not connected with a Presbyterian denomination, although its board members, who serve without pay, are all from two conservative branches of the church, the Reformed Presbyterian Church, Evangelical Synod, and the Orthodox Presbyterian Church. It has space for 375 residents, making it larger than the average, and it is well off financially, having just completed a $2 million expansion without borrowing.
The home has no fund-raising drives, doesn’t advertise, and has no capital debt. Ask Dyrness to explain it, and you’ll get a sermon—and a pretty good one: “It’s a dedication, and if it’s anything less than that, there is something wrong with it. This is the Lord’s work, and he will be exalted through it. When we started, we didn’t have the money or the skill to cause us to take credit for it now. We’ve seen God come to our rescue over and over again.”
Dyrness operates on the principle that people must feel important to feel happy, and his efforts to accommodate the residents are obvious. One man who entered the home to retire had a well-equipped machine shop in his basement. Dyrness invited him to bring his tools along, and the shop was set up in one of the garages. Next to the machine shop is a mechanic’s shop, and it is the province of another resident who had retired from his job as a master mechanic for a Cadillac dealer. The men work on useful projects at their own pace, and they are paid by the home for what they do. One lady handles all the bookkeeping for a denominational insurance program at a fraction of what that service would cost otherwise. The result is less expensive insurance as well as therapy for the woman. One man with a love for flowers asked if he could have a patch of ground on which to raise a few, and Dyrness promptly bought 130 rosebushes for him. The man tended those bushes lovingly until he died, and now someone else who loves roses has assumed responsibility for them.
Dyrness said many people have approached him about establishing homes like Quarryville Presbyterian elsewhere. He’s been offered several sites: a fruit farm in Michigan, a mansion with 60 acres in Baltimore, a building near the Boardwalk in Atlantic City, as well as a site near Lookout Mountain in Chattanooga, offered by two businessmen who assured him that money was no object. Dyrness turned them all down—although he can envision more homes like his around the country. It’s just that he is convinced money is not the key to a successful Christian retirement home. The key is dedication; that is, men who believe they have been called by God for the purpose of tending his aging sheep. “Show me a person who has given his life to God’s work, and I’ll show you a successful person,” he said. “God’s work, done in God’s way, and done to God’s glory, will never lack for supply.”
The costs of retiring in a Christian home are high, as they are everywhere, and it is quite obviously not something everyone can afford. The smallest “independent living” arrangement at the Fairhaven Christian Home in Rockford is an 11′6″ by 10′10″ living room-bedroom combination with a shared half bath. It requires a “founder’s fee” (a one-time lump sum payment) of $8,000 and a monthly charge of $330, which can rise as costs rise. The smallest apartment has a living room and a bedroom, each 10′6″ by 10′8″, plus a kitchenette and a full bath. For that, the founder’s fee is $18,700 and $420 a month, or, for two people, $23,500 and $755 a month. These figures rise with the apartment size. The fee in the home’s nursing center is the customary monthly charge plus an extra $15 a day. Fairhaven’s fees are actually lower than at many other homes, but the fee structures are similar elsewhere.
At Quarryville, however, financial arrangements are altogether different. Residents pay $500 entrance expense, plus a monthly room or apartment charge ($275 for the smallest room), and in addition, they turn over all other financial assets to the home, according to a legal contract with an escape clause. Those assets are pooled and invested, and interest of 8 to 9 percent is paid. When the resident dies, the assets are distributed to the heirs less 5 percent for each year the resident has been at the home up to four years. During the contract period, the money actually remains the property of the resident, and is available for his use should the need arise.
In 1977, a book titled Too Old, Too Sick, Too Bad. by Sen, Frank Moss and his assistant, Val Halamandaris, was published. Moss headed a Senate subcommittee that investigated nursing home abuses brought to light in newspaper stories during the seventies, and the subcommittee was able to substantiate the astonishing extent to which elderly nursing home patients were made to suffer at the hands of nursing home owners whose primary motivation was profit. The authors wrote about the investigation in their book of more than 300 pages; it took only two pages to explain what makes a good nursing home. Part of that conclusion says: “The lesson appears to be that it is an intangible—esprit de corps—a sense of motivation manifested in individualized treatment and maximizing human dignity that marks the best nursing homes. Neither this esprit nor tender loving care can be imposed by government fiat. It must be the result of the desire and commitment on the part of nursing home personnel. All American homes can provide superior care. All that is required is the will to do so.”
Even if they had been trying to do it, the authors could not have painted a more accurate picture of homes operated on Christian principles. How could there possibly be a better way to “maximize” human dignity than simply to believe that people are made in the image of God, and that, therefore, their dignity is beyond measure? What better motivation can there be for “tender loving care” than the belief that when a patient dies, he is merely being transferred from nursing care to the Lord’s care?
“Many times,” said Marvin Johnson of Fairhaven, “I have been at the bedside of a dying person, and I’ve found there is nothing more beautiful than to be there, with someone I’ve known for five years or so, and to have them say thanks, that they appreciated so much what the home has meant for them, and to know that they’re going to be with the Lord. It’s an experience I’ll never forget. It makes me feel that my life has a real purpose, that society has a real purpose.”
Such things have even been known to turn nursing home owners into committed Christians. That was the case with Clifford Fischer, who became administrator of the Brookside Manor Home in Overbrook, Kansas, in 1965, at the tender age of 23. He said that even at that age he feared death, and in his job he naturally confronted it frequently. Said Fischer, “I had the opportunity to be with a lot of Christian people when they faced death, and I just didn’t understand how they could have the peace they had. It was out of those experiences that I started searching, and I ultimately came into contact with a young man who had the same peace these older people had. Through a sharing time with him, and after about seven years of Bible study, I finally came to realize what that peace was. Of course it was knowing Jesus as my personal Savior.”
Although Brookside Manor did not start out to be a Christian nursing home, it surely is one now, said Fischer. He owns the home, and it is run for profit, so by no means are all profit-making homes unsatisfactory places. But, says Fischer, “I hope that people really see something different about us than they see in the so-called secular world, because we really do care for our people. I’ll go out of my way to demonstrate to them how good God has been to me, and how in turn he expects me to be the same way toward other people.” Fischer sees his business as a missionary field that God has given to him, along with gifts of administrative ability and compassion that enable him to run it successfully.
Most of the church-sponsored retirement and nursing homes in the country are operated by mainstream Protestant denominations. Evangelical churches have not entered the field in anywhere near the same numbers. One reason for that, according to Bernard King, executive director of a large retirement center in Florida owned by the Christian and Missionary Alliance, is that these churches have seen evangelism and missions work as their calling, rather than social needs, such as caring for the elderly.
King manages Shell Point Village in Fort Myers, which has about a thousand residents. He said his denomination is happy to have it, but “I don’t think the Alliance now would ever spend the money or the organizational energy to start a place like Shell Point.… This kind of social program does not have the highest priority according to the goals that are being looked upon in the 1980s, because we feel that God has given us an evangelical missionary goal.”
Nonetheless, it is safe to say that conservative Christian churches will be faced ever more directly with the burden of caring for their aging members, if only because the elderly are growing faster as a group than any other segment of the population. But beyond that, it seems that evangelicals, who have captured the attention of a cynical nation in the last year or so, will be challenged by the doubters and the skeptics with the very challenge thrown down by James—the challenge to prove their faith by their good works. But perhaps most importantly, as the building contractor in Pennsylvania found out, the atmosphere of a Christian retirement home can dissipate the greatest fear that possesses people, the fear of dying.
MOTHER AND CHILD
Mother, my most recent child,
Wrapped in wool and scanning space,
Is to age unreconciled.
She who reared me, taught me grace
And thoughtfulness, commands me now
With strident voice and stormy face.
She who loved my gifts is slow
To use and quick to criticize
The offerings I now bestow.
Discontentment fills her eyes.
Age and loneliness combine
To shake her family with surprise.
We who love will not resign
Her failing self to others’ care;
Her petulance serves to refine.
She who nurtured us with prayer,
Shared our sorrows and our bliss,
She was gentle once and fair.
What trick of motherhood is this
Which overwhelms a child with guilt
And makes her offspring feel remiss?
Self-pity is by illness built.
My mother’s gone—this is a child
Who needs my love. Lord, as Thou wilt.
Grant me patience, manner mild;
This charge I will accept from Thee,
To tend with love my mother-child
Until she gains eternity.
GERALDINE CRAIG
