(Note: Limited editorial comments and personal observations are contained in the body of this post. Given the nature of the information presented, it was not feasible to separate them out.)
Previously, the POA Board sent 60 questions to LiveWell, and they responded with a nine page letter. On May 7th, the Board shared this information with the community, and both items can be found here: Questions Answers
If you take the time to read both documents, you can form your own judgments as to the quality of information provided in their letter.
However, I felt that several important items were not addressed in their response. Therefore, I wrote to Ms. Beckett on May 12th asking several well-defined questions. The purpose of this post is to share two of those questions and answers; and I think the second one is the more important of the two.
Question 1: Will these two facilities handle “end-of-life” situations?
Background: Please bear with me on this, because there was a specific reason for asking this question. It goes back to a meeting that was held on April 7th with approximately ten residents; and which I summarized in a separate post here: LiveWell Meeting 4/9/15
From that meeting, I was left with the clear impression that these facilities would handle people that were in between “active” and “bedridden”. Ms. Beckett clearly said that this facility would not be for active seniors, but I thought she also said that they would not be able to handle complicated medical issues associated with being bedridden. Therefore, I assumed that these facilities would not handle patients through “end of life”. Perhaps others made a similar assumption.
However, within the nine page response to the POA’s questions was a sentence that indirectly implied otherwise. Therefore, I asked the question in a more direct manner. Here is Ms. Beckett’s reply:
LiveWell has handled and is able to handle the end stages of life. The rules governing admission and discharge of residents is covered in the Family Care Home Rule Book 10A NCAC 13G .0705. In short, admission and discharge decisions are determined by the resident’s physician. These decisions are highly individualized in nature. As such there are a variety of scenarios whereby a resident would be allowed to remain in a LiveWell home until end of life.
I don’t think that fact was made clear in the April 9 meeting; which is why I wanted to share this information.
Question 2: Where will residents engage in outdoor activities (for example; walking)?
Background: From my perspective, there are no suitable outdoor areas around these cottages; especially for walking. It appears to me that any resident who walks ten to twenty feet away from either building will be in either an unsafe or unauthorized area. And, in the case of one structure, there is not only no back yard; but the back side is patently dangerous to elderly people. I outlined all of this in more detail when I asked my question.
I believe those who attended the April 9 meeting would agree with my assessment that Ms. Beckett was not especially forthcoming in her answers to our questions. In numerous instances, she spoke at length without ever getting to the issue raised. That has basically happened here. I tried three times, but I don’t believe the question was answered. Copied below is the entire exchange.
Please note two items. First, I don’t consider the narrow walkways in front of the cottages to be suitable walking paths. Rather, they seem to be designed solely to allow access from the parking spaces to the front doors of the cottages. Second, my initial inquiry stated that there are no sidewalks on Governors Drive. What I should have clarified was that there are no accessible sidewalks on Governors Drive. That point is made clear in my third attempt to obtain an answer to this question.
May 12, 2015 – Initial Question to Ms. Beckett
Numerous questions (in the POA’s list) addressed the issue of accessing areas outside the premises for walks and/or other outdoor activities. None of those questions were addressed, so I will try to summarize them into one. First, it might be worthwhile reviewing the physical limitations of the cottages.
Based on the plot maps I have seen, neither cottage has a front yard or garden area of any significant size within its legal boundaries. In the back, there might be some small areas adjacent to the right of way for the golf course and driving range. But the slopes are such that accessing even those small areas would appear to be impossible for elderly patients. Furthermore, there is a community wide rule against fences; so it would be difficult to delineate where it would be permissible to walk.
There is a small shaded area in the parking lot that houses the mailboxes for the cottages. It is covered in pine straw and not really suitable for walking. Furthermore, I am not sure that is considered a common area for the cottages and thus might not be available for the use of your residents.
There are no common or public sidewalks in the front of the cottages, and Governors Drive has no sidewalks. As soon as you go beyond the parking spaces for each cottage, you are pretty much in the country club access road and/or parking lot; neither of which can be used for outdoor activities.
Given that, where do you propose to allow patients to walk or otherwise engage in outdoor activities without encroaching on country club property?
Reply from Ms. Beckett dated May 29, 2015:
In accordance to FCR 10A NCAC 13 G. 0905. Family care homes shall develop a program of activities designed to promote the residents’ active involvement with each other, their families and the community. Specifically, care homes are required to develop a minimum of 14 hours of a variety of planned group activities per week. Residents will utilize the walking trails and all other permissible walking areas in accordance to the standards and practice of the community.
Follow up attempt dated May 31, 2015:
Your answer outlines the requirements for group activities; which state that “residents will utilize the walking trails and all other permissible walking areas in accordance to the standards and practice of the community”. That is not what I asked. Rather, I asked where you intended to allow your residents to partake of any outdoor activities. As noted in my original e-mail, suitable outdoor areas for your proposed operation do not appear to exist. For example, it appears to me that there are no “permissible walking areas” anywhere near these cottages.
But perhaps I am missing something or have the wrong information, which is why I asked the question of “Where?”. If you have concluded that you will be able to allow your residents to engage in outside activities, even something as simple as walking, I am simply asking where you expect that to occur.
Will you provide an answer to that question? I would very much appreciate knowing that before I share your answers with others in the community.
Reply from Ms. Beckett dated June 8, 2015:
In terms of “where residents will walk”, cottage residents will use GC walking paths and all other suitable areas in accordance to community standards.
I hope this answers your question.
Follow-up attempt dated June 8, 2015
I would appreciate further clarification, because all you have done is repeat what you wrote in the first reply.
The only community walking path that would be available to your residents is on the other side of the parking lot. To reach that walking path, there are two alternatives. Your residents will have to either walk in the loop road all the way around to the other side or, alternatively, cross the full length of the country club parking lot plus the loop road (twice).
Do you plan to use either one or both of these alternatives to reach the walking path?
In my original email, I used the walking path only as an example. But I was referring to all outdoor activities. So, I will ask again. In terms of other outdoor activities, where do you propose that these will be held? I am asking because I see little, if any, areas outside these cottages where residents can do anything. Therefore, I would appreciate your clarifying where outdoor activities will be held.
Reply from Ms. Beckett dated June 10, 2015:
LiveWell’s activities are highly individualized and based on the life histories, interests and aspirations of each resident.
As such, our activity plan, which will take into account many factors including logistical matters and the “limited” outdoor areas, will be decided during the lease-up phase.
We can speak about your specific concerns at that time.
I gave up at this point, because it appears that Ms. Beckett does not wish to answer the question but will not admit that to be the case.