Nursing Home

When you have a loved one approaching the end, you feel like you're walking along the edge of a cliff in the dark, but at least you've got plenty of company. I'm still sifting through hundreds of responses to my July 17 column about my dad, who took a fall a couple of months ago and landed in a nursing home. Readers have sent heartfelt ruminations on death and dying; postcards from the abyss. I've gotten an education on hospice and palliative care from readers, many of them doctors.

My aunt is in a nursing home. They tell us she isn't allowed to leave unless she gets the doctor's permission. If she does, she has to sign a statement saying she doesn't hold them liable and will lose all her healthcare coverage. She is on Medicare. Can you help? For starters, no doctor or any other healthcare provider has the authority to strip you of your health insurance benefits, including Medicare, the federal program for senior citizens. There are requirements that must be met in order for Medicare to cover some of the cost of your aunt's current stay in the skilled nursing facility, or SNF. However, it's unlikely that the care she's already received from the home would be denied because she left against the doctor's orders.

In the first decade of the 1900s, a Spanish couple boarded a ship in Malaga and sailed to Hawaii to work in the sugar cane fields. They later continued to California, opened a small grocery store an hour east of San Francisco and raised six children, the youngest of whom is my father. My grandparents died before I was born, and my aunts and uncles are gone now, too. All that's left of that family is my dad, who is 83 and has spent the last few weeks in a nursing home on the Oakland side of the bay. My father, who can barely walk because the cartilage in his knees is worn down, took a fall late one night while trying to get to the bathroom in the dark.

Roberts Blossom, a veteran character actor who played the old, white-bearded next-door neighbor who befriends young Macaulay Culkin in the hit movie "Home Alone," has died. He was 87. Blossom died Friday of natural causes at a nursing home in Santa Monica, said his daughter, Deborah. The winner of three Obie Awards for his performances in off-Broadway productions during the 1950s, '60s and '70s, Blossom also appeared on Broadway a number of times, including playing roles in Edward Albee's adaptation of Carson McCullers' "The Ballad of the Sad Cafe" and Sam Shepard's "Operation Sidewinder.

James "Whitey" Bulger's image seemed set in stone. He was a Boston "Southie," a street punk who climbed out of the projects on a ladder of crime — petty larceny, then burglary, then bank robbery, then at least 21 murders, according to authorities, one in which a man standing in a phone booth was shot so many times his torso was nearly severed from his legs. Savvy and feared, Bulger seized control of a mob empire, running rackets, shakedowns and drug deals over 40 years, officials say, before fleeing Boston in December 1994 on the eve of a federal indictment.

Patricia McGinnis has six brothers and sisters who help her take care of their 89-year-old mother. Though their mother is alert and able to live on her own, she is blind and has balance problems that have led to several falls, for which she has received care. It takes all of the siblings working together to help their mother stay at home. But every day, as president of the California Advocates for Nursing Home Reform, McGinnis deals with people who don't have that choice and must live in nursing homes because they lack the financial resources or social support to remain at home as they age. Home-based care is increasingly seen as a legitimate and less costly alternative to nursing home care.

When the tornado hit, Staci Perry, a scrub technician at St. John's Regional Medical Center, had just left the operating room to grab a piece of equipment for a surgery in progress. An urgent announcement came over the loudspeaker: "Execute condition gray. " That was the hospital's code for an impending disaster, though in drills, the command was always preceded by "Prepare for condition gray. " There was no time to prepare. As she heard the massive glass walls crack, Perry, 33, dashed back to surgery.

We've all heard that government paperwork is a drag on productivity and a backdoor tax on the economy. Here's a case where it may actually be helping to improve people's lives. The paperwork at issue is a questionnaire of up to 38 pages nursing homes now have to fill out for every resident upon admission. The form has to be filled out again periodically during the resident's stay, and again upon the resident's discharge, no matter whether he or she is being sent home to live with family, or sent to a hospital by ambulance in the middle of the night.

A looming boom in the number of older Americans in need of senior apartments, assisted living, healthcare services and access to skilled nursing has prompted another major real estate purchase, as a Chicago company that owns hundreds of senior housing facilities has agreed to buy a Newport Beach competitor in a $5.8-billion stock deal. Ventas Inc.'s purchase of Nationwide Health Properties Inc. is one of the bolder moves in a recent flurry of acquisition deals. Also Monday, Health Care REIT Inc. of Toledo, Ohio, bought nearly 150 properties from rehabilitation facility and nursing home operator Genesis HealthCare Corp.

Hollywood's embattled nursing home may get a second act. The Motion Picture and Television Fund said Wednesday that it had reached an agreement with hospital chain Providence Health & Services that would allow the fund to keep open the hospital and nursing home in Woodland Hills. Under the proposed agreement, which was first reported in the Los Angeles Times in December, Providence would sign a long-term lease agreement with the fund to manage the hospital and nursing home and assume financial responsibility for its operations.