美国国家公共电台 NPR A Workable Alternative To Nursing Homes In Vermont — Adult Family Care

 

SCOTT SIMON, HOST:

As baby boomers age and the workforce¹ shrinks, what if there's not enough people or money to care for older people? That's the concern in Vermont that's come to pass for some elderly Vermonters, but a growing number of families in Vermont have opened their homes to them. Vermont Public Radio's Emily Corwin reports on how this works and why.

EMILY CORWIN: Robert Bousquet didn't need to be in the hospital, but he was stuck there anyway for two long months earlier this year.

(SOUNDBITE OF ARCHIVED RECORDING)

JOAN BOUSQUET: It was a nightmare. I've never cried so much in my life. I would leave him to go home and sob² all the way home.

CORWIN: This is Joan Bousquet, Robert's wife. Robert has Alzheimer's. The hospital treated his bladder infection quickly, but Joan felt she couldn't care for him at home any longer. And none of the handful of nursing homes in driving distance of their rural Vermont home would take him. See, Robert qualifies for Medicaid for long-term care and Medicaid doesn't pay enough to cover the costs of high-needs patients, like those with dementia. This happens all over the country. But in Vermont, where there's already more elderly patients than there are nurses to go around, nursing homes are especially picky. Jane Suder heads up patient management at a small Vermont hospital called Northwestern Medical Center.

(SOUNDBITE OF ARCHIVED RECORDING)

JANE SUDER: We've had people here from one month to, recently, four months. But sometimes - I know, years ago, we had someone here almost a year.

CORWIN: Recently, she says, six of her hospital's 34 inpatient beds were taken up by people like Robert, waiting for care - people who didn't need to be there.

(DOG BARKING)

CORWIN: There is a program that's helping³.

(SOUNDBITE OF ARCHIVED RECORDING)

CRYSTAL ABEL: Hello? Come on. Go outside. Go. Go see.

CORWIN: This is Crystal Abel's house.

(SOUNDBITE OF ARCHIVED RECORDING)

ABEL: Dave, you want to come on out, buddy⁴?

CORWIN: For eight years, David Calderwood lived in a residential⁵ care facility. When it announced plans to close, he spent three months trying to get into another facility. Finally, he moved in here, to a room with walls still turquoise⁶ from when it belonged to the Abel's now-grown daughter.

(SOUNDBITE OF ARCHIVED RECORDING)

DAVID CALDERWOOD: Just like my own family.

CORWIN: Calderwood is not related to Abel or her husband. He's part of a program in Vermont called Adult Family Care. Other states have similar programs. Vermont's works a lot like foster care. Families, like the Abels, can have up to two residents move into their home. The residents pay room and board. The state pays the family between 80 and $160 a day, per person, based on the complexity⁷ of their needs. The money comes from the same Medicaid dollars that would be going to a nursing facility, only this program costs the state less.

(SOUNDBITE OF ARCHIVED RECORDING)

ABEL: It's definitely more money than I was making before.

CORWIN: Abel cares for Calderwood and another gentleman. She isn't trained in health care. Before this, she worked at the local dollar tree and in a school cafeteria.

(SOUNDBITE OF ARCHIVED RECORDING)

ABEL: Even if, you know, my husband and I had talked about it and even if the money wasn't there, we would find a way to make it work. You know, I can't imagine our lives without them.

CORWIN: Abel helps Calderwood with bathing and meals. She divvies up his 30 different prescriptions⁸ and make sure he uses his oxygen machine. It's a 24/7 job, save for when the guys go to day programs a few days each week. At first, Calderwood says, moving into a stranger's house felt pretty weird⁹. But he says he came around.

(SOUNDBITE OF ARCHIVED RECORDING)

CALDERWOOD: There is an openness here - year a give and take, which I never had before.

CORWIN: The Abel family is mischievous¹⁰.

(SOUNDBITE OF ARCHIVED RECORDING)

CORWIN: Do you, like, tease each other or...

ABEL: Oh, yes, all the time. We tease each other more than we're serious, I think.

CORWIN: You get in on the teasing?

CALDERWOOD: Oh, my God, yes. I love to tease.

CORWIN: Some advocacy groups warn badly-managed programs can lead to neglect or abuse. A review suggests that hasn't happened in Vermont. Here, participation¹¹ in the program has been growing by an average of 30 recipients¹² a year - a lot for this tiny state. As demand grows, the challenge is convincing ever more families to open their homes. For NPR News, I'm Emily Corwin in Vermont.

(SOUNDBITE OF MUSIC)

1 workforce   

n.劳动大军，劳动力

参考例句：

• A large part of the workforce is employed in agriculture.劳动人口中一大部分受雇于农业。
• A quarter of the local workforce is unemployed.本地劳动力中有四分之一失业。

2 sob   

n.空间轨道的轰炸机；呜咽，哭泣

参考例句：

• The child started to sob when he couldn't find his mother.孩子因找不到他妈妈哭了起来。
• The girl didn't answer,but continued to sob with her head on the table.那个女孩不回答，也不抬起头来。她只顾低声哭着。

3 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

4 buddy   

n.（美口）密友，伙伴

参考例句：

• Calm down,buddy.What's the trouble?压压气，老兄。有什么麻烦吗？
• Get out of my way,buddy!别挡道了，你这家伙！

5 residential   

adj.提供住宿的；居住的；住宅的

参考例句：

• The mayor inspected the residential section of the city.市长视察了该市的住宅区。
• The residential blocks were integrated with the rest of the college.住宿区与学院其他部分结合在了一起。

6 turquoise   

n.绿宝石；adj.蓝绿色的

参考例句：

• She wore a string of turquoise round her neck.她脖子上戴着一串绿宝石。
• The women have elaborate necklaces of turquoise.那些女人戴着由绿松石制成的精美项链。

7 complexity   

n.复杂(性)，复杂的事物

参考例句：

• Only now did he understand the full complexity of the problem.直到现在他才明白这一问题的全部复杂性。
• The complexity of the road map puzzled me.错综复杂的公路图把我搞糊涂了。

8 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

9 weird   

adj.古怪的，离奇的；怪诞的，神秘而可怕的

参考例句：

• From his weird behaviour,he seems a bit of an oddity.从他不寻常的行为看来，他好像有点怪。
• His weird clothes really gas me.他的怪衣裳简直笑死人。

10 mischievous   

adj.调皮的，恶作剧的，有害的，伤人的

参考例句：

• He is a mischievous but lovable boy.他是一个淘气但可爱的小孩。
• A mischievous cur must be tied short.恶狗必须拴得短。

11 participation   

n.参与，参加，分享

参考例句：

• Some of the magic tricks called for audience participation.有些魔术要求有观众的参与。
• The scheme aims to encourage increased participation in sporting activities.这个方案旨在鼓励大众更多地参与体育活动。

12 recipients   

adj.接受的；受领的；容纳的；愿意接受的n.收件人；接受者；受领者；接受器

参考例句：

• The recipients of the prizes had their names printed in the paper. 获奖者的姓名登在报上。 来自《简明英汉词典》
• The recipients of prizes had their names printed in the paper. 获奖者名单登在报上。 来自《现代英汉综合大词典》