Ana is a friendly, optimistic woman with a heartwarming smile and bright eyes. But even Ana got discouraged when chronic health challenges landed her in a nursing home after a hospital stay for an urgent medical condition. Her chronic issues don’t require nursing home care but do make some help necessary for her to live at home. Sometimes health is the major barrier to returning home but in Ana’s case it was more the maze-like process that seemed to result in Murphy’s Law (“Everything that can go wrong will.”) at every turn. With the help of caring professionals, Ana made it through the maze and found the door to home.

Initially, a social worker at the nursing home tried to help Ana. One idea was for Ana to live with her daughter but Ana can no longer navigate stairs so that was ruled out. Assisted living was considered but Ana was rejected because they weren’t prepared to support some of her care needs. In the midst of Ana’s search for a home, the nursing home was sold and there was staff turnover which sent Ana back to square one with a new social worker. Fortunately, that social worker realized the toll this setback was taking on Ana and engaged Springwell to help her find a home.

Springwell’s RNs and Social Workers, with the backing of our experienced multi-disciplinary staff, have expertise in all of the components of support that are necessary to facilitate a move out of a nursing facility. Stephanie, a Community Discharge Planner, initially met with Ana to weigh the pros and cons of leaving or staying. It was clear that Ana wanted to go home and that it was medically manageable. She was mobile except for not being able to do stairs and wanted to resume her life. Stephanie set out to help Ana reach her goal. With Stephanie’s support, Ana applied to several local housing authorities. The process dragged on but Ana and Stephanie persisted. Ana, an avid knitter and crocheter, tried to remain upbeat and hopeful by joking with Stephanie about knitting a big blanket and living under a bridge.

About two years after moving into the nursing facility, good news came from the Waltham Housing Authority’s Elder and Disabled Housing manager. An accessible apartment was available for Ana. In September, with support from family and Springwell, Ana happily moved to her new home. Her loving adult children and grandchild visit often and with the help of ongoing Springwell services, Ana gets the care she needs and lives her life safely in the comfort of her own home. She no longer worries about knitting a big blanket for living under a bridge, but instead knits and crochets blankets for family, friends and new babies.

If you know someone who wants to live at home in the community, learn more about how Springwell can assist with alternatives to nursing home care.