In Support Of The New Our Island Home

To the editor: I retired from the board of the Friends of Our Island Home at the beginning of 2024 and am writing this letter as a private citizen, not as a representative of the organization.

The Friends of Our Island Home planned a forum about future plans for OIH to take place at the Dreamland on Tuesday, October 22, but they did not secure funding. At the Elder Expo on October 19, they held two informational sessions that were sparsely attended. Concerns expressed included what effect building a new facility would have on Nantucketers’ tax bills, who is eligible for care at OIH, and why the proposed new facility is so large. Closer to the May Annual Town Meeting, the Friends of OIH hope to be able to hold one or more informational events to address such questions.

I am saddened at the prospect of the OIH residents moving away from their present location, and I have concerns about the design presented on Saturday, but I am resigned to both because it is essential that OIH continue to exist and serve the Nantucket community. Our situation is unique. Nantucket is the most remote inhabited island in Massachusetts. Unlike mainland communities, we cannot place people in long-term care in facilities just a drive down the road.

The Children of Men by British novelist P. D. James was published in 1992. In the book, the present generation of adults is the last on the globe. No more children have been born. The young adults lavish love and money on their pets while perceiving elders as useless and too expensive to maintain. At age 60, people are encouraged to commit suicide. To facilitate this, barges are loaded up with 60-year-olds, towed out to sea, and scuttled.

Can we in this real world send fragile Nantucketers off to mainland facilities where we will rarely or never see them again? Where they will have no one on hand to advocate for them? Where we cannot monitor their care and wellbeing?

We all share the aspiration to live at home to the end and be buried in the back yard, but some of us will be left behind. Some of us will require 24/7 care that is more than an aging spouse or parents still raising children can provide. The day comes for some of us when we can’t cut our own toenails or be trusted with access to kitchen appliances. Some of us will roam and not find the way home. Nantucket must have a safe place for those in need. The Town of Nantucket has maintained a place for people unable to care for themselves for reasons of age or disability since 1822. Our Island Home has been that place since 1905, first in what is now the Landmark Building and since 1980 in the building on East Creek Road overlooking the Creeks.

The current OIH facility was built to code of the late 1970s. The care provided within is extraordinary, but the building is no longer up to minimum standards and must be replaced by one that will serve for decades to come. It is claimed that at the 2022 Annual Town Meeting we voted for a new facility to be built at Sherburne Commons. What we voted for was funds to pay for building design. It was Select Board members who decided on behalf of us all that the facility would be located at Sherburne Commons. A previous plan to build at Sherburne Commons was defeated at the ATM for many reasons. Among them were that the design required purchase of abutting land and that there were problems with emergency vehicle access from Miacomet Road. This time the plan is to locate the new building off South Shore Road, requiring the removal of some existing buildings. The SB has stated that a new Saltmarsh Senior Center will be located on the East Creek Road site currently occupied by OIH. If and when this promise is fulfilled, a different elder population will be served, and the potential for fatal flooding will be moot, since the Saltmarsh Center is not residential.

Despite deficiencies in the 1980 OIH building, there are features that will be lost in the new facility. One is the large dining room with views to expansive lawn and trees. The dining room is flooded with sunshine in the morning and offers unobstructed views of moonrise at suppertime. Tables are cleared away in this big room for dance performances, religious services, holiday parties, and the annual Coast Guard Valentine’s Day dance. In the new H-shaped design, the dining room is interior. A living room can potentially be opened to the dining room on occasion, creating an L-shaped space. How will that work for sight-lines at events?

Residents in skilled nursing homes nationally experience next to no exposure to natural sunlight. Even for OIH residents unable to take advantage of the Wheelers and van rides to get out and about, the big partially-roofed outdoor patio offers a place for all to gather for cook-outs and concerts and to watch the annual Boston Pops performance on big outdoor screens. On any nice day OIH residents are out on the patio taking in the fresh air, sunshine, and the view of Nantucket Harbor and the town skyline. The plan for the new facility is to make up for this loss with small outdoor table areas and large-format photos indoors. The windows in the residents’ rooms will look across slot courtyards to the walls of the opposite wing or at parked cars. The current proposal features “neighborhoods” which are colored-coded wings with multiple interconnections rather than the much maligned “institutional long halls.”

I have been skeptical of features of the earlier proposed small-house/green-house model: isolating residents in small groups; open kitchens where Certified Nursing Assistants who provide care would also be expected to assist residents with meals on demand and/or doing their own cooking; and housekeeping added to the CNAs’ primary responsibilities. Proponents of this level of “person-centered” care assert that there exist dedicated people who will accept such work assignments for the honor of being designated “shahbazim.” Where could we hope to find such potential employees on Nantucket?

Even with the toning down of some of what I considered excesses of the earlier model with its individual “houses,” the proposed new facility is more than double the size of the present one. Currently OIH residents share rooms; in the new facility each of the 45 residents will have a private room but with the possibility that in the future some of these rooms can be turned into shared-occupancy rooms. Given that the fastest-growing segment of Nantucket’s population is those over 60, this need may arise, but meeting it would require getting permission to expand beyond the current 45 permitted beds.

People ask how the town can justify such an enormous expenditure on the care of just 45 people. This is care of 45 individuals at one time, but of hundreds over a fairly short time, and for every one of those residents there is a family being served as well.

Our Island Home has provided vital help to me and my extended family repeatedly through decades. My mother was cared for in the former building to the end of her life, and my husband spent his last 2 ½ years at OIH not long ago. In between, care has been extended to countless of my cousins, cousins-by-marriage, distant family members, teachers, and friends. To count them up and place a price on the care of each is beyond me, and I am sure the same is true for many, if not most Nantucket families.

Whatever dissatisfaction I feel in the plans for the new OIH facility, I urge all my fellow Nantucketers to get the new facility built now and to guarantee on-island care for all those in need into the future.

Frances Karttunen