We Need To Make A New Our Island Home Happen

To the editor: The editorial in the July 18 issue of the Inquirer and Mirror calls for some response. It must be understood that Our Island Home is not an assisted living facility. It is a skilled nursing facility for individuals who can no longer safely live at home with services delivered to the home.

Consider these cases in point: an elderly woman living alone who was receiving three-times-a-week visits from the town nurse to dress leg ulcers until it was determined that she would face amputation without seven-day-a-week care; a woman whose dementia had reached the point that her family had been forced to turn their home into a domestic prison with locks, gates, alarms, and disabled kitchen-stove burners; a man who was rescued at the point of death from self-neglect after losing his wife. When one spouse is disabled, disoriented, and dependent on a caregiver who is equally elderly, physically frail, and desperately sleep-deprived, catastrophe lurks in the wings.

I know this from personal experience and from the two-and-half years that my husband was a resident of Our Island Home. I got to know all the residents at the time, and there was not one of them who didn’t need to be there. We can only thank our lucky stars that Nantucket, the most remote inhabited island in the Commonwealth, provides a safe place for our most fragile elders.

Nantucket is not mainland Massachusetts, where services can be accessed in some other community a highway drive away. When one of us comes to the point of needing the residential care that Our Island Home provides, there is no place other than Nantucket where it is possible to maintain connection with family, friends, and others. Nursing facilities on the Cape have closed, and residents have been transferred to facilities even less accessible.

It is not an option to decide that we would rather put our tax dollars into other projects and let OIH go. We cannot offload this level of care onto the backs of family members until they break under the burden, nor can we ship fellow Nantucketers off to some hinterland not to be seen again. Only people with no aging loved ones could imagine that as a possibility.

The reason that OIH runs at a deficit is that MassHealth reimbursements are inadequate. This is a statewide issue that needs to be addressed at the state level. Locally there seems to be hope that if a new OIH is built that seems sort of plush, more people will be willing to pay the monthly private pay costs to place family members there. The fact that most OIH residents are currently on MassHealth should show us where the need lies in our community. The other hope is that there will be available beds for people undergoing rehab, and that will bring in compensatory revenue. The fastest growing segment of Nantucket’s population is residents over 65. The need for those 45 beds will not decrease, and the plan is already there for doubling up some residents if demand exceeds capacity. So where would rehab patients fit in?

There is no question that the current OIH building must be replaced. Corners were cut when it was built to keep the initial cost down, and that has long-since caught up with the now aging and outdated building. Fairly recently, the Town spent a lot of money on consultation on the feasibility of rebuilding on-site. Plans were drawn up and discussed, and the point of that exercise seems to have been to provide fodder for the argument that while it could be done, the cost would be too great for taxpayers to even consider. Now the estimate for building at the alternative site has come in for as much or more than those bought-and-paid-for plans (ones that seem to me to have been intended as strategic throw-aways).

Regrets are expressed that taxpayers rejected the plans that were brought forward in 2017. Had the taxpayers approved, it would have been done at half the present projected cost. But there were crucial unanswered questions at that time. The design offered called for more land than was available at the designated site, so abutting land would have to be purchased. Emergency vehicle access from Miacomet Road would have been problematical, but there was nothing in the proposed budget for rebuilding the road, and the proximity to Miacomet Pond was such that improving the road would have been difficult to impossible. The scope of the archaeological survey of the area did not inspire confidence. All of this was on top of reluctance to deprive OIH residents of their location in sight of Nantucket Harbor, Brant Point, and the town skyline, all of which help to maintain orientation and connection.

This final therapeutic concern has once again been dismissed in favor of relocation to mid-island, and the only compensation is that the present OIH location is said to be the future site of the Saltmarsh Senior Center, which serves Nantucket’s ambulatory senior population. The long-ago proposal to sell off the East Creek Road property to raise money to build a new facility seems off the table. I worry, nonetheless, that the present promise held out to the Saltmarsh Center could evaporate, and where will the money to build a new senior center come from?

There is just no point to going on about how OIH is the last municipal skilled nursing home in the Commonwealth. As islanders we must take on the responsibility of caring for each other. Our Island Home needs a new, up-to-date facility. We need to make it happen.

Frances Karttunen