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July 2007
Home Away From Home
By Ellison Clary

      There has to be a better way to care for older adults with cognitive and functional impairments, Lynn Ivey decided as she sought options for her mother, whose memory and functionality was failing because of mini-strokes.

     Besides her mother’s well-being, Ivey worried about the burden her mother’s situation placed on her father, and what it was doing to the family.

     Her search for a higher quality of life for her mother and her immediate family led Ivey to a career change. She left a 25-year banking career to build an upscale day care center for older adults.

     The result is rising on a little more than an acre in SouthPark. Called The Ivey, the 11,000-square-foot, single-level structure will feature myriad services for those who need care as well as those who give it. The timetable is to complete the facility in August, obtain all licensing as soon as possible thereafter, and open in November.

     Though it will accept those with a wide range of infirmities, The Ivey will target people who suffer from Alzheimer’s and Parkinson’s diseases as well as other dementias and the effects of stroke.

     The Ivey will operate with a club-like atmosphere for its members from 7:00 a.m. until 7:00 p.m., Monday through Friday, giving those who care for them at home a respite from their duties.

     “We’re targeting people with mild to moderate impairment, cognitively and functionally,” says Ivey, 51, who worked in mortgage banking for Wachovia Corporation predecessor First Union and then led regional banking teams for Bank of America until 2004.

      That’s when she left her position as a senior vice president in Charlotte on a combined medical and personal leave. Commuting between Charlotte and Wilmington, N.C., where her parents lived, she helped her father deal with the aftermath of a series of strokes suffered by her mother.

      “It’s really a niche time,” she says of the period when day care is appropriate for those with cognitive and functional challenges. “It’s when you’re getting a little worried about mom or dad losing keys, or other memory concerns. But it’s really not time for them to go to assisted living. It’s about a two-year niche.”

      Finding a daytime refuge for her then 76-year-old mother in Wilmington was a challenge for Ivey. The family needed a place for her mother to spend quality time while Ivey’s 74-year-old father and others ran errands and generally recharged their batteries. But Ivey wasn’t impressed with the options.

     They settled on a routine in which an in-home care service helped get her mother out of bed, and then transported her to a center for a few hours before her father picked her up. Soon her mother’s condition deteriorated and precluded anything except in-home care, but Ivey thinks a better daytime alternative could have lengthened the active months before her mother’s death in October 2006 at 79.

     She’s ready to test that theory. “What we’re hoping to provide at The Ivey is such a phenomenal service for both the family caregivers and the family member that it may prolong the member’s functioning capabilities,” Ivey says.

 

Social Needs and Medical Services

 

     Proper medical supervision and social stimulation can work wonders, Ivey believes, as can changing the dynamics of the family relationship.

     “Once you cross over into being the caregiver around the tasks of daily living,” Ivey explains, “that family relationship changes.” She and her father struggled to balance care giving with her mother’s continuing need “to hold hands and be loved,” she remembers.

     When it opens, The Ivey will be what the state of North Carolina calls a combination model, a facility that fills social needs while it provides medical services.

     So Ivey wants the facility named for her family and dedicated to her mother to be “a real family place,” one where a daughter and mother, for instance, might share an appointment for their nails or for a massage. Or they could get their hair done together in the salon.

     And with that, she touches only the tip of the iceberg of amenities envisioned for The Ivey. A patio will feature a putting green. The pub will have a widescreen television. An exercise room will include treadmills, stationary bikes and the like. Bathing rooms will be equipped with whirlpool tubs.

     Activities will include formal exercise, indoor and outdoor recreation and field trips. There will be soothing music and reminiscence therapy.

     Also, The Ivey will offer pet therapy. “It has been proven,” Ivey says, “that if you have a dog sitting on your lap, and you are loving that dog, your blood pressure decreases.”

     Interior designer Sharon Coughlin of Perkins Eastman is experienced in planning senior living spaces and will arrange furniture appropriately. Chairs will be plush and the height of seats will reflect special needs of older adults. Fabrics will be moisture resistant and easy to clean.

    Ivey’s artist cousin, Lauren Ivey, will create scenes to encourage uplifted eyes in the rooms with 11-foot ceilings. Quiet spaces and a place for naps also are built in. Some rooms will feature huge windows facing a wooded area.

     The Morrison division of The Compass Group will provide nutritious meals—mindful of dietary concerns—during the day as well as take-home dinners for both the member and caregivers. That’s part of a concierge service that also will run errands.

     A library near the entrance will house information on diseases such as Alzheimer’s and Parkinson’s and on other dementias and the after-effects of strokes. It also will store materials on care options. Ivey envisions it as a convenient resource for caregivers.

     Ivey has worked closely for two years with licensing officials at the Mecklenburg County Department of Social Services and the N.C. Division of Aging and is preparing a licensing application package. She is developing operational procedures according to the Standards of Certification for Adult Day Care of the N.C. Division of Aging. She’s paying special attention to daily programming design, to incorporate best-practice research for stimulating cognitive processes and maximizing physical functioning.

     Ivey’s state-of-the-art facility will exceed required provisions, she says, for details such as square footage per member, quantities of restrooms, handicapped-accessible rooms, doorways and hall widths. A sprinkler system and a comprehensive security package should help provide peace of mind for families, she says.

     The Ivey’s staff of 30 will include 23 caregivers, including many certified nursing aides. The staff will be supervised by a full-time medical manager who is a registered nurse, and an experienced certified recreational therapist with a four-year degree. The ratio of staff to members will be one-to-five, bettering the standard of one-to-six.

 

Demographically Appealing

    “Demographically, it’s very appealing to be located in SouthPark and service the SouthPark, Quail Hollow, Carmel Road and southeast Charlotte area,” says David Dooley, a board member and executive vice president of R.T. Dooley Construction Company, builder of the facility.

    “My parents and in-laws are both living in retirement communities,” Dooley says. “I understand the services that those facilities offer and there’s no real platform for somebody who needs daytime supervision where they can go out during the day and get the kind of services that Lynn’s offering.”

    As Ivey searched for a place to enhance her mother’s last years, she learned that while there are more than 3,400 adult day care centers in the United States, few provide the enriching services she hoped to find. Nearly 80 percent are non-profits and about half run a fiscal deficit.

     The director of a 10-year study of adult day care centers conducted at Wake Forest University referred her to three that she classified as among the best in North Carolina. Ivey visited one in Winston-Salem and another in Concord before going to the third in Kings Mountain.

     The Kings Mountain facility was new when she toured it in December 2004 and in its 14,000 square feet, it offered some of what Ivey was looking for. “I walked in and went, ‘This is it,’” she remembers. “‘I’m going to build an adult day care so this demographic has choices.’”

    Suzi Kennedy, the executive director of the Kings Mountain facility, has been a mentor for Ivey.

    Although there are eight adult day care centers in Charlotte, none in the southeast quadrant offers the high-end comprehensive services and amenities that the Ivey will feature, Ivey says.

     The Ivey is a for-profit facility with initial one-time memberships of $2,500 for those who meet its medical evaluation criteria, which includes a copy of their most recent doctor’s exam and an in-home evaluation by The Ivey’s medical manager and care manager. Members will pay monthly, based on the number of days they attend each week. There is a two-day, a three-day and a five-day plan and Ivey hasn’t ruled out offering a one-day option.

     Pricing yardsticks are based on a couple of variables. The average payout of private long-term healthcare insurance in Mecklenburg County is $155 to $165 a day, Ivey says, and in-home care ranges from $15 to $18 an hour. A round-the-clock nurse costs $25 to $30 an hour.

     “We’re offering the nurse, a caregiver and much more,” Ivey says, “but it’s going to be more in the range of what you pay for in-home care.”

The Ivey will serve no more than 75 members daily but, with various attendance packages, total membership could come to 150.

 

Anticipated Demand

     Board member Marian Nisbet, whose husband is an Alzheimer’s patient and is in an assisted living center, believes the demand for space in The Ivey will be high.

“The idea that she’s trying to make it upscale will appeal to the people who can afford that,” Nisbet says.

     Yet Ivey says she doesn’t mean to be elitist. “I’m trying to serve a population that is underserved,” she says. “Alzheimer’s, dementia, Parkinson’s and stroke don’t know a socio-economic status. This demographic is underserved in daytime choices. And our two-day packages are more economical. We’ve had an overwhelming response so far.”

Though she’s only recently started marketing The Ivey and taking reservations, Ivey already has visions of building more such facilities. Whether they will be wholly owned or franchised, she isn’t sure.

     Meanwhile, her father is excited about the concept. “He’s so proud,” she beams.

The retired chief executive of a Wilmington savings and loan, Ben Ivey sees The Ivey as a business venture. “He was my first investor,” Ivey adds. “He’s one of my best and closest business advisors.”

      Because she’s been a single, career woman, Ivey’s immediate family is Lacey, her 3-year-old Bichon Frise. These days, Ivey squeezes in a wine tasting and sometimes does a bit of gardening at her home only a stone’s throw from The Ivey site.

     But mostly, she’s marketing her concept. She’s working with agencies that provide services to seniors and conducting tours of a simulated Ivey in an office building across the street from the construction site. A direct mail campaign is underway and she’s making contacts at churches and major employers.

     Ivey has a focused message for human resource executives in corporate settings such as Bank of America, Wachovia, Duke Energy and large law firms. She tells them about the costs their firms incur when people like her take a leave to care for elders. “The latest numbers I’m reading are up in the mid-$40 billion a year range,” she says. The Ivey offers a solution that enables workers to remain on the job and still care for aging parents at home, she adds.

       Her efforts are paying off. “Any little challenge has been nothing more than a quick bump,” she says. That tells her The Ivey is destined to be, she says. With a slow smile, she adds, “I know I’m doing a wonderful thing, and the right thing.”
Ellison Clary is a Charlotte-based freelance writer.
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