After Margaret Batchelor, an 83-year-old with advanced Alzheimer's, became too challenging to care for at home, her daughter placed her in a nearby suburban Atlanta personal care home. The move was traumatic.
Less than a year later, Batchelor needed assistance getting in her wheelchair, so her family was told she needed to move yet again, this time to a nursing home.
"She's been through this once. We don't need to put her through it again," said Batchelor's daughter, Mignon Fleishel, 57. "This is not about nursing homes. This is about aging in place, about being able to die where you want."
The concept of aging in place is not a reality for many Georgians who cannot live on their own. The state licenses about 2,500 personal care homes that provide minimal assistance and 370 nursing homes that offer round-the-clock medical care. There is nothing for the growing number of people who fall in between.
When the Georgia General Assembly convenes in January, Rep. Chuck Martin, R-Alpharetta, plans to introduce legislation to create a new category — assisted living facilities — that would help fill the gap. Martin authored a similar bill last year, but the Assembly did not vote on it.
"We don't want our seniors to have to move because of an archaic rule that simply doesn't take into account what is real life and human and touches people," Martin said.
AARP Georgia and other advocates for older residents have been pushing for a new level of care for at least 16 years. In the past, the nursing home industry successfully blocked it by convincing lawmakers the regulatory system is not in place to guarantee resident safety.
"The basic concept is to give the consumer more choice. We get that," said Jon Howell, president and CEO of the Georgia Health Care Association, the long-term care industry trade group. "We just want to make sure it doesn't inadvertently put residents of assisted living at risk."
Currently, there is only one choice for Georgians who can't administer their own medicine or, as in Batchelor's case, get in and out of a wheelchair on their own — a nursing home. Martin's legislation would allow such residents to grow older in assisted living facilities. Twenty-two states have similar provisions, according to the Assisted Living Federation of America.
"We are comfortable that residents would be as safe as in nursing homes" said Kathy Floyd, AARP Georgia associate director for advocacy.
Martin, vice chairman of the House Appropriations Committee, expects the benefit to taxpayers to far outweigh the cost.
"We are not creating sticks and bricks here," he said. "There will be some cost to get the regulation for another licensing category. The savings comes when people can stay and get the care they need as opposed to being forced into a nursing facility."
A private room in a Georgia nursing home costs, on average, $5,310 a month, compared with the average cost of one bedroom in a personal care home, which runs $3,116 a month, according to a recent report by MetLife Mature Market Institute. Assisted living would cost somewhere in between.
Many residents who enter nursing homes deplete their savings and turn to Medicaid for help. Medicaid pays for 80 percent of Georgia's nursing home beds. For qualified nursing home residents, it covers room and board and services.
Medicaid does not cover room and board for personal care home residents, but it may pay for some services. It would also pay for some services for those in assisted care.
Ann Hardie is a freelance writer living in Atlanta.