Due to Dad's deterioating condition, nursing home becomes a necessary option that we must consider as a way to handle this situation. The following are notes most based on recollection and first impression so that they are likely biased and are certainly opinionated.

    Sites visited:

    1. 北京金手杖: recommended by my college group and by a highschool friend. Either the marketing was well done or the word-of-mouth was quite successful.
    2. 苏州怡养园: recommended by 大姐、小姐 and our neighbour. It's meant to be the best option in Suzhou.
    3. 上海泰康申园: recommended by a BJ friend. The facility also has locations in BJ and Guangzhou. Well known for its patients such as 前外交部长吴 仪. It was also mentioned that enrolled patients can move from location to location free of charge.
    4. 上海凯健国际Cascade Health: invested by Cascade from the States. Looks great on paper. Highend service.

    Basic model

    All sites run with the same model by having two offerings: independent living 自理 and dependent care 护理.

    Independent care rents a room with one or two beds. Helper is extra and completly depending on client's preference. You can either hire theirs or bring your own. Costs include rent, helper, food, utility.

    Dependent care charge per bed. Helper is mandatory and is depending on the severity of client's condition. Costs include rent, helper, and food. Overall expanse is roughly 50% more expansive than the one of independent care.

    There are community rooms of various kind and group activities such as singing, dancing, movie, interest group and such. Basic services usually include laundry, room cleaning, hair cut, physical therapy, nutrition consulting. Quality however varies.

    Evaluation 北京金手杖 苏州怡养园 上海泰康申园 上海凯健 cascade health
    Accessibility Car dependent Bus 301 + 10min walk Line 9 + 10min taxi, car dependent Line 9 + 20min taxi
    Has自理区 Y Y Y Y
    Has护理区 Y Y Y Y
    Has 1-on-1 option Y Y bu not recommended N Y
    Facility condition (1-5) 4 4 5 2
    Activity rooms (1-5) 4 3 5 1
    Cleaness (1-5) 4 4 5+ 2
    Has odor N N N N
    Info organized (1-5) 4 3 5 2
    Sales熟悉业务程度 (1-5) 4 3 4 1

    Independent care 自理区

    Independent care can be rather lively. People in BJ site are rather young. So it feels more like a group living that these people are seeking fun being together. Since helper service is not mandatory it is more of a rental service with basic house cleaning, community living, 一日三餐 ready, and accessibility to medical service and additional help when needed.

    Helpers are nearly all 农村妇女 with likely low education level since the expectation is room service instead of personal/medical service. They usually charge a basic fee regardless whether you hire their helpers or not. Utility is charged per room. One can cook, and some even allow unregistered family members living there so a room can accommodate more than the patient. 上海泰康 charge per head instead of room.

    Evaluation 北京金手杖 苏州怡养园 上海泰康申园 上海凯健 cascade health
    自理区room for couple Y Y Y Y
    自理区 one-person expanse per month 10000 6000 11000
    自理区 two-ppl expanses per month 11200 7000 15000
    expanse breakdown: room rent 8000 5000 11000
    expanse breakdown: food 1200 750 include
    expanse breakdown: utilities 200 200 included
    老人精神面貌 (1-5) 5 3
    护工精神面貌 (1-5) 4 3 2

    Dependent care 护理区

    First of all, none provide dedicated dementia services. They all have such patients. Only 上海泰康 is actively pursing assisting methods to battle deterioating situation; all others are merely accommodating with challenges of basic living and no more.

    Since these patients are at mercy of these care takers, I think it becomes crucial to evaluate their attitude towards the disease, the effect on the patient and people around him, and the approach they are to take to help the situation.

    北京金手杖

    Facility is nearly identical to its independent care section except an added nurse frontdesk on each floor. However the woman doctor disappaered during my short visit and the desk was unattended. Even though there is medical cabinet in the back room, I felt the room was strangely uncluttered so I suspect the room doesn't have much supply, therefore the service it can provide will also be limited.

    I did not see any patient with Dad's symptom. They may be taken for walk, or the patient they have are 卧床 type instead of Dad's situation. Either way, helpers are midage country women who unlikely received much training. There is 1 on 1 available but the person will not sleep in the same room, therefore this is only a 12-hour deal. Independent section, on the other hand, has room with double beds or a small storage room that can be used for helper's bedroom.

    Each room has two beds so it is shared. However, not many patients on the floor I visited so many rooms are open to pick.

    The sales we spoke to knew the services well. There were a few occasions that residents greeted her so she was well recognized and people seemed like her. The atmosphere was light hearted and easygoing, which was a comforting sign.

    苏州怡养园

    Facility is similar to its independent care section with an added nurse frontdesk. Nurse was there chatting with an old guy on wheelchair. The old man wanted to make a call to his son and so she helped him that. I couldn't tell whether it was a pretended call or real. The old guy started talking to the person on the other end of the phone that 你怎么还不来阿,他们对我不好... and the nurse and a few people nearby looked at the scene and thought it was funny. There was no sign that a visitor like me may be disturbed by such a message however unreal it may be. This made me quite uncomfortable.

    We visited at their lunch time. There were about 30 patients, 5 to 6 per table. Same cookie cutter food (see photo) with no personal care to feed them even though one person apparently had trouble finding his mouth. All were wearing an apron (their way to keep them tidy). There was little conversation between staff and the olds. Another thing that brushed me the wrong side was that I was allowed to take photos of them sitting at desk eating or waiting for their food despite of the No photo is allowed sign on wall. Neither the sales nor the nurse showed any sign of warning. I felt bad for these olds sitting there as if they were on display.

    Helpers were mostly country looking midage male and females, reminding me the staff who used to work in my college cateferia. Nurse at the front desk is a girl in her 20s.

    Each room has the old's photo posted but there were few personal belongs such as photos. The whole place made me feel that person touch was there for a show.

    Sales were a young guy with busy phone calls throughout our conversation. He lacked knowledge (or there just wasn't any) of service details and used common skills to skim through my questions without giving straight answers. Further, I met the head doctor, a woman in her mid-40s, who appeared to be knowledgeable of Alzhymer symptoms. We were discussing about medical evaluation options, during which she brought up a few times that they are not responsible for medical conditions and will send the old to hospital if medical attention is needed. Even though this is mutually understood, but she made feel a lack of will to be responsible in general. Both these two people talked with shifting eyes looking at each other as if to sync the message. This turned me off.

    上海泰康(申园)

    Facility is absolutely top notch. The library room and movie theater were impressive. There were cleaning staff throughout the building and everything was nearly spotless. All elevators are equipped with a bench where the olds can sit down — a nice touch. Facility includes a full scale hospital and its 19th and 20th floor are dedicated dementia (they call it memory loss) sections. Section is guarded with double security doors and required badge access.

    We run into the young girl who is charge of this section. First impression was good. She felt 很细心, not rushing to speak when asked and knew her stuff very well. She has a notebook with patient's schedule and observation notes. Each patient's are listed in 30-min intervals with handwriting notes of the person's preference, habit, things staff should pay attention. When we wanted to sit down in community room for further discussion, the sales girl asked for her permission and she closed door behind us. It was apparent that protecting the patient's space was well observed.

    Also, photo of patient was strictly prohibited. Another plus point. I visited at their lunch time. There were two young girl at desk helping three olders, one was being fed by a young girl. The others had no trouble eating by themselves. They actually appeared completly normal. Nurse at frontdesk were also helping at desk which is located right in front of the nurse counter. The girls know these patients well and can elaborate their features, habits, and often their recent changes. The conversation between them were soft, kind and not demeaning in any way.

    Patient has single room. Occupied rooms are off the limit for visitors and doors were all shut. This was another difference from the other sites, at which sales were inviting me to look into others' as a showroom.

    A highlight of this visit was when I was impressing how little one can do to help them. The woman manager countered that they created simple games for them, similar to ones for babies, and "他们可以作这些简单的 游戏". There is also nutritionist who is responsible to each patient's meals.

    Overall, in this place I felt hopeful, and what a priceless feeling anyone can wish for right now?

    上海凯健Cascade Health

    This was a complete disappointment. The sales contact were not there and the frontdesk boy she directed me knew next to nothing about the service and price. Walking around the facility was rather depressing also.

    First, the location bragged river view (by 黄浦江). Yet the section of that water can at most be called a creek. Forget about the view, I suspect there is even much water in that canal.

    Many sections of the facility had no lights. Since it was a cloudy day the whole place felt poor lit and damp. I peeked into a few rooms in both sections. There were couples living together with likely their own furniture since they look awefully familiar to those I found in 江 南 homes — all dark colored and looked heavy. All room doors were semi-opened which is another living custom among southerners.

    There were physical therapy for patients who are paralyzed. I couldn't however tell how well it was received or performed. Since little information the boy was able to provide, the tour was short, dry and little helpful. Oh well, so much for an international name.

    Evaluation 北京金手杖 苏州怡养园 上海泰康申园 上海凯健 cascade health
    护理区room for couple N N N
    护理区share room 2 per room 2-3 1
    护理区 overall expanse per month 16000 10000 24000
    expanse breakdown: bed rent 6500 4000 n/a
    expanse breakdown: helper 8000 (1 on 1) 4500 (shared, 1 to 6) n/a
    expanse breakdown: food 1200 750 n/a
    helper ratio 1-8 or 1-1 1-6 1-1
    helper age 50+, all women 50+, mixed 20+, all women
    helper education (1-5) 1 1 3-4 1
    On site clinic N Y Y
    On site hospital N N Y
    Emergency access to medical service (1-5) 2 1 5
    老人精神面貌 (1-5) 4 3 5
    护工精神面貌 (1-5) 4 3 5 2

    Recommendation

    Based on all these and the indirect signals I picked up, I highly recommend 上海泰康 for Dad's well being both in the short term and in the long run.

    To get in it requires 200k deposit and 3-month fee, an all-inclusive 24k per month → 280k at first payment. Each following month payment can be handled by dividing it into three tranches:

    1. Dad's pension: 7000
    2. Suzhou fund: 10000
    3. Feng: 7000

    First of all, this is sustainable. Suzhou fund has plenty to sustain in that rate and will leave good amount reserve for rainy days. My portion is affordable with my current job.

    Second, this makes it possible that we all keep our current job and family setup without much change. Of course being nearby is still preferred. But this level of service makes one feel comfortable to leave for job or travel if needed.

    Third, Mom may join. If the facility is inviting for her, she can decide to join nursing home soon, thus making an arrangement now instead of later. To afford this we will make it clear that one of the two houses must be used for the support. This can also help her to realize the tradeoff and, if so, use the equity for true need instead of paper profit. Not to mention liquidation now also lessen the hassles of their will concerns.

    — by Feng Xia

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