Residents on Nantucket are locked in debate over what to do about the island's only skilled-nursing home. It's called Our Island Home, and right now, residents there have one of the best views on the island. But Nantucket is facing some big choices when it comes to the future of its eldercare, as plans are afoot to possibly rebuild the facility elsewhere.
Nantucketer Fran Karttunen spends about seven hours a day with her husband at Nantucket's only skilled nursing facility, Our Island Home. And the first thing she wants to show me when I walk in? The view out the window.
“We're looking straight across the Salt Marsh, the creeks, to Brant Point, and the red light comes on just at sunset,” said Karttunen. “And we also have a very good view of the tides rising and lowering.”
The view is beautiful. But Our Island Home has major problems. It was built by the town more than thirty years ago, and its in really rough shape. Almost everything has issues: the roof, the electrical system, the plumbing, fire safety—it needs to be rebuilt. But the question is: where? And what will the future of eldercare on Nantucket look like?
“That's the thing about being an island is that we can't just use a facility down the round in a neighboring town. We have to provide here,” said Karttunen.
Last fall, Nantucket's town government started planning a new Island Home. It would be much harder and more expensive to rebuild the facility on site. So, the town is considering moving the Island Home inland next door to Sherbourne Commons, an assisted living facility in the pine woods on the south side of the island. But for some Nantucketers, the Island Home's waterfront view is invaluable. Karttunen is a leader in a group opposing the potential move.
“I felt that this siting is really strongly therapeutic to the residents here,” said Karttunen. “And I felt that perhaps there was some lack of imagination on the part of the people who were planning to move this facility basically out into the scrub pines.”
So, Karttunen started a petition on Change.org. The title? “Our Seniors Need A View! Keep Our Island Home Where It Is!” To date, more than 500 people have signed it.
“I mean anybody would wanna look at that view,” said Nantucket town manager Libby Gibson.
She's involved because the Island Home is owned and operated by the Town. That's unusual. It's one of the only municipal nursing homes left in Massachusetts, and it operates at a huge loss: about $4 million every year. The island's tax-payers pick up the bill. For the town, Gibson said, it can't be all about the view.
“Can it be more efficient? And cost-effective? It's a big project either way, $30 or more million dollars,” Gibson said.
That's just one item on a growing list of major expenses for the town. During this past winter, the town and other groups organized discussions about the issue. Things got intense. At one meeting in February, one person felt so strongly that she submitted her own building design for consideration. But some aren't so sure the view is so important. Like Gail Ellis, director of nursing at Our Island Home. She's observed that just a small percentage of residents actually spend time looking at the view.
“I would say less than a quarter,” Ellis said. “I mean staff, visitors, are the people who love it the most. The people that live here, it's all about what their lives are like. Not where they're living their lives.”
This winter, the town hired consultants to help with the decision. In March, those consultants recommended relocation away from the waterfront. That's because the facility is at risk of storm surge from hurricanes. Jude Rabig was one of the town's consultants. She says that after Hurricane Katrina, that's a deal-breaker for the state.
“The government scrutinizes the site that you're proposing to use," Rabig said in a presentation to the Nantucket Board of Selectmen. "We experienced with Katrina death to people in nursing homes who were subjected to water. And the inability to move those people, to evacuate them, created havoc. It's not us saying no. There is no state government that at this time in our history who would approve this picture.”
Still, some people weren't convinced. Couldn't the town try raising the elevation of the site? Or lifting the building? Kartunnen said it's not all about efficiency.
“It's easy to say, well, there's emotion but then there's practicalities and dollars and cents," she said. "But I think in a matter of caring for our most fragile elders, emotion has its place.”
And Director of Nursing Gail Ellis is dealing with a little bit of both emotion and practicality.
“I think the Sherbourne site is... do I feel that that's a compromise? Yes. Do I think it's the safest and healthiest compromise? Yes. Would I miss this site? Oh, most certainly,” said Ellis.
Nantucket's Board of Selectmen is set to make a decision on the location at their meeting on Wednesday, May 4. After that, the island's voters will get their say at an upcoming town meeting.