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Kittay House/Jewish Home & Hospital Nursing Home
2550 Webb Ave., nr. W. Kingsbridge Rd., the Bronx; 718-410-1420; kittayhouse.org
Facilities: 295 independent apartments; 816 nursing beds.
Fees: $1,584 per month for a studio to $3,048 for a one-bedroom with income restrictions.
Waiting list: None.

While the décor runs more to linoleum than marble, Kittay House is a best buy for moderate-income New Yorkers who value an energetic social scene—and appreciate having a nursing home nearby. While the 36-year-old high-rise—part of the Mitchell-Lama affordable-housing initiative—has a dormlike feel, it’s in the middle of a $9 million makeover to senior-proof kitchens and baths. (Until the redo is done next year, there’s a noticeable gap between the spruced up apartments and the rest.) Kittay House tends to attract middle-class, Jewish Democrats who debate the Times’ op-ed pages in the library; a social-action committee stages weekly antiwar street protests. Service throughout the facility is friendly, both residents and elder-care experts say. For apartment-dwellers, extra help is strictly BYO, but Kittay residents have access on a pay-as-you-go basis to rehab and other services next door at Jewish Home, a teaching nursing home affiliated with the Mount Sinai School of Medicine. Jewish Home’s pioneering Alzheimer’s program has won awards from groups including the New York Association of Homes and Services for the Aging.

4. ASSISTED LIVING

Lott Assisted Living Residence, Manhattan
1261 Fifth Ave., at 108th St.; 212-534-6464, ext. 153; lottresidence.org
Facilities: 127 studio apartments.

Fees: $4,500 per month; Medicaid accepted.
Waiting list: One to two months.

Manhattan’s only assisted-living home that accepts Medicaid, Lott looks and feels a lot more like a luxury-condo development than a state-run program geared mainly to low-income seniors. As part of its assisted-living program, Lott provides help with bathing, grooming, and medication, along with five-day-a-week access to a St. Vincent’s geriatrician who consults with on-site caregivers, including a full-time social worker. (One thing the Lott team has learned to watch for: patients who downplay ailments so they don’t have to leave.) Residents are ethnically and religiously mixed; while only 10 percent of those who live here pay the full fee, all have access to the plush lobby and a fourteenth-floor dining room, where meals are served on linen-covered tables in a restaurant-like setting overlooking Central Park. Activities include Spanish and English gospel hours, a joke hour, and spelling bees. Studio apartments are small, with a mini-fridge, microwave, and full stove, but complaints are few. “I have a beautiful room with four picture windows facing Fifth Avenue and the Harlem Meer,” says Catherine O’Rourke, 89, a retired typist who’s lived there for two years. “I walk around the lake every morning.”

“I like being able to take the 22 bus, walk to the movies. The last one I saw was The Queen. I think Helen Mirren's going to get another Oscar. She was just like Queen Elizabeth II. That mean little bitch.”
Bea Duchowny, 86, Hallmark

Hearthstone Alzheimer Care
305 West End Ave., at 74th St.; 212-799-7100; thehearth.org
Facilities: 29 beds.
Fees: $6,000 to $8,000 per month.
Waiting list: Two to three months; you need to pay a refundable $3,000 deposit to get on the list.

Assistance here includes a special focus on Alzheimer’s disease. Located on the seventh floor of the Esplanade (see page 1; the two facilities are otherwise separate) Hearthstone has one of the industry’s highest caregiver-to-patient ratios: five to one for mild dementia and three to one for severe cases. The staff, among the best-trained in the industry, “speak Alzheimer’s,” which means, for one, never pressing a resident who can’t summon the right words. Every aspect of living here is designed to minimize confusion. The secured floor is specially shaped so that residents don’t feel trapped. Glass-enclosed memory boxes with family photos, jewelry, or war medals mark doorways and help residents find their rooms. There are trips to Riverside Park, concerts at Juilliard, and visits to MoMA where the museum’s docents are specially trained by Hearthstone staff to give tours in a way that triggers memories and conversation. Residents—retired executives, teachers, and doctors, mostly Manhattanites—live alone or in a comfortable double room with a bathroom.

5. NURSING HOMES

Cobble Hill Health Center
380 Henry St., Brooklyn; 718-855-6789, ext. 110; cobblehill.org
Facilities: 520 nursing beds.
Fees: $11,280 per month.
Waiting list: None.

Referred to as a sub-acute-care facility for its strong medical services, this 30-plus-year-old facility provides care rivaling that of many good community hospitals. Some 60 medical consultants, including oncologists and a dermatologist, make weekly rounds here, as do a slew of social workers and counselors. The Alzheimer’s unit is recognized as a model by the State Department of Health; the hemodialysis and cardiac-rehabilitation programs are also distinguished. The ethnically mixed crowd hails mainly from Lower Manhattan and Brooklyn, and 75 percent are on Medicaid. Cobble Hill is touted by many in the industry for its commitment to “culture change.” In part, that means dividing residents and medical personnel into smaller, more personalized communities—an initiative that helped the facility win the Commissioners Award for Innovation from the New York City Department for the Aging. A $60 million overhaul of the nineteenth-century building, to begin next year, will do away with triple and quadruple rooms.

Jewish Home & Hospital
www.jewishhome.org; Manhattan Campus, 120 W. 106th St., nr. Columbus Ave.; 212-870-5000
Facilities: 520 nursing beds.
Fees: $330 a day.
Waiting list: None.

While it could be considered a poorer cousin to the Jewish Home location in the Bronx, the Manhattan facility is nevertheless considered a strong and affordable choice for those with chronic conditions like advanced heart disease, diabetes, and dementia. For those who live in Manhattan and want to keep a loved one close by, the location itself can’t be ignored—elder-care experts say patients in any facility get the best care when their family members are around to take an active role. In some ways, this home’s more progressive instincts are hobbled by its architecture. It was built as a nursing home in the early 1870s, long before the current vogue for homelike patient lounges and “barrier-free” floor plans for Alzheimer’s patients. Management is doing its best to modernize by putting dining areas on each floor, with juice machines and help-yourself refrigerators so that residents can wake and dine when they please. Residents are ethnically and economically diverse, mostly local, and, despite the facility’s name, only 43 percent Jewish; 64 percent of long-term residents are on Medicaid. General practitioners, dentists, and ophthalmologists make regular visits.

Additional reporting by Ariel Brewster, Nitasha Tiku, and Wesley Wade


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