The dangers of assisted living facilities and small residential group homes:

Before going to sleep on Aug. 31, 2006, a 72-year-old woman living at Oceanside Home Care in Los Osos was fed some macaroni salad and corn bread.

The next morning staff at the six-bed residential care home found her lying unconscious on the bedroom floor. Paramedics took her to the hospital after diagnosing a diabetic coma—her second in three weeks.

The woman, whose identify was not released by state investigators, never regained consciousness and died in the hospital seven days later.

Her death prompted an investigation by state officials, who found Oceanside had “insufficient and unqualified” staff who failed to monitor the woman’s diabetes. The woman’s memory was impaired, and staff did not follow her prescribed diet, record her glucose levels and track her insulin injections, inspectors found.

Assisted living facilities and group homes do not have to utilize nurses; or CNA’s. Anyone can work at these places, as an aide. Anyone can be “trained” to check glucose levels and pass meds. Often we see illegal immigrants working for these places out in CA and the other western states. Another problem with assisted living- it’s not regulated. At all. Anything goes…and we’ve seen countless examples of this here in horror stories like the one above.

For families looking for info about assisted living facilities, that info is often hard to find. Key questions to ask would include how many nurses and CNA’s (make sure at least some of the aides are certified) work each shift; how often are residents checked on through the night; who is responsible for passing medications AND very importantly, are the residents themselves responsible for this? Inquire about staff education about meals, snacks and diabetes and other nutritional issues if it’s pertinent to your loved one.

Good news:

Despite the graying of the nation, the percentage of elderly living in nursing homes has declined, according to Census data released today. The downturn reflects the improved health of seniors and more choices of care for the elderly.

About 7.4% of Americans aged 75 and older lived in nursing homes in 2006, compared with 8.1% in 2000 and 10.2% in 1990.
[...]
The nursing home numbers do not include assisted-living facilities. “There’s no federal definition of assisted living and that’s a void in the data,” Bolda says. “Fortunately, communities are taking responsibility for addressing the needs of older adults rather than waiting for federal policy solutions.”

Let’s hope the numbers continue to go down…and that includes assisted living. Community housing is not home- no matter how pretty it looks. Bring the money to the families, who can take of their elderly loved ones at home. The best solution and also the least costly.

A new book written by a woman who worked as an aide. Celia Berdes, of The Direct Care Clearinghouse writes an excellent review, which I am quoting some portions from here- as readers hopefully know, the red text is a link to the DCCH site:

Dancing with Rose: Finding Life in the Land of Alzheimer’s (York: Viking, 2007), a new book by Lauren Kessler, is the best book yet written on the lives of old people in residential care and the people who care for them. It is not the first book about working as a nurse’s aide: Sallie Tisdale’s 1987 classic, Harvest Moon: Portrait of a Nursing Home, was based on the author’s work as an aide, and more recently, Thomas Edward Gass’ Nobody’s Home: Candid Reflections of a Nursing Home Aide (2004) gave a highly personalized and excessively candid report. Dancing with Rose, by contrast, balances the personal with the public, and Kessler tells her story with such skill and sensitivity that the reader will find it hard to put the book down.

More:

The leading players are nurse’s aides, and Kessler does an excellent job of capturing them and their work experiences. She tells how some seem to have an aptitude for caring, often relying on their experiences of mothering or other kinds of nurturing. She pinpoints the role of attitude, how for some each new task is taken up with a sense of mission, while for others it is just another chore. She describes the special skills that they use in giving Alzheimer’s care, how they must intuit needs that cannot be expressed and witness residents’ decline without looking away. She describes in fine detail the effect of doing everything–cleaning, feeding, laundry, toileting–for more than ten residents per shift. Without flinching, she describes the challenges of low-wage work, the incessant search for a little step up, the hanging-by-a-thread arrangements for childcare and transportation that enable women to do this sort of work. And she describes what it means for workers to care for residents who always, ultimately, die.

Dancing with Rose leads us to this inescapable conclusion: that caring aptitudes and attitudes of skilled direct care workers are the most important components of high quality care. In a call for systemic reform, Kessler asks us to think about our own aging: ”If I do need help when I get older, if it becomes impossible for me to live independently, how do I want to live? Do I want to be cared for by an overworked, underpaid woman with so many chores to accomplish on her shift that she can barely spare a minute to talk to me?

To read the entire review go here- the Direct Care Clearinghouse.

Sounds like an excellent read, and it’s pretty inexpensive too!

It sounds like a lot of money but it’s not really, when one considers the profit this chain makes.

A nursing home company has been found negligent in the death of an elderly man and ordered to pay $1.4 million in compensatory damages.

After deliberating for three and a half hours Monday, the Ouachita County jury awarded $875,000 in punitive damages in the case filed against Beverly Enterprises and its nursing home in Camden. The company was sued for the April 2005 death of Herman Johnson.

Johnson went into the nursing home March 18, 2005. Two weeks later, he was found unresponsive in his wheelchair in the dining room. Two nurses tried to revive Johnson before an ambulance took him to Ouachita County Medical Center, where he was pronounced dead. An examination of the body found bed sores and evidence of malnutrition and dehydration.

The suit claimed the nursing home was insufficiently staffed to provide adequate care for Johnson. Lawyers for Beverly said Johnson’s condition was due to long-term alcohol abuse and other chronic health problems, including anemia, diabetes, high blood pressure and kidney failure. They say Johnson also had a history of refusing to take vitamins and medicine prescribed for him.

Now, if every resident who died of neglect sued Beverly Enterprises, it would certainly have an effect on Beverly’s bottom line.
One case means nothing; many cases can bring a company down.

From a Press Release:

EDWARDS UNVEILS DECLARATION OF INDEPENDENCE FOR OLDER AMERICANS

Des Moines, Iowa - Senator John Edwards today unveiled a new agenda for older Americans based on the values of security, dignity and choice. Edwards’ Declaration of Independence for Older Americans will help older Americans get the health care they need and the financial protection they deserve while allowing them to live as independently as they desire.

From the Actual Declaration:

LIVING WITH DIGNITY

9. OFFER CHOICE IN LONG-TERM CARE: Our long-term care system is poorly equipped to give independence to older Americans and forces many families to juggle elder care, child care, and their jobs or spend themselves into poverty to pay for nursing homes. Edwards will reform Medicaid and Medicare to let people to choose home-based care in their communities and test innovations such as asset and income protection programs. He will also support states and communities offering much-needed and often less expensive alternatives - like adult day care and senior villages - that allow seniors to live at home with their loved ones.

10. IMPROVE NURSING HOMES AND CRACK DOWN ON ELDER ABUSE: Independence is the goal, but we also need to strengthen quality and safety protection in nursing homes. Edwards will establish national standards for nursing home care, increase national enforcement against abusive nursing home chains, expand inspections and increase penalties for homes that fail to provide decent care. He will also help improve quality of care with measures like reducing patient-staff ratios and improving care provider training.

11. PROMOTE LIVABLE COMMUNITIES AND ACCESSIBLE TRANSPORTATION: Too many seniors are forced to move from their private homes because they lack supportive services or reliable transportation. Edwards will promote livable communities to make sure every American has the right to age in the setting of their choice. He will create new supportive housing options that give older Americans the choice of community-based living, vigorously enforce civil rights laws to ensure that federally-funded housing is accessible, and protect supportive services like meals-on-wheels and senior centers that sustain independent living. He will also meet the special needs of senior drivers by helping health professionals educate their senior patients about the interaction between health and driving and encourage automakers to make affordable, wheelchair-accessible vehicles. In the Edwards administration, the Department of Transportation will prioritize transportation access requirements, fund accessible mass transit like “kneeling buses” that are easier to board, and support paratransit services in rural areas.

There is much more; this is the last section of this declaration.

Utah advocates for elderly citizens are starting to educate others about the alternatives to nursing homes.

MIDWAY — Home is not only where the heart is for aging Americans; that is where they are better off and state funds for senior care programs are better spent — six times better at least.

So say Utah senior advocates, government-agency representatives and care providers. They are so sure that promoting independence of individuals is healthier to both seniors and to state coffers that they want a freeze imposed on any public funds spent on long-term care facilities.

A special panel of lawmakers reviewing state spending on Medicaid and other programs for senior and disabled Utahns will receive the proposal at its next meeting Oct. 3. The lawmakers will make a recommendation by November, and the full Legislature would still have to act on it during the 2008 general session beginning in January.

“This is simply recognizing that the traditional skilled nursing at a care center model of caregiving is on the way out,” Alan Ormsby, director of the state Division of Aging and Adult Services, said Tuesday. “I would never say there isn’t a place for long-term care centers. But when you can provide safe and often more effective services at home and at less than a sixth the cost for most seniors, we have to at least begin moving in that direction.”

I like that statement: …”traditional skilled nursing at a care center model of caregiving is on the way out”– and I think it’s starting to come to reality. Almost everyone would benefit from a change of this model; nursing homes are not a HOME no matter how hard they try. The culture changes we see within nursing homes, the Eden type models, are good. But nothing replicates being at HOME. In control of your own destiny and in charge of your own life. The more resources that are fed into this the better off we all are.

SEIU members attended a rally, protesting the sale and terms of the recent sale of Manor Care nursing homes.

About 175 union activists rallied yesterday at the Washington headquarters of a private-equity group to protest the terms of its planned takeover of Toledo nursing home giant Manor Care Inc.

Chanting “Better staffing, better care, not more money for millionaires,” members of the Service Employees International Union marched into the lobby of the headquarters of Carlyle Group LP, said Andrew McDonald, a union spokesman.

The rally attendees were not met with open doors though.

But they were turned away when they tried to deliver a list of demands to officials of the multibillion-dollar investment group. “Today, we kicked off what is going to be a national effort around this Manor Care buyout,” the spokesman said.

Manor Care is one of the nation’s largest nursing-home operators, with 550 nursing homes and related facilities nationwide.

These kinds of protests are usually well received. Maybe the unions should think of a better way? I don’t think it would matter with Manor Care though- for them it IS all about profit.