ProPublica: Life and Death in Assisted Living

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    ProPublica: Life and Death in Assisted Living

    Last updated: Monday, July 29, 2013, 9:51 AM

    ...During a tour, a salesperson gave Myron and his two sons, Eric and Mark, a brochure. “Just because she’s confused at times,” the brochure reassured them, “doesn’t mean she has to lose her independence.”

    Here are a few things the brochure didn’t mention: Just months earlier, Emeritus supervisors had audited the operations of the memory care unit where Joan would be living. It had been found wanting in almost every important regard. In truth, those “specially trained” staffers hadn’t actually been trained to care for people with Alzheimer’s and other forms of dementia, a violation of California law. The facility relied on a single nurse to track the health of its scores of residents, and the few licensed medical professionals who worked there tended not to last long. During the three years prior to Joan’s arrival, Emerald Hills had cycled through three nurses and was now employing its fourth. At least one of those nurses was alarmed by what she saw, telling top Emeritus executives — in writing — that Emerald Hills suffered from “a huge shortage of staff” and was mired in “total dysfunction.”

    During some stretches, the facility went months without a full-time nurse on the payroll. The paucity of workers led to neglect, according to a nurse who oversaw the facility before resigning in disgust. Calls for help went unanswered. Residents suffering from incontinence were left soaking in their own urine. One woman, addled by dementia, was allowed to urinate in the same spot in the hallway of the memory care wing over and over and over. The brochure also made no mention of the company’s problems at its other facilities. State inspectors for years had cited Emeritus facilities across California, faulting them for failing to employ enough staff members or adequately train them, as well as for other basic shortcomings...


    Last edit by NRSKarenRN on Jul 30, '13
    BrandonLPN, VivaLasViejas, lindarn, and 1 other like this.

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  2. 18 Comments...

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    I'd really like to read the next part, but I have a feeling how its going to go, and it's probably not going to go well...
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    Check your local PBS stations as Frontline is running a series based upon the ProPublica story.

    Long story short this isn't something many of us didn't already know but there is more out there, much, much more.

    Assisted living has become another "profit center" for persons to make money off the elderly and or their families. With nursing home beds declining as more older Americans turn to aging in place, this new market has grown to take advantage of a "niche" market. The best places do what they say and well, then there are others that are total nightmares and rival or equal the worst of nursing home abuses.

    Much of the problems stem from the often loose regulation in states of assisted living facilities. It is a growth industry with money to spread around (to grease the proper wheels), which seems in many instances to beat back proposals to tighten up laws and or oversight.
    amoLucia, StNeotser, lindarn, and 2 others like this.
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    So so sad...and people pay big money for some of these places.
    For profit exercises in the care of our elderly and infirm.
    herring_RN likes this.
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    Thanks, I will watch that when I have time. I have noticed through visiting AL facilities that many of the patients they have seem to need LTC but they are in AL.
    VivaLasViejas and herring_RN like this.
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    Is it bad that I'm more interested in what the original ALF apparently did right? (They re-taught her how to eat with silverware!) But that gets totally glossed over.
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    Quote from StNeotser
    I have noticed through visiting AL facilities that many of the patients they have seem to need LTC but they are in AL.
    True!!! Part of the problem is that families and the patients are misinformed by ALFs (I suppose by the sales-side of the house) and will prefer Assisted Living Facilities (ALFs) even if it is obvious to any health care provider that the person will not do well in an assisted living environment. Assisted Living Facilities is a living environment for people who would normally be "OK" living at home, but are in need of some basic assistance (meal prep, medication admin reminders, ADLs, etc). Not people who are confused at baseline and who walk and fall every few steps.

    The resident and his/her family find out that the resident needs to live in a higher level of care after they paid a lot of money to the ALFs and had multiple ED visits for a variety of reasons that all relate to the fact that the resident cannot take care of themselves and are not taken care of properly at the ALF level. In fact, this is also after a Nurse Case Manager and/or Social Worker intervenes at the hospital. Ironically, that is also the first time the family is told by the ALF that the resident is not appropriate for an ALF and are better off somewhere else. At least, this has been my experience.
    lindarn, TheCommuter, VivaLasViejas, and 1 other like this.
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    Thanks for your input. When I worked on a medicare rehab floor some years ago I remember that Assisted Livings would reject some of our possible discharges due to high ADL needs or too complex a level of medical care being required. Now that I am working hospice I seem to be visiting people who are incontinent of bowel and bladder as well as falling all the time. I did think that when they moved to the AL that perhaps they were at a higher level of functioning, but then I find out from the families that they were not.

    Of course this is just my humble opinion.
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    lindarn and anothergrumpyoldRN like this.
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    Here in the interior of Alaska we have one SNF/LTC.
    All other facilities for the elderly are ALF.
    They are very loosely regulated.
    The care is NOT even close to being the same.
    lindarn and BrandonLPN like this.

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