By Sharon Byrne, as featured in the Santa Barbara Sentinel
When I was little, we often visited our UK relatives. Grandma Byrne lived in a Home for the Aged, as Brits call them. She had a nice flat, with a parakeet, and her own furniture. The Home took them round to the shops, and on outings. She was well looked after, especially given it was government-run.
But that’s Europe for you – they take care of you from cradle to grave over there.
By contrast, the American system of care for the elderly is a bit of a crapshoot. There are good facilities, to be sure, but there are some awful ones too. Lest you think I am talking about some dreadful state-run facility for destitute elderly, egregious instances of elder abuse also occur in private facilities, the kind you pay a lot of money for.
It’s an old joke here that Santa Barbara is for the newly-wed and nearly-dead, but there’s some truth to the adage, as there are quite a few senior living communities here. The climate is gentle on older bones, and the scenery stunning. Senior living options include:
1. Independent Living
2. Assisted Living
3. Skilled Nursing Care
These are fairly self-explanatory, and the cost goes up as you move down the list. Assisted living facilities are not inexpensive, with some here running at $5,000 per month. That doesn’t include extras: hospital beds, wheelchairs, diapers, medications, bedding, and additional care-givers.
Senior living facilities aren’t charities. They’re a business, so their job is to generate revenues and minimize expenses. They must market themselves, and the brochures for some of these places look terrific. Piano in the main room, activities, gourmet meals – they sound a bit like resorts. But the reality can be quite different. Some facilities draw clients by advertising that they have an RN on site, but the staff are hourly workers without nursing skills, and the RN is never there. So who’s dispensing medication?
Economic pressures drive leaner staffs, so seniors that require too much labor can be subjected to some dreadful tactics. Someone who needs considerable assistance to use the restroom, for example, is sedated and diapered so as to reduce staff load. The family is told the senior is now incontinent. And don’t disrupt the dining room by complaining loudly about the food or causing a scene. You will be isolated to meals in your room.
One facility here has a ‘death closet’, where the recently deceased are stored while awaiting removal. A family with a loved one at this facility came to visit. The loved one had cognitive impairment issues, so the family was quite surprised to discover she was not in her room, but someone else was. When the family cornered staff on her whereabouts, they discovered to their horror that she had been moved into the ‘death closet’. The facility wanted to rent out her room at a higher rate, while still charging the family for it.
Some workers are understandably horrified by these kinds of abuses, but fear speaking out, as whistle-blowers aren’t likely to be welcomed at other facilities. The same goes for family members who protest about problems with their loved one’s care. Bills for newly necessary equipment, new requirements for a caregiver at your expense, and even eviction can ensue as retribution.
Many of us take care with our health, strive to live a long life…. and shudder at the thought of wasting away in a nursing home as our closing chapter. We also cringe with worry over subjecting our parents to potential abuse when they’re very frail. Money is supposed to be the great equalizer in this country – we believe that by having financial resources, we can insulate ourselves from being at the mercy of others, particularly when we are at our most vulnerable. But even with expensive senior care, there are no guarantees. The industry is loosely regulated, and California generously warns facilities of impending inspections.
What can you do? Review the Medicaire ratings for facilities. A Place For Mom also has great info on audits and complaints. Hire caregivers to keep eyes on your loved one when you can’t be there. Make surprise visits. Ensure your family puts these provisions in place for you.
As a country with a large population of aging baby boomers facing their golden years, you can bet this issue will generate increasing scrutiny, as it should. Our senior care options should be a lot better than this.