Recently, PBS’s Frontline produced an in depth three part series on what life is like inside of assisted living facilities. PBS focused on assisted living facilities run by Emeritus, the parent company of the largest chain of assisted-living facilities in the nation. Emeritus was chosen as the focus because, as a large national chain, it has the resources and infrastructure to provide adequate care to patients. Unfortunately, it alleged that Emeritus was falling short and letting patients down in many ways.
The disturbing three-part Frontline series highlighted tragic stories of patients in assisted living facilities who died in care facilities that did not have the tools or policies in place to care for them. Unfortunately, variations of these stories may happen without the headlines at many assisted living facilities throughout the United States, as the business model of assisted living may be set up to encourage a focus on profits rather than people.
Problems in assisted living facilities typically occur for three primary reasons: there is insufficient data on facilities for families placing loved ones; many families and individuals fail to understand the differences between assisted living and nursing home care; and families often face time pressure when trying to place relatives who need care immediately.
An Absence of Information on Assisted Living Facilities Puts Patients at Risk
The problems at the Emeritus assisted living facilities stemmed from trying to keep beds full and prevent residents from moving out into nursing homes, patients died as a result of a lack of supervision and improper care. One patient, for example, was poisoned by industrial strength cleaners that were not locked away. Another suffered untreated bedsores.
These cases were well-publicized by the PBS documentary, but too many cases of neglect go unreported in the United States. In fact, the National Center on Elder Abuse estimates that for every one case of abuse, neglect or exploitation that is reported to authorities, five cases of elder abuse go unreported.
Even when deficiencies come to the attention of authorities, there is no central database that family members can easily go to in order to see that an assisted living facility has been cited for abuse or had complaints made against it. Where report cards and databases do exist, such as the Medicare nursing home compare tools, these databases are usually focused on nursing homes. Assisted living facilities are generally subject to less regulation and less oversight, typically, because most of these facilities are not intended to provide nursing care to patients.
This leaves family members who are struggling to place loved ones left with limited sources of information about assisted living facilities.
A Fundamental Misunderstanding
The PBS documentary portrayed several situations where patients remained at an assisted living facility for too long, as the patients developed medical issues that should have resulted in them moving into a nursing home.
Unfortunately, many patients and families misunderstand the difference between nursing homes and assisted living environments. As the documentary clearly illustrated, assisted living facilities are not equipped to provide advanced nursing care to patients and should provide a living solution for those who are not yet ready for nursing homes. Assisted living facilities are less restrictive and less institutional but do not have resources or trained personnel who are capable of responding to life-threatening conditions.
Unfortunately, some assisted living facilities focus on occupancy and want to keep beds filled. As a result, employees discuss a focus on keeping patients from going “out the back door,” or leaving the residencies.
In one case, efforts to keep a patient in an assisted living facility resulted in employees covering up cases of severe bedsores, attempting to treat this problem in-house without the tools or ability to do so, so the patient would not move to a nursing home when they should. The result of this was fatal. Individuals and family members of patients need to understand the fundamental differences between assisted living facilities and nursing homes so that they can ensure that patients are in the right place to get the help they need.
Time Pressure Exacerbates Problems
The problems associated with a lack of information and a lack of understanding of the role of assisted living facilities are often exacerbated by the fact that families may wait to do research on assisted living facilities and nursing homes until they are in a situation where action needs to be taken right away. Once it becomes unsafe for a senior to live by himself or herself, a move needs to be made quickly. This can result in family members scrambling to find a facility without doing the proper research to determine if the facility is the right one.
Difficulty finding facilities with open beds can make the situation worse, as family members may end up simply choosing the first home they can find without a waiting list, even if that home is not equipped to provide the necessary care to the senior.
Do you have any experience(s) with you or a loved one looking for a potential Assisted Living provider? Have you gone through any of these struggles and have first-hand information or feedback that you could share? Please do let us know and share it with our #OpenCommunity network and leave a comment and/or feedback below in the comments section.