Scary Truths About Facility Care. Click HERE instead to see a one minute video that can save you the 3 minutes it will take to read this written article. We will be examining some SCARY truths in regards to Senior Facility Ratings Home Care vs. Facility Care.
You may look high and far for honesty about facilities like this. You may never find it. You will certainly not find it in the 30 page marketing material ad you will see each of the 200+ facilities for elderly care you can find in Columbus, Ohio. You won’t hear these kinds of numbers from an administrator or an admissions coordinator inside of a facility. Nope. But, I hope you will at least consider our argument here.
Let me start with this nugget: Always There Home Care is provider that exclusively provides one-on-one care for seniors in Columbus, Ohio. We therefor have a love/hate relationship with facilities.
It was a surprise 15 years ago when we started getting weekly calls from facilities who are simply not capable to spend one-on-one time with patients who require extra attention. We are glad to provide this supplemental care because it makes all the difference in the world to a senior going thru a difficult time of crisis.
I have personally been in 95% of the facilities in Central Ohio to capture these impressions. We have our opinions based on 20 years of gathering stories, opinions, and hearing from our clients about the realities of their experiences living in senior home care facilities in Columbus, Ohio. We also collect our data about senior rehab centers and skilled nursing facilities in Central Ohio.
I will start with the positive. Here’s the best we can do. We “love” facilities because they and their teams work earnestly to serve a senior population that are simply void of other options. These facilities work to serve a large and growing segment of our population who did not retire with proper funds to support their needs past retirement age. Most people will fall short of securing the savings necessary to fund their retirement. This is a spotlight on the reality of facility life.
The costs for care are skyrocketing. We’ve seen insurances for providing senior care skyrocketing. Saving effectively for care expenses at end of life is nearly impossible for an overwhelming majority of the hardest working Americans. Inflation and premium costs are always rising.
So we can’t blame facilities for attempting to make the most of a failing situation. If it were not for the tireless work that these facilities are doing around-the-clock each day? Countless seniors would be forced to rely upon care of family members or they would simply go without care whatsoever. In a nutshell, facilities excel in these ways: Providing warmth, shelter, food and a baseline of critical care.
While this is not a politically motivated article, I must point out some guidelines. Facility care is simply not good enough. Facility care is reliant upon an assumption that seniors can survive with uniform care. Not specialized care. Not one-on-one care. Uniform care. But what is one size fits all care? It’s baseline care. It’s someone checking on you a few times a day. Facilities provide a bed and a chair and a television and meals. It’s nothing like the care you can receive at home. Facility care doesn’t work for your loved one or for mine. And it really doesn’t work when we are talking about serving those who can not self-advocate.
There is tremendous inequity among our aging population. While facilities work to provide care for thousands, they will always fall short of providing the right care at the right time for each individual. It’s a process that has failed and yet we rely upon it.
Lets examine fictitious Patient A: Ruth. Ruth is an 85-year-old woman with dementia. She does not have the capacity to remember to eat or bathe. Ruth certainly lacks the wherewithal to advocate for herself. Call button care won’t work for Ruth. Pull this lever for help won’t work for Ruth. So how will Ruth do with Uniform Care?
In a Medicaid funded facility, Ruth will receive bathing, meals, and medicine. Her laundry will be done. She will have an activity room where if she decides to, she may take part in whatever the facility has to offer. Ruth will be placed in a wheelchair and pushed down the hall to a dining room (for an extra fee as she can’t walk herself) or a meal will be presented to her in bed (for an extra fee) The facility caring for Ruth, and it’s care team are funded by the government. Medicaid or Medicare will pay for all the care Ruth will receive. How much actual hands-on care will Ruth receive? It will be scarce. Almost none in fact. What if Ruth is a wanderer? What if Ruth walks into other residents rooms? Ruth’s caregivers are not equipped for this kind of redirection. Ruth will be highly likely to be sedated.
We have interviewed thousands of caregivers who have had facility experience over the last twenty years. I can speak accurately about this fact: In a 24-Hour Day, Ruth is likely to receive less than 30 minutes of expedited hands-on-care. Ruth’s hands-on caregiver who is not likely an RN. Ruth’s care will largely be provided by staff who are at the bottom of the food chain of care providers. Ruth will not be given a choice about the sex of her caregiver. Ruth will not be given a choice about meal times, bathing, or medicine. Additionally, Ruth’s caregiver is very busy. Facility caregivers have up to 25 other patients who’s needs they are responsible for. In fact, Ruth’s caregiver will be reprimanded if she doesn’t reach all of her patients each shift. Sadly, if Ruth has a need that requires more than 2-5 minutes of direct attention, Ruth’s issues will go unresolved.
Ruth is therefore made to wait at times of greatest need. Soiled garments do not result in immediate attention. Rampant confusion does not either. Ruth’s condition does not enable her to engage additional facility attendants.
If Ruth were to pull a chord to attract attention and ask for help, her alarm will be one of a dozen other alarms going off at the nurse’s station. Ruth will have to wait at least an hour.
Waiting an hour or more for attentive care is best case scenario and this is IF Ruth is capable of self-advocating. As Ruth’s condition would prohibit her from caring for herself, Ruth must wait. Ruth will be in soiled clothing for hours. As Ruth is likely to be confused and agitated, Ruth may have to wait until two caregivers are available to change her quickly, forcefully and awkwardly. This is BEST CASE SCENARIO for Ruth in facility care.
Ruth’s reality is the nearly the same as everyone else’s in a facility. The facility care recipients who are at greatest need do not get more care than those who are not. It’s uniform care. Staffing ratios for facility care in Ohio are set to provide merely a baseline of care. Conveniently, and in order to actually turn a profit, facility care is spread thin. Very thin. Caregiver’s like Ruth’s are tasked with the near impossible. While facility caregivers are fighting the good fight, they can never really succeed in providing appropriate care. The squeaky wheel gets the oil.
There was recently another nightmare story to surface about a gentlemen in a facility in Columbus, Ohio who’s suffered unthinkably. Without elaborating, you can find the story here.
This story surfaced and picket signs went up on social media. People are enraged about the lack of attentive care. They want someone to pay a price for this level of neglect. They want caregivers fired. But what people fail to realize is that this gentlemen’s story is a culprit of a system that is failing us.
As bad as care has been in some facilities and as chronically under represented as facility residents are, the facilities are working hard with thin budgets and they are always short on staff. They know this: They are going to fail their care recipients.
Here’s the surprise. If Ruth receives care at a $10,000/month facility on the prosperous side of town, she is going to receive an almost identical reality than her reality at the ‘lesser’ facility. The floors may be made of nicer shinier materials. The ceiling may be higher. There may even be an ice cream parlor, or a pool. In the modern for profit facility, amenities like these will be available in spades. But we have to remember that Ruth doesn’t self-advocate. Ruth will receive roughly the exact same amount of attentive care.
But that’s not fair! Ruth needs more care than that. But uniform care is perfectly legal. State survey can’t ramp up it’s expectations of care simply because one facility is more pristine than another. Ruth is going to receive the same amount of care as long as she’s still in a facility.
Let’s examine Home Care Recipient B: Mary. Mary is also 85 years old. Mary started developing memory issues in her 70’s and her concerned family made preparations. Mary had advanced directives. She advised her family early in her senior days that she would prefer to stay at home. She had friends who went into facility. She wanted to stay at home in the place of greatest comfort where she knew she could receive one-on-one care.
Over the course of 5 years of care, Mary moved from a modest care plan to receive more care. What was care a few days a week became care a few hours a day. As Mary’s condition worsened, the care level increased. Familiarity became more and more critical. One-on-one care was mandatory. Mary’s home care staff were eventually asked to provide around-the-clock care over the last 6 months of Mary’s life.
Here’s the difference in outcomes for Ruth & Mary. 70% of Ruth’s allotted care dollars went toward the shared creation, ownership, management and upkeep of a 100,000 sq. ft. facility she would call home for the last 5 years of her life. That was broken up something like these pie graphics demonstrate.
Home Care’s Value is a message somehow lost in the grand smoke screen of the perception that quality of life is somehow better in a large facility than in the comfort and privacy of your own home. Here’s another chance to observe a quick hitting message about the real value of home care.
Who cares if the facility where your loved one resides has so much to do when none if it is relevant to your Mom? How many of the lawyers, carpenters, maintenance men, administrators or kitchen staff are relevant to your Mother’s one-on-one care needs? These are excesses all easily avoided with Home Care.
We are all familiar with one of Albert Einstein’s greatest quotes.
How many times do we need to remember we can get it right the first time if we stop and consider all the data. It is not our hope to throw all facilities under the bus. Our hope is that for your loved one, you will not be simply be wowed by amazing and irrelevant amenities when the real decision for the best care comes down to the quantity and quantity of care you will receive in one setting vs. another. This after all is what speaks volumes about quality of life. Where are we most comfortable? How much care do we get for every dollar we spend?
Scary isn’t it?
Ben Smith is Always There Home Care’s Founder & President. Having served Columbus, Ohio’s elderly population for 20 years professionally, Smith has been building a team in Columbus since 2004. Call today to learn more about how we may best serve your loved one’s needs. Care plans are available for a few visits each week up to care 24-Hours a day. Call where it’s always “Your Home. Your Rules. Our Care.” Call 614-Home Care: 466-3227