Dangers of Assisted Living, Part 2

Learn the truth about the hidden costs and lack of care in assisted living and why it's important to not judge a book by its cover.

Dangers of Assisted Living, Part 2
Assisted Living is a Social Model Not a Medical Model

Are You Aware of the Hazards Lurking in Assisted Living?

When I explain to my clients that Assisted Living is potentially one of the riskiest components of the healthcare system, they often perceive it as an exaggeration. After all, how could these elegant establishments, complete with dining rooms staffed with chefs and lobbies graced by Steinway pianos, be perilous in any way?

As I traverse these facilities, with their grand spiral staircases adorning the entrance, I can't help but wonder what the architects had in mind. Assisted Living has evolved into the alternative to nursing homes for housing elderly parents. There's an unfortunate misconception that the opulence of these buildings guarantees top-notch care. However, in high-end Assisted Living facilities, you pay for every service, no matter how small. Do you desire room cleaning? There's a fee for that. Need your blood pressure checked? Expect an additional charge. Anything beyond your standard monthly fee incurs extra costs. It's crucial to understand that even the most upscale establishments can be as hazardous and dysfunctional as their low-end counterparts.

There are Assisted Living buildings designed for individuals relying on Social Security. These represent the lower end of the spectrum and can be just as concerning. Residents in these facilities often lack access to the amenities enjoyed by their high-end counterparts, and, unfortunately, many feel voiceless.

The food quality in these establishments is often subpar, and heating and air conditioning can be inadequate. Astonishingly, I'm aware of a low-end facility that removed the heating and air-conditioning clause from its contracts following a change in ownership.

One consistent concern in all Assisted Living facilities is that they primarily adhere to a "social model" rather than a medical one. Yet, if you visit an Assisted Living Facility on any given day, you'll find residents:

  • Using oxygen
  • Relying on walkers
  • Coping with various medical conditions such as diabetes and kidney disease

A recent study even revealed that as many as two-thirds of Assisted Living residents suffer from some form of dementia.

These social models typically incorporate medication management systems, much like those in nursing homes, to assist residents incapable of managing their medications independently. However, this service comes at an additional cost. Medications in high-end Assisted Living facilities might be distributed by nurses or, in most cases, by aides who have undergone a single day of training to become medication technicians.

Recently, I observed a med tech distributing medications to a resident in one such facility. As I engaged in conversation with the resident, I noticed her chewing all the pills. I inquired why the med tech hadn't administered the pills with applesauce or yogurt to ease her swallowing. His response was that none of the 156 clients required assistance with swallowing and that he was confident all the medications could be chewed, despite lacking information on her specific medications.

These Assisted Living facilities operate as "social models," even accepting residents in wheelchairs with needs ranging from incontinence care to insulin injections and occasional wound care. They rely on home care agencies to provide intermittent care. However, issues arise with insulin-dependent clients who may have difficulty administering injections due to poor eyesight. Unfortunately, insurance doesn't cover this ongoing service, yet low-end facilities accept these residents before determining how to provide the care. Profit often takes precedence over safety.

For seniors with multiple medical conditions, the "social model" of Assisted Living is no longer a safe or acceptable living arrangement. A recent incident involving one of my clients, an electric wheelchair user with limited mobility and few opportunities to leave the facility, illustrated the perils. While navigating a narrow walkway, her wheelchair tipped over. We had to summon an ambulance for assistance, which led to an ER visit for assessment.

During this ordeal, I noticed that her pants were wet, and she hadn't received a change before leaving the facility. When I mentioned this to the ambulance crew and hospital staff, their responses cast a negative light on the assisted living facility's reputation.

When I discussed my concerns with the facility's administrator, his response was disheartening. It ultimately came down to finances; she was a high-paying client who had transitioned to Social Security, necessitating cuts in her care. According to him, his staff was doing an excellent job.

In another incident, I witnessed staff transferring the same client from her wheelchair to the bed improperly, causing her unnecessary pain. Despite offering a more suitable approach, the aides resisted, citing their experience and dismissing my suggestions.

One day, while browsing an aide forum, I stumbled upon a concerning account from an aide working in an Assisted Living facility. She had observed a med tech discarding medications meant for residents into the trash, only to be ignored when reporting it to the administration.

These are just a few examples of the safety issues that can plague Assisted Living facilities and board-and-care homes.

I will delve deeper into the perspective of organizations like Emeritus and the Assisted Living Federation of America (ALFA), shedding light on their promotion of Assisted Living.

First, let me share Emeritus response to the Frontline story here

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Assisted Living -Dangerous, Deceiving and Dysfunctional Part 1

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Emeritus Senior Living: Response to Frontline Story- Part 3


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