The way the medical system talks about aging often gets it all wrong.
That’s what Bruce Chernof, a geriatric physician and head of The Scan Foundation in Los Angeles, wants you to know.
“People define themselves by the function they retain, not the function they’ve lost,” he says.
That means there’s a huge disjoint between the words older Americans use most frequently to describe the kind of care they want in later life (words like “choice,” “independence,” “dignity”) and the most common words doctors rely on (“palliative care,” “geriatrics,” “advanced directive,” “donut hole”). Continue reading
“It takes a village” is a common refrain.
Now “Villages” — yes, with a capital V — are sweeping the U.S., looking to redefine how people age in their communities.
The Village movement brings together older adults who want to age in their homes independently, but believe it will be too hard to do so, unless they have some support. These virtual villages link independent living seniors together. Members offer support to each other as they are able, and ask for support when they need it through an organized system.
Half of all villages in the U.S. started in the last three years. Because they are such a recent phenomenon, there have not been many studies about their outcomes. Continue reading
By Deborah Schoch, Center for Health Reporting
Gov. Jerry Brown signed into law Monday a bill imposing a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.
The top fine will now be $15,000, for violations causing death or serious injury, up from $150.
The relatively low fines were highlighted in a series of stories produced last year by the CHCF Center for Health Reporting and the U-T San Diego. The series focused on 27 deaths and hundreds of injuries at homes in San Diego County caused by abuse and neglect.
The bill to increase fines, co-authored by Assemblyman Brian Maienschein, (R-San Diego), was amended during the legislative process to allow a four-step appeals process. Also, a proposal to boost fines for some lesser offenses to $1,000 from $150 was removed from the bill amid lobbying from smaller assisted living homes. Continue reading
(Philippe Hugue/AFP/Getty Images)
By Ina Jaffe, NPR
A federal lawsuit against two Watsonville nursing homes may offer a new approach to dealing with the persistent problem of such facilities overmedicating their residents.
The lawsuit details multiple cases when the government says these drugs were inappropriately administered to patients. Watsonville is northeast of Monterey, in Santa Cruz County.
For instance when an 86-year-old man identified in the lawsuit as Patient 1 was admitted to Country Villa Watsonville West, he could speak clearly and walked in under his own power. Within days the facility began giving him Haldol and Risperdal, drugs used to treat schizophrenia and bipolar disorder, and he became bedridden, stopped eating and developed bedsores and infections. Continue reading
Christina Selder and Chris Murphy of Consumer Advocates for RCFE Reform in San Diego conduct their crusade from a modest home office. (Rachael Myrow/KQED)
Many of us dream of starting a revolution. Few of us make it happen. One of the most dramatic stories of the last year belongs to a loose collection of activists, working to reform assisted living oversight in California. Together with lawmakers, these activists launched 17 bills in Sacramento, 12 of which passed, 2 of which have become law, so far.
It’s a big story, but let’s break off one piece, involving a couple women in San Diego with a passion for raw data, strong coffee and home-baked muffins.
About a decade ago, Chris Murphy’s mom was suffering from Stage 4 ovarian cancer. She couldn’t live on her own. Someone suggested Murphy check out an assisted living facility, and so she took a tour.
“This is really a cool place,” Murphy says she thought at the time. “Maybe my mother would like to live here. I would like to live here. I was sucked in by the chandeliers, and by the garden, and by the apparent appearance of the facility.”
By Polly Stryker
Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)
Last Thursday, August 14, was the day that bills still in the state Senate Appropriations Committee sank or swam. The Senate Appropriations Committee is where bills costing $150,000 or more go for consideration. If bills make it out of this committee, then bills are still in play and could make it to the governor’s desk, albeit with potential amendments along the way. If not, they die.
Going into the home stretch of this legislative session, 16 bills were on the table that, altogether, constituted the first major overhaul of the assisted living industry in nearly 30 years.
Two have already made it to the governor’s desk. AB1523 mandates liability insurance for all assisted living facilities. Advocates say liability insurance is one of the best ways to improve conditions in the industry. Operators whose violations make buying insurance too expensive will be simply forced out of business. The industry group California Assisted Living Association supported AB1523. AB1572 mandates facility operators allow and support resident and family councils at assisted living facilities. CALA supported that one as well.
Most of the rest of the bills are still swimming. But what about the bills that died?
A “crime book” maintained by the San Diego advocacy group Consumer Advocates for RCFE Reform. (RCFE is short for Residential Care Facility for the Elderly.) This book contains cases of what CARR calls “egregious neglect” at San Diego assisted living facilities. (Rachael Myrow/KQED)
Over the last 25 years, the number of assisted living facilities in California has nearly doubled. The homes are intended to care for relatively independent, healthy seniors, but that doesn’t describe a lot of the people living in them today.
“There’s been a seismic shift in the population they serve,” says Deborah Schoch of the California HealthCare Foundation Center for Health Reporting. Schoch says the system was set up to meet the needs of people who could use some extra help with the tasks of daily living –- and it does. But many of those people need a lot of help.
The system, she says, is caring for people “who are frail, who may have dementia, who may be wheelchair bound, who may not be able to turn on their own in bed.”
Stacy Siriani’s father suffered a serious injury while in an assisted living facility in San Diego. (Rachael Myrow/KQED)
When families place a loved one in an assisted living facility, there’s an expectation that if something goes wrong, there will be consequences. Mistakes will be addressed. If crimes are committed, they will be prosecuted. Or at least investigated by law enforcement.
But that’s not always what happens.
Take the case of Stacey Siriani of San Diego County. Her experience with assisted living began four years ago when she got an awful phone call from Houston. Her father was involved in an auto accident that left him brain damaged.
“It was very tough,” she recalls. Siriani is an only child; her father is a widower. There was nowhere else to turn for support.
Lorchid Macri, 70, says she couldn’t find any information online when she had to find an assisted living facility for her mother in California. (April Dembosky/KQED)
Lorchid Macri wasn’t sleeping. Her elderly mother was wandering out of the house in the middle of the night, forgetting to turn the stove off. Macri had to keep watch over her 24/7.
“Dementia is a cruel disease,” Macri says.
She says the stress of caring for her mother was overwhelming. It wasn’t until she landed in the hospital herself — losing the sight in her right eye for 10 days — that she was ready to confront the fact that it was time to place her mother in assisted living.
“It’s gut wrenching to put someone that you love and who has cared for you in a facility with strangers,” she says. Continue reading
TV lounge at Westchester Villa, an assisted living facility in Inglewood, in Los Angeles County. (Rachael Myrow/KQED)
This week, lawmakers in Sacramento get busy on 15 bills that together constitute the most comprehensive overhaul of assisted living facility regulation in three decades. But for many Californians, it’s not even clear what an assisted living facility is. People often ask if assisted living is the same thing as a nursing home. It’s not.
In nursing homes, people get round-the-clock medical care from licensed nurses. Assisted living comes in because not everyone who needs help also needs that level of care. Sometimes that assistance doesn’t even involve a facility. Sometimes people can receive assistance and remain living in their own homes.
Say you’ve noticed your mother is walking with a new shuffle and dropping things, or that dad is mixing up his medications — and getting argumentative when you bring it up. Something is going on that must be addressed, even though your parent is still physically healthy and wants to be independent. Continue reading