(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
Teri Lim, an attorney in Los Angeles, had a tough time finding a nursing home for her mother. After a stroke, her mother needed constant care but many nursing homes in the area were ill-equipped to deal with Korean-speaking patients. (Ryder Diaz/KQED)
Editor’s Note: Finding a nursing home for a loved one can be a daunting task. The job becomes more complicated when that family member doesn’t speak English. As part of our ongoing health series, Vital Signs, we hear from Teri Lim who immigrated with her parents to Los Angeles from Korea. After her mother had a stroke two years ago, Lim started searching for a place to give her mom around-the-clock care.
By Teri Lim
I found this great rehabilitation home, and I took her there (but) she couldn’t last a day because she couldn’t speak English. When she pressed her button for help, someone would peek in, but my mom was not able to really fully articulate what was wrong with her, and they would just leave. Then she would press the button again.
After a while my mom was perceived as kind of a difficult patient because her needs were not met. She was so frustrated. I could just see in her face that she was very strained.
Dr. Anna Chodos, a UCSF geriatrician, has worked with many seniors who lived in dangerous situations due to lack of awareness and early screening for dementia. (Ryder Diaz/KQED)
Editor’s Note: As Californians live longer, the number of dementia, a disease that destroys not only memory but also critical-thinking skills will grow. As part of our ongoing series on health, called Vital Signs, we hear from Anna Chodos, a physician specializing in geriatrics. She says that social services can often keep people with dementia safe in their homes, but many older adults aren’t getting the diagnosis they need.
By Anna Chodos
To diagnosis [dementia] early is to give people a chance to be a part of planning for the future in a very meaningful way. And that’s exactly what I’m not seeing. I’m seeing people stuck in situations where they now don’t have the ability to engage with you in complicated decision making and they’re not making safe decisions for themselves.
Dementia can affect your ability to remember to pay bills. It affects your ability to comply with your medical plan. Continue reading
Next month, a federal pilot program aimed at improving care for the most vulnerable is set to start rolling out in some California counties.
Cal MediConnect is supposed to help seniors and disabled people in seven California counties get better coordinated health services — from in-home caregivers to physicians. Those who are affected will automatically be rolled into the program. They have the opportunity, though, to make choices about where and how they will get their care.
But some advocates say information about making those choices has been unclear and is coming too late.
With four counties set to roll out the program in April and May, they are calling on the state to put the program on hold.
“We sent (the state) a letter with five other organizations saying there should be a delay,” said Amber Cutler, a staff attorney with the National Senior Citizens Law Center. “They are always putting out fires (with this) and have no time to prepare to prevent problems. That is particularly troublesome when thinking about adding Los Angeles and Alameda in July. We’re talking about hundreds of thousands of people who will be affected.” Continue reading