Our Response: Frontline's “Life and Death in Assisted Living”

Posted by: Nikki Buckelew

Watching the Frontline Special titled “Life and Death in Assisted Living,” I found myself experiencing two distinct dilemmas: 

1. Listening from a place of curiosity while staying out of judgment, and

2. Assimilating the stories, facts, and information as both a professional and a caregiver.

I knew going in that the story was going to emphasize the tragic cases of assisted living residents who had been neglected or died, so I was prepared to listen with empathy and love for those family members interviewed. 

It was also evident from the promotional excerpts that there would be a fair amount of evidence to paint a pretty negative picture of Emeritus, the largest assisted living provider in the country. My intention was to try and appreciate both the corporate viewpoint as well as the personal perspectives. 

With that, here are my initial thoughts...

Sadly, it is true that many assisted living communities are accepting new residents and retaining existing ones who need more care than they are equipped to provide. It is also true that many families would prefer to have their loved one at an assisted living rather than a skilled care facility (i.e. nursing home) despite the fact that they recognize the need for higher levels of care. 



Let’s be honest 

Fear, guilt, money, marketing, and many other factors play a part here. 

When we were faced with the decision of transitioning my grandfather from the farm to “someplace he could be cared for,” the thought of a nursing home was painful. Assisted living was the answer -- so we thought. In retrospect, he needed more care than assisted living could provide, but we insisted and they accepted him. It was only a short time before it became evident that he needed more care and this particular assisted living was helpful in counseling us to face reality. The truth is all we really did was delay the inevitable. 

By the way, moving someone at that point in their life is hard enough -- now move them twice -- lesson learned. 

Cost for care                                                                                                                 

Another hot topic that seemed to be emphasized in the report by Frontline is the cost for assisted living being so high. No, it’s not cheap, however, according to SkilledNursingFacilities.org the cost for skilled nursing facilities is roughly double on average across the country. Yet another reason that families opt for assisted living versus skilled care. The Frontline and ProPublica interviewers made it sound as though Emeritus is somehow price-gouging. Could they increase their staffing and improve resident care for the prices they are charging? Highly likely. But the fact remains that their price point makes the decision against skilled care and in favor of assisted living that much more appealing. 

Revolving door

What was glaringly clear to me and something that I have personally experienced in working closely with senior living communities over the years, is that there is a huge disconnect between the corporate push for profits and the level of resident care. 

As REALTORS, we have watched the revolving door of marketing reps and sales counselors at senior living communities and have spoken with many of them candidly, as did the Frontline interviewers. The story is the same. These individuals were hired for positions where they thought their job description was to care for people in their later years, when in reality, their jobs were to fill vacancies and keep the back door closed. 

Most of the sales counselors, executive directors, activity directors, and nursing staff employed at assisted living communities have completed degrees or some level of education in sociology, gerontology, nursing, psychology, hospital administration, or some other related field. These are people who “take care of people.” They are nurturers. They aren’t typically corporate executives, MBAs, or salespeople types. 

Is it any wonder that they are confused when they show up on the job and the only training they get is on how to increase revenue and decrease overhead? Knowing this, it certainly isn’t any secret as to why assisted living communities have high staffing turnover.

Educate and equip

My biggest “take-away” to this point in my thought process is how important it is that we pay attention and educate ourselves as caregivers. I am fortunate enough to have some training and a background in gerontology and psychology, and yet I still make caregiving mistakes. The average person, however, is entering this caregiving game totally unprepared and completely ill-equipped. 

The man on the Frontline interview mentioned that when visiting his mother he held her hand and they talked. He didn’t think to pull down her blanket or remove her night gown to check for bed sores. Of course not. Most sons, and daughters for that matter, trust that they are getting the care required and would never even think to do a body scan for possible concerns. 

As a real estate professional specializing in senior housing, this Frontline report only validated what I already intuitively knew -- our work is important. What we do makes a difference and it is time to “up our game” and help educate families and caregivers at a higher level. This isn’t just about senior living -- it’s about lives of seniors. 

More thoughts to come in Part 2  


 




Nikki Buckelew is the Founder and CEO of the Seniors Real Estate Institute and administrator for the Certified Senior Housing Professional® (CSHP) designation. A veteran REALTOR® of over two decades, she holds a bachelor’s degree in gerontology and a master’s degree in counseling psychology. As a professional speaker, coach, and trainer, Nikki is committed to empowering, equipping, and educating real estate sales and senior housing professionals seeking to better serve the mature market segment. 


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