Who is “ Assisting” at Assisted Living Facilities and…… Is It Enough?

Assisting living facilities are a popular alternative to the traditional nursing home and the number of facilities  opening here in Ohio and around the country are growing fast. But is this tread good for our seniors?  The biggest danger is, are they staffed with enough well-trained personnel? A recent article highlighted this concern.

Hina Shah of the Coalition for a Fair and Equitable Caregiving Industry released a new report that shows the changes needed including

  • mandated staffing ratios,
  • inspections and enforcement, and
  • licensing, including mandatory wage and hour compliance training.

All of this would improve the quality of care for residents and the working conditions of the caregivers.

According to Shah’s report, 53% of the state’s (California) Residential Care Facilities for the Elderly, residents are aged 85 or more years, 40% have Alzheimer’s disease or dementia and 39% have cardiovascular disease.  Nationally, those numbers indicate 40% have Alzheimer’s disease or dementia, and 46% have cardiovascular disease.  I have no doubt Ohio’s numbers are comparable. So these residents need well trained caregivers and enough caregivers to keep the residents safe and cared for.

What working conditions need changed for caregivers?  Ms. Shah’s report highlights some their challenges:

  • Caregivers are understaffed and overworked. Live-in caregivers do not get sufficient sleep because many work in 24-hour shifts;
  • There is a lack of dignity and care. The work is physically demanding and many caregivers succumb to chronic stress, anxiety, loneliness and/or other mental health problems.  Grief counseling when dealing with the death of the resident is rarely provided, if at all;
  • Wage theft. When caregivers are required to work around the clock for a flat rate, many times the hours worked calculates to less than minimum wage; and
  • Miscalculation as independent contractors.

What About Ohio?

The challenge, and in some cultures the privilege, of caring for seniors is something most everyone will face in their lifetime.  So how safe are Ohio’s assisted living and skilled care centers?  Consider the Ohio Attorney General’s 2016 Ohio Medicaid Fraud Control Unit report covering the period between July 1, 2015 and June 30, 2016.  As of June 30, 2016, there were a total of 1,333 open investigations.  The highest number of investigations were opened in the categories of Nursing Facilities with 104 open investigations and 97 completed; Personal Care Services Attendant with 153 open investigations and 173 completed; and Home Health Agency with 116 open investigations and 85 completed compared to Assisted Living Facilities with 12 open investigations and 22 completed.  It has been my experience that most cases of neglect happen as a result of not enough staff or inadequately trained staff, so these proposed changes can only improve care for our seniors. The real issue will be can these necessary changes be enacted in the face of a resistant long-term care industry?

Reports like these are scary, for seniors and their  families trying to make difficult placement decisions. But being aware of the fact that good , safe care in assisted living facilities is dependent on well-trained  and sufficient numbers of staff, will give you questions to ask when investigating assisted living facilities