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?  Take a look at 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

Falls Can Kill — Stay STEADI

Falls can kill — keep seniors STEADIFalling can be deadly for any of us, but especially for people over 65 years of age. The CDC (Centers for Disease Control and Prevention) just issued a report outlining the danger and prevalence of falls in nursing homes and at home.

The numbers are scary: In 2014, falls caused 27,000 deaths and 7 million injuries. About 25 percent of older adults reported falling at least once in the last year.

So, falls are happening to many elderly. But are they just an inevitable part of aging? Not according to this report and a new program the CDC has recently launched.

The new program is called STEADI: Stopping Elderly Accidents, Deaths and Injuries. The program identifies fall risks and interventions to lower the risk of falls for both individuals and practitioners. It also offers education, practice guidelines and materials for practitioners.

For example, the CDC suggests three questions for health practitioners to ask their patients:

  • Have you fallen in the past year?
  • Do you feel unsteady when standing or walking?
  • Do you worry about falling?

People who answer yes to any of these questions face an increased risk for falling, and the CDC recommends further assessment.

Some of the interventions include a review of all the medications a person is taking. Practitioners should eliminate unneeded medications and reduce those that affect balance and cognition. If a vitamin D deficiency exists, adding this vitamin will improve bone, muscle and nerve health.

Falls can be the beginning of the loss of independence — especially for our seniors. So I appreciate these simple efforts to reduce the risk of falls.




Helmet Design May Affect Concussion Risks in Football

Have you seen the movie called “Leatherheads” in which George Clooney is a football player wearing a leather helmet? Helmet design has certainly changed over the years, but football players still assume a serious bodily injury liability, especially to their heads.

Not surprisingly, football has the highest incidence of concussion for any sport in the United States according to the Sports Concussion Institute. A new study published in the Journal of Neurosurgery has found that the risk of suffering a concussion may be dependent on the type of helmet worn. Football helmets are designed to reduce the chance of serious head injuries.

Researchers from Virginia Tech analyzed head impact data from more than 1,800 players from eight college football teams between 2005 and 2010. Two helmets — a Riddell VSR4 and a Riddell Revolution — included sensors that measured head acceleration for more than one million impacts. The Revolution helmet, which has a greater offset and 40 percent thicker foam, reduced concussion risk by 54 percent.

“Head impacts in football will always occur, even with the best rules and technique,” says Stefan Duma, co-author of the study. He adds: “This is where improving helmet design to best reduce concussion risk becomes critical. Our data clearly demonstrate that this is possible.”