An American lawyer was having lunch in the French city of Lyon with Father Louis Genton, a priest who cared for the aged. Staring deeply into the America’s eyes, Genton made a prediction which, decades later, would indeed come true:
“Medical science has let the genie out of the bottle, making it possible to live far longer than ever dreamed of, but what quality of life will that genie provide? Dennis, he may well be the devil in disguise, giving us long lives ravaged by dementia, health issues we have yet to discover and which will consume vast resources. As death — for many a blessed deliverance — will be postponed, how to care for mom, dad, husband or wife will be our greatest social challenge.”
If you are one of the 77 million baby boomers, or perhaps the child of a boomer, then today’s story will help prevent you from being ripped off and will answer these questions:
Should I place my elderly family member in a skilled nursing home, or an assisted living facility? What are the differences? What are the red flags?
As we learned from a passionate advocate for the elderly, San Francisco-based attorney Kathryn Stebner, “In terms of assisted living and long-term care, it’s the Wild West out there, and the opportunities for families to be taken advantage of — and their loved ones poorly cared for — are simply shocking.”
Stebner outlined what to look for when considering long-term care and how to determine which type of facility would be best.
Assisted living facilities — not for everyone
“To be in an assisted living facility, you should not be dependent on others to help you with most of your activities of daily living,” she points out.
“Reality is that many people in assisted living facilities require a higher level of care than they are receiving. Most people want to move into an assisted living facility, as these generally have a homey or hotel atmosphere. Nursing homes look more like a hospital, but the laws and regulations, as well as the required staff, make it more likely that they will provide the care needed. Families are often misled into thinking that assisted living is sufficient, but that is rarely the case. It is helpful to understand:
- Their profit motives and margins are huge, as they are privately operated, private pay, charging high rates but paying low wages. They are not covered by Medicare or Medicaid, while nursing homes are.
- This explains the pressure on families to move in loved ones who actually belong in a nursing home. Most assisted living facilities are not properly equipped to care for residents requiring a higher level of care.
- Most assisted living staff members are not certified nurses and, in smaller facilities, you will rarely find a registered nurse, which is a requirement in a nursing home.
Nice neighborhood? Don’t bet on it!
One rule of business is that costs must be kept down, starting with rent. Usually, the nicer the area, the higher the rent, and vice-versa.
Stebner has found that, in California and many other states, “A majority of assisted living facilities are six beds or less, located in depressed neighborhoods, often just a house with three bedrooms.
“The majority of assisted living facilities in California have two people per bedroom, with cost fairly low, about $2,500 a month,” she notes.
How about $10,000 a month
“$10,000 per month is what some of the large corporate facilities charge, offering nicer rooms but not necessarily better care, as typically, the same low-level-of-skill people are working there. They might have a registered nurse on call or possibly a licensed vocational nurse — which the smaller ones will not have — and you are paying for that.
“Many of these chains cater to upper middle class families, who want to a good feeling about where they are putting mom or dad, but they are getting ripped off,” she strongly maintains, adding, “But it gets worse with their point system.
“Many large chains have a point system where your dad starts at level one, and you will pay X amount, and then a few months later, he is at level two, three and so on.
“The idea behind the level system is that he needs more minutes of care, but we have found that the people did not get more care at a higher rate — it is more of a billing system, to charge more — and not provide greater care or hire more staff.”
Next time: Attorney Stebner shows how to reduce the chances of being taken, beginning with the sniff test.