The Tragedy of Senior Care in this Country and Maybe Everywhere.

There are a number of trends in senior housing that have been realized in recent years, due to the rise of our aging population. I don’t know anyone who is not going through trying to handle the care of an aging parent or other family member.

The convalescent home that housed my grandmother after my grandfather died many years ago, which is the event that shined a bright light on how badly my grandmother’s condition had become, was of the type we think of now in horror. That “smell” that hits you in the face when you open the front door, the way the residents were parked at the nursing station in the middle of the day, giving residents a “change of scenery” from their mostly drab rooms.

It’s easy not to truly notice how bad your loved one’s condition has become, as they have been living usually, in an environment they are very familiar with, thereby making it almost impossible to see how bad their condition really is. Not to mention the fact that you realize later, you were trying to ignore the signs and continue to believe that the inevitable, had not arrived.

That was the case with my grandmother those many years ago and we found this out again, when we moved my mother-in-law to assisted living a little more than five years ago. After managing her care with two twenty-four hour care givers, seven days a week, in the home she had lived in for nearly fifty years, it was time to move her to more supervised care in a presumably safer environment and hopefully be able to cut down on the falling and growing disagreements with those charged with caring for her at home.

Though the in-home care was possible for nearly five years, her occasions of falling and hurting herself had become more frequent and her irritability more prevalent, including slapping one of the care givers, a behavior I hear from many of our friends and family members as they navigate caring for their own aging relatives.

From an emotional well-being standpoint, staying in a place like your own home provides a level of familiarity, comfort and security to your aging friend or loved one. While physical and mental changes may not be avoidable, seniors are empowered to choose their consistent surroundings. Similarly, many seniors find it simpler to move around spaces they already understand.

While today’s assisted and long-term care facilities appear at least on the surface, to be more pleasing visually, and to the senses, I wanted to share what I observed going on in the facility we chose to move my mother-in-law to, the ever-growing cost of that care and what continues to be shockingly "lacking" in that care.

Since Covid, staffing seems to be the issue that I think needs the most attention. We had Mom at a “Sunrise” facility in the San Gabriel Valley, here in California. The care began with a strong attention to all of her needs and a staff to patient ratio that seemed adequate. After nearly six years in that facility however, and with Covid in the “rear view” one staff member to ten patients seemed like the occurrence on a good day.

This of course is not adequate. You don’t have to be a “rocket scientist” to know that that is way too little assistance and supervision. Especially in light of what we found to be the rising costs of her care as time went by. What started as more than an adequate caregiver to patient ratio, in a shared room, at approximately $7,500 per month, ballooned exponentially over those nearly six years. Mom was unable to share a room fairly quickly, as she became irritable and combative with her roommate and those around her. Her outbursts and “fist shaking” caused several falls, which took her to the emergency room numerous times. So, we moved her into a private room, which did cut down on her injuries and trips to the hospital, but the room rate increase for that, along with her continued need for more comprehensive care, led to a price tag of about $12,000 per month in the last couple of years.

She did have some retirement income from my deceased Father-in-Law, along with some social security benefits and investments, but she probably would have run out of funds completely had she lived another twelve months. Truly frightening.

It’s important to know that she not only had never spent that amount of money per month during most of her life but that had she been aware of her surroundings and the related costs, she would have thrown a royal “Italian fit” if she had known and understood the amount it was taking to care for her. Of course, if she had been aware of what was going on as regards those details, we would have been able to keep her in her home.

All this to try to shed light and “sound the alarm” that things have gotten out of hand. While she was lucky that my Father-in-Law had been able to make such preparations for her before his death. I daresay this is not the story for many or most families in this country. Not only that, we had to lie to her from the moment we placed her there. Promising to take her home as soon as we could, having told her we were having the house, her home, remodeled to accommodate her in her later years. But with my brothers-in-law living out of state and my husband and I still working and not having the necessary training or facility in our own home to care for her, we felt that we had no choice. As it was, while she was still in her home with the help of twenty-four hour caregivers, my husband was there three days a week for a chunk of those days, managing her medications and the matters related to her care at home, then filling out and submitting the insurance forms related to her long term care insurance, also a Godsend when it came to offsetting part of the expense. Then we were there at least one weekend day to visit, check on the house, laundry, etc.

You would think too, that the price for her care at Sunrise would have covered everything associated with her living there, but we still had to provide supplies related to her incontinency, laundry soap, gloves, wipes and clothing, all of which were very often missing or “out’ needing replacement due to caregivers using her supplies on others, clothing showing up on other residents or just plain gone, in addition to the jewelry that will never be seen again or passed down to a grandchild. Really frustrating, disappointing and expensive.

We thought briefly about trying to move her to another care facility, but each big change, only debilitates further, the already declining condition of these patients and residents and we knew people whose loved ones were receiving worse care at a higher cost. Unbelievable. As a result, moving her was not an option.

No one appears to be governing this. I am at a loss to understand how this will be resolved. While I hope we find a way to improve this as a people, I honestly don’t have much faith that this will occur.

I only hope I “go” in my sleep.