Older parents-WWYD?

[KQ]

Thanks for any advice KQ. My sister is flying to us in January and we are going to do the "what retirement place" talk with my Mom. The awkward part will be when she asks "why can't I live with one of you instead?"

And then we have to figure out if we all can afford what she wants, since she is running out of money in about 4-5 years.

Money or lack there-of is a deal breaker in these situations but there are some work arounds without resorting to home care which can be exhausting and impossible for the family and not always the best choice for the elderly relative depending on the level of care needed. Having my mother remain in her retirement community is a huge peace of mind for me. They order and administer all her meds. They can get her to the hosp. if necessary or Dr. appts. They provide all her meals, housekeeping and laundry and assist with bathing/physical therapy/socializing. I don't have to worry if a snow storm makes me homebound or I can't get to the pharmacy etc.

If you can find a close enough place in a more rural area you may find better prices with just as good care as a big city. I'm sure the cost of my Mom's care would be double in Seattle compared to Walla Walla. Fortunately my Mother has a realtively good pension and SS though she has no savings left. I do have to bridge the gap but it's not unsurmountable at this point.

Once your Mom is out of money and if it's not possible for you to supplement, Medicaid will kick in. There are things you can do to bring her assets down but you need to start before you need Medicaid because there is a look-back period.

++++

My partner is still taking care of her 95 yo dad and 93 yo mom in the house in which my mil was borne. Cooking, cleaning, shopping, appointment driving and she comes home wasted virtually every night. It's sucked. Her dad makes Archie Bunker look like a girl scout. Then there's feeding the 10 pasture horses, 1 remaining dog and 4 cats.

And now we have covid with no real backup.

Wow... I can't imagine. Your wife is going to need some serious support herself. There were points where I was seriously broken and spent the day in bed crying and I wasn't the one caring for her though I will concede that this whole episode opened the doors to pain I'd buried for years after the deaths of my brothers and the 10yr decline/death of my father. The though of losing my last family member brought it all home. Someone posted in this thread that the saddest thing for them was seeing the life of their father (FIL?) reduced to a pile of boxes set out by the dumpster and I have to agree. Cleaning out my mother's apartment was emotional wrenching.

Have you looked into working with an equine rescue to find homes for the horses? There are several in your area that I can send you links to - they might not take them in but they can help by getting word out to their community of followers that the horses need homes. They will make sure they are good homes. I got my donkeys through a donkey rescue that acted as a facilitator for an elderly couple who could no longer care for them.

[Buster Highmen]

Wow... I can't imagine. Your wife is going to need some serious support herself. There were points where I was seriously broken and spent the day in bed crying and I wasn't the one caring for her though I will concede that this whole episode opened the doors to pain I'd buried for years after the deaths of my brothers and the 10yr decline/death of my father. The though of losing my last family member brought it all home. Someone posted in this thread that the saddest thing for them was seeing the life of their father (FIL?) reduced to a pile of boxes set out by the dumpster and I have to agree. Cleaning out my mother's apartment was emotional wrenching.

I do what I can by taking care of all the food and most of the cleaning at home. Plus being sure to exert extra care and support when she walks in the door. She is just incredibly tough.

Have you looked into working with an equine rescue to find homes for the horses? There are several in your area that I can send you links to - they might not take them in but they can help by getting word out to their community of followers that the horses need homes. They will make sure they are good homes. I got my donkeys through a donkey rescue that acted as a facilitator for an elderly couple who could no longer care for them.

Not going to happen, the horses are boarded and income for my inlaws. Thanks though.

[KQ]

I do what I can by taking care of all the food and most of the cleaning at home. Plus being sure to exert extra care and support when she walks in the door. She is just incredibly tough.



Not going to happen, the horses are boarded and income for my inlaws. Thanks though.

Oh... thought the horses where theirs. As long as they are boarders horses and care is covered, no need to worry about them. If needed you can turn the place into a co-op with each boarder taking on their own stall cleaning but still have someone feed and water - possibly a boarder who pays reduced board.

[Buster Highmen]

They're just pastured, no stalls or barn. But the water tanks need scrubbing and this time of year they have to be fed.

[gravitylover]

We got the 2am call that he fell and was on the way to the hospital with a bloody head, 4 hours later and another interesting car ride back to his place and I'm going back to bed. Fuck

[riser4]

We got the 2am call that he fell and was on the way to the hospital with a bloody head, 4 hours later and another interesting car ride back to his place and I'm going back to bed. Fuck

+++Vibes+++

Went through this with my dad and both of my in-laws.

[ticketchecker]

My Dad wiped out twice in the last month, he lives alone in Florida. First one was middle of the night and he spent like three hours on the floor until he finally made it to the phone. We got him the life alert necklace after that and he already had to use it. Nine staples in the side of his head from hitting the TV. Fuck is right


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[liv2ski]

All I have to offer at this point is to be sure your parents will/Trust is updated and PERFECTLY clear and that every beneficiary has seen it in advance (and they will still bust the executor's balls). Cause my mom's former partners family has been a total PITA and I have had to tell them they are not beneficiaries under the Trust so to fuck off.

[ghosthop]

All I have to offer at this point is to be sure your parents will/Trust is updated and PERFECTLY clear and that every beneficiary has seen it in advance (and they will still bust the executor's balls). Cause my mom's former partners family has been a total PITA and I have had to tell them they are not beneficiaries under the Trust so to fuck off.

I have avoided posting about this but my brother and I both haven't talked to our dad in about six months after begging him for years to get any of his legal documents in a row. We told him no more phone calls until he can get his shit together because it's too frustrating listening to him complain about unemployment, brag about buying a new toy, and then complain that he doesn't have enough time to complete basic tasks. He started escalating in the past few weeks calling names and passive aggressive texts but so far we are being resolute. We have no other ideas about how to coax him from out of state, he is losing out on time getting to know his grandson but seems unperturbed. It is so upsetting.

[KQ]

We got the 2am call that he fell and was on the way to the hospital with a bloody head, 4 hours later and another interesting car ride back to his place and I'm going back to bed. Fuck

My Dad wiped out twice in the last month, he lives alone in Florida. First one was middle of the night and he spent like three hours on the floor until he finally made it to the phone. We got him the life alert necklace after that and he already had to use it. Nine staples in the side of his head from hitting the TV. Fuck is right


Sent from my iPad using TGR Forums

I have avoided posting about this but my brother and I both haven't talked to our dad in about six months after begging him for years to get any of his legal documents in a row. We told him no more phone calls until he can get his shit together because it's too frustrating listening to him complain about unemployment, brag about buying a new toy, and then complain that he doesn't have enough time to complete basic tasks. He started escalating in the past few weeks calling names and passive aggressive texts but so far we are being resolute. We have no other ideas about how to coax him from out of state, he is losing out on time getting to know his grandson but seems unperturbed. It is so upsetting.

++++Vibes++++

Tough times when it's hard to believe "this too shall pass."

We're here for you whenever you need to talk.

[Buster Highmen]

My Dad wiped out twice in the last month, he lives alone in Florida. First one was middle of the night and he spent like three hours on the floor until he finally made it to the phone. We got him the life alert necklace after that and he already had to use it. Nine staples in the side of his head from hitting the TV. Fuck is right

I went through 5 or 6 similar events, except my dad was passing out from blood loss due to stomach lesions that came from too many blood thinners. I went rounds and rounds with his doctors and with him. I never once got a call. Fortunately (?) my mom had had dementia for years and it was her care givers that happened across my dad passed out on the floor. They lived in FL I live in WA and the amount of guilt trips laid on me by others, not my dad, was a travelogue. My dad wanted to be left alone and told me so several times.

So, all the love and support and madness, it sucks, but things will shake out for the best.

[muted reborn]

Money or lack there-of is a deal breaker in these situations but there are some work arounds without resorting to home care which can be exhausting and impossible for the family and not always the best choice for the elderly relative depending on the level of care needed. Having my mother remain in her retirement community is a huge peace of mind for me. They order and administer all her meds. They can get her to the hosp. if necessary or Dr. appts. They provide all her meals, housekeeping and laundry and assist with bathing/physical therapy/socializing. I don't have to worry if a snow storm makes me homebound or I can't get to the pharmacy etc.

Thanks - I've hear rumors that spots in good retirement homes are scarce and there aren't enough workers for daily home care. I suppose a bit of local sleuthing will calm my fears or escalate them.

Good luck with your Mom.

[mcski]

My Dad wiped out twice in the last month, he lives alone in Florida. First one was middle of the night and he spent like three hours on the floor until he finally made it to the phone. We got him the life alert necklace after that and he already had to use it. Nine staples in the side of his head from hitting the TV. Fuck is right


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At least he used the phone and the life alert. Olds are stubborn af when it comes to that. My dad lived in our in law apt downstairs and would fall and never call out or anything. Can not even count the number of times I’d go down to check and find him on the floor and he’d say “I’m fine”

Finally added a couple cameras so i could check in on him without barging in all the time. Worked great

[Bunion 2020]

NOT reassuring.

Understaffed and neglected: How real estate investors reshaped assisted living
Surveillance video captured a 97-year-old woman’s death outside the locked doors of a high-end Colorado home, a symptom of deeper problems in the $34 billion industry
By Douglas MacMillan

LOUISVILLE, Colo. — Lavender Farms, an upscale assisted-living facility in the Boulder suburbs, promised “24/7 on-site care” in its marketing materials. But managers at its operating company, Balfour Senior Living, worried deeply about their ability to care for the elderly residents who roamed the farmhouse-chic corridors at odd hours and sometimes wandered outside unnoticed, documents and interviews show.

Balfour managers proposed raising wages to hire and retain more and better caregivers to improve resident safety. But to do that, the managers said, Balfour needed the approval of Welltower, the $40 billion investment firm that owned Lavender Farms.

Executives at Welltower balked.

“Their position was: We are trying to increase our profitability,” said one former Balfour executive, speaking on the condition of anonymity to discuss internal matters. “Care is an ancillary part of the conversation.”
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For two decades, Balfour has been a star of the senior-housing industry, marketing its properties like boutique hotels, replete with high-end furnishings, fine dining and concierge services. But as Welltower and other professional investors have acquired the buildings where Balfour operates, waves of cost cutting have left it unable to meet the basic needs of many residents, according to interviews and documents obtained by The Washington Post.

Last year, resident Mary Jo Staub, 97, died after banging repeatedly on the locked doors of Lavender Farms in subfreezing temperatures. Her death was among at least 20 incidents of neglect, missing people or avoidable deaths cited by state inspectors at Balfour’s Colorado facilities since its founding in 1997. Since Balfour sold its properties to corporate investors in 2014, the vast majority of citations have indicated problems with staff.

Failures at Balfour facilities are symptoms of deeper problems in the $34 billion market for assisted living and memory care, a growing industry that now provides care and housing for more than a million Americans, according to industry estimates.

Conceived about 40 years ago to give seniors more freedom in their final years of life, the assisted-living industry has been reshaped by real estate speculators looking to cash in on an aging nation. They were aided by Congress in 2008, when a new law gave certain investors the ability to hold senior-housing properties tax-free while also taking a slice of their annual income.

As a result, many facilities across the nation are now held by investors under pressure to produce profits for shareholders. In some places, a bare-bones approach to staffing and pay has produced a chaotic environment where medications are missed, falls and bed sores go unnoticed, residents are abused and confused seniors wander away undetected, according to a review of 160,000 state inspection reports and interviews with more than 50 current and former employees of assisted-living businesses and relatives of current and former residents.

In the past five years alone, nearly 100 residents have died after wandering away from these facilities or being left unattended outside, a Post investigation found. State regulators investigating these deaths frequently cited limited staff, poor training or neglect.

Business leaders acknowledge struggling to find workers, a problem they blame on a nationwide labor shortage that worsened during the pandemic. Companies have had to adjust by “asking current staff to work extra shifts, hiring agency staff, or limiting new admissions because they refuse to compromise care,” Rachel Reeves, a spokeswoman for the American Health Care Association/National Center for Assisted Living, an industry lobbying group, said in an email.

[Bunion 2020]

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‘I am exhausted’

But data and interviews suggest these facilities are losing staff because they don’t pay a competitive wage.

Nationally, assisted-living aides make an average of $15 an hour, according to the U.S. Bureau of Labor Statistics — less than most Starbucks baristas. Yet these employees are tasked with bathing, toileting, medicating and safeguarding a population growing increasingly frail and likely to suffer from dementia or Alzheimer’s.

When staff is limited, one caregiver may assume responsibility for two dozen residents. Last year, in a national survey of 120 facilities by the National Center for Assisted Living, 98 percent said they asked staff to work extra shifts to make up for staffing shortages.

“Of course the care is going to suffer. Because I am exhausted,” said Amanda Matthews, 46, a longtime caregiver and manager of memory-care facilities in Colorado.

Neither Balfour nor Kisco Senior Living, the Carlsbad, Calif.-based company that combined with Balfour in October, responded to numerous requests for comment. A Lavender Farms manager declined to answer questions from a reporter who visited the facility. A Welltower spokesperson also declined to comment.

Even as workers struggle and some residents suffer, many businesses are thriving.

Long-term investors in senior home real estate, which includes assisted living, receive returns of nearly 9 percent a year on average — more than double the yield for offices and hotels, according to the National Council of Real Estate Investment Fiduciaries.

Investors prefer to buy the buildings that house senior homes — instead of buying equity in the businesses — because they gain rental income and valuable property portfolios without being directly exposed to the legal risks of caring for a fragile population. Typically, a real estate owner will approve a detailed business plan that sets out budgets for labor and care, and pay a management company a fee to run the facility according to plan.

Residents may never know the names of the investment firms that own their buildings, but these firms typically collect about 30 percent of their monthly rent checks, according to commercial real estate researcher Green Street. In a typical arrangement, about 65 percent of income goes to cover costs such as labor, marketing and supplies, while 5 percent goes to a management company, such as Balfour.
Locked out

The night of Feb. 25, 2022 — long after Lavender Farms managers had raised concerns to Balfour executives about wandering residents — Mary Jo Staub left the facility wearing pajamas and a robe in 15-degree weather. After breaking her ankle and realizing she was locked out, she used a broom to bang on a door next to the nurse’s station for 30 minutes, according to security-camera footage obtained by The Post through an open records request. No one came to help.

A lawsuit brought by Staub’s family alleged that the two staff members on duty — women who made around $20 an hour — had been in the third-floor theater room when they were supposed to be checking on Staub, who had been flagged for close monitoring because of confusion and hallucinations.

Near 6 a.m., one of the women finally found Staub outside, unresponsive on the pavement. Her walker was stuck in the snow and a trail of blood traced her path to the door she had desperately tried to reenter, according to videos, photos and records provided by police.

Balfour notified residents that someone died “after leaving the building on her own and experiencing a fall outside.” The company has repeatedly declined to comment to media about Staub’s death.

In legal filings, Balfour’s lawyers denied claims by Staub’s family that the company’s negligence resulted in her death, and that its marketing of exceptional care and safety amounted to fraudulent misrepresentation.

Staub’s death shocked relatives of Lavender Farms residents who demanded to know why the facility had not hired more staff or done more to ensure that nighttime caregivers were monitoring the exits. “How did this happen?” said Shari Edelstein, whose mother lived in Lavender Farms until her death earlier this year. “This is one of the most expensive facilities in Boulder.”

But to people who have worked in assisted living, Staub’s death was another data point in a pattern that has unfolded across the industry. Hundreds of properties change corporate owners every year, and staffing and pay are often the first expenses trimmed by investors focused on profits, according to interviews with industry experts and current and former employees at multiple companies.

“These companies come in and purchase communities and say they are going to make everything better,” said Matthews, who has worked for several senior-care companies, including Balfour. “The reality is, being somebody in the trenches, it doesn’t get better. The pay doesn’t change. The expectations are: ‘Now you are going to do more, for the same amount of money or less.’”
EDITOR’S NOTE

Viewers may find the following video disturbing. The Post reviewed 34 hours of video and carefully selected footage with an eye toward balancing sensitivity to the viewer and accuracy in portraying the final hours of Mary Jo Staub’s life. The Post concluded that allowing the public to witness these events firsthand provides a deeper understanding than words alone can convey.
Mary Jo Staub froze to death outside Balfour at Lavender Farms, an assisted-living facility in Louisville, Colo., on Feb. 26, 2022. (Video: Joy Yi, Douglas MacMillan, Sarah Hashemi/The Washington Post)

Assisted living got its start in the 1980s, when pioneers drew inspiration from nonprofit and faith-based “board and care” homes to develop for-profit options for older adults who needed help with daily activities but were not sick enough for nursing homes. These businesses arrived as women increasingly entered the workforce, leaving two-income families in a quandary over how to care for elderly parents.

“Along came assisted living, in a Victorian mansion, with a chandelier and a curved staircase,” said Bob Kramer, who co-founded the National Investment Center for Seniors Housing & Care, or NIC, a nonprofit research group, in 1991.

[Bunion 2020]

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Early success led to rapid construction through the 1990s, with several chains launching initial public offerings. Wall Street investors were attracted by the growing sector, which promised to explode as baby boomers retired.

“We had people who didn’t understand the business getting into it,” said Pat Sprigg, who spent three decades as chief executive of a nonprofit facility in North Carolina. “They understood there were boomers on the horizon and their approach was: ‘Let’s just warehouse them. Let’s do the brass-and-glass game and attract people into these beautiful places, and then neglect to train staff and neglect to pay them a fair wage.’”

Questions to ask before choosing an assisted living facility

The financiers included private-equity firms — investors who manage giant pools of money on behalf of even larger investors such as pension funds and endowments. These firms typically try to boost the value of assets and sell them after five to 10 years, providing returns to themselves and their outside investors.

Some senior homes were also bought by real estate investment trusts, or REITs, an investment class created by Congress in the 1960s to give stock market investors the ability to buy and sell shares in real estate. REITs pay no corporate income tax and distribute dividends to shareholders. Nearly half of Americans — around 45 percent of U.S. households — are invested in some type of commercial real estate REIT through retirement funds or pensions, according to industry group Nareit.
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Congress gave these businesses a boost in 2008 with a new law allowing senior-housing REITs to share in the profits from operations, rather than act as passive landlords. This corporate structure, also common in hotels, incentivizes REIT investors to replace management teams that fail to generate expected profits.

“They hold the hammer,” said David Kingsley, a researcher with the nonprofit Center for Health Information & Policy.

Welltower, the biggest owner of senior homes in the country, distributes more than $1 billion in dividends to shareholders annually, including mutual fund giants Vanguard and BlackRock and the pension fund of Norway. Other senior-housing investors have collectively generated hundreds of millions of dollars for public pension plans in Arizona, Indiana, Maryland, North Carolina, Texas and other states, investor filings show.

Kramer said the industry has never strayed from its mission of providing quality care, but that also requires a careful focus on costs and profit margins. “If you don’t have a margin, you can’t pursue a mission,” he said. “If you don’t have a mission, you’re also not going to produce a margin.”

Balfour rode the early wave of enthusiasm for assisted living. Its founder, Michael Schonbrun, envisioned a “Four Seasons experience,” building a series of Colorado facilities that reflect local culture. There’s an equestrian-themed community in the gold rush town of Littleton and a glitzy seniors home developed from a historic train station in downtown Denver.

A former health-care executive, Schonbrun initially funded his business through bank loans and individual investors. But in 2014, he sold all three of Balfour’s buildings to AEW, a Boston-based private-equity firm.

Some senior homes are left hobbled by private-equity ownership, according to interviews and records. Brookdale is the nation’s largest operator of senior-living homes. After it was acquired by private equity in 2000, it sold many of its buildings to investment firms to pay down debt, corporate filings show, which then locked Brookdale into costly long-term leases with the new owners.

Despite collecting more than $1 billion in rent from residents and other fees each of the past 17 years, Brookdale lost money in all of those years except 2020. Its stock price, which peaked at $53 a share in 2006, has dwindled to $5.
Cost cutting

Meanwhile, eight residents filed a lawsuit in 2017 claiming that Brookdale systemically understaffed its facilities to boost profits. More than 80 residents and their relatives described in legal declarations how short staffing led to falls, diaper rashes, urinary tract infections, broken bones and residents waiting hours for their call pendant buttons to be answered, but a federal judge rejected a motion to elevate the case to a class action. The case is set for trial next year.

In 2020, three residents of Brookdale facilities — in Arizona, Delaware and Florida — died after leaving the buildings unsupervised, according to reports by state regulators.

Jackie Dickson, a spokeswoman for Brookdale, denied allegations of understaffing. Despite the “significant negative financial impact” of the pandemic, Brookdale has continued to invest in the growth and development of its workforce, she said. She declined to comment on the three deaths, but said the well-being of residents “always has been our top priority.”

Emily Schillinger, a spokeswoman for the American Investment Council, a private-equity industry group, said that health-care facilities in general face workforce shortages. “When private-equity firms invest in facilities, their focus is delivering high-quality care and improving patient outcomes,” she said.

After AEW acquired Balfour’s buildings, it expanded to several new locations. But it also looked for ways to cut costs, according to a former senior manager.
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While Balfour still advertised food rivaling “Colorado’s best restaurants,” fresh menu items were replaced with fried foods and processed meals, causing problems for some residents who required low-sodium diets, said Mary Shomaker, who moved her father to a different facility. “We tried to get them to see that this was a big mistake,” she said.

AEW spokeswoman Maureen Richardson declined to comment.

Meanwhile, cuts to the nursing staff made it difficult for Balfour to make good on its marketing promise of “24-hour on-site nursing,” said a former executive who supervised nursing.

On Christmas Eve 2018, the day nurse at Balfour’s downtown Denver facility ended her shift at 8 p.m., and the night nurse came on at 10 p.m. During that two-hour gap, a male resident in his 70s with Type 1 diabetes was not given his required insulin injection, state records show. Around 3 a.m., a staff member discovered the mistake and gave him the drug. But the man was dead by 7 a.m. Christmas morning.

Balfour reported these events to state inspectors. The death certificate said the man died from a “probable cardiac event and complications from diabetes mellitus,” state records show. Balfour told authorities it would not have any future gaps in nursing coverage “when there are insulins scheduled.”

A few months later, AEW sold Balfour’s buildings to Welltower for $300 million. AEW’s biggest outside investor in the fund that bought and sold the buildings, the Texas teacher pension fund, made at least $30 million on its investment, according to Rob Maxwell, a spokesman for the pension fund. He declined to comment on its investment strategy.
Low pay, low quality

The investment frenzy over senior housing was on full display at NIC’s fall 2022 industry conference in Washington, D.C., which featured a mock version of the “Deal or No Deal” game show. Investors fired fake money from toy handguns labeled “MAKE IT RAIN” when contestants pitched a senior home concept with promise.

The gathering this October in Chicago was more sober, with experts bemoaning high interest rates and a shortage of low-cost labor.

Welltower chief executive Shankh Mitra acknowledged that wages matter but said businesses also need to make jobs more appealing, for example, by using technology to reduce the time workers spend on administrative tasks. “We have to double down on employee experience,” Mitra said during an onstage interview. “The turnover in our business needs to go down. We can create real career tracks for people.”

[Bunion 2020]

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Welltower owns about 95,000 senior-home units, from apartment-like “independent-living” dwellings to secure memory-care units. Its top rival, Ventas, owns about 68,000. Together, the two REITs own more senior-home units than the next nine biggest players combined, according to data from the American Seniors Housing Association.

Assisted-living businesses strive for operating profit margins of 20 to 30 percent — on par with software and pharmaceutical companies. Welltower touts its partnerships with operators who push margins even higher. In 2021, it removed Sunrise Senior Living as manager of six properties in California and replaced it with Oakmont Senior Living, which moved in more residents and raised rates by about 10 percent, increasing annual operating income from $600,000 to $14 million, according to a corporate filing.

When Welltower bought Balfour’s properties in 2019, it began holding regular calls with Balfour management geared toward reining in spending, several former managers said.

Balfour was allowed to continue spending on aesthetic renovations, even some that compromised resident safety. For example, executives insisted on placing an ottoman in the center of a common area though it caused frail residents to trip and fall, former managers said. And apartment doors in a memory-care facility were painted black though clinicians warned that some residents suffering from dementia would see them as black holes.

But Welltower pushed back when managers asked for more money to address growing problems with the quality of Balfour’s workforce. Former employees say they saw workers sleeping on the job, watching movies in the theater room and spending hours vaping in the kitchen. Some staffers felt uncomfortable administering certain drugs, such as vaginal suppositories, so they simply didn’t.

“They will just hire anyone who is willing to learn,” said Josie Charron, who worked as a medical technician at Lavender Farms until leaving in 2021 to become a journalist.
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In a 2020 interview published on Balfour’s website, Schonbrun acknowledged that the company struggled with “painful personnel issues” as Balfour expanded to nine facilities.

“In some cases people deselected themselves, moved on to other opportunities,” Schonbrun said. “In other cases, we had to give them a nudge out the door and then reassure the people who stayed behind that the fundamentals of the culture were going to stay in place.”

Tell The Washington Post about your experience with assisted living

About 43 percent of assisted-living workers, excluding new hires, left their jobs in 2022, according to a survey by industry researcher Hospital & Healthcare Compensation Service. Workers say they can make more money at easier jobs in restaurants or retail. King Soopers, the grocery store across the street from Lavender Farms, paid higher wages than the senior home.

“When you see how much work you do at the end of the day and you get paid that amount? It’s insane,” said Culix Wibonele, a certified nursing assistant who earns $16 an hour at an assisted-living facility in Atlanta.

Some businesses offered pay raises of $1 or $2 an hour during the pandemic, but stopped short of boosting wages enough to make the jobs sustainable for most people, said Melissa Unger, executive director of SEIU Local 503 in Oregon. Residential-care aides, including those who work in assisted living, are 85 percent female and disproportionately people of color and immigrants, according to research aggregated by labor advocacy group PHI.

Matthews, who managed the memory-care wing in one of Balfour’s Denver facilities from 2016 through 2019, said three-quarters of her front-line staff relied on some form of government assistance.

How your state regulates assisted-living facilities

Welltower’s Mitra, on the other hand, has risen to become one of the highest-paid executives in the country. Last year, his pay package totaled $38 million, including equity grants that Mitra forfeits if Welltower does not hit certain growth targets in the next four years. That made him the 13th highest-paid CEO on the S&P 500 stock index, among those who have been in their jobs for at least two years, according to compensation researcher Equilar — close behind the heads of Netflix, American Express and Morgan Stanley.

Welltower’s board of directors defended the pay package in its annual proxy statement to investors, saying the company has outperformed rivals during Mitra’s tenure.
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Mounting problems

Staub, a mother of three daughters who earned a private pilot’s license and started her own sewing business later in life, moved into Lavender Farms in 2019, after her husband died.

In the months before her death, problems were mounting at the facility. A King Soopers manager said she repeatedly called to report wandering seniors who did not know their names or where they lived. An administrator told state inspectors that installing an exit door alarm was “considered but not implemented.” An employee interviewed by inspectors said there was “only so much we can do” to keep track of residents.

Some Balfour residents probably should have been in a dedicated dementia facility, where doors are alarmed and often locked, former employees said. But the company allowed its sales and marketing team to assess new residents — sometimes without input from medical staff — and some were improperly assigned to the nearest empty bed, the former employees said.

In November 2021, Staub was transferred to a nursing home after falling and fracturing her pelvis. Two months later, Balfour encouraged Staub to return to Lavender Farms, agreeing to place her on a higher level of care with more frequent checks for $1,500 a month on top of standard monthly fees, which are currently advertised as starting at $6,800.

A nurse practitioner who assessed Staub at the time wrote that she “had a history of weakness and episodes of confusion” and should be monitored “throughout the night for sleep walking,” according to the Staub family lawsuit against Balfour, Schonbrun and the two night staffers. The case settled last month for an undisclosed amount.

After Staub’s body was discovered, a Lavender Farms manager called Staub’s daughter to say her mother had “hurt her ankle” and was being taken to the hospital, according to the legal complaint. The daughter learned of her mother’s death and nightlong ordeal only after “she arrived at the hospital and was asked to identify Mary Jo’s body under a blood-soaked sheet,” the lawsuit said.

In police interviews, the two caregivers tasked with monitoring residents that night said they had checked on Staub around midnight; she was spotted on surveillance cameras at 12:41 a.m.
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However, they did not record any checks in Lavender Farms’ records. One of the women left the building shortly before midnight, security-camera footage shows. The other had previously been reported to management for sleeping during night shifts and letting resident calls go unanswered for hours, said a former employee who witnessed and reported this behavior but was not authorized to publicly discuss personnel matters.

Sarah Krus, a facility administrator, told police that Staub had instructed staff months earlier to reduce nightly checks to avoid waking her up, but she said the facility had no written record of the request.

Balfour administrators did not answer The Post’s questions about why no one came to open the doors; they told police the doors were locked at night in response to “numerous instances of homeless individuals and others on the property after hours.”

In their report on the incident, state inspectors said Lavender Farms had created “an immediate jeopardy risk of injury or death” to everyone who lived there. Regulators fined the facility $1,500 and required improvements to resident safety. Local authorities declined to bring criminal charges.

Balfour told state regulators it would reassess residents who were known to wander and initiate nightly sweeps of the building. A woman who had been locked outside for an hour the same night Staub died was moved out shortly afterward.

In May 2022, Colorado lawmakers passed new laws requiring stricter background checks for employees and minimum levels of experience for managers at assisted-living facilities. The new law — enacted after a spate of preventable deaths — also allowed regulators to impose stiffer fines, which had previously been capped at $2,000 per facility per year.

Meanwhile, Balfour executives quietly ordered security cameras to be permanently removed from Lavender Farms, according to a person who was briefed on the matter. The reason, the person said, was “to minimize liability.

ROI, that is what it comes down to. Old people as a commodity.

[XXX-er]

My sister was a senior banker who lived 1 block from my mother so she pretty much had all my mothers $ affairs in very good order, I think my sister got us all payed out in 9 months which is pretty fast and a testament to good planning we had joint acts with all our names on them so when mom died just write checks to each kid.

still my mother managed to fuck it up so instead of giving my sister a GIC that came due to put into cash she didn't think she needed to or sft which is what happen with old folk, They fuck up/ don't take meds end up in hospitol and never come out

[skaredshtles]

.

ROI, that is what it comes down to. Old people as a commodity.

“Care is an ancillary part of the conversation.”

[gravitylover]

The staffing is atrocious! I freaked today and told the property director, office mgr and front desk flunky to fuck themselves for being somewhat less than human. It's a long story, I'll type it out later.

[KQ]

^yup - lots of horror stories out there of elder abuse both at the hands of professionals and family. It's really screwed up.

My mother is at a family owned facility. She lived there for 15 in the independent side and as mentioned over and over has moved into the assisted side in the end of November. I liked the place when she was in the independent side and really love the assisted side. The caregivers are amazing. She's got one guy who works with her, a talk hispanic probably in his 30s. He's been there for 12 years. Blows me away how he cares for all those in his charge. I'm not that good of a person. He is patient and kind and speaks to everyone as if they are the most important person in his life. Not sure what he's paid but it can't be enough.

From the maintainance staff to the nurses to the resturant wait staff everyone is caring and thoughtful in their interactions with residents. Sure there are people who turn out to be poorly suited for that kind of work (and someone did steal my Mom's Oxy) but they don't tend to stay long because they realize it's a bad fit or they are rooted out by higher ups.

The place she lives is family owned by Generations LLC. The have 11 locations in Washington, Oregon, California, Utah and Colorado. Right now she is paying a little over 4K a month for a studio apt in assisted living (this could go up or down depending on the level of care she requires). Independent was just under 3K for a one bedroom/den apartment.

I feel so fortunate to have a place like Generations in our small little town. Really lucked out on that one.

[Buzzworthy]

Talked to my anxiety ridden mom tonight and it’s gotten so much worse. She refuses to see that anxiety has taken over her life, complaining about every possible thing but not trying to overcome the issue at hand, will not help herself and makes excuses why, the house is a disaster because her brain is malfunctioning she can’t do things for herself anymore and my dad says my solutions are “aggressive” and that they have things under control. She’s become my grandmother and my grandmother died just like this, letting life lead you and becoming one with her chair, barely venturing outside or into the real world.
She now has been diagnosed with chronic fatigue syndrome and everything my psychologist of a wife says it’s the anxiety that’s slowly kill her.
Asked if she’s tried to see a professional and the excuse was the wait was 3-4 months. Did she actually get on the list? No, she couldn’t wait that long. This was 6 months ago. I’m sad and mad at the same time right now. She just won’t help herself.

[KQ]

Talked to my anxiety ridden mom tonight and it’s gotten so much worse. She refuses to see that anxiety has taken over her life, complaining about every possible thing but not trying to overcome the issue at hand, will not help herself and makes excuses why, the house is a disaster because her brain is malfunctioning she can’t do things for herself anymore and my dad says my solutions are “aggressive” and that they have things under control. She’s become my grandmother and my grandmother died just like this, letting life lead you and becoming one with her chair, barely venturing outside or into the real world.
She now has been diagnosed with chronic fatigue syndrome and everything my psychologist of a wife says it’s the anxiety that’s slowly kill her.
Asked if she’s tried to see a professional and the excuse was the wait was 3-4 months. Did she actually get on the list? No, she couldn’t wait that long. This was 6 months ago. I’m sad and mad at the same time right now. She just won’t help herself.

Blerg.

Can you hire outside help? When my Mom was at her worst during this 2 month ordeal we could not communicate without her shutting down.

It was as much the Mother/Daughter thing as anything else. I finally learned to shut up and let others who knew how to get through and had no history/relationship deal with her.

[gravitylover]

Grab a cup of coffee

So it turns out that Friday's episode may have had something to do with the episode yesterday. On Friday his O2 levels were a little low but mostly pretty good so the doc wanted a chest x-ray and they sent him to the hospital. When he was there they didn't find anything and released him in just a few hours but with a scrip for cough medicine for a small but deep cough. Saturday seemed ok but he was fuzzier than usual and then the fall overnight leading to another hospital visit and another difficult car ride home. Sunday morning we couldn't get a straight answer from the nurse about him getting his meds on schedule in the morning and he was just babbling on the phone so we went over there to follow the second round of meds before lunch and the shit hit the fan.

When we walked in and saw that the director was there we asked to talk to her and were told she was on the phone with the state DOH. We joked, was it Covid? After being there for almost an hour and noticing that the staff was more aloof than usual another resident's family member came in masked up and asked us why we weren't. *ding ding ding* Apparently there were already several residents with covid and it had started on Thursday when they had a full property social event, which it turns out was a superspreader event. It looks like there are residents in every wing of the building who are now covid positive including my FIL Now he's quarantined to his room with no supervision, they say they'll check hourly when staffing levels allow it but they admit there may be longer periods. He'll get no socialization of consequence for at least 5 days and will just be sitting there babbling to himself while getting increasingly confused and will withdraw further into whatever is left of who he was. We're not allowed in to visit him so our only option is to stand outside his window and look at him in the wheelchair inside but that only works if they have enough staff to get him into the chair to move him by the window. My wife is beside herself that it might end this way...

These assholes should have known it was in the building on Friday afternoon when the first residents had a problem and by Saturday it should have been obvious. Unfortunately, the highest ranking staff member on Saturday was the activities director and this cutesy blonde kid (27 years old) was way out of her element and the Agency nurses they had working that night are all idiots so nobody realized what was up. At that point we had been there a few times with direct contact with a few of the infected people and were now about to be right in my FIL's face putting him in the car after the ER visit. They chose not to tell us or anyone else that covid was in the building and even the staff didn't know it until I lost my shit on Monday morning when I found out. I went to the office to ask why they felt it was ok to not tell us (or anyone else) and when the flunky looked me in the face and said "it's not my place to do that" all I could do is say "Fuck you and your corporate bullshit, this is people communicating with people and you can't even handle that!" as I grabbed a couple of masks, looked the office mgr in the face and said "don't even open your mouth" as the director screamed at me to shut up while I walked back inside. As I headed down the hall to give my wife a mask all of the staff radios squawked a security code, by the time I got to the room the staff was masking up, I tossed the mask to my wife and walked out.

There was another significant episode in the office where I voiced my opinion about the behavior of the team and actually explained to them calmly that the right thing to do would've been to tell people they were walking into a petri dish, that some of us have underlying medical issues making us more vulnerable and we deserve to know. The answer was "We're not required to, the DOH told us that we don't have to notify people and that we can handle it in-house". WTAF! Nobody who has anything to do with the place is "young" other than some of the staff so there's a fair chance most of the people around the place have something going on that means they deserve to know. So now I can't even go see my dad because the facility he lives in is pretty strict about people that have been exposed entering, I'm not allowed back in there until after Christmas. The fuckn guy is in hospice and I can't go see him! These fucks took that time away from me and I'm pissed. His birthday is Friday and I can't be there with him Our daughter that moved away last summer has been battling covid for 12 days now and we didn't go help her because we couldn't be the ones to bring it back to our dads so she's been alone other than her BF who also had it, but not as bad, and now it's here anyway.

Thanx for letting me blow off some steam. I'm sure there'll be more later today.

[riser4]

That fucking sucks. Vibes man. And so another COVID season begins. Buckle up, it's going to be a bumpy ride.