AlzHub

You're Either Part Of The Problem Or Part Of The Solution

Thanks to The Tangled Neuron for this post responding to a surprisingly shallow and poorly researched article on How To Run A Senior Living Home from Forbes.com.

Where is the "assisted" part of assisted living?  Looking at the assisted living industry as a numbers game should not be encouraged.  There's too much of that already.  This is an industry with problems.

Using Sunrise Senior Living as a role model was an immediate red flag for me.  A model for neglect, accounting and stock irregularities?  Sure.  Role model?  No.

Neglect Is A Symptom Of Greed

The Sunrise Senior Living saga gets uglier every day:

Accounting problems, suspiciously timed stock selling and a call for investigation.

-Corrupted Chamber of Commerce: Thomas Donahue by Matt Stoller at The Huffington Post.

"If it were possible to pick one person as the representative for American business in Washington, Thomas Donahue is that man.  He is the President and CEO of the United States Chamber of Commerce, the most important business lobbying group in the country.  He is also on the Board of Directors and the Audit Committee of Sunrise Senior Living, and was caught selling stock ahead of the revelations of accounting problems."

-SunriseShareholders.org

A project of the Service Employees International Union (SEIU) Capital Stewardship Program that owns a lot of Sunrise stock and wants an investigation into problems at the company.

-Sunrise Insider Sales Need Independent Probe, Pension Fund Says - by Mark Pittman at Bloomberg.com

"Five board members, including founder and chief executive Paul J. Klaassen and his wife, director Teresa M. Klaassen, sold $32 million in shares before a May 9 announcement that the company would review its accounting, pension fund spokesman Dan O'Sullivan said in a statement today that repeated claims made in last week's letter."

2006 Alzheimer's Association Memory Walk Los Angeles

The Memory Walk was a huge success again this year.  They announced that this walk alone had raised over $500,000 and counting.  I won't even attempt to estimate how many people were there, let's just call it "thousands".

I'm guessing, but the Los Angeles walk has got to be one of the largest of all the walks held around the country.  The actual walk part was supposed to be 3 miles but it couldn't have been much more than a mile. 

There was live music, information booths from various companies and organizations and some food.

Since this is Los Angeles, there were also celebrities.  Celebrities whose lives have also been affected by Alzheimer's.  They come out year after year to take part, help raise money and to cheer the rest of us on.

Thanks to everyone invovled.

And now, the photo's:
(Click the images for larger versions)

Celebrities leading the walk.
L to R: L.A. County Supervisor Yvonne Brathwaite Burke, Rafer Johnson,
Ron Rifkin, Shelley Fabares, Steve Edwards, Leeza Gibbons, Bryan Cranston,
Victor Garber, David Hyde Pierce, Bob Goen.

Start of the walk.

Walking along the infield of Hollywood Park.

Walking along the water.

and what would an event be without dancing...

More celebrity images:

Bryan Cranston

Leeza Gibbons

Shelley Fabares

Peter Gallagher

Rafer Johnson

Ron Rifkin

Victor Garber

Steve Edwards and David Hyde Pierce

2006 Alzheimer's Association Memory Walk

I registered this morning to walk in the Alzheimer's Association Memory Walk at Hollywood Park next weekend (Oct. 7th).  I missed last year and am looking forward to going again.

If there's a walk near you, get out and raise a little money, get some exercise and raise awareness of Alzheimer's disease.

I plan to follow up here with some photo's from the event.

Alzheimer's Association Memory Walk website.

The Los Angeles Memory Walk website.

Consumer Reports On Assisted Living

Finding problems with the quality of care at assisted living facilities is, unfortunately, like shooting fish in a barrel.  Here's an article from Consumer Reports titled: Assisted Living - How much assistance can you really count on?

It shouldn't be any surprise that the answer is not much.  Also no surprise, the article includes examples featuring Sunrise Senior Living.

10 Things

Continuing the theme from my last post, here is an article from SmartMoney.com pointing out common problems faced with assisted living facilities.

The article is called "10 Things Your Assisted-Living Facility Won't Tell You" by Stacey L. Bradford.

Here's the list:

1) We promise more than we can deliver.
2) We can raise our prices at any time.
3) Our staff has very little training.
4) Medication errors are common and our pharmacy charges too much.
5) We face scant regulation.
6) You're practically on your own at night.
7) You may have to hire a private-duty nurse, too.
8) We stop spending once our beds are full.
9) Practically anyone can hang an assisted-living shingle.
10) Check your dignity at the door.

I personally had to deal with #'s 1, 3, 4, 5, 6 and 10.  In fact, the only one I can definitely rule out is number 2 because our contract specified when prices could be raised.  It isn't surprising to me to see that Sunrise Senior Living* is mentioned more than once in the article.

Click here to read the entire article and each item on the list in more detail.  Scary stuff.

*Sunrise Senior Living and Sunrise Assisted Living are the same company.  They changed the "assisted" part of their name a few years ago in what now seems a rather prophetic move.

The Evil Within

I've written about the following incident in more general terms in a previous post about vigilance of Alzheimer's care homes.  I'm now writing about it in more detail after reading recent posts by Karma at JewBu Quest.  The problems she writes about and the response that she gets are far too familiar.  I've been there.  Same thing.  Same company.  Different facility.  It brings back all the frustration and anger that I had at the time I was going through it.

Not providing detail about what happened to mom is not fair to anyone who may be facing the prospect of putting a loved one in a home.  When I was a caregiver, the more information I had to work with, the better.  Not being specific also let Sunrise Senior Living off the hook.  It's time to correct that.

Before getting into what happened, here's a little background on mom to help you understand the situation and the change.  Prior to getting sick mom was active, talkative, ate in the main dining room and, while using a walker for balance, walked around the facility daily.

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Here's my Sunrise Senior Living story:

The new director was promoted from coordinator from a nearby facility in the same chain of companies.  Right away she seemed intimidated by her position.  She tended to make herself pretty scarce.  Some of the better staff quit or were forced out and pretty soon there were new staff that were basically unfriendly and didn't care too much about the residents.

With a hands off director and staff with little oversight, things went downhill very quickly.

One day I went to visit mom and could see right away that she was sick - a lot of coughing and congestion.  I stopped by to see the nurse on the way out to make sure they'd keep an eye on her.  The nurse wasn't aware that mom was sick but said they'd check on her.

The nurse called the next day to say they made an appointment with mom's doctor.  I took mom myself and learned she had pneumonia and was dehydrated.  The doctors orders were to keep her hydrated and if any changes, take her to urgent care.

I visited again three days later.  There wasn't any noticeable change and she was still dehydrated.  I trusted that they were following doctors orders and since I didn't hear anything I assumed everything was under control.

Three or four days after that I had a meeting with the new director and the coordinators of both the assisted living and Alzheimer's sections.  They admitted that there were care and communication problems but they already had fixes planned and everything would be great.

I came back to visit mom the next day about 2 in the afternoon.  I opened mom's door, saw mom and my first thought was that she was dead.  She was sitting in her chair, mouth open and dry, lips chapped, vacant look in her eyes and not moving.  Didn't even look at me when I walked in.  After checking her she also had trouble speaking and breathing.  She was too weak to stand.  The difference was shocking and obvious.

I lost it after this.  I went straight to the directors office and literally yelled at her.  Mom got meds every morning and evening, the care managers saw her daily, the promises from the day before and no one lifted a finger to help her.  No one called me or her doctor.  The nurse said no one said anything to her but I found out they had documented that mom was not eating or drinking.  They knew there were changes, they could see that she was getting worse, they had doctors orders and they walked away and did nothing.  I took her to urgent care.

A couple days later I stopped by the directors office to see what she had to say.  I reminded her that they have a nurse and that help in these situations are what we pay a lot of money for.  She made more promises about fixing things.  As I was leaving the office, the director said "it's a good thing you visit as often as you do".  I wasn't sure what she meant, so I asked her.  She said "if you hadn't been here your mother wouldn't have lasted the weekend".  Then she chuckled a little bit.

I just turned and left the office before I did something drastic.  I truly don't think she understood why I would be so angry.

After all this they still couldn't get their act together.  I would get there after dinner was brought to mom's room just to see if they were helping her.  The food was always cold by the time they brought it and they would just set it on a table and leave even though they knew mom didn't have the strength to feed herself.  They would pick it up later untouched.  This would happen repeatedly.

One night they didn't bring anything at all to drink.  So much for orders to keep her hydrated.  From this point on I went there every day.  I couldn't trust them.

I had been concerned about retaliation.  Up until this incident, I never threatened them with filing complaints.  I just kept after them.  But after this, there was nothing to lose.

I called the ombudsman first, she was shocked and said to call the California Department of Social Services and tell them.  They came out and investigated (which took all of 15 minutes), and substantiated my claim of neglect.

On the report under "Plan of Corrections", it is blank.  A far as I know, Sunrise didn't get in much trouble.  Things didn't get any better.  Six months later, the director was replaced right around the time mom passed away.

The only things I know that happed after that are they re-rented mom's room and dumped her stuff in another empty room without telling us even though we were paid through the end of the month and they were going to cut staffing levels even further.

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This was not a minor slip-up that got out of control.  This was not one person making an isolated mistake.  This neglect was not addressed or corrected in a timely manner.  This neglect required several people at at levels of the facility (care managers, coordinators and director) to ignore the obvious.  This neglect required them to withhold basic care repeatedly.  This neglect continued after the problems were brought to their attention.

This is expensive professional Alzheimer's care in a facility that is part of a large, worldwide organization that is generally regarded as one of the better organizations.  I think that their generally positive reputation says more about the level of oversight these homes receive than the quality of care that Sunrise provides.

Karma is absolutely right - this is unacceptable.  It's time to shine a light on this industry problem.  Change won't take place until people become aware and we let it be known that we demand better and our loved ones deserve better.

Free Publication: Visiting Someone With Dementia / Alzheimer's

Visiting with someone that has Alzheimer's or dementia can cause some anxiety for a lot of people.  Probably most people.  Both friends and immediate family wonder what to do or say, how to act, what the visit will be like.  This anxiety keeps a lot of people from making visits.  More out of the fear of the unknown than anything else. 

I came across a very good publication from Baycrest called: Visiting with Elders: Strategies to help you have a meaningful and rich visit with an elderly loved one that helps answer most of the questions you may have.  It is an amazing resource that takes the mystery out of your visits and helps you make your visits something everyone hopes they will be.

From the Baycrest website:

Baycrest has produced a free online resource to help families learn new ways of communicating and interacting with an elderly loved one who has Alzheimer's or other dementia. 

As our elders live into old age, with increased likelihood of chronic illness, institutionalization becomes a necessary choice for some for the provision of care. Families and relationships will continue, though ways of connecting with one another may change. These can be difficult and emotionally stressful times, but there are many ways to have a positive and meaningful visit.

That's right, this information is free.

Follow the link below to go to the website where you can click the link to read or download the publication:

Visiting with Elders:  Strategies to help you have a meaningful and rich visit with an elderly loved one.

Medical University Of Ohio And Dementia Care Training For Students

The Medical University of Ohio is giving its medical students the chance to spend some time with Alzheimer's patients and caregivers.

I think this is a great idea and long overdue. Book learning only goes so far. Real world experience and exposure to what patients and caregivers go through will be invaluable to everyone.

School is probably the best and last opportunity students will get for something like this.

Read the article here:

MUO course strives to develop compassionate dementia care - by Luke Shockman, staff writer - Toledo Blade.

Technorati Tags: Medical University of Ohio, MUO

Vigilance Of Alzheimer's Care Homes

Here’s a tip that you can only learn by going through it.

If you’ve reached the point where you’ve had to put your loved one in a home (assisted living or one that specializes in Alzheimer’s patients), visit as often as you can. The obvious reason is because they are your loved ones. But there is another important and overlooked reason.

No matter how good the home was when you first went there to look around, or when your loved one moved in, things can and do change. The only way you will know if problems arise is if you are there enough to notice it yourself. Trust me, if problems come up, they are not going to call you or send you a letter letting you know.

When mom moved into the home she lived in, it had a reputation as one of the best in the area. There were a couple of problems, but they were quickly corrected. I felt good about the care she was receiving. Your comfort level about the home cannot be overstated.

Then the Executive Director left and a new one arrived. From day one, things went quickly and dramatically downhill. To the point that they were found guilty of neglect by the California Department of Social Services. Problems weren’t corrected. Just a lot of empty promises.

If you visit once a month or every couple of weeks for a couple of hours, you’d never notice anything was wrong. Take an active part in your loved ones care. Are they getting the right medication? Is it being dispensed properly? Is there adequate supervision on group outings? Are maintenance and repairs handled in an appropriate time frame? Is the staff following your doctors orders? Is your loved one getting the quality of care they should be?

You don’t need to be aggressive or demanding. Just take an active part so that they know you will notice if they don’t take their responsibilities seriously.

In case you were wondering, the problem Executive Director did get replaced.

Technorati Tags: assisted living, caretaker