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I just got off the phone with “Irene”, a brilliant, educated, successful "baby boomer" who could not stop crying. Why? Because she needed to move her mom to a “higher level of care” and could not believe the time, effort and difficulty involved.
Mostly, though, “Irene" was crying out of sheer frustration...frustration with the "Community Relations Director" at the Assisted Living Facility who could not explain their "points" scale and how that translated into cost; frustration with the nurse at the "Memory Care" center who had a great deal to say about their wonderful chef and extracurricular activities but could not clarify how they would manage her mother's anxiety and confusion. As Irene recounted her experience, I could only empathize and agree.
If you thought dementia was confusing, try traversing the overwhelming and exasperating path taken by those in search of the "best, most affordable care" for their aging parents. Whether your mom suffers from cancer or your dad from congestive heart failure, figuring out the best care options available for your loved one is a confusing and overwhelming situation; toss in the additional stress of finding a facility under pressure because your parent is in the hospital and "ready for discharge" (but absolutely NOT ready for discharge home) and emotional upheaval is sure to ensue.
Although the "elder care" business is booming, I remain frustrated with the quality of the "elder care specialists" who proclaim to know what is best for our loved ones. Why in the world is the sales and marketing director in charge of figuring out the "appropriate level of care" for an older person. Why doesn't the facility manager know the difference between a LVN (licensed vocational nurse) and an NP (nurse practitioner)? And why can't I get a straight answer when I ask what the policy or procedure is when a resident becomes confused or agitated and lashes out at staff?
In the past six months, I have visited and toured over a dozen different elder care facilities throughout the Bay Area. Initially, I thought I could come up with an Excel spreadsheet so that I could provide my clients with a clear comparison of rates, room sizes/types, levels of care and amenities offered; it soon become clear, however, that this was an exercise in futility. Some facilities have “buy in” requirements, some have “admission fees”; some have flat rates for different levels of care and others follow a “point system” depending on the type and frequency of assistance required.
Both my conversation with Irene and my unsuccessful attempt to “compare and contrast” the care options available highlight the obvious: if I, a trained professional who has worked in the field of elder care for 18 years, get frustrated with the murky and inconsistent information presently available, what does this say about the present climate of elder care?
Well that answer is, I'm afraid, crystal clear.
Mary Hulme, LCSW, ASW-G, C-SWHC of Moonstone Geriatrics is a geriatric consultant, health care advocate and dementia specialist who grew up in San Francisco.
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