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Substandard eldercare: It's more than a COVID worker shortage

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Inferior eldercare has been systemic, apparently linked to profit enhancement – at the expense of our loved ones, a reality that hit me when a fall upended my mother’s life.
By: Jean Greenwood

Substandard eldercare is nothing new. Inadequate staffing, supervision and accountability have been chronic. COVID has merely highlighted and exacerbated pre-pandemic problems. A 2020 Elder Voice Family Advocates report revealed 44% of central Minnesota long-term care providers were investigated for care violations in 2018-2019.


Pre-pandemic staff shortages appear tied to low wages and benefits. Meanwhile, the senior housing industry reaped 12% profits over a 10 year period ending September 2020, while according to the National Investment Center for Seniors Housing & Care hotels earned 4%. Not surprising that between 2000 and 2018 private equity firms increased their investment in the industry from $5 billion to $100 billion according to the New York Times.


Inferior eldercare has been systemic, apparently linked to profit enhancement – at the expense of our loved ones, a reality that hit me when a fall upended my mother’s life.


Mom, in her 90s, loved assisted living, and everyone loved her. She was active, happily walking (with walker) to all activities, attending family gatherings and her church until one day a volunteer, delivering flowers and cookies, ignored her agency’s protocols, removing Mom from exercise activities and walking to her apartment, without contacting staff. She then left Mom there at lunchtime, without notifying staff or bringing her to lunch.


Unfortunately, the facility lacked volunteer protocols. Staff never spoke with volunteers. If the volunteer had consulted staff, she’d have known that Mom never walked without staff escort, occasionally needing to sit.


Mom’s aide noticed the stranger taking her from exercise but didn’t inquire, and didn’t fetch Mom for lunch 15 minutes later, as scheduled. He waited more than an hour to check on her. Alone in her apartment, a bit confused from an untreated bladder infection (I wasn’t informed of recent wandering episodes which always signaled bladder infection, as staff knew), Mom fell, fracturing her neck.


What ensued? Four hospital stays, two rehab placements, a cascade of errors. After the first hospitalization, Mom’s facility terminated her care, after nine years’ residency, saying they couldn’t meet her needs. “We don’t know what Mom’s needs will be,” I protested, unsuccessfully.


Everywhere we went: “Have you considered hospice?” Hospice? With no life-threatening conditions, Mom wanted medical, not just comfort, care. An ER doc asked, “What’s your goal for your Mom?” “To get well,” I said. He looked surprised. Ageism? Records indicate staff everywhere expected Mom to live well past six months.