Let’s Call a Spade a Spade







Assisted living facilities. For some, this brings to mind elderly folks who need minimal assistance. Maybe lonely people who are retired or widowed and could use a hand with light housekeeping chores and superficial supervision. To be fair, there is a be very small segment of my facility’s population that fits into that description, which in and of itself is part of the problem.

         The REALITY of it is we have residents with a very wide range of illnesses, levels of care and ages. On my hall, we have twenty-five residents. We have Hoyer lifts, people who are living with both colostomy bags and catheters, residents who need total care, residents who are on hospice and several feeders. We have residents living with severe mental illness, addictions and other ailments that prevent them from living on their own but also make them ineligible for any type of skilled facility. Due to the lack of resources and options for long-term mental healthcare in my state, they are stuck in a sort of limbo. While assisted living facilities are a less than ideal option, it is certainly better than living on the streets. We also have an Alzheimer’s unit.

       All of these folks with this wide variety of physical and mental illnesses are intermingled with varying degrees of success and without an onsite nurse. We have nursing agencies that come in as needed or scheduled. Many of my residents end up in assisted living rather than skilled because, quite frankly, they can afford it more easily and DHHS allows it.

     My assisted living facility is not the exception to the rule. The reality of it is that as the baby boomer generation ages, and the population bulge moves through the Long Term Care system, the difference between a skilled facility and assisted living steadily shrinks. The supply is simply not meeting the demand.

      So facilities like mine have less staff to resident ratios, less pay, but in all reality an equal amount of work. While we may have fewer people with total care needs, we have more with mental health issues. Our training, from the top down, does not meet with the reality.

     These are the facts. One cannot solve a problem by ignoring facts in order to preserve a mental image. It’s the mental image that has to be adjusted so that they encompass the reality.  Those who should know better exacerbate the problem by perpetuating the facade, rather than acknowledging the situation for what it is and taking steps to fix it. New regulations and better education is needed. The first step to solving a problem is recognizing that it exists.

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