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My husband's assisted living, which seems like a decent place, has had high staff turnover lately. I am getting concerned.

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I'm a potential care receiver, but I've learned a lot from this Forum. I guess I was somewhat naive in my 60s-70s not to have foreseen/prepared for these 3 things. That: (1) I, now 86, (and my spouse, now 93) would live as long as we have--which neither of us expected, intended or wanted!; (2) inflation would be as high as it is; (3) there is almost no reliable help to be hired for any price that middle-class older adults on a moderate fixed income can afford.

I just will NOT burden our adult child(ren) with our care, so I need to figure something out. So far, we're managing on our own with a twice-monthly housecleaner and occasional yard and home maintenance workers, but after following this Forum for a while, I'm good and scared about what the future holds. We just got notified by our long-term care insurer that we have "options": to continue our current, good coverage but at ever-increasing and potentially unaffordable premiums, or accept a lower or zero premium "buyout" that would maybe cover a year or two of NH or ALF care for ONE of us. We've been paying into this for 25 years! I feel cheated, but it is what it is. We saved as much as we could and tried to prepare for our older years, but . . . here we are.

At this point I'm NO fan of longevity! We have all our legal paperwork in order (wills, POAs, healthcare directives, POLSTs). No passports, though, which would be necessary for a visit to Zurich. . .
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NeedHelpWithMom May 2023
Thank you for telling the story of many people. So very true!

My mom lived to be 95, my uncle, mom’s brother lived to be 96. My great aunts lived into their late 90’s.

My cousin is now 100, still dresses very stylishly and drives to church, the grocery, the dollar store, her exercise class, Walmart and lunch with her friends. She cooks and cleans her apartment and helps her neighbors in her independent living apartment. Oh, and she will tell me about her travel plans for next year! LOL 😆

I truly hope that I don’t inherit the longevity on my mother’s side of the family!

Old age is fine for people like my cousin who don’t have any major health issues and enough money to live comfortably. People who are burdened with health issues and financial difficulties feel stressed and don’t want the burden of a long life.

My dad died at 85.

Mom had Parkinson’s disease. When people would tell her that she would live to be 100, her answer would be, “Oh, God. I hope not!”
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Its funny how you would not burden your children...Im a nursing assistant & its hard hard work. Its alot for $12-15 an hour when we have to take care of you physically & many times emotionally. Many times Im not appreciated or thanked for my care & its very strange how the patients dont disrespect the doctors or nurses but love to cross lines with the very people that care for them. Thats why the high turn over. You both seem to have a good head on your shoulders Just never forget to respect to be respected...
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I have seen low pay, not enough staff so the workload is unbearable, and stupid decisions by the management in the nursing homes I have visited where my family has been in residence so unfortunately it does seem normal. We need a sea change in this country in how we treat our elderly and handicapped,
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betskand May 2023
You can say that again. You don't need to, though -- almost everyone I know -- either old or younger-and-taking-care -- is saying exactly the same thing. The elder-care situation in this country is a huge mess. I read in the Washington Post recently that a significant number of elderly people, many with dementia, are ending up living on the streets.
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There are probably many reasons for the high turnover. Mostly that it's hard work. The former director at the assisted living facility where my mom was told me she quit because of the corporation's new policies. She was the professional, a caregiver and nutritionist for 20 years, and the new owners knew nothing about elder care. The facility was once private and is now owned by a corporation that bought up several other businesses in my small city. I could go on an on about how they've ruined all of their acquired businesses, but I won't. I see this corporate take over as a really bad sign for our future. Money made at the top and everyone else has to work hard for little pay.
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Thank you for the input. I realize that Zurich is neither inexpensive nor easy (I've looked into it), but the $20,000+ it would cost for one is small compared to $80-$100,000+ every YEAR if I end up in a NH or ALF (X2 if we both do). Who except the extremely wealthy can afford that for long? I would also consider VSED as a possible option as long as I remain "competent" and could find the necessary medical support. MAiD is legal in our state, but there are SO many restrictions, including that the requester must be expected to die within 6 months.

I will speak solely for myself here, although my spouse shares most, if not quite all, of my views. I have already made as clear as I possibly can, in writing, that I do not want any "heroic measures" taken to keep me alive should I acquire a life-destroying illness or disability--no CPR, no feeding tubes, no ventilators, no pacemakers, no surgery. Being tethered to machines in an ICU is absolutely not my idea of a peaceful death. I have no desire for continued existence if I can no longer care for my own basic personal needs. Comfort care--period. I can only hope that my wishes will be followed.

While I may be envious of 100 Y/Os who are still high functioning, I fear that I will not be one of them. I am already experiencing significant chronic pain and encroaching physical limitations. I am still able to grocery shop, do the laundry, care for our 13 Y/O cat and keep up our home (with twice-monthly housecleaning and other occasional help) but for how long? I worry about what-ifs a lot, although I know that worrying won't help. I checked out several local "facilities" some years ago. I wasn't at all impressed but, before becoming a burden on my family, I would seriously consider that option and hope my funds would last as long as I did.
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RedVanAnnie May 2023
Lots of things to worry about regarding our own future care, aren't there?! Many times something happens that we never expected ahead of time. I'm many of us on this forum share your concerns. It would be wonderful if pay and working conditions for Health Care workers improved enough to attract more skillfull, caring people to that work.
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I absolutely concur that front line care work should be paid very well and come with good benefits, along with respect, which is certainly not the case currently. I agree that low pay, coupled with often-unpleasant working conditions, probably largely explain high staff turnover although, as others have noted, a wide variety of industries are experiencing staffing shortages.

I understand that many elder care facilities across the nation are being bought out by private equity companies, whose ONLY interest is return on investment. These companies have eviscerated local news organizations and are moving on to healthcare as their next cash cow. That does not bode well for any moderate-income older adult who may need care. Affordable care isn't a problem for the wealthy or for the low-income (Medicaid eligible), but there is a HUGE unaddressed cohort in the middle. Many moderate-income retirees did their best to prepare for their "golden years", but the ground has shifted.

The cost of even subpar NH or ALF care is often out of reach for all but the relatively wealthy if it is needed for more than a year or two. Long term care insurance can help, although ours recently notified us of changes that are decidedly not in our favor. Many of today's older adults (me included) have lived longer than we intended or wanted to. That, coupled with inflation/the high cost of living and the current labor market, has created a "perfect storm" for remnants of The Silent Generation and the coming influx of boomers. I don't have the answer--wish I did!
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Lizhappens May 2023
you’re so right. It’s so scary to think of the future in these terms seeing what we see now. Some thing we try not to think about and you pray for a healthy life and then die overnight.
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Yep. Very common. The complaints I heard from staff was facilities do not hire enough people and exhaust the ones they do hire. You can tour a facility (doesn't matter what kind) and will be told there are x number of staff on an area and each person handles 4-6 patients. In reality if you go there and actually observe, they have hired on person to handle about 15 people...impossible task.

Corners that may be cut are person assigned to shower 7 or 8 people on one side of hall, however those on other side ring their bell for some kind of help. Staff member leaves one person on a shower chair to answer call bell. If person falls in the shower, there's a good chance it won't be reported if all is well. Another example is long wait times to be helped to the bathroom. Answer to that is slap a diaper on the person.

If you're seeing high turnover, then you need to be going regularly at various times to observe first hand what care your loved one may be getting neglected on. Don't stop and chit chat with everyone on your way in the door. Enter and observe. Then bring issues to the attention of the person who runs the show, ask for how they will resolve, and follow up to see if problem fixed.
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Lizhappens May 2023
So true. My friend, who I call my adopted mother, I visited her in a dementia care facility that was supposed to be one of the best. As we sat during lunch she urinated in her diaper which leaked onto the floor. I called an attendant to come assist her and he looked at her and said we’ll do it after lunch. I told him he would do it now. I felt bad being demanding in on one hand, but on the other hand this is what you’re supposed to do. How long would she have sat in that overly wet diaper had I not been there?
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The staff turnover is a great concern for my Dad’s ALF also. And each time there are new staff, we the family have to make sure they know dads individual needs (how to use the lift chair, make sure he is taken to the bathroom at least enough not to sit in a wet depends, make sure he is encouraged to leave the room to eat, how to encourage him to let them shower him). Just as a caregiver seems to be familiar with him, they leave. And the facility is understaffed for the 48 residents they have. And he is in one of the nicer ones. The dilemma is if they pay more to the workers, Which they should, they would have to raise rates and so many already can’t afford an ALF even though they need it. Dad only affords it due to his veterans benefits of disability (if your loved one is a vet, check this out with the VA)
I think our country needs to worry less about other countries and sending money around the world and help finance the ALFs so they can pay staff more. Pay the ones directly working with the residents not just the managers.
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Isthisrealyreal May 2023
No, they wouldn't have to raise rates, they would have to give up some of their astronomical profits and that is why they pay crap wages.
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The United States - and in particular members of certain political parties - doesn’t feel that health care is important whether that means for children, young mothers, healthy adults, or the elderly. It is evident not just in how we treat our elderly but in how we treat everyone. My mother’s side of the family is European (France and Netherlands) and they don’t have these problems with high costs, low levels of care, and staff turnover because most of the facilities are state run and not for profit.

Doctors visit people at their homes, caregivers are provided for free, and when the time come you are eligible to move to a government owned apartment complex with other seniors that we would call assisted living - all free of charge. The people who work there are employees of the state, are paid well, and have good benefits.

My relatives are always shocked when I tell them that here you pay $6000-10000 per month and what you get for that money. They say “I thought America is the wealthiest country!”

The only solution to this problem is to eliminate private insurers and offer a lot more public senior care facilities. This country’s emphasis on letting private corporations manage our healthcare for profit is killing us all.
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lisatrevor May 2023
That's not the solution at all! In some western Europe countries they do in fact have major issues related to healthcare that we do not have in America. The wait times for appointments and procedures is often months, as your relatives who live there will verify, and the care can be substandard, even dangerous, depending on the country. It's true these countries contain their costs very well for the citizens but this is the result of the culture, of long history and homogeneity of people, as a whole agreeing and paying for it. America has a totally different history and culture and this could not be done, at least for the foreseeable future. Look at the Affordable Care Act. How has that worked out?What the solution is: To privatize everything and get rid of all the unnecessary regulations, many of which appear to favor special interests. This will allow private companies to compete to provide the best care at the lowest prices. In this way the culture of, or should I say brainwashing of, insurance will disappear as people realize that the best way to handle health care costs is like any costs - pay it yourself! My doctors love the fact that I am "self-pay" and I always get a discount.
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There is high turnover in all areas of healthcare. There is a huge shortage of healthcare workers. The people who do stay and continue to work are pressured to work harder than ever due to the shortage. Good workers are getting burned out. This is likely to continue.
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pamzimmrrt May 2023
Lisa this is sooo true! I am getting ready to retire from one of the biggest/best hospitals in the country.. and every time I think "maybe not yet" I go to work,,, LOL and think "yep, its time" I have been with the same hospital for 26 years and boy have things changed!
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