Reply for cmotta re question about the "Zurich Plan": In context, this commonly refers to Voluntary Assistance in Dying (VAD), which is legal in Switzerland. In the U.S., variations on that option involve the medical industry and are severely restricted to the point of being less than useful for many. (Bioethics arguments may exist but are a separate issue IMO.) Even in states where it is legal, VAD or MAiD (Medical Assistance in Dying) may be possible but only under explicitly defined and documented conditions. In Switzerland, it is potentially available to any older adult who determines that s/he has lived a "completed life" even if they are not suffering from a terminal illness that is expected to end in natural death within 6 months.
The catch? For non-residents of Switzerland, the arrangements for VAD are complex and very expensive! Speaking only for myself, however, I would seriously consider expending my last $15-20K on a one-way trip to Switzerland vs. who knows how many years I might "live" in a NH or ALF costing $80-100K+ per YEAR, payable out of pocket until my funds run out, then by Medicaid.
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.
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?
djenning6msncom: The high staff turnover rate at assisted living facilities makes perfect sense since caregiving has to be one of the most underappreciated jobs.
It's not that it is an underappreciated job; I greatly, or rather infinitely, appreciate all the employees at the assisted living facility where my father is. I believe the turnover is so high is because the pay is too low for what they do. In my father's facility it seems every time I go there there are new employees. In fact only about 30% I recognize from only a few months ago. These are mostly those that have the most responsibility, like nurses and managers. The good thing is almost everyone that I have interacted with there is very friendly, caring and competent.
I recently heard on the news that there is a major shortage of professional caregivers in the US. This to me would suggest that the pay would therefore be higher but this is apparently not the case. The facilities can only pay so much, if they want to stay in business. What are all these employees doing when they leave? I have no idea.
There is a high turn over. There was also language barriers between the caregivers and residents in my situation. I agree with many comments that the turn over is related to management and the processes they develop. You need a clear care plan that is communicated to all levels of the caregivers. Managers need ways to ensure that the caregivers are completing their task. A thankless job but, in my case, management had no idea if the requirements for care were being met. I ended up going daily and journalizing the daily experience. I kept records of baths, eating, clothing, bed changes. I was able to use that detail to communicate the gaps to management but would not have seen improvement without that documentation. Management did not have the processes to monitor the care. Great caregivers will stay where there is clear direction and the right patient to caregiver ratio. That responsibility falls entirely on management and owners.
A lot of older people died in nursing homes and at the hospital - the nurses and caregivers are burnt out - that’s the reason . Plus we have so many boomers and the Family unit is not strong in America . I have seen assisted living places and Memory care at nursing homes - it’s really about whose running the place . My Brother was in a Carribean nursing home and they treated the staff and nurses well - people were happy to work there .
If they are taking care of husband the way you want them to, and you are able to communicate with them in a timely manner, I would not worry about the high turnover.
The industry typically has a high turnover as it is a high stress job, variable hours, and with certain jobs, does not require much advanced education. As people get their nursing degree or realize there are better opportunities if they move to a new job or get to the limit to where they cannot progress anymore, they will leave.
It is kind of like teachers. They don't get paid nearly as much as they should. The difference is teachers get much better benefits and get some long periods of time where they don't have to work nearly as hard as the rest of the time.
My experience is that, yes, it is normal. Most of the ASL centers in my town are understaffed. When I question this, they always say that they have the "required" number of people employed. I find this ridiculous. The number of staff that you employ should be based on the care needs of your residents, not what is "required". I believe the turnover is due to the caregivers being overworked and underpayed. I've been in these facilities and see the frustration with the caregivers trying to keep up with the demands put on them. The ASL where my mom resides has many residents who complain constantly about the littlest things. The tomato soup is too thin, you only brought me 3 washcloths instead of 4, you were 30 minutes late giving me my meds, why can't the temperature in my room CONSTANTLY remain at 74° and stop going to 73 or 75°? And on and on. My mom is one of the constant complainers and she is in the best facility in my area. She literally doesn't have to lift a finger if she doesn't want to! I tell the caregivers every single time that I talk to them that I greatly appreciate them and I have no idea how they do their jobs as I could NEVER do it. It just always seems to me that they are overworked and underpaid. I absolutely could not put up with the physical, emotional and psychological demands on a daily basis. They must feel so unappreciated... :(
Momma's assisted living has a high turnover of staff and nurses. She has been living there for a little over four years and they have gone through a number of nurses, aides and cannot keep a housekeeper. Right now they are on their second president.
The catch? For non-residents of Switzerland, the arrangements for VAD are complex and very expensive! Speaking only for myself, however, I would seriously consider expending my last $15-20K on a one-way trip to Switzerland vs. who knows how many years I might "live" in a NH or ALF costing $80-100K+ per YEAR, payable out of pocket until my funds run out, then by Medicaid.
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.
I recently heard on the news that there is a major shortage of professional caregivers in the US. This to me would suggest that the pay would therefore be higher but this is apparently not the case. The facilities can only pay so much, if they want to stay in business. What are all these employees doing when they leave? I have no idea.
The industry typically has a high turnover as it is a high stress job, variable hours, and with certain jobs, does not require much advanced education. As people get their nursing degree or realize there are better opportunities if they move to a new job or get to the limit to where they cannot progress anymore, they will leave.
It is kind of like teachers. They don't get paid nearly as much as they should. The difference is teachers get much better benefits and get some long periods of time where they don't have to work nearly as hard as the rest of the time.
I believe the turnover is due to the caregivers being overworked and underpayed. I've been in these facilities and see the frustration with the caregivers trying to keep up with the demands put on them. The ASL where my mom resides has many residents who complain constantly about the littlest things. The tomato soup is too thin, you only brought me 3 washcloths instead of 4, you were 30 minutes late giving me my meds, why can't the temperature in my room CONSTANTLY remain at 74° and stop going to 73 or 75°? And on and on. My mom is one of the constant complainers and she is in the best facility in my area. She literally doesn't have to lift a finger if she doesn't want to! I tell the caregivers every single time that I talk to them that I greatly appreciate them and I have no idea how they do their jobs as I could NEVER do it. It just always seems to me that they are overworked and underpaid. I absolutely could not put up with the physical, emotional and psychological demands on a daily basis. They must feel so unappreciated... :(