Hi, I am on a small volunteer board of directors of my apartment building (66 units) which is not any kind of "facility" or "residence" for the elderly in any official capacity, but which has a lot of very elderly residents (at least 1/3) some of whom have been there for decades and grown old there.
The board is seeing some emerging problems with some of these elderly: falls in the basement not discovered for hours; people ill in their apartments without asking for help and discovered by accident by neighbors; people with alzheimers wandering in the corridors; people boiling pots dry; people leaving their faucets running for hours and forgetting flooding the downstairs neighbor; people too deaf to hear their smoke alarms or too frail to make their way to the safe meeting point in the case of a fire.
Some of them have CLSC home visits (sort of community clinics), some don't, some don't want it.
We have drawn up a list of these vulnerable people and it looks pretty daunting to deal with for a team of 4 volunteers. We deal with each issue as it arises. We have no policies or protocols treating the safety of our elderly residents, nor do we really know what to do, but it's becoming clear we'll need to have some kind of best practices in writing.
Do you know of any protocols that we could use as a guide?
Yikes! - there are 186 related articles in this section. Not all of them will be of use, of course, because you're not setting up a service as such; but I hope that if you tinker a bit with your search options you'll find service studies, descriptions and guidelines that you can pick from to design your own framework.
These are good reasons to get some serious legal advice before making changes, and to create policies and stances which delineate what the purpose of the facility is, what it does and does not provide for. I.e., establish baseline intents and purposes.
Sometimes things you attempt to do for safety come back in odd ways to bite you in the bottom under the heading of "what you did NOT do" or think of.
Usually making "best efforts" always comes out in your favor in a suit. The thing is things can also vary on whether just an apartment building owned by an owner, or whether a co-op with buy in or condo.
Let us say you have addressed about 20 issues, grab rails, safety mats, stair stick to prevent sliding, raised toilets, monitoring cameras, automatic lighting going on and off and etc. You, the board, the owner? Have made "best efforts" for safety.
BUT there is one hidden issue no one thought of; and a Senior ends up injured. Now you have the family. The family sues management/owner (because they look for the deepest pockets), and this is the argument in court:
"You KNEW you had elders in this building who were not safe.
You had board meetings and you discussed safety issues.
You addressed some issues, but you did NOT address THIS issue.
And you should have. Because you KNEW...........etc."
Of course people and families can always sue in our litigation prone times, but probably making "best efforts" is a good idea. Certainly morally this is the right thing to do and could save life and limb. But boy, it's a big job in quite a bit building, and would not be cheap by any means.
I hate to say it but if we are pursued legally over something and the building funds are bankrupted, then none of us have a place to live. And all because we started meddling in elder care.
I think we need to stop this train before it starts by refusing to engage with the issue. Sad but true...
Is there any agency in Quebec to which you can report a vulnerable elder like our American friends have with APS? I know there is nothing in Ontario short of contacting the office of the public guardian or filing a police report.
there's an elder abuse helpline https://www.aideabusaines.ca/en/ but again, not really about general vulnerability.
And the police, I suppose.
I suppose we'd have to start with these.
Addressing your response to CWillie on the issue of not doing anything, I think that would be a mistake. Fortunately or unfortunately, a situation exists, and there may be some fiduciary capacity of the Board to at least acknowledge the needs of residents. That would turn on health law liability, an area in which I have no familiarity.
I would suggest considering a consult with a real estate attorney who represents not only commercial entities but one who represents individual and chain rehab, IL, AL, and similar facilities.
Better yet, You might also consider a healthcare law firm; it's probably more likely that you'll find an amalgam of relevant practice areas in that kind of firm. Health care law was a new practice area a few decades ago. I suspect it's grown given the number of aging people and the facilities created to address their needs.
This is one of the most helpful threads I've seen on the topic of aging in place.
In the meantime, have you considered monitors, and perhaps something like motion sensors for the areas in which the elderly are falling? Or is there another area to which the common facilities could be moved?
When I was much younger and lived in an apartment complex, laundry facilities were also in the basement. I wasn't concerned or afraid then, but now I'd be more concerned about people who have no legitimate reason to be there, and in fact may be there for nefarious purposes.
You may want to research state laws concerning your responsibility to these residents. Are you able to, under the circumstances, not renew their leases because they are now a liability? Call your insurance company and see where you stand with them.
My idea would be to get all this information together. Then have
a meeting with the families of these residents. Maybe having a rep from the insurance company there. Explain the problems that are arising now their family member is aging. Your limited liability. That its the families responsibility to find accomadations that better meet the needs of their family member. If there is no family, then Adult Protection Services should be called into evaluate those residents u feel need help.
Even 55 and up complexes are not responsible for residents. They just provide a more safe environment. Your building having wheelchair accessibility is probably the law. In addition, 55 and up complexes provide bars in the shower. Showers you can step into. Maybe an apartment that is more open, less walls. Another thing I would check out, is if the complex would allow bars to be installed in showers at the residents expense.
I admire that your Board is aware of the problems and are trying to solve it but in the end, it the residents families that need to be made aware of the problem and need to solve it. It may take you saying that the residents lease will not be renewed, because of the liability involved.
I worked as a Secretary for a Visiting Nurse Assoc. I had a table set up where people came in for appts. On that table I had pamphlets from Office of Aging concerning the resources they had. All the ALs and LTC facilities. All the Care agencies in the area. The local durable equipment store. List of Flu shots being given free in the area. (This I got from the health dept.) This would be nice to have set up at the meeting for the residents families.
Good Luck in your endeavor.
We just need to create a file of complaints or incidents about a tenant to use as a basis for resiliation of the lease (in quebec, "eviction" means obliging the tenant to leave in order to demolish or divide up the unit).
So, documenting incidents of pots boiled dry, taps left on and flooding the downstairs neighbors, wandering and knocking on doors, hoarding and unsanitary premises, etc.
You might check out the Village Movement and its info clearinghouse, the Village to Village Network. (vtvnetwork dot org) It grew from an experience in Boston when a group of elderly neighbors in an apartment complex created a membership based, voluntary structure to facilitate their "aging in place." The movement has spread --- there are now several hundred "villages" in the U.S. --- and the Network publishes handbooks, protocols, etc., for establishing and operating villages. The village may be a building, a neighborhood, a city block, etc. Note: most or all assume that the members will pay dues to finance the costs of operation. I don't know anything except what I have read, but it sounds interesting.
In my case, it wouldn't work as most of the elderly in the building are subsidized by the government as they are deemed low income, so they couldn't pay dues as they just don't have the funds. But yeah, where there is private money, this sounds really interesting!
Take a look at this.
The NYC Department of Aging has some good materials on "NORCs"--Naturally Occuring Retirement Communities. I'll see what I can find.
I know that Penn South hired at least one Social Worker to coordinate getting older residents hooked up with municipal services--think meals on wheels, etc. But you are such a small building, I doubt you could bear the expense.
Making a list of those at risk is beneficial but I can't see what you can do about it beyond setting up a chain of volunteers to check on them. An IL often has contracts in place that force an eviction of residents who are becoming a danger to themselves and to the building as a whole, you don't have that option. You can't force residents to were alert pendents or to accept caregivers, you can't offer supervision of people who are too frail, deaf, blind, confused to function safely on their own. As far as I can see the best you could offer is contact information for your area agency on aging and I suppose you could contact adult protective services if you see anyone who is at risk.
Maybe we ought to take the position that ahmijoy above suggests which is that we continue to have no policies or protocols in place, and acknowledge no responsibility specifically over the welfare of seniors, so as to minimize exposure to lawsuits.
The truth is we are not equipped or trained to handle their growing needs, so maybe the best position to take is "dont ask, dont tell" and aside from calling 911 is necessary, let them assume responsibility for themselves. If something happens, so be it?
Each state regulates Assisted Living staffing requirements and standards the center should follow when setting up and running an AL.
You are somewhere between both.
I don’t understand exactly what you are asking, as you are a “volunteer”? Sounds like you live in a building with many Section 8 seniors and their health is being compromised as they are not in the proper setting to receive the care they need. And you are volunteering to fix it.
I admire your concern. Glad someone is looking out for the seniors where you live.
This link is the results of a Canadian study on Aging in place that might be of interest.
The book “Being Mortal” by Atul Gawande is a great resource for looking at the big picture.
Also google the ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living). These activities have to be addressed for each elder.
The Area Agency on Aging for your County offers many services. You could contact them for advice. Take a look at their website to see what they cover.
Also familiarize yourself with Adult Protection Services should you need to call on their services for those residents whose self neglect needs attention by someone with the authority to take action.
Perhaps you already have data for each resident that lists a “who to call should there be an emergency”.
If not, that’s probably something you would need to do for all 66 apartments.
It’s a big problem the four of you have. I think it’s important and I wish you luck.
But about taking responsibility for assessing needs and then providing for those.... yikes. I agree, that's something I don't think we should touch.