by Jane Gross
A Bittersweet Season: Caring for Our Parents and Ourselves
By: Jane Gross
This is not an old book, but it is not as recent as most of the books we review on this site. I reread it recently and wanted to recommend it as a well written, incredible resource for those caring for loved ones, particularly loved ones considering or already in an assisted living facility.Ms. Gross’ chapter entitled The Myth of Assisted Living is a clarion confirmation of the fact that the consuming public needs just what 4OurElders offers—help finding the safest, more caring and service oriented home out there for your loved one-- precisely because assisted living is the most dangerous category of long term care housing options out there. “Buyer beware!”
The title of the chapter he Myth of Assisted Living comes from Ms. Gross’ mother’s doctor, Dr. Woodson, who had written in a guidebook that she considered “assisted living to be a ‘myth,’ ‘a place for people who do not exist.’ Dr. Woodson explained to Ms. Gross that “[r]esidents are supposedly people who ‘just need a little help.’” Dr Woodson, Ms. Gross relates, considers that catchphrase to be an absurdity. ‘“If they needed just a little help, they would be living in the community.’” “But families are told that Mom or Dad will be looked after, so the grown children can ‘focus on jobs and families,’ which is exactly what they want to hear. Their parents will be fine, and their own lives will be uninterrupted.” Then, before you know it…it can all go wrong!!!
Ms Gross goes on as follows: “This yawning gap between expectation and reality is what makes assisted living problematic for so many families. Even the term is meaningless, since each state defines it differently and providers vary greatly within states…. [A]t its core, assisted living is a social, rather than a medical, model of long-term care. Your parent is a tenant, not a patient. Ms Gross specifically lists what assisted living is NOT:
1) “It is NOT ‘a nursing home with fancy furniture,’ says the respected Gilbert Guide to long-term care, which urges the ‘hidden consumers’—adult children (mostly female the demographics overwhelming bear out) to consider whether ‘nursing care or constant supervision’ will likely be needed in the ‘near’ future,’ because ‘moving an elder twice in a short time can be very hard on both of you.’”
2) “It is ‘neither fish nor fowl, the grayest of options,’ since…’most assisted living facilities do not view themselves as health care providers and respond to medical problems by sending the resident to the emergency room’, often with the gravest of consequences. (see It Shouldn’t Be This Way; The Failure of Long-Term Care, by Dr. Robert L. Kane and Joan C. West).
3) “It is NOT designed to deal with the realities of aging.”
She goes on to observe that “assisted living facilities ARE by and large part of large for-profit corporations, with mighty propaganda machines that hit quilt-ridden, frightened, and thus fuzzy-headed adult children who would do just about anything to avoid putting their parent in a nursing home… with the hard sell.”
Perhaps most insidiously with assisted living, there is the money. Assisted living facilities are 1) (unlike nursing homes) not covered by Medicaid (Ms. Gross’ chapter on Medicaid and Medicare, entitled Follow the Money, is quite instructive and should be must reading for all considering long-term care housing options), 2) often excluded from long term care insurance policies, either by law or more often by unilateral fiat from insurance carriers whose first (and often continuing) response is to ALWAYS say NO, and 3) usually require additional expense of some sort of ancillary care or service providers to supplement all that an assisted living facility does NOT provide as part of even its “premium” package.
Please check this book out if you are considering long term care housing. Check out our website for advice on questions to ask and what to look for and please give us a call if you need help working through “the grayest of options”—assisted living. We can give you the peace of mind that comes with making the best decision possible for yourself and your loved one.