Connecticut's Elder Care Reckoning

Submitted by ctmirror t3_124wihx in Connecticut

We at CT Mirror have published the first two parts of a four-part series on the state of elder care in Connecticut, titled "Connecticut's Elder Care Reckoning."

The series looks into nursing homes, where resident complaints are on the rise as facilities face staff shortages and shifting finances. It also dives deeply into issues with programs designed to keep residents in their homes and communities.

The first story can be found here: https://ctmirror.org/2023/03/19/ct-nursing-home-care-seniors-a-aarp-medicaid-1199-seiu/

The second story can be found here: https://ctmirror.org/2023/03/26/ct-nursing-homes-long-term-care/

Two more are coming later this week! If anyone has had issues dealing with the state's elder care system, we're all ears — comment or message me directly, and I'll pass your messages along to our reporters.

~Gabby

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mynameisnotshamus t1_je176c9 wrote

Very important work, thank you. My parents are in their 80’s and still doing ok enough to live in their home but many of their friends have had experience in. It’s short and long term facilities. I think every one has some bad story. Most recently, someone who wasn’t bathed for over a week.

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Hionhelium87 t1_je17r9j wrote

My grandmother with dementia is on her 3rd memory care facility. The last one threatened to kick her out because she was displaying aggressiveness which is a very common sign of….you guessed it…dementia. We moved her out anyway because she kept getting frequent UTIs due to lack of care/cleanliness. They rarely bathed her. It’s sickening.

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mynameisnotshamus t1_je18myi wrote

That’s awful. Frequent UTIs are unfortunately very common in my limited experience. There is a lot of money in elder care, but it seems to all go to administration/ executives rather than the staff. They are very over worked and under paid. Not to give excuses- no person (or animal) should ever be treated these ways, but it seems very much a too down issue.

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Hionhelium87 t1_je19cub wrote

Oh I agree 100%. The actual staff need to be paid more and there needs to be more of them. This specific place I know cuts hours of their workers even though they don’t need to. This causes gaps in coverage - overnight especially. Since we know that’s on purpose it somehow makes it more underhanded and evil - both for their staff and for the patients. The woman that ran the memory care unit at our place 100% should not be allowed to be in charge of anyone let alone folks with memory issues.

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buried_lede t1_je3spfq wrote

Even the best facilities have issues. And they are cost cutting. One place eliminated their entire medical staff and contracted out to a practice in CT that does gobs of nursing homes here. So the doctors and APRNs actually work for this practice. The educational credentials of the personnel don’t compare at all with prior staff

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Xyldarran t1_je2yo79 wrote

It's not just a CT problem. Hell it's not even a US problem. Most of the developed world is having a demographics crisis.

Good thing we make it oh so easy to have kids /s

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RededHaid t1_je1pq7p wrote

I'd like to hear about assisted living and memory care facilities as well as nursing homes.

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ctmirror OP t1_je1u27p wrote

Good to know! I'll pass your message along to our reporting staff.

~Gabby

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buried_lede t1_je3c1pt wrote

I also have experience with self-paid live in home care and just want to leave one important piece of info for people:

There is a big difference between a home health agency licensed by the health dept and a “homemaker companion” agency that is licensed by the consumer dept. Know the difference and supervise, don’t be supervised, by the latter. Also, don’t let them work beyond their license, which they can easily slide into, and don’t think the quality of care will remain fine if you don’t stay involved.

Edit: oh, another thing, for those families that can stay on top of it who hire in home aids to do non medical care such as meals, bathing etc, you can hire aids directly instead of going to an agency.

You must pay them as employees, not 1099 but lucky for us, payroll companies now cater to home help. ADP, for example, has a relatively affordable payroll service for families who hire home help and take care of the taxes, etc.and cut the checks. Others like Paychex, might too, not sure

I mention this because agencies get paid a lot but the workers get paid very little. If you have the ability to be hands on and get recommendations for experienced aids, you can hire one directly, pay them a truly livable wage and still save money over an agency.

In my experience, lots of aids are pretty honest and caring while some agency reps might not be and can be a pain

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DeepIntoTheInternet t1_je4t4l3 wrote

Interesting. How much does ADP charge? Any link or info you could provide?

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buried_lede t1_je61rl7 wrote

If I recall correctly it was maybe $60 a payroll, so if you pay twice a month, $120 a month. It might have been cheaper. And ADP is the granddaddy of payroll services in the country so competitors might be cheaper. I did all the research for my family which was using an agency but we didn’t switch because at that point siblings didn’t want to.

https://www.adp.com/resources/articles-and-insights/articles/n/nanny-payroll-services.aspx

They call it “nanny payroll services,” but explain that it’s for household employees.

When I went to find this link by googling, I saw that there are a lot more companies doing it now. One key element you want is for the service to handle all the irs end of year forms and accept liability for errors

Another thing to plan for when you oversee this yourself is to line up substitute caregivers when yours takes vacations or calls in sick. That takes a little work and there was an agency that was willing to provide short term like that. You just have to call around. I can’t remember the agency and there are so many, and they change a lot.

I really wanted to make the switch myself but it was a family decision

Edit:

Just some additional thoughts. “Homemaker Companion agency,” a term that is defined in statute and are companies overseen by the Consumer Dept, not the health dept, add a huge amount of overhead cost. So, for example, my family member required really major assistance because he was partially paralyzed. The agency charged over $90k a year. And almost anyone can open a homemaker agency- no credentials.

Our caregivers were paid garbage. The mark up had to be roughly 60-percent at least.

We could have given a caregiver a massive raise and still cut tens of thousands off the yearly cost of care even with the cost of a payroll service to cover payroll. To me it was a no brainer, especially if a family member is close by and can take care of managing it.

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BluenotesBb t1_je24ohm wrote

Gabby, thank you for putting this out there , elder care was a mess 20 yrs ago when I was a recreational therapist for a LTC facility, and I'm facing placing my dad in short term rehab this week, and it scares me. I am going back and forth from Yale New Haven and let me tell you, the care THERE is bordering horrendous.

The hospital is filthy, the 3 ppl in his room are not getting the care they deserve, in fact, it's bordering neglect and that's at Yale. No washing up, barely any pain control, they will not help him eat despite the broken arm, call bells are placed where he can't reach it, urine placed next to his food, same dirty foot print on the floor for 3 days ....I really could go on.

I expect less from the rehab and that's terrifying.

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buried_lede t1_je3tkju wrote

Yale’s patient relations Dept has gone way down hill too. It’s nothing more than bare risk management at this point.

Also, some of the floors seem to be big on cycling through new, recently graduated nurses with few more mid career or senior nurses floating around and that just doesn’t work, they aren’t up for it when they are that thin on mentors present for at least most of the time. Other depts though this is not the case. I don’t know how they prioritize it

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murphymc t1_je4im8h wrote

There's a certain amount of "blood from a stone" going on with nurses that people don't seem to realize.

There weren't enough of us in 2019, and a huge chunk of us either left the profession or fucking died in the past 3 years and combined with the normal attrition rate now there's nowhere near enough of us, and you can't just train up a new nurse in a couple months, and a competent one takes years.

This is going to get worse before it gets better.

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PacoLin246 t1_je2bv0z wrote

What’s the difference in quality/care that you found at for-profit facilities vs non-profit facilities?

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Bone_Dice_in_Aspic t1_je3lt7l wrote

I can't speak generally, but in my case, I worked at a facility that was profit, then went nonprofit for a few years, then switched back. Nothing changed during that time; it was explained to us as a tax status thing, and we were explicitly told nothing would be changing.

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2SLGBTQIA t1_je17ak9 wrote

Hi Gabby, I've been reading alot about the global population crisis. How does this uniquely impact Connecticut differently and are there any possible solutions to this growing problem?

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W00DERS0N t1_je2g7se wrote

There is no population crisis.

As standards of living rise, birth rates decline.

Happening right now in lots of places around the globe.

People have been worried about this for 300 years.

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ctmirror OP t1_je1twh6 wrote

Hi! Would you mind defining "global population crisis?" I've seen reporting about overpopulation, but also stories of communities where populations are aging rapidly without enough young people to sustain them.

~Gabby

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mynameisnotshamus t1_je1y7j3 wrote

Calling it a crisis is a bit extreme. It’s definitely a big problem in places like China, but we’ll be OK. Adjustments definitely will need to be made in elderly care though.

The US population is not growing. The elderly demographic is therefore increasing. This tends to happen when there are major health or negative economic events. It’s predicted in about 10 years that the 65+ population will out number the under 18 population. With better health care, people are living longer. That doesn’t mean they are able to take care of themselves though.

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DaveTwoOh t1_je30l4u wrote

My mother was at the memory care unit at The Village in South Windsor. Absolutely, TERRIBLE facility.

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buried_lede t1_je3b5yr wrote

I know someone who tried to take advantage of the home care program and should qualify but the process was endless, application submitted in August, zero action past an interview with him. Tried to resuscitate it in something like December or January. They say oh yes yes, we’re going to help you Two months goes by then a call asking him to submit a whole new application.

Sometimes I think it’s a fake program, like the fake state money set aside to reward essential workers that nobody seemed to get, or the applications for assistance with rent or bills if you were affected by Covid that were never given case numbers and received no response.

I’d understand this kind of performance if we were a poor state like Mississippi and overwhelmed, but we have very well paid state workers with pension and health care benefits that dwarf the benefits of federal employees, albeit, with a good deal of nepotism in the ranks with a straight line to the legislature and governor. We are one of the highest taxed states in the country. I would like benefits to the poor expedited and not bogged down and wasted by inefficient state agencies.

My friend gave up on his home care application for now. He needed the help yesterday and is scrimping along hiring help here and there but the state exhausted his energies and equanimity. He can’t take it anymore, even rejecting help from his friends. Life is short and he doesn’t want it dominated by their dysfunction and mediocrity.

Unfortunately, he would not be interested in talking about it so that’s not much help for ct mirror.

Edit: I just want to add that if the state is leaning towards aging in place ( and I support that) it really has to get it together. The guy I described above is on Medicare and Medicaid and CT Medicaid a while back decided to support care at home. But when someone gets home from rehab in August and still has no ongoing services in January, that’s not a program ready for an influx of new people.

To be clear, he had the medically prescribed home health nurse visits after rehab ( they failed to make the Medicare deadline but they did check in by the third day); the months long delay was for other home supports that are part of this program that Medicaid is supporting now. I don’t have a list of the tasks they do, I am afraid. I had a basic outline. I think it was typical of what a CNA provides and also what is referred to in statute as a “homemaker companion” so they could clean the apartment, make meals etc.

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Bone_Dice_in_Aspic t1_je3m24k wrote

I got my essential worker money.

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buried_lede t1_je3qdtj wrote

Glad to hear that. People were posting that they were hearing nothing

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Bone_Dice_in_Aspic t1_je3rbua wrote

Maybe some are getting stiffed, my wife and I both got ours though. Could be based on how soon you applied

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BluenotesBb t1_je5whaj wrote

Here is something else to piss you off:

   The state is holding back billions of promised money to these programs....

Expect a very large strike in April/May.

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handsonabirdbody t1_je5r03b wrote

Thanks for posting these, definitely on my list to read today. I’ve worked in a nursing home for over three years and did a few years of non medical home care before that so I’ve seen different sides of the same issues. Nice to see more attention being brought to this.

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Acousticks t1_je4hku0 wrote

7 grand a month for assisted living

20 grand a month for full time 24 hour care.

So fucked up.

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buried_lede t1_je6amic wrote

$20k a month? Three years ago we were paying $10-12k a month. Wait, less than that, we were paying under $10k

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buried_lede t1_je6e67t wrote

I like Painter’s idea in the second story that we have smaller, home-like facilities.

Also in the second story, I caught the part about private equity ownership, which could use a major story all by itself. I think CT should go out if it’s way to put in disincentives for private equity - how it does that while maintaining enough facilities, I don’t know, but PE is the worst. It will be a nightmare.

“The influx of private equity money into the nursing home field has caught the attention of legislators who are proposing a transparency bill, seeking to make providers reveal quarterly where state funds they receive are going.”

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Fadingmist-1554 t1_je72hk9 wrote

I am a home care aid at a local agency. My duties include lifting and washing clients twice my size, feeding and changing soiled clothes, and emptying urine and colostomy bags. Some of my clients have advanced conditions such as movement disorders and Alzheimer’s disease and need constant supervision. I get paid $15 per hour, no benefits or paid time off. I love my job and my clients but the pay is ridiculously low for the experience and skills I bring to the job

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