Episode Transcript
[00:00:00] Speaker A: So why does my loved one's assisted living facility keep getting sold and why can't they keep any nurses?
So. Well, if that's happening to y', all also, first off, you're not nuts, and it's probably not just your facility. This is happening all over the place right now, and a lot of families feel like they're the only ones seeing it.
[00:00:32] Speaker B: How you doing, Bear?
[00:00:33] Speaker A: I am doing better than I deserve, so, you know, I can't. You know, it's one of those days. Yeah.
[00:00:37] Speaker B: There ain't no need to complain about things.
[00:00:39] Speaker A: That's exactly right. Yeah, it's. It's all good.
Just kind of dealing with the winter a little bit and, you know, all the stuff that goes along with that. But it's all good. And we.
[00:00:49] Speaker B: I'm not sure where our listeners are, but for us, it's hot, cold, hot, cold, hot, cold.
[00:00:54] Speaker A: Yeah, it's nuts. Yesterday I was freezing. Today I have on shorts. You just never know. It's South Carolina for you.
[00:01:01] Speaker B: Yeah, it is.
[00:01:01] Speaker A: We had a fault spring there for a few days and then it got cold again. And then we'll have a beam. Fault spring came back again here soon. Nuts. So people don't. But that's why people tune in. They want to know about our weather in South Carolina.
[00:01:12] Speaker B: Yeah, of course. It's weather tech tips.
[00:01:15] Speaker A: Well, I think today we have got. We got assisted living facilities and nursing homes on the brain here, don't we? And we. I think we both have a lot to say about this. And so y' all buckle up. We're about to. We're about to give you our opinions.
[00:01:29] Speaker B: Yes.
[00:01:29] Speaker A: That's what you're here for. Right.
[00:01:31] Speaker B: As meaningful as they are, they are backed up with some AI research a little bit. And maybe some practical stuff, too.
[00:01:37] Speaker A: And some practical stuff. So I'm going to start it off, if you don't mind.
[00:01:40] Speaker B: No, Right.
[00:01:41] Speaker A: So here's. Here's the deal. I got this. I got this letter in the mail, actually, from my aunt who she got the letter and she likes to take photos of these letters and she texts them to me, my aunt's own assisted facility, living facility about. I don't know, about an hour away. And this place has. For the last year and a half, I think they have been sold twice, and they are always losing staff, especially nurses. So I dug into this a little bit and wanted to find out what's going on. So the way I'm framing it here is like, I got my own question here. So why does my loved one's assisted living facility keep getting sold and why can't they keep any nurses?
So, well, if that's happening to y' all also, first off, you're not nuts and it's probably not just your facility. This is happening all over the place right now and a lot of families feel like they're the only ones seeing it. Right. Well, I'm digging in a little bit and what I found is, is the big reason is ownership churn. A lot of assisted living facilities today aren't owned by local family anymore. It's owned by an investment group. And they buy a struggling building and they try to improve the numbers and then they sell it on to the next operator.
So what happens is, is families see the name change every year and they think something shady is going on. And sometimes it's not shady, it's just very, let's call it spreadsheet driven, I think is a good way to think about it. Well, so another thing that surprises people, and this was new to me too, is that the building and the operator are often two totally completely different companies. One company owns the real estate and another runs to care.
So the sign changes and management changes and policies change, but your loved one is still in the same room. It. It feels chaotic, honestly, because, well, you know, it's all kind of behind the scenes is what's going on.
So let's talk about, let's talk about the staffing piece because this is the part that really hurts. The reason that nurses don't stay usually isn't that they don't care.
Assisted living can just be a really tough environment.
You might have one nurse covering dozens of residents, heavy dementia needs, you got constant family expectations and really not a lot of backup. Then they realize that they can make more money in a hospital or a clinic and they just bounce. I mean, I can't blame them, honestly.
So, and here's the part that a lot of families don't realize.
Most of the hands on care isn't even given by nurses. It's given by aides and it's given by med techs. And those are hard factors, physical, emotional jobs, and they really don't pay that much.
So when those roles churn, the nurses burn out faster and the whole place starts feeling like a revolving door. And once a building falls into that cycle, it's really hard to stabilize.
And one thing I wish more families understood is that the assisted living industry isn't regulated like a nursing home. It's more. There's a lot more variability. Some places are fantastic, some are Barely holding it together, and two buildings that look identical on a tour. They can be completely different under the hood.
So the question I always come back to is, is it really. Is ownership changing? It's. Is the day to day care stable? Are the residents clean? Do staff know people's names? Is there someone constant, consistently and constantly in charge on the floor?
Because sometimes the corporate musical chairs, they're annoying, but the care is still solid. But in other times, the instability leaks into real life, and that that's when families need to lead in and have talk whenever they can.
So, honestly, a lot of this is probably still an aftershock from COVID When things got really weird, the workforce got hammered. A lot of caregivers never came back. Costs went up, margins got thin, and some facilities, they're just operating in survival mode. And that doesn't make it okay, but it explains why so many families are seeing the same patterns at the same time.
So I guess what it comes down to is if you're going through this with a parent or in my case, an aunt or whoever, just know you're not alone with all this. This is one of those things nobody really warns you about when you step into caregiving in the whole assisted living, nursing home world, that the system itself can kind of feel unstable.
[00:06:01] Speaker B: Yeah. And it's really hard to fathom, especially when you're focused on your loved one and you're not seeing the big picture. I think what's good about what you're saying is getting to understand that this industry is not directing this attitude or these actions at you personally.
They're actually suffering a pretty commonly felt set of circumstances across our nation into the U.S. maybe across other places, too, but certainly in the U.S. so you have to approach it from that.
[00:06:31] Speaker A: Yeah.
[00:06:32] Speaker B: And I think ultimately not get caught up in the idea that they're doing it to you. They're probably doing it because their industry is in a similar situation.
[00:06:40] Speaker A: Yeah, that's for sure. And I think the key is, you know, keep your eyes on the lived experience of the person that you have there. Make sure that they're okay and not just the logo on the building. So, you know, sometimes it's okay if they get sold, or maybe the next company is going to be better than one. But keep an eye on things. And if things are. If people are relatively happy, then that's maybe okay, but if they're not, then it's time to start asking some questions and maybe some uncomfortable ones, but that's worth doing.
[00:07:04] Speaker B: So as we were talking about this earlier, I decided, thought maybe a good idea would be to come up with what are the good core principles that a common center, a good quality center share.
And I went and looked into some articles, did a little AI and I realized that they were all talking about the same five or six core principles really. And I wanted to kind of put them out just as, as an idea. If you're looking for a nursing facility for your loved one, if you're looking to move your person to another place, maybe you can use these as guideposts to identify where the quality is. And that's not to say it will capture every use case, but I think what it felt like to me and when I had the conversation with you earlier, those kinds of principles were in our heads anyway and I think it's good to bring them out. So you know, this kind of stuff can be really overwhelming to people, especially if you've never done it before. Again, no one tells you that this is going to thing that you're going to end up doing for your loved one.
It just sort of happens.
But you can rely on a couple of things that I think are really centering and help you get it. So it made some, some resources, made a quick chart and I just want to run through this a little quickly and I'm not going to go through everything on it, but I think there's some highlights on it that really make a lot of sense. So first of all I came up with really three things that are everywhere now. This, the sender, the, the idea of a person centered care that good ones are, are paying attention to your loved one as the center focus of their attention. Right. They're, they're, they're not, they're not talking to you about corporate works, they're not talking to you about facilities so much. They're talking about taking care of your loved one and leading with that. There is a mention of ethics and dignity and care that's mentioned in many places when you were talking about that, that if that doesn't come up very quickly then something will amiss and then they have a mission and value statement that's guiding them for the community you're in. And they, they proudly post it. You know, their employees know it. And so I think that's, those are really three common ones but then there's some other ones that kind of go in and out and there's always talks about dignity and independence and choice, goal driven kinds of care where they're trying to get your loved one to a point where you want them to Be in my particular case with my mother in rehab, there's a goal set toward that. And so you want to identify people that recognize that your loved one is on a journey to get to a certain place.
And that might be comfort if they're in the later stages of their life, that might be giving them the choice of what they eat, if they, that's what their power center is, where their love language is. And so you got to think about that kind of thing. So just a couple of things on that Person centered care. Just what I mean by that is individual care plans, tailored support, honoring preferences, making sure routines and cultures are there. They ask you when your loved one's favorite shows are on, promoting independence and autonomy.
And that ensures your loved one doesn't receive this one fits all kinds of care, that they're going to tailor their care toward that person, toward your loved one. And I think when you hear that and see what most of them have social directors who are asking you questions and asking your loved one questions about what they want.
The other thing that I think, and it goes back to ethics and dignity, is respect, privacy, fairness, professional conduct, always asking before they touch people. You know, often they frame that as a time and accountability. But it builds trust. It lets caregivers know that their loved one will be respected. You need to look for signs for that. If they come in to take a loved one to go to the bathroom, first of all, it's not that long to do it. And second of all, when they do it, they do it with care and dignity. Realizing that this is not the best comfort situation for your loved one. If they need assistance in that way, clear set of goals should be listed somewhere. You shouldn't have to ask for it. It should be plainly said and really be part of their culture. The way they address you, the way they address your loved one. And it really evaluates what their ability to look at a loved one is. So if you want to be, if you want something that's born family centric, they you ought to be able to identify that it shouldn't be a question in your mind. And so there's some other ones on here too, like for independence and safety and social engagement, which I think is a big one for a lot of people who loved ones who are lonely, that they be involved in activities. So you want to make sure that, that the needs of your loved one get addressed in somewhere.
And then one that I'll just say once you've selected a place you want to go, your presence is necessary in that arrangement. You have to show up, you have to show them, show that facility that you care, that you're going to be there, that you're going to advocate for your loved one.
And it doesn't mean you always show up at the same time at the same day. Sometimes you need to vary it so they understand that this is somebody who has a loved one who cares.
That's necessary for the, for the whole psyche. Not just. I mean, you can get good care of facilities, but sometimes people get in a rut and they. If they think someone's not being attended to, the tendency in their mind is to not be as attentive.
You need to break that tendency.
[00:12:28] Speaker A: They don't get as high priority as to someone that they know is going to be there.
[00:12:32] Speaker B: And I don't think there's anything personal and directed to it. But if they know you're coming every other day, they know you've got an advocate who's going to be around.
They just know they can't do certain things. And so supervisors pay more attention, nurses pay more attention, aides more. Pay more attention. You know, I try to identify people by name. I try to know people who are. When I walk in, I go, I know your name. And I think it matters. So. So I do that naturally. And Barry probably knows I. I do that naturally. I do that with the waitress that comes in and serves us breakfast in the morning. I mean, so. But. But you turn it on because I think that's a necessary part of what you do. That's part of your advocacy duty.
[00:13:08] Speaker A: And two, you know, along those lines, we, We're. I know we were talking about some of this earlier, before the show, that we.
I'm reminded that, you know, we have some friends at the show who have folks in. Or a loved one in, in an assisted living, actually, in a nursing home facility. And there's a lot of. There's a balance I think you got to strike there, there. You want to show up and you want to be there, but you also have to caution yourself about feeling like you need to be there 100% of the time every day and that kind of thing. So that's. So that's a hard balance. And I know, I know you've run into some ways to kind of mitigate that and, you know, talk about that a little bit.
[00:13:47] Speaker B: Well, I mentioned some of them already by making. Identifying allies in the, in the facility and endearing trust.
I'm not doing it because, you know, I naturally ask people their names. I want to know who they were.
My mom is in a situation where some of the people in the facility she's with, she's actually taught, you know, and so finding those identifiable things, what they have in common. There's one lady who's a social person at their mom's facility. They're in the same sorority, so she went to the same college. You want to look for that and try to identify that in some way. And it's easier than you think when you try and you get used to it. It's about how you, how you bring people together with common interest.
Even if you're the one that's identifying the common interest and going to the emcee, you have something in common. And I do that with my mom and with some of the aides and I think it helps. Yeah, that's a little skilled to do, but it's certainly what I try to do.
And then the other thing is employ people in your community. Some of us, I hope most of us have allies in the community who will visit, who will come by, who will talk to you about what they saw and what they see. You know, make sure you have a conversation with doctors and charge nurses about quality of care. Again, back to the point we made, I think some time ago. Make sure that you have the proper access to be the right advocate for your loved one. So if you have power of attorney or medical power of attorney, you need to go ahead and take the pair of the proper work to do that so that they realize that you're someone that they can share things with.
And you know, there are probably other things we could do too. Maybe I'll throw some notes in there on some techniques for that too. But it's about building trust. Yeah, you and I built up on the same thing.
We find out who we're talking to, we relate ourselves to them. And you have to do that with that staff too to help you and your loved one get the best care.
[00:15:44] Speaker A: When you talk about staff too, I know in my mother in law's facility there, there's some of the residents there who don't have a lot of family who, or have family, but they're a long distance away. And those folks are in the position where they can, can also employ some other, like external caregivers, like comfort keepers.
In their case, there's a comfort keeper lady who comes by, I think it's like about every other day, and she comes in, she checks on her and she, you know, takes her. She needs to go to a doctor's appointment or she needs to go out to to Walmart or something along those lines. This person's there, but that's another line of. I call it a line of defense, but it's really, it's a, it's another, another factor in that the resident, resident staff will pay attention. But it's not just a family member there, but there is another person from the, from the outside who's going to be there and show up on a regular basis. And, and I think that's, that's, that, that's a good position to be in if you can afford that, and very helpful in getting better care.
[00:16:50] Speaker B: Sometimes it's not that expensive, depending on what you do. I mean, I mean, I've seen anywhere from 10 to $25 an hour for some of those kinds of services. And, you know, you don't have to have a lot of time doing that in special cases. For you and I, we are doing specific things to our loved ones and it may not apply to most people, but you're just talking about somebody come by and say hello and speak to them and make sure that things are o.
That's probably worth your time and your money.
[00:17:15] Speaker A: Yeah, for sure. For sure.
Well, I think that's all good advice and there's a lot, a lot to think about. And I know folks are in these situations and have questions and have, have, have worries and hopefully we can kind of help allay some of that.
And always, as always, we'd love it if you could reach out to us at caretech and tipsmail.com send us questions or let us, let us know you're connecting with us. Especially even if you're listening to this on YouTube, please leave us a comment. Let us comment.
[00:17:45] Speaker B: Like and subscribe.
[00:17:46] Speaker A: Like. Yeah, definitely like and subscribe. Tell us if we've got anything wrong here, you want to, or if there's anything that you want to hear about, we would love to hear from you.
We still got a few new people popping in here and there around the world. We've had some, some new German listeners, I think, and we've had a lot of Hong Kong and Singapore here of late.
That's been nice to see. And I'm seeing some new cities in the US Pop up here and there. So it's always neat to go back and look at the analytics and see where people are coming from and listening in.
So I think that's about all I have for today. What about you?
[00:18:23] Speaker B: Yeah, I think so. I mean, not so many tech tips today, but I think we kind of loaded up on the last episode on some of that stuff, but I think it's really important to have some of this conversation to get people in the right frame of mind, especially when you're making choices, whether you're bringing somebody to a new place that you're transferring. So these are. These are good things to understand, and it'll help you understand what you're seeing sometimes.
So, yeah, I think this is probably great.
[00:18:46] Speaker A: Good deal. 100%. All right, everybody. We will see you next time on Caretaker Tips. Take care. All right.
[00:18:52] Speaker B: Bye, everybody.
[00:18:53] Speaker A: Bye, everybody.
