GET THE RIGHT AMOUNT OF CARE

If you know someone who has had a surgery, you may know that when they first heard that they needed the procedure, they were bummed out. Chances are they got a second opinion in case another source gave them hope that there was an alternative. Similarly, anyone should get a second opinion before choosing a senior care provider.  Here’s why:

Senior care is very expensive. You should not rely on the providers to tell you what you or your loved one needs. Their opinions can be biased. That’s because providers typically generate more profit by providing higher levels of care. Before you choose a care provider, we recommend that you seek an unbiased opinion from a senior advisor, the benefits of which are more than just saving money.

While care providers typically administer an assessment, it can be incomplete. For instance, an incomplete assessment is likely to happen when someone who would qualify to live in an independent living community, applies to live in an assisted living community—a more expensive care setting. The nurse at the assisted living community will qualify the senior to live in assisted living; however, the nurse will avoid opining on whether the senior qualifies for independent living as well.

You never want to pay for more help than you need. The reason is that you will be over paying for care, and the person entering into care can prematurely lose their autonomy. If you take one thing away from this post, take this: it is extremely important to preserve a senior’s autonomy.

Karen Wilson, an original builder of assisted living communities, was inspired by her mother, because her mom wanted more independence than what she had in a nursing home. When Karen approached investors, they were skeptical of the assisted living concept, because they thought there was a tradeoff between health and freedom (i.e. more freedom meant worse health outcomes). Fortunately, she received funding and constructed an assisted living community in Portland, Oregon.

The community that Karen built supported impoverished elderly people on government support. When the community began to admit residents, she tracked their health, cognitive capabilities, physical function, and life satisfaction. Her findings revealed that the residents didn’t trade their health for freedom. In fact, their life-satisfaction increased, physical and cognitive function improved, and incidence of major depression fell. The program was a success from the cost side too: costs for those on government support were 20% lower than what they would have been at a nursing home. Karen believed that the assisted living community restored a portion of the residents’ independence, which boosted their quality of life and then drove positive health outcomes.

Granted, sometimes nursing homes are necessary. While nursing homes are for people who need a high level of care, the best ones creatively find ways to give seniors purpose. When Bill Thomas became the medical director at Chase Memorial Nursing Home, he enhanced the purpose of the residents when he purchased one hundred birds, four dogs, two cats, a flock of hens, a colony of rabbits, and hundreds of plants. Some of the residents got birds, some got plants, and some got both. Bill said that people who had been completely withdrawn and non-ambulatory started walking the dogs, and others, who he thought couldn’t speak, started to talk again.

Researchers studied the effects of Bill’s program over two years, comparing a variety of measures of Chase’s residents with those of residents at a nearby nursing home. Prescriptions-required-per-resident fell to half that of the nearby nursing home, total drug costs fell to just 30 percent of the comparison facility, and deaths fell by 15 percent. The study couldn’t say why, but to Bill it was obvious that the difference in death rates could be traced to the fundamental, human need for a reason to live. In this case it was caring for a plant or an animal.

The key take away from Karen’s story is that independence can actually improve health outcomes and quality of life. Bill’s story demonstrates that when given responsibility, seniors’ will-to-live increased. When someone is overqualified for a level of care, but he or she is given that level of care anyway, his or her autonomy can be prematurely stripped—the assistant performs more of the senior’s daily tasks than needed, which can have undermining effects on the senior. This may result in an expedited decline of the senior’s health, because the caregiver has just taken away something fundamental to that person, a sense of purpose.

Rather than asking a care provider if a person qualifies for a level of care, ask a senior advisor. A senior advisor will give you unbiased advice that could preserve a person’s quality of life and lower the bill.

This post was inspired by “Being Mortal” by Atul Gawande. His book is a must read if you find this topic interesting. The stories herein are from his book. 

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