Having spent the past week moving my home and business, I’ve finally had an opportunity to sit down and watch the PBS documentary entitled “Life & Death in Assisted Living.” The stories are horrifying and heartbreaking to hear, but unfortunately, not at all surprising to me. The corporation being investigated could have been just about any one of the larger assisted living corporations in the U.S. today because the problems of understaffing and lack of training in dementia care is ubiquitous. These large corporations are always more concerned about the bottom line than they are about the residents and the caregivers who work for them. Executives have layer upon layer of administration to cushion and shield them from the realities of what is really going on in their company. It will always take something tragic (for families and residents) and expensive (to the company) to bring about a positive change in the corporation. The reality is that a documentary such as this will serve as a warning to families to be ever more vigilant about advocating for their loved ones in facilities, but it will always take many large, successful lawsuits and regulation changes to decrease the tragedies happening every, single day nationwide.
I have worked in facilities as a nurse and in management, and I know just how much those front-line caregivers need increasing and ongoing dementia training. As a dementia trainer and consultant, I know of the positive impact of dementia training for staff, for residents, for families and for the facility’s bottom line. Studies in these areas bear this out as well. One of the keys to success for any dementia training is that management also receive the training and continually reinforces it. Every worker in the facility should receive the training, and it must be on-going. Would that closet containing the dishwasher soap have been left unlocked if all staff there had received dementia training? Would the floor have been left unattended if management had been on top of what went on during those night hours with staff? It always comes back to management and how they do or do not care about the safety and well-being of the workers and the residents. If Emeritus truly cared, they would not be telling administration to cut labor. Dementia patients must have more eyes and ears on them at all times. Their very lives are in the hands of those caregivers who tend to them daily. If I’m a kind and conscientious aide caring for elders with dementia, but I’ve only received the minimum (standard) 8 hours of dementia training, then it will only be a matter of time before I burn out under the stress of not being able to interact appropriately with those elders. I, or they, will be injured during my care because I’ve not been taught how to prevent escalating agitation, or recognize an illness or injury. So, I will leave and the next warm body off the street will be hired in my place. If management truly cared about the workers and the residents, they would see that I receive ongoing and intensive dementia training. Once I see what a positive difference I am making in the lives of these elders, I’m a much more effective and happy worker, and the elders lives’ are enriched as well. The facility’s bottom line improves because they’re saving thousands of dollars on staff turnover, and the elders are being better care for. That’s a very simplified version of what should go on within these corporations.
These complex issues must be addressed by oversight and accountability by these corporations, and by public outcry against the status quo. It won’t be too many years before we baby boomers are in those facilities, and a significant number of us will have dementia. This is our future, so we had best begin to design it for our safety and comfort.

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