Tag Archives: elder care services

The State of Care: Dementia Care Facilities Across State Lines

Members of modern families are often separated by geography. When a parent’s dementia reaches the crisis point, choosing a residential facility can be very hard. It takes cooperation and research to find a site that offers quality care and shared geographic access.


My friend Rob and his siblings have moved their mother three times. Though the moves were necessary to ensure her care and safety, his mom resisted change. The first stop was an assisted living facility in Florida , her long-time state of residence. Her children were spread across the U.S., but she wanted to stay in Florida so they found a site where staff members monitored her safety and well-being on a daily basis. As her condition declined, it become harder for her children to oversee her care from a distance. Rob’s mom then moved to a second Florida facility with more supportive services. When her dementia advanced further, Rob finally moved her to Pennsylvania. After three moves, his family learned a lot about choosing facilities.

When deciding between providers, Rob’s family reviewed incident reports from each facility under consideration. Sites with many incidents may have serious problems with the delivery of care. Anyone can check the incident records of individual nursing homes by going to the Member of the Family website. Once there, you can click on your state, and compare the number of serious incidents reported at each facility. You can also determine whether a facility has been place on the National Watch list. Homes on the National Watch List have had recent survey violations or substantiated complaints of actual harm or immediate jeopardy to residents in their care.

Ultimately, Rob’s family selected a care facility that was close to Rob’s house. This proximity allows him to check on her every day. His siblings fly in periodically to do the same. The site had some violations but Rob felt they were due to the building’s large size. Residents are spread over 24 floors with various levels of care. He believed that choosing a nursing home near his house would allow him to make more visits to monitor his mom’s care. When I asked him whether he saw much variation in quality at her three care providers, Rob said, “There are problems in all these institutions. But being present as an advocate makes a huge difference.” He thinks his mom is getting better care in Pennsylvania, but that is “only because I’m such an active participant in her care.” In his experience, administrators appreciate family involvement as long as issues are presented in a calm, professional way. If he must discuss problems with them, he writes everything down and gives his letter to an administrator to make a record of the matter. He also reminded me that many people go in and out of a dementia patient’s room and families should never leave valuables there. His family learned this lesson the hard way when his father’s wedding band disappeared from his mom’s room.

Rob also suggests that families consider the type of care a loved one will need in the long run. At his mother’s current facility, she has to run out of money and qualify for Medicaid before she can be placed in a skilled nursing unit. Because there is a wait list for those Medicaid beds, she will get progressive care until a bed becomes available. If your loved one moves to an assisted living facility that has no skilled nursing, later on it may be tough to secure a bed at another site. All things considered, if you are considering a move for your loved one, planning ahead ought to come first.

Protecting Public Funding for Services to Elders — an Interview with Charles Getz

In some towns, caregivers can ease the financial burden of dementia care by getting aid from public programs for the elderly. But funding varies widely by county and state. That’s often because certain elected officials champion the interests of the elderly. In Carbon County PA, where I live, elders were helped for many years by Charles Getz, a county commissioner who just retired from public office. I talked with Mr. Getz to learn how and why he supported elder programs.

Although Mr. Getz owns several private businesses — including a horse farm and a bus company — he spent much of his life in public service. In 1977 he won his first election as a local township supervisor. He was later elected to office as a county commissioner. Though he won his final election in November 2011, he chose to retire before serving his term. Mr. Getz felt that the mood during his final campaign season was nasty and divisive, so he opted to retire before a negative political environment could disrupt the quality of his family life.

Mr. Getz became a champion of services for seniors partly because he had been raised to respect the elderly. He attended a one-room school house for his first years of elementary education and spent a lot of time with older people who shared knowledge he came to value. Mr. Getz was also deeply affected by the experience of looking after his own mother who suffered from Alzheimer’s Disease. With the help of his wife and short weekly visits from a nursing aide, they cared for his mother at their home until the end of her life at age 86. Getz was also distressed by the economic plight of elders in his district. When seniors submitted applications to enter Weatherwood, a county-funded home for the aged, they were required to declare their annual earnings. Mr. Getz was shocked at the tiny income on which many elders survived.

During the annual county budgeting process, Mr. Getz’ advocacy for elder care funding was aided by the director of the county’s Agency on Aging. She was zealous in her efforts to educate officials about the need for services and she took steps to cuts costs whenever possible. It was wise, Getz felt, to fund services that helped seniors live safely in their homes for a long time. Many residents in his district had worked hard in coal mines or mills and bought homes in tight-knit communities with strong support networks. Programs that helped them stay at home also cost much less than publicly-funded nursing homes.

Today the number of elderly residents in Carbon County continues to rise. I asked Mr. Getz if he felt the county was prepared for the rapid growth of the elderly population. He says, “The network of services and providers is strong”  but “elected officials will be forced to make hard choices” if the current trend of cutting taxes and public services continues. Eventually, he says, programs “will reach a point where costs cannot be cut further” and needs will not diminish. He feels that the plight of those who have worked hard all their lives should not be neglected. While in office, Mr. Getz listened to constituents when they spoke to him about urgent issues and programs they valued. He believes that government functions best when all branches (local, state and federal) work together. So the bottom line on funding for elder programs is this: To protect public programs that help your loved one — or help you as a caregiver — you must share your views with all candidates running for office during election season.