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senior living

Do contests propel innovation in an industry that lacks infrastructure?

Incubators and contests -- do they enable innovation?  Paul Krugman's interesting article about GE’s competition to find a new design raises a question about how to boost innovation and lower its cost. If you read the article, entitled 'Complexity is Free' – you will discover how a simple contest, fielded internationally, generated a design improvement at almost no cost for GE: "The winning prize pool [was] $20,000, spread out across 8 finalists, with awards ranging from $1,000 to $7,000 each." So for $20K, GE got something it wanted, layered that something into a design process that enables continuous revision to designs without new infrastructure investment (the 'free' in the title.) Does anyone else find it interesting that there was no internal engineer who could figure out how to design a lighter-weight bracket component -- and that a contest was required? Or was this a publicity stunt to generate good will for GE? 

Decline of median income stats are in – will anybody notice the 65+?

Consider the data, check elsewhere, and discard this report. This kind of thing catches my eye. You know by now which single age demographic income group saw a statistically significant increase in median income since the recession (supposedly) ended in 2007. The New York Times helpfully tells us – it was those 65-74 folk. Says the Times insightfully: “helped perhaps by the decision of some older workers to remain in the work force or re-enter it.”  A long way down in the article, we learn that the 5.1 percent increase for those 65-74 put them at a median income of $43,000 -- the national median rose to $52,100 in June -- even though in many cases the head of the household was retired. Guess those 65+ must be doing okay.

Crisis avoidance with web cameras and other technology – why not?

Why wait for a crisis to decide to deploy web cameras in senior care?  Did you know that, according to the Administration on Aging, this  is the year of elder abuse prevention? Perhaps it should be the year for webcam deployment in all senior care settings, especially now that that the Frontline story aimed an investigative spotlight at assisted living. So I heard a story this week about an elderly person abused by a home care worker – not surprising, really, when a care recipient is frail and no one is around except the care provider.  The family subsequently placed a web camera in the home.  According to a family member, it was quite a deterrent for the subsequent hires, made aware from the start about its presence. Plus, it was as an enabler for day-time check-ins while an adult daughter was at work.  So why aren’t web cameras ubiquitous in senior care settings – especially to observe care activities like entrances and exits of workers when residents are less mobile, in bed or stranded in wheelchairs? Your opinions are welcome:

Why not apply Federal Regulations to Assisted Living?

When the lights go on – much becomes visible. Warning – rant on. I have to ask, what do you think is the biggest fear of the Assisted Living industry? Is it PBS and documentaries about their industry?  No, many have rationalized their own organizations or will be contemplating new ways to manage bad publicity and thus prepared, they moved on. Lawsuits? They are certainly an issue – and cost time and potentially substantial amount of money. But risk managers and lawyers are around to help avert through policy and procedures, training, etc.  No – the real and pervasive fear of the industry is federal regulation. And how hard they work to avoid it at all and enormous cost – lobbying is vigilant and continuous to ensure that the industry remains within the regulatory (and wildly varying) domains of the states.

PBS shines a bright light on Assisted Living – will change follow?

By now, you’ve probably heard about or seen it.  PBS’ Frontline and ProPublica spent a year researching care, life and wrongful deaths in the largest of assisted living companies, Emeritus Senior Living. After the broadcast, some honest self-examination, but also those expected positioning statements and self-righteous comments emerged from Emeritus, industry observers, plus defensive responses from the industry lobbying leaders – ALFA and Leading Age. Larry Minnix (Leading Age) tells ALF executives to ask themselves, “What are your staffing levels?” Indeed. And we should ask as well. What should they be in an AL memory unit? He doesn’t say. Read the Frontline attached interview with a regulatory agency CEO -- and how variations across state boundaries can be justified. Really. So shouldn't facilities be shut down after horrible incidents like these? Remember the Miami Herald series Neglected to Death? Not just one company (as in the Frontline story) but many organizations, large and small, throughout Florida, not just one incident but multiple. As with many incidents, company growth may slow a bit, organizations may consolidate under new ownership or new names, but rarely are they shut down.

Memory care – the door is locked, but is anyone home when the ambulance arrives?

When the 911 call may be necessary but not sufficient.  The news about the no-CPR policy in an independent living community in California brought me back.  In the incident reported everywhere, the nurse claimed that the policy in independent living did not include providing CPR – and as a result, the elderly woman died. Years ago when my mother spent some time in an assisted living facility, 911 was invoked nine times within a single year before they ejected her to a nearby nursing home, claiming they could not provide care. Each of her ER visits involved either my sister or me – racing to the ER from work so that we could explain her history – one time we stopped a dose of Bactrim that she was allergic to – another time we interrupted her inaccurate description of her medical history cheerfully being offered to an intern who had not checked her chart and apparently did not know she had dementia.

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