Caring for an aging family member who is descending into dementia raises many difficult questions.
The answers won’t get any easier after public television’s “Frontline” and the journalism nonprofit Pro Publica this week unveil a blistering investigation of the assisted-living industry’s enthusiastic marketing of so-called “memory-care” facilities.
Focused on Seattle-based Emeritus, the nation’s largest operator of assisted-living communities, an hourlong “Frontline” documentary to be broadcast Tuesday spotlights the disturbing and preventable deaths of several residents with dementia.
The piece also raises larger questions: Are patients who shouldn’t be in assisted living admitted anyhow to boost the bottom line? Did Emeritus facilities chronically skimp on staffing and training because of corporate pressure to make their numbers? Should the industry be regulated more strictly?
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“Life and Death in Assisted Living” offers a parade of former Emeritus employees and outside experts whose answer is yes.
Emeritus President and CEO Granger Cobb and other company representatives also appear, defending the company’s track record and practices.
“When you’re dealing with this many residents, particularly a population that can have unpredictable behavior or is frail and is high risk to begin with, we will have situations from time to time,” Cobb says in the documentary. “But they are the vast minority.”
“Frontline” provided a preview copy of the documentary, with the standard proviso that the subjects could not be contacted before it airs. ProPublica this week will publish a 15,000-word series of articles on the industry, which will also be available as an e-book.
A.C. Thompson, the “Frontline ” correspondent, says he was working on other issues involving the elderly when he became interested in assisted living.
“A lot of people don’t realize the regulations are incredibly lax,” he says in an interview. “In California you only need 40 hours of training to run one of these.”
Because nursing homes get federal money, “there’s a whole world of federal regulations that provide a baseline on how they should be run,” he says. “When you come over to this world, there’s none of that.”
Instead, there’s a patchwork of state rules. Data on how well the industry cares for its wards is equally scattered.
One of the dementia deaths examined by “Frontline” is that of Joan Boice, the case in which a Sacramento, Calif., jury recently awarded a $23 million verdict against Emeritus.
Another is Cheryl Morgan’s father, who suffered fatal injuries after drinking toxic industrial-strength dishwashing liquid that was left unsecured at a Georgia assisted-living facility run by Emeritus.
The state, reports “Frontline,” fined Emeritus $601. “It means nothing,” says Morgan.
Maggie Carter, who was fired by Emeritus as director of a memory-care unit in Mississippi, says the company often admitted residents who were too incapacitated, either physically or mentally. And once such clients were admitted, employees “were under pressure to keep them in that building at any cost.”
Laws in many states say people in such condition belong in skilled-nursing facilities, “Frontline” points out.
But the nursing-home sector has plenty of its own tragic stories. And so does another alternative — care at home by immediate family members or hired help.
That’s a point Emeritus spokeswoman Karen Lucas made in an April email for a Seattle Times story: “The national tragedy for millions of Americans is that the quality of life for both the caregiver and the cared-for is thoroughly compromised and the outcomes are sometimes horrible and deadly,” she wrote about home care for dementia patients. “Many seniors would live a far better quality of life in an assisted living community that’s staffed with 24/7 caregivers who are trained to provide the appropriate care.”
Thompson doesn’t dispute that other modes of dementia care also have their problems.
“We have a serious public-health crisis that we are failing to acknowledge as a society … and frankly I don’t think we’ve made a real earnest effort to figure out what the best ways to take care of that population are,” he says.
Yet when assisted-living operators like Emeritus “are holding themselves out as the optimum model of care for dementia,” he continues, “you expect more out of them.”
Peoples v. Peoples
Somebody call Judge Wapner — this is clearly a case for The People’s Court.
Peoples Bank, a 92-year-old financial institution in Bellingham, has sued Peoples Bank, a 141-year-old firm based in Kansas.
They are fighting over use of the “Peoples” name in selling financial products and services in Washington.
Peoples of Washington, in a trademark-infringement lawsuit filed this month in federal court here, says it registered the “Peoples Bank” trademark in the state back in 1994.
The Kansas bank has been sending direct-mail pitches for refinancing deals to Washington residents, even on the local bank’s home turf in Whatcom County, according to the Bellingham Peoples. That tramples on a trademark in which it has invested hundreds of thousands of dollars, says the suit.
The Whatcom County bank’s two dozen branches extend as far south as Seattle and Kirkland.
The Kansas bank has branches only in its home state and northern New Mexico, and it runs home-loan operations in six others. But as its website advises, “No locations in your state? Not a problem! We lend in all states.”
To complicate the legal question, federal marks for the term “Peoples Bank” are registered to a completely different outfit, the much bigger, Ohio-based Peoples Bancorp.
And don’t even mention the little Peoples Bank of Commerce in Central Oregon, or the former Seattle-based Peoples National Bank, acquired in 1988 by U.S. Bancorp.
The Bellingham Peoples says that without a federal trademark registration, the Kansas Peoples “has no nationwide rights” and can only claim historical rights in “a small number of Midwestern states.”
Wint Winter, CEO and general counsel of the Kansas bank, would not comment on the suit but said, “We obviously hope this is resolved soon.”
If only someone would offer to work it out in friendly fashion over lunch: “Have your Peoples call my Peoples.”
Rami Grunbaum: 206-464-8541 or firstname.lastname@example.org