Last week I passed this banner displayed in a neighboring small city.
I asked several people if they noticed it, or what it meant to them. While people said older adults in their families have played an important role in their lives, (i.e., grandparents) they acknowledged that, while they agree older adults should be valued, they hadn’t thought much about it and had no knowledge of the month of May dedicated to honoring the oldest among us.
The reactions were consistent with my initial impression. I live a few minutes away from this city and am not aware of any programs throughout the month dedicated to highlighting the value of older adults, increasing awareness about the number of older adults living in the community, or ways in which fellow community members can help the increasing number of older adults who are in need.
More and more older adults are choosing to remain in their homes as they age rather than move to nursing home environments that are more institutional rather than home settings. Therefore, there are more older adults living in our communities. Many are lonely, isolated and in need of help or care.
The question remains are we providing adequate care and oversight so that people remaining in their homes remain safe and secure allowing their families to have peace of mind.
Families who have loved ones living independently often rely on home companion agencies to provide the extra help needed. However, this is a highly flawed system that in fact, does little to protect older adults.
The Connecticut Mirror wrote a four-part series entitled CT’s Elder Care Reckoning, addressing the state’s aging population and the challenges in finding ways to care for people.
The series of articles is as follows:
Part 1: The Country’s Aging Population Is Expected To More Than Double. Connecticut’s Network Of Supports Is Struggling. 3/19/23
Part 2: Nursing Homes Face A Reckoning As They Deal With Fewer Residents, A Change In Pay And Plans To ‘Right Size’ The Industry. 3/26/23
Part 3: As More People Choose Home And Community Options Over Institutional Care, Will Access To Services Be Equal For All? 3/30/23
Part 4: More People Are Aging In Place. But The State’s Home Care Industry Operates With Little Oversight.
Connecticut State Rep. Jane Garibay, a Democrat from Windsor who is co-chair of the Aging Committee stated at a hearing, “Here we are discussing if we can afford to put in air conditioning for seniors when the majority of our animal shelters have air conditioning. We have to change the way we think.” When someone says, ‘I went to see my father. He got up in the morning, and they didn’t answer his bell so they could assist him to the bathroom. After three hours, he went in his bed and they served him lunch in that state without cleaning him,’ people will say, ‘Oh, that’s awful.’ But there’s just not the outrage. I get outraged.”
My contention is that It is only through outrage that the situation will change.
The CT state study on long-term care lays out recommendations to prepare for the ballooning aging population. To expand the home care workforce, it suggests recruiting employees who have left the nursing home industry. It also recommends boosting the profile of myplacect.org, increasing the number of physicians’ offices, hospitals and other locations that provide information on long-term care options, and creating an educational campaign for hospital social workers and discharge planners to improve awareness of home care services.
“The country as a whole is undergoing a shift in demographics,” said Deidre Gifford, senior adviser to the governor on health and human services and executive director of the state Office of Health Strategy. “The population of the country is aging, and people are wanting to age in place. We need to adapt our health care system to align with those changing demographics.”
Beyond being informed about available care options, families need to educate themselves on guidelines that agencies are required to follow in order to provide adequate care. There is actually little or no oversight for home companion agencies. People would be horrified to know agencies that, though required to perform background checks for their hires up until a few years ago it was permissible to place a convicted felon as a home companion caregiver but ,they are not required to provide them with any type of training. The key issues is that the Department of Consumer Protection does not adequately check to see if background checks have actually been conducted.
As a dementia care specialist, I have encountered a lack of caring or concern from home care agencies in the state of Connecticut. As a certified trainer for dementia practitioners, I have offered training to countless home care agencies. Providing them the opportunity to give their workers the necessary tools to offer quality care to their clientele who are living with cognitive impairment. Not one agency was willing to have their caregivers adequately trained in dementia care.
Presently, home companion agencies are not legally permitted to require training and are prohibited from mentioning that caregivers have been trained in their collateral material. Thus, there is no incentive for them to pay for such training. There is hope that a new bill that will pass the present CT congressional session which will ultimately require standardized dementia training for these caregivers.
In the state of Connecticut, nearly a quarter of the state's nursing homes had a 1-star CMS quality rating as of February 2023, up from only 8% in January 2020. One of the reasons, the state is now participating in the money follows the person program where more of its Medicaid dollars are directed into home health care.
In 2018, Connecticut spent more Medicaid money on home and community-based services than on institutional care, 53% to 47%, state data show. By 2022, 58% of its Medicaid long-term care funds was spent on home services, as opposed to 42% for nursing homes and other facilities. This increasing trend will likely grow to a whopping 75% for home care and only 25% for nursing homes.
On the Podcast: Connecticut’s Home-Care Industry Lacks Oversight
WSHU Public Radio Group - NPR News & Classical Music
April 3, 2023
WSHU’s Ebong Udoma spoke with CT Mirror’s Dave Altimari to discuss the article he wrote with Jenna Carlesso, “Home care providers: A growing but unregulated industry,” as part of the collaborative podcast Long Story Short.
“The issues over the increasing number of Connecticut residents desiring to age at home is not particular to the state of Connecticut alone. The question remains, can the country keep up with a growing home health care industry that has to date been unregulated in many states?
This shift away from nursing homes or long-term care facilities as more people prefer to age at home doesn’t come without problems. Home care providers are not properly supervised in Connecticut, as well as in many other state’s which results in egregious situations, both for older adults living at home as well as for those who have companions helping them for hours/day in assisted living communities.”
While reporting on this series, as a result of intense family and professional advocacy, the Connecticut legislature formed a Home Companion Task Force aimed at looking into the Department of Consumer Protection’s oversight into this industry. The feeling was that the Department of Consumer Protection was too lenient and did not have the ability to properly regulate the industry and adequately enforce regulations.
There has been an approximate increase of 137% in the number of CT home companion agencies in 10 years. In 2012, there were 380 agencies with 1 full time investigator in the Department of Consumer Protection (DCP) dedicated to oversight for these agencies. In 2022, there were 903 agencies; the DCP had only increased their full-time investigator staff to two persons. This is insufficient and places our seniors at great risk.
As a result of that investigation, there is a bill that has padded out of committee that would mandate a plan to be submitted to transfer the jurisdiction of CT's home companion agencies from the Department of Consumer Protection to the Department of Health. This would provide proper training for home companion workers, expertise for caring for the most vulnerable older adults, and oversight for home care agencies.
With the current lack of oversight of CT's home companion agencies and an 18-month waiting period for complaints to be addressed, it is vital that we educate ourselves on how to find safe home care. CT is urging its seniors to age in place yet is actively refraining from providing the vital information to do so safely. Look for a special guide in an upcoming blog which will provide the essential questions to ask when interviewing home companion agencies - questions that are being hidden from the public eye.
Will the present generation of baby boomers, the largest generation of older adults to be living in the United States, lead the charge, lead the outcry, to stand up, speak out, and say, “we’re mad as hell and we’re not going to tolerate this situation, for our loved one’s or for ourselves.”
For more information on finding the best care solutions for your loved one, and how to become the most informed and effective advocate for your loved one’s care, email: phyllis@phyllisaymanassociates.com
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