5 ms·

My parents ended up being forced by circumstances to move into a retirement home about five years ago. Fortunately, the place turned out to be run by people wh

by lisper 6mo ago

My parents ended up being forced by circumstances to move into a retirement home about five years ago. Fortunately, the place turned out to be run by people who mostly cared about their clients and so my parents' lives were basically OK, except that the food sucked (which AFAICT is par for the course at retirement homes). But a few months ago the place was acquired by a different company, which is trying to squeeze out higher profits. Staffing and services are being cut, and prices are going up. Even the food got worse, which I didn't think was even possible. The response when someone complains is, "If you don't like it you are free to leave." Yeah, right. My barely mobile 90-year-old parents, one of whom has Parkinson's, are just going to pack up and go. They know perfectly well that they have a captive audience. Thankfully, my mother died before the acquisition, and my father died last week, only a few months after the acquisition, so I don't have to deal with this any more. But caveat emptor: if you ever go into a retirement home, think about what will happen if they change ownership. Even if it looks great, or even acceptable, now, there is no guarantee that it will still be great, or even acceptable, tomorrow, unless you somehow manage to negotiate such a guarantee. I have no idea what a contract provision like that would even look like. But I am going to be facing this problem myself some day, so I'd love to hear ideas.

rawgabbit 6mo ago
Where I live Medicare and Medicaid want people to live (and die) in their own homes. They send out nurses and nurse practitioners to you. That is what I want. After some research I realized the provider that I want which is UTSW in Dallas has a geographical radius that they serve. I am planning to eventually move to be within that radius. https://utswmed.org/medblog/geriatrics-cove-team-makes-house-calls-and-reduces-readmissions/ https://utswmed.org/medblog/geriatrics-cove-team-makes-house...
- lisper 6mo ago
  That was my parents' original plan. But they were in denial about how much preparation would be needed to make that happen. They lived in a split-level house and my father had severe osteoarthritis in his knees. It's actually a miracle that he didn't fall and break his neck going up and down the stairs. But one day he fell in the shower and could not get back up, and that was the beginning of the end.
- paulryanrogers 6mo ago
  It's a nice idea, though I hope I'm humble enough to vacate my house for a younger family that will make the most use of it. By which time I hope to be in a manageable apartment, or perhaps a group home where I can pass the time with others at a similar stage in life.
- a_t48 6mo ago
  For some (like one of my family members), circumstances are such that they need more social attention than the family/medical system can provide. That's one of the reasons we are considering.
- Spooky23 6mo ago
  That’s totally doable and encouraged, as it’s by far more cost effective. But you really, really need a support system of willing people who care about you, and are savvy enough to effectively advocate for you when you lose that ability. Independent home care works well when you need help, not constant care. Our family worked with this for 6 years with my bad post stroke and for about a year with my mom and cancer. My siblings were all on board and my mom was uniquely positioned - she was a regulator at the state level who was adept with the rules (and had in fact wrote many!). Even so, as things progressed it was hard. My mom was devoted to my dad, and filled every gap. We depended on hired help for mom, and despite the financial resources it was difficult to get staff. Family and friends are key.
  - yowayb 6mo ago
    This is going to sound a bit wild, and only viable under 70 or so, but I've met a lot of 55-70 expats in walkable southeast asian cities. There's obviously varying circumstances so do the research, but you can almost get adopted by your landlord family, where you're getting home cooked meals, rides, doors held open, etc. This part of the world is so family oriented, it just comes naturally to many of them.
    - Spooky23 6mo ago
      Makes sense. If you travel regularly, you can see that in relative terms, the standard of living in the US has declined relative to many places.
- AbstractH24 6mo ago
  >Where I live Medicare and Medicaid want people to live (and die) in their own homes. They send out nurses and nurse practitioners to you. In NY State at least that's turned into a cashgrab too. One they are having trouble reforming.
rootsudo 6mo ago
The biggest sign something is broken is when someone writes: "Thankfully, my mother died before the acquisition, and my father died last week, only a few months after the acquisition, so I don't have to deal with this any more." Depressing to read. I'm not sure on which side.
- lisper 6mo ago
  To be fair, my mother had cancer and my father had Parkinson's, and that was a much bigger factor in their ultimate quality of life than any deficiencies in the retirement home they found themselves in. So I don't mean "thankfully" in the sense that "thankfully they died prematurely so they didn't have to suffer under their home's new management", I mean it, "Thankfully the natural course of their lives timed their deaths so that they were minimally affected by the new management." But yeah, it kinda sucks, and not just for the residents who are still there. It sucks for the rank-and-file staff as well, most of whom still really care about their clients, but who now have to answer to people who absolutely do not care about anything other than money.
  - master_crab 6mo ago
    I got what you were saying. I read it the same way. I’m sorry for your loss. No one leaves this planet alive, and the best you can hope for is that the majority of your time is spent relatively healthy and independent.
  - tsol 6mo ago
    I didn't read that as saying anything about your character; it's an understandable way to react. It is an indictment of the system that people have to feel that way when it really shouldn't have to feel that way.
    - lisper 6mo ago
      > I didn't read that as saying anything about your character I didn't take it that way, I just wanted to make sure there was no misunderstanding. This is an emotionally charged topic.
bradleyjg 6mo ago
I’m sure the new owners are scummy, but the fundamental problem isn’t scummy people. There’s lots of markets that are okay-ish notwithstanding scummy people. Even those with natural lock in effects. The fundamental problem is it is at the intersection of two out of the three areas of the economy that have had insane cost growth over the last 30 years—-housing and healthcare (the third is education.) For the first one we know roughly what we need to do but won’t. For the second we don’t even have that.
- lisper 6mo ago
  > There’s lots of markets that are okay-ish notwithstanding scummy people. It is not at all clear to me that there are "lots" of such markets, but that is neither here nor there. A prerequisite for an okay-ish market is that buyers need to be able to choose not to buy, and when you have literal limited mobility it becomes very difficult to walk away from your housing and care provider, either literally or figuratively.
- CPLX 6mo ago
  That's not the fundamental problem. The fundamental problem is that we have ceased demanding that our government produce reasonable outcomes. The reasons for that are many, but it's a core sign of how far we've fallen that there's even a discussion or argument about this obvious fact. We are in charge. We can just ban private equity companies from doing this you know. There didn't used to be ambiguity about the point of having a society and having that society governed by the people and having those people's representatives solve problems like this. That ambiguity was created on purpose, for money, by specific people. Not coincidentally, they're the same people making the profits in this story.
  - jfengel 6mo ago
    We have done quite the opposite. We have insisted that the government allow, and even encourage, unreasonable outcomes, so long as they benefit the right people at the cost of... well, if you have to ask, it's you.
  - rayiner 6mo ago
FireBeyond 6mo ago
As a (former) paramedic, PE-run SNFs (skilled nursing facilities) are an absolute evil that absolutely kills people. I do want to be clear before any of the following that while there is a truth that many of the nursing staff at these facilities are often the lower quality tier of nursing care, they often care greatly for their patients/residents. Staffing/flooring ratios? Laughable correlation to reality. Many a time? A single LPN "supervising" a floor of CNAs. Doctor consultation? The CNA oftentimes leaves a voicemail for the physician to review and care decisions are made without the physician talking to either the patient or a nurse (I'm not sure how this isn't malpractice, and I'm not convinced it's not). Facility "policy", often hidden behind "insurance requirements" have the facility overburdening the local EMS system because "we are required to call 911 for anything larger than a bandaid", and we can find ourselves doing anything from the most basic wound care to pointing out to a sleep-deprived CNA "you know your patient appears to have had a stroke sometime recently, right?". EMS arrives and often gets woefully incomplete or inaccurate history information (often for patients who are unable to be reliable historians themselves). There is, however, ALWAYS money for the colorful glossy brochures/books at the front desk, or the big shiny billboard or TV ad that talks about "mom being in good hands with round the clock nursing care!" (and of course, a facility fee per month that would make you feel like she has her own personal RN and on-call MD 24/7").
- lisper 6mo ago
  > There is, however, ALWAYS money for the colorful glossy brochures OMG, so much this! One of the things that happened after the acquisition is that they changed the phones to play a marketing pitch whenever you were on hold. (They even did this on the resident's phones!) One of the things the pitch said was that the place featured "chef-inspired meals" which was about as disconnected as you could possibly get from what I knew first-hand to be reality. It was one of the most bald-faced lies I have ever heard in my life, and it really steamed my clams because I knew there was nothing I could do about it.
- germinalphrase 6mo ago
  Aren’t these kind of borderline fraudulent business practices the sort of thing state attorney generals are supposed to investigate?
paraknight 6mo ago
The way you nonchalantly mentioned your dad died last week caught me off guard -- my condolences!
- lisper 6mo ago
  Thank you. But he was two months shy of his 90th birthday and, except for struggles with osteoarthritis and Parkinson's, he had a good run. I'm sad that he's gone, but it's not like it took anyone by surprise. And I'm glad that his suffering, which towards the end was not insignificant (though he was very stoic about it), is over. The last week has actually been pretty (ahem) interesting in a lot of ways. I should probably write a blog post about it.
areoform 6mo ago
I am very sorry for your loss.
jdkee 6mo ago
Sorry for your loss.
slopinthebag 6mo ago
I'm sorry about your parent's death, and sorry you guys were forced into this circumstance in the first place. Venture capital is one of the biggest stains on the concept of free market enterprise. I don't offer any solutions.
Henchman21 6mo ago
The people that perform these acts to the elderly should be tortured to death. You may think "wow thats some hyperbole right there!" but active torture is effectively what they're engaged in against the people in their care. So let's give them an eye for an eye.
- cindyllm 6mo ago
  [dead]
seanmcdirmid 6mo ago
> Fortunately, the place turned out to be run by people who mostly cared about their clients and so my parents' lives were basically OK, except that the food sucked (which AFAICT is par for the course at retirement homes). My dad unfortunately never made it to a retirement home (cancer onset when he just turned 70), but in his one week hospice stay, he couldn’t help but complain about the food.

by lisper 6mo ago

rawgabbit 6mo ago

Where I live Medicare and Medicaid want people to live (and die) in their own homes. They send out nurses and nurse practitioners to you. That is what I want. After some research I realized the provider that I want which is UTSW in Dallas has a geographical radius that they serve. I am planning to eventually move to be within that radius. https://utswmed.org/medblog/geriatrics-cove-team-makes-house-calls-and-reduces-readmissions/ https://utswmed.org/medblog/geriatrics-cove-team-makes-house...

lisper 6mo ago
That was my parents' original plan. But they were in denial about how much preparation would be needed to make that happen. They lived in a split-level house and my father had severe osteoarthritis in his knees. It's actually a miracle that he didn't fall and break his neck going up and down the stairs. But one day he fell in the shower and could not get back up, and that was the beginning of the end.
paulryanrogers 6mo ago
It's a nice idea, though I hope I'm humble enough to vacate my house for a younger family that will make the most use of it. By which time I hope to be in a manageable apartment, or perhaps a group home where I can pass the time with others at a similar stage in life.
a_t48 6mo ago
For some (like one of my family members), circumstances are such that they need more social attention than the family/medical system can provide. That's one of the reasons we are considering.
Spooky23 6mo ago
That’s totally doable and encouraged, as it’s by far more cost effective. But you really, really need a support system of willing people who care about you, and are savvy enough to effectively advocate for you when you lose that ability. Independent home care works well when you need help, not constant care. Our family worked with this for 6 years with my bad post stroke and for about a year with my mom and cancer. My siblings were all on board and my mom was uniquely positioned - she was a regulator at the state level who was adept with the rules (and had in fact wrote many!). Even so, as things progressed it was hard. My mom was devoted to my dad, and filled every gap. We depended on hired help for mom, and despite the financial resources it was difficult to get staff. Family and friends are key.
- yowayb 6mo ago
  This is going to sound a bit wild, and only viable under 70 or so, but I've met a lot of 55-70 expats in walkable southeast asian cities. There's obviously varying circumstances so do the research, but you can almost get adopted by your landlord family, where you're getting home cooked meals, rides, doors held open, etc. This part of the world is so family oriented, it just comes naturally to many of them.
  - Spooky23 6mo ago
    Makes sense. If you travel regularly, you can see that in relative terms, the standard of living in the US has declined relative to many places.
AbstractH24 6mo ago
>Where I live Medicare and Medicaid want people to live (and die) in their own homes. They send out nurses and nurse practitioners to you. In NY State at least that's turned into a cashgrab too. One they are having trouble reforming.

rootsudo 6mo ago

The biggest sign something is broken is when someone writes: "Thankfully, my mother died before the acquisition, and my father died last week, only a few months after the acquisition, so I don't have to deal with this any more." Depressing to read. I'm not sure on which side.

lisper 6mo ago
To be fair, my mother had cancer and my father had Parkinson's, and that was a much bigger factor in their ultimate quality of life than any deficiencies in the retirement home they found themselves in. So I don't mean "thankfully" in the sense that "thankfully they died prematurely so they didn't have to suffer under their home's new management", I mean it, "Thankfully the natural course of their lives timed their deaths so that they were minimally affected by the new management." But yeah, it kinda sucks, and not just for the residents who are still there. It sucks for the rank-and-file staff as well, most of whom still really care about their clients, but who now have to answer to people who absolutely do not care about anything other than money.
- master_crab 6mo ago
  I got what you were saying. I read it the same way. I’m sorry for your loss. No one leaves this planet alive, and the best you can hope for is that the majority of your time is spent relatively healthy and independent.
- tsol 6mo ago
  I didn't read that as saying anything about your character; it's an understandable way to react. It is an indictment of the system that people have to feel that way when it really shouldn't have to feel that way.
  - lisper 6mo ago
    > I didn't read that as saying anything about your character I didn't take it that way, I just wanted to make sure there was no misunderstanding. This is an emotionally charged topic.

bradleyjg 6mo ago

I’m sure the new owners are scummy, but the fundamental problem isn’t scummy people. There’s lots of markets that are okay-ish notwithstanding scummy people. Even those with natural lock in effects. The fundamental problem is it is at the intersection of two out of the three areas of the economy that have had insane cost growth over the last 30 years—-housing and healthcare (the third is education.) For the first one we know roughly what we need to do but won’t. For the second we don’t even have that.

lisper 6mo ago
> There’s lots of markets that are okay-ish notwithstanding scummy people. It is not at all clear to me that there are "lots" of such markets, but that is neither here nor there. A prerequisite for an okay-ish market is that buyers need to be able to choose not to buy, and when you have literal limited mobility it becomes very difficult to walk away from your housing and care provider, either literally or figuratively.
CPLX 6mo ago
That's not the fundamental problem. The fundamental problem is that we have ceased demanding that our government produce reasonable outcomes. The reasons for that are many, but it's a core sign of how far we've fallen that there's even a discussion or argument about this obvious fact. We are in charge. We can just ban private equity companies from doing this you know. There didn't used to be ambiguity about the point of having a society and having that society governed by the people and having those people's representatives solve problems like this. That ambiguity was created on purpose, for money, by specific people. Not coincidentally, they're the same people making the profits in this story.
- jfengel 6mo ago
  We have done quite the opposite. We have insisted that the government allow, and even encourage, unreasonable outcomes, so long as they benefit the right people at the cost of... well, if you have to ask, it's you.
- rayiner 6mo ago

FireBeyond 6mo ago

As a (former) paramedic, PE-run SNFs (skilled nursing facilities) are an absolute evil that absolutely kills people. I do want to be clear before any of the following that while there is a truth that many of the nursing staff at these facilities are often the lower quality tier of nursing care, they often care greatly for their patients/residents. Staffing/flooring ratios? Laughable correlation to reality. Many a time? A single LPN "supervising" a floor of CNAs. Doctor consultation? The CNA oftentimes leaves a voicemail for the physician to review and care decisions are made without the physician talking to either the patient or a nurse (I'm not sure how this isn't malpractice, and I'm not convinced it's not). Facility "policy", often hidden behind "insurance requirements" have the facility overburdening the local EMS system because "we are required to call 911 for anything larger than a bandaid", and we can find ourselves doing anything from the most basic wound care to pointing out to a sleep-deprived CNA "you know your patient appears to have had a stroke sometime recently, right?". EMS arrives and often gets woefully incomplete or inaccurate history information (often for patients who are unable to be reliable historians themselves). There is, however, ALWAYS money for the colorful glossy brochures/books at the front desk, or the big shiny billboard or TV ad that talks about "mom being in good hands with round the clock nursing care!" (and of course, a facility fee per month that would make you feel like she has her own personal RN and on-call MD 24/7").

lisper 6mo ago
> There is, however, ALWAYS money for the colorful glossy brochures OMG, so much this! One of the things that happened after the acquisition is that they changed the phones to play a marketing pitch whenever you were on hold. (They even did this on the resident's phones!) One of the things the pitch said was that the place featured "chef-inspired meals" which was about as disconnected as you could possibly get from what I knew first-hand to be reality. It was one of the most bald-faced lies I have ever heard in my life, and it really steamed my clams because I knew there was nothing I could do about it.
germinalphrase 6mo ago
Aren’t these kind of borderline fraudulent business practices the sort of thing state attorney generals are supposed to investigate?

paraknight 6mo ago

The way you nonchalantly mentioned your dad died last week caught me off guard -- my condolences!

lisper 6mo ago
Thank you. But he was two months shy of his 90th birthday and, except for struggles with osteoarthritis and Parkinson's, he had a good run. I'm sad that he's gone, but it's not like it took anyone by surprise. And I'm glad that his suffering, which towards the end was not insignificant (though he was very stoic about it), is over. The last week has actually been pretty (ahem) interesting in a lot of ways. I should probably write a blog post about it.

areoform 6mo ago

I am very sorry for your loss.

jdkee 6mo ago

Sorry for your loss.

slopinthebag 6mo ago

I'm sorry about your parent's death, and sorry you guys were forced into this circumstance in the first place. Venture capital is one of the biggest stains on the concept of free market enterprise. I don't offer any solutions.

Henchman21 6mo ago

The people that perform these acts to the elderly should be tortured to death. You may think "wow thats some hyperbole right there!" but active torture is effectively what they're engaged in against the people in their care. So let's give them an eye for an eye.

cindyllm 6mo ago
[dead]

seanmcdirmid 6mo ago

> Fortunately, the place turned out to be run by people who mostly cared about their clients and so my parents' lives were basically OK, except that the food sucked (which AFAICT is par for the course at retirement homes). My dad unfortunately never made it to a retirement home (cancer onset when he just turned 70), but in his one week hospice stay, he couldn’t help but complain about the food.