A small piece of paper brought back a very bad memory for me this month.
Rifling through the perennial stack on my desk at home, I unearthed a medical referral for my mother-in-law. It was her gateway to see a specialist for a dislocated shoulder.
That wee-hours injury occurred nearly six years ago during one of her first nights – perhaps even her very first night, I can’t honestly recall – spent in a metro Atlanta assisted-living facility.
It was one of the places our reporters made specific mention of in The Atlanta Journal-Constitution’s ongoing “Unprotected” series, which exposes serious problems at some assisted-living and personal care communities in Georgia.
For my family, and no doubt many others, the AJC's investigation into cases of abuse and neglect at some facilities resonated on a personal level.
So you know, I’ve had no role in overseeing the “Unprotected” reporting project. For commonsense reasons, our newsroom keeps a degree of separation between our newsgathering and opinion operations. We’ve always believed that’s important; and the harshly partisan times we’re now living in makes the wisdom of that policy even more apparent.
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All of which means I’ve read “Unprotected” pretty much from the same vantage point as any AJC reader.
And it took me back to earlier chapters in my family’s ongoing saga of caring for two, then one, nonagenarian elders.
My mother-in-law, now only two years shy of 100, has lived with Alzheimer’s for nearly 20 long years now. Her mental and physical decline from this disease has been jagged, but sadly consistent.
It’s increasingly rare to see even flashes of old personality from the once quick-witted retired schoolteacher who loved to laugh and was sharp enough to work her way through college as a bomb inspector at a WWII munitions plant.
For half a decade, she and my mom both lived with us. We added a mothers-in-law (yes, plural) suite to our home. And we adjusted our lives to care for two members of the Greatest Generation who were on the long glide slope of dementia as they entered their 90s. For multiple reasons during that time, we usually slept very, very lightly, if at all.
I’ll spare details, but suffice to say that my daughter’s high school English teacher told us she cried after reading our teenager’s essay describing routine caregiving for her grannies after getting home from school.
My mom died in 2014. She spent the last 60 or so days of her life in a small personal care home after growing too feeble to be safely left at home with only my mother-in-law.
I’ll be forever grateful to the caregivers there who did superbly well by her. The looks of concern and sadness on their faces when mom was moved to hospice care a few days before the end were nothing but sincere, I believe.
After she died, we began searching for assisted living places for my mother-in-law. We settled on one that looked very nice in online brochures and during tours. On one such visit, while a cheery marketing type extolled the virtues of the place, I let my skeptical reporter’s eye quietly sweep over the place, assessing how the employees interacted with residents especially. It seemed right, aside from quietly nagging worries about the sincerity of the marketing as well as the binding arbitration agreement we signed.
I rationalized away those feelings, and we moved her in. Then came the fall.
The home’s director was profusely apologetic, and they quickly installed non-slip strips on the floor of her bath. They also offered a big discount on the next month’s rent – a considerable sum since the place wasn’t cheap.
My Greatest Generation mother-in-law is physically tough, so her shoulder healed quickly.
» SEARCHABLE DATABASE: Details on every facility studied by the AJC
» MORE: The 'Unprotected' investigative series
The next big problem was that the facility’s med techs seemed unable to properly administer her relatively few medications. And their medical director seemed powerless to make that happen. My wife discovered her mom was getting the wrong pills at incorrect times more often than not.
We quickly decided the plush surroundings and hosted activities were not worth what we saw as risks to her well-being.
So, one Saturday, my son and I hauled out her furniture and moved her into a personal care facility run by a dedicated small businessperson whose heart – and care operation – both seemed in the right place.
And there things remained for two years, until the glide slope of her decline took another lurch. As her Alzheimer’s progressed, my mother-in-law eventually lost use of her legs and pretty much stopped eating for a time, which meant she couldn’t remain per state rules in the personal care home.
So we brought her back to our house, this time with 24/7/365 caregivers. Both my wife and I – and the doctors and nurses involved – thought this would amount to a relatively quick transition toward her peaceful passing.
Well, the lady with the quick laugh has, so far, proved us all wrong. Three years in now, she remains in her old room in our house as the final chapter of this story remains to be written.
I realize not all are blessed enough to be able to stretch and provide comprehensive care at home for loved ones. That’s where Georgia’s assisted-living and personal care homes are supposed to step in, providing competent care for our elders.
As the AJC’s “Unprotected” work shows, too often that’s not the case. My family’s seen the system at its best and far less than best.
To my mind, that’s proof that Georgia’s inadequate oversight of these places must improve – quickly. Our elders deserve far better.
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