[0:00]All right, let's go. Is this how you'd like to be careful when you're older? We would have no idea what went on with dad had we not had the cameras in there? Hello, I'm Nick Haines, you've just watched our new film on aging. Now we dig for answers. We're heading to the Kansas City Plaza Library for a town hall on the state of aging in our metro. We have the experts and a big audience. We also have a front row seat for you next on Kansas City PBS. I didn't want her to have to spend another day with people that were not sympathetic to her. And so if I hadn't been here, it would have been one more night that she not only would have been in pain, but she also would have been hungry, and I'm just not sure that it would have been addressed. What residents often tell us, I wish I would have died then to live like this.
[0:52]And you've been watching how should we care on Kansas City PBS? Hello, I'm Nick Haines, by a show of hands, how many of us in this room are getting younger? Oh, okay. All right. That's what I thought. We are all aging. America is aging. By 2030, according to the, uh, US census, Americans 65 and older will for the very first time in the country's history outnumber children. Who's going to look after all of these people? And how are we doing it now? And that's the purpose of our next hour together and we've got a think tank of experts with us who can to for answers for some of our questions. Uh, you just saw Camille Russell in the documentary. She is the Kansas long-term care ombudsman who looks at the citizen complaints about elderly care facilities in Kansas. She's coming to us from Topeka. By the way, she also serves under two Kansas attorney general's as director of the abuse, neglect, and exploitation unit. Melody Elston is just wrapping up an assignment as interim aging director at the Mid-America Regional Council. She keeps a broad eye on issues and trends involving elder care on both sides of state line. Janet Baker's full-time job is empowering, celebrating, and serving older adults to help them age gracefully in Kansas City. She lives the challenge every day as director of the Kansas City Shepherd Center. She doesn't have a white coat or a stethoscope strategically placed around her neck. But Dr. Jessica Calendar Rich is a geriatric at the University of Kansas Health System who teaches about the care of aging adults and works closely with the Landon Center on aging. And Samantha Shepherd is the founding partner of the Shepherd Elder Law Group, which has offices in Overland Park, Kansas and Hutcheson. She spends every day talking to families navigating those tough financial, health, and emotional problems involving elder care planning. Please welcome our panel to the stage here.
[3:00]By the way, we also have filmmaker Michael Price with us, who spent basically, Michael, a year of your life lifting up the hood on adult living facilities, nursing homes, looking at aging in place in Kansas City.
[3:14]What was the big take home for you having done that film? Well, because the film itself took me into sadly, one of the main issues that too many people face which is going into a long-term care facility where they're receiving sub standard care. And of course, in some instances, I was spending time with the families of those people. What I what I quickly came to realize is the impact of that on the families outside of the care home as it were, who aren't putting their loved ones in these care homes and then washing their hands. They care for them still, they love for them. they still love them. They're trying to monitor the care, they're trying to improve the care, they're advocating for conditions to improve. And it's a devastating reality for them as well, when week after week, they're witnessing, they're sort of vicariously experiencing the substandard care for their for their loved one. Um, it's a huge issue for too many people. I'd say that's my main take away. Michael Price, thank you very much. Camille Russell, we saw you in the documentary. Um, you said there were some people who come to you as the long-term care ombudsman and say they would prefer to be at a van in the river by the river rather than being one of these facilities. Really? It's actually what I tell my family. I say it would be preferable to me to be living in a van by the river then don't put me in a nursing home. When COVID happened, the Washington Post claimed that there was no more dangerous place to be in America than a nursing home, not just for the patients, but for the staff as well. You just served on the coronavirus nursing home task force there. Did that change COVID change people's perceptions and say, you know, I never want to go there anymore. You know, I think um COVID really exposed some of the challenges that had been already in place in many of these facilities. In addition, the staffing impact that happened during the pandemic when people really didn't feel comfortable working any longer in that setting because of all of the things that you mentioned and not feeling safe, that really just compounded the issue. We have the impression of course that we have tons of regulations. Uh, the state looks after these things, the federal government does. The federal law requires that there be a comprehensive inspection at least every 15 months, but one in four Missouri nursing homes have not had an inspection in more than two years according to Propublica. Kansas has its own issues. Even before the pandemic, less than 40% of nursing homes met the federal government inspection target. Are there simply not enough inspectors? They're not enough inspectors and they're not enough of the right inspectors. We're under resourced and um it's amazing what they get done with the few resources, but the the plain field's really unlevel and it's in the favor of the providers. What are the red flags we should be paying attention to before we consider that choice? Um, first of all, when you walk in, I I say use your five senses. You want to look and see what you observe as far as um, the the residents who are there.
[6:16]You want to hear if they're call lights, you know, going off and no one attending to them. You want to smell, um, you want to look at what the residents are wearing if they're still in um their uh sleeping clothes or if they're in dressed. So there are just use your five and you can kind of gauge, you know, the the quality of that home. I Dr. Jessica, you were also a medical director at a nursing home. What are the red flags that you tell patients or their families who maybe feeling they need to go to a long-term care facility? So I actually tell people to stop by, to use those five senses but to stop by and not at noon on a Monday, but to actually stop by on a weekend or an evening and see how things feel and sound and smell.
[7:08]Um, and um in addition to that, really just um asking all of the questions that are burning in all of our minds. And because we all have questions, right? What's the biggest question that you hear? I mean, the biggest question I think that I hear is, you know, are you going to care for my loved one, right? A different question we could be asking is how are you going to care for my loved one? When you again, you're dealing with this every day. You have clients coming into your home, you have family members who are worried about making a decision. What are the red flags? What do you tell them about how to choose a long-term care facility? Exactly as the others are saying, I say go at unexpected times. Don't wait for an invitation. It's a, it's a home, which means that you're allowed to show up. You don't need an appointment with the admissions personnel, you show up. Now one expert again tell us you should make an announced visit prior to choosing a facility. Are they just going to hate you for doing that though? Oh, if they're going to hate you for doing that, that's a red flag. That's not where you want your parent to live. So that that's the last that's the last place and and the person that's going to live there. I don't know if about any of you, but do you buy a home without seeing it yourself? Why would we have our loved one go live somewhere that they didn't visit? I would also say speak to the residents, you know, the people who are walking around or, you know, observing the bird cage or whatever's there, you know, speak to the residents. Ask them and speak to their loved ones if they're visiting, they will be able to give you honest insight, um, on the care of their loved one. and what concerns are there. Now we've been told by some aging experts that you should be actually looking into assisted living or nursing homes before your loved one actually needs it because there are we're told substantial waiting lists. Is that really a big problem that all these facilities that we see now popping up all over our metro, wherever there's a a spare piece of land, it seems to be we have a new assisted living facility or a nursing home. Absolutely. Some of them are 18 months long. I advise someone today to go to one particular place while they could manage and get on the waiting list for the other, which I think is perhaps a 12-month wait. This sounding a little bit like people with child care that even before the baby is born, they're now considering the child care option. And you don't want to learn when you're in the moment of crisis. If you, if you are an aging person now and you see signs, well, I suppose you don't usually see the your your own signs, but if one of your family members has dementia and you're considering when is the right time for placement. I hate the idea that you've waited to the moment of crisis to then start exploring. The AARP has a study out recent study that says 77% of people over 50 want to age at home. Janet Baker, that's what you do. That's about the wrap around service allowing people to age at home. What is the number one obstacle in Kansas City to doing that? Well, I would say for nonprofit organizations like Kansas City Shepherd Center, the number one obstacle is sustainable funding to support the true wrap-around services that are needed to help an older adult live in their own homes in their communities with the wrap-around services they need. We have uh, all of our programs like Meals on Wheels, senior companions, phone pal, adventures in learning. We can provide the entire plethora of programs and services to make it possible for older adults to live safely, happily, independently in their own homes for about the cost of a day in the hospital. For a year. You mentioned 77% said that they would uh like to Yes. Well, but once they're there, I would tell you that they tell long-term careman a much a higher percentage that they wish they had done more but more planning. And and done it different. They accommodated um fear of their family members to be there and things like that. They'd wish they had stayed at home longer that they'd planned and we could do that with less money, like Janet said. My wife, by the way, was a fitness specialist at one of the most luxurious um assisted living facilities in our metropolitan area. And I've been holding her trying to get information from her and the the people, the residents she has spoken with every single one of them has told her their only regret is they waited too long to get there. You provided security, you provided a lot of different things that you might not get if you're aging at home. So you said something that's going to irritate me all night, a luxurious place. So so you know what I find if it's the children and I I do have a Johnson County practice as well as a Kansas City practice. So we get we get rubbed a little bit for that. So there's an appeal to the children for the outside lobby. Can I beg you to go beyond the lobby? So the luxury, I'm I'm not trying to fault you for your perception that the the place is luxurious because the lobby is, but maybe I am actually. Who else is faulting me for luxury? Yes, Melody. I would just piggyback off of what Janet said, the service staff usually travel from to each long-term care facility, so just because the facility appears luxurious, the care may be the same. I think about luxury and I'm going to say the word because this is really a lot of people's concern is how do you afford to stay in some of these facilities? The current cost of a nursing home hovers around $100,000 a year. Who has the money to pay $8 to $9,000 a month to get that kind of care? Isn't that luxury? I will tell you that the older adults in Kansas City with a medium income in their lifetime of $58,000 a year can't. And the people that we serve, who are largely low income, uh, older adults, and particularly people of color, who didn't have jobs where they accrued much social security and didn't have positions where they accrued any kind of pension can't. Well, we've got to do something different. We've got to and we've got to look at what the billions of dollars that we are spending on long-term care, uh, where it's going. We've got to look at true transparency to make sure that the money is going to the actual cost for direct care and is not being for We completely box them in. So our government dollars are paying, I'm not running for office, so I can say what I need to say. So so our government dollars are going to pay for Medicaid and I help people get on Medicaid every day. But we will not pay for assisted living, hardly at all in in Missouri. So that's a impractical financial calculation. As you said, 100,000, if you're lucky, it might be closer to 120,000 a year. We're forcing people to go into the nursing home who could stay in assisted living or could stay at home because we won't put our dollars there. Something that came out of this film that was surprising to me and I'm pleased this is another area. You you got mad at me over the luxurious one. I'm sorry. I use interchangeably sort of assisted living and nursing homes. And yet what a huge difference there is and I can see that guy uh, nodding there in agreement. But also in terms of the law, that was kind of surprising. Uh, for instance, uh, people who who's nursing home bills are paid by Medicaid are protected by federal law from eviction. They can't be removing you, but that's not true of assisted living. And yet it's one of the biggest um issues that long-term care ombudsman have dealt with with years as infecctions. And people in assisted living often do not have the same rights, um, and and it is important that they be able to appeal and have those, um, legal remedies that you and I would have if we rented an apartment out in the community. And she mentioned rights and I think that speaks to how to advocate for your loved one. Know the their rights, know that they have the rights that anyone would have in the community to make those decisions. So knowing the rights while you're in long-term care plays a major role in the quality a lot of times. In the film, staffing is the big issue. Uh the nation's largest nursing home lobbying group has 52 nursing homes in Kansas, have closed due to staffing issues since the onset of the pandemic. In fact, one industry survey conducted in December found eight out of 10 nursing homes in the country experienced a staffing shortage. So what does that mean for us now beginning to think about elder care, Dr. Jessica? There there really are not enough people working in these facilities to take care of them in the way that we believe and they deserve to be taken care of. I went to a symposium on aging at the University of Kansas and they had a as part of a panel, a funeral home director from Texas who said at this symposium and it's burned into my brain. He says, I can always tell as a funeral director if the person has been looked after at home or they've been looked after in a nursing home, the person who is in the nursing home is in a lot better shape. I can see Janet looking at me. The argument being Janet, why would you expect someone at home and we want to make this a mythical experience. We're so good, we're so morally upright, we're looking after our loved one at home, but there's just you. And you may be older yourself, you may have your own issues. And now it may take, you know, a team of six to eight people looking after you in a, you know, assisted living facility. You got a lot more care, a lot more support. Well, except to the extent that you're hearing from these experts that the staffing is the issue and you're not getting that level of support. So perhaps he lived in a different kind of community than we have. Okay. But Camille, Camille deals with the people who are complaining. You're dealing with a lot of other folks, are they happy being in assisted living facilities, nursing homes? Are you tracking folks who come through your office, Samantha? Of course I am. But I have a personal experience that I'm just going to pray for one minute that my mother's not watching, okay? So, cut this out of the clip. Um, my father died at home. The day he died, she said to me, she called that last day and said, okay, you can take him. I work in this field. Did I want that? But my mother is less than 100 pounds. My father had ALS, he had bed sores. And I work in this field. We couldn't move him, the two of us. Sometimes your own limitations as a human, as a daughter, as a mother, require you to seek alternative care. But that's my whole point about being able to age in place and having the support services needed to augment what a family can do. And those services are available and everything that nonprofits like Shepherd Center does are at no expense to the family. That require philanthropic funding that is very difficult to get. But I I'm my position is invest in prevention. It's far less expensive than than paying for failure. And at the beginning of the day, if we invested in the support services to keep people supported at their home, then we wouldn't be waiting until the last minute and then getting a substandard care in a nursing home. We've already got a lot of questions coming in already from our own audience since we started the whole project. We heard from Sandy in Micah, Kansas, who writes, my dad refuses to consider moving into assisted living. He's in his late eighties, a cancer survivor and taking care of my mother who has mild dementia. How can I bring this up with my parents and help them understand that assisted living would be good for everyone and it's not what they think it is? Dr. Jessica. I want to answer at the question you asked and that is yes. We need more men in this field. We need all of the people to really stand up there and help all of the people. We are all hopefully going to be older adults someday. And we need to all be ready for that. We always like to think of ourselves to be talking about somebody else, but it is us. All of us are going to be doing that even our young interns at our television stations. So why are you doing aging? Well, we're all going to be be in this age category ourselves. We need to be thinking about it. And real quick, how about the age? What's a good age for somebody in an old. Anyone that cares and all hands on deck. There's no excuse. There's no excuse to not provide the kind of care that people need regardless of what their status is. So that so that's the bottom line. It's it's all hands on deck. Thank you for your question, sir. Thank you very much. Thank you very much. I really appreciate it. Let's give all these people a hand. Thank you so much.
