An outcome of increased medical knowledge and its applied technology is that many individuals continue to live well beyond 65 years. During 1900, the median age at time of death was 49 years. Today, 35% of the American male population is already 72 years old and women even live a bit longer.
So it behooves any adult who still has living elderly parents to do some planning about the care that may be needed when that elderly parent or relative becomes ill or incapacitated. This topic needs to be addressed responsibly because many adults did not save enough to have an adequate retirement plan, and only 16% invested in a long-term care insurance policy. With today’s implementation of the Affordable Care Act, some support may become available to your family if you know how to plan for the qualifications needed. This is the ‘family’ side of the ‘long term care’ challenges that an individual will face. Unfortunately, too many do not think about this inevitable need in time to implement an effective program.
There is another public policy matter already upon us. Think of the continuum of care that an individual may need eventually. Officials at the Department of Health, State of California, are increasingly having to cope with unlicensed ‘board and care residences’. Several ‘extended care’ residences exist. Only those whose bed capacity exceeds 6 beds are required to be licensed. An expert in this field recently informed the Mental Health Board that an estimated 15,000 unlicensed ‘Board and Care Residences’ exist in California. The number of them that exist in the County of Santa Clara is not known. The State and County Health Departments do not have the resources (budget and staff) to assess the existing B&CR entities in operation today. This is the case for individuals who need some assistance in taking their medications, performing their rehabilitation exercises and/or having access to healthy meals and social activities. Also, there is the need for appropriate levels of care. ‘Oversight and monitoring’ is important in those cases where an individual with mental health issues needs to take his/her medication, which mitigates their specific issue.
The issue of ‘Board and Care Residences’ (B&CR) is very important because too often a patient, who is ready for discharge from a hospital, cannot be released because there is no appropriate care-level empty bed available in a local licensed skilled nursing, extended care, or BC&R facility.
The Mental Health Board, Systems Planning and Fiscal Subcommittee, is proposing to the Board of Supervisors to look into this matter in depth. An objective is to locate and identify both facilities needed, and professional staffing required. If adequate capacity can be identified, prepared and made available, then patients ready to be transferred from high per diem cost hospitals to an appropriate level extended care residential facility can be moved expeditiously.
This ‘human care service’ arena is very complex. Trained staffing is needed to deliver these labor-intensive medical care services. Fortunately, organizations such as NAMI (National Alliance for Mental Illness,) the Board & Care Improvement Project of the Mental Health Department, SCVMC, its Mental Health Advocacy Project have produced two documents entitled, ‘Resident’s Rights in Unlicensed Room and Board Homes (Independent Living Homes)’ and ‘Resident’s Rights in Licensed Room and Board Homes (Independent Living)’. Know that certain B&CR specialize in clients having developmental challenges; Alzheimer’s Syndrome, specific physical challenges, and mental health issues. Support services such as ‘Meals on Wheels’, case managers who do home visits, mental health and social services workers can be, and are, made available to assist families with the extended care challenges being faced in the home.
It is very important to not wait until the care of an elderly family member has reached crisis levels that require high cost emergency services. Many health care challenges, both mental and physical, develop over time. One can learn to anticipate, to identify to enable early intervention and prevention, and to know that competent help can be made available. Prompt and effective extended care services take some planning and taking time to schedule. This process will help keep costs of services down; effectiveness up and personal stress levels down.
The above information was developed by SCC Mental Health Enhanced Supplemental Board and Care Services; Margaret Oblior, Kim Pedersen, MHAP and Lorraine Zeller, Law Foundation of Silicon Valley.