a lobbyist with Cassidy & Associates.
Increasingly, lawmakers are showing a
willingness to have those discussions, in
large part thanks to the fiscal pressures.
The economics can be relatively easy
to sum up. “Some folks need skilled nurs-
ing, most probably don’t. That resonates
with folks on the Hill. Those are some
of our regular talking points,” Bernstein
says. “I mean, it’s not all about money.
But it is about money.”
The fiscal impact runs high when
financing does not align with appropri-
ate living settings. Billions of dollars
are spent each year to track wandering
seniors with Alzheimer’s disease and re-
lated dementias when caregivers are not
appropriately equipped to deal with such
circumstances. Family members lose bil-
lions in productive work time caring for
loved ones.
“We know what it’s costing us here.
We just need to connect the dots back to
things like assisted living,” says Andrew
Carle, assistant professor and director
of the Program in Assisted Living/Se-nior Housing Administration at George
Mason University. “We need to begin to
document how we have reduced falls,
how we have reduced medication errors,
how we have reduced rates of depression.
What we’re not seeing from Capitol Hill
is an interest in maybe funding some of
those studies.”
PHOTOS BY KASSIE BAKER PHOTOGRAPHY
in the medical arena could do much to
bring order to the situation. “Medication
management is the best example,” Allen
says. “The era of a nurse passing a pill
needs to be over, but unfortunately in
too many states, my home state being a
prime example, that’s still essentially the
mantra.”
Pill-passing exclusively by RNs is not
cost effective, but it also is becoming a
change that with the stroke of a pen. We
can bring people to this country who will
come here and promise to work in these
kinds of positions,’” Carle says. When
lawmakers take this sort of approach to
policy, “They’re not telling us how to run
our business, but they are putting the re-
sources in place to allow the entire system
… to have the resources they need to then
continue to contribute.”
“DEMOGRAPHIC AND FINANCIAL IMPERATIVES
WILL BE ADDING STRESS TO OUR
SYSTEM FOR YEARS AND YEARS TO COME.”
—ROBERT EGGE
Beyond the Dollar Signs
It’s not just a matter of Congress allocating more cash. Research grants are just
one example of the ways that lawmakers
can move the needle on senior living.
For example, successful care mod-
els could be replicated on a wider basis.
“There are some really well-vetted train-
ing programs that have been through
randomized controlled trials first, then
through limited deployment, and right
now that’s where many of these pro-
grams are stuck,” says Robert Egge, the
Alzheimer’s Association vice president
of public policy. “Programs like REACH
[Resources for Enhancing Alzheimer’s
Caregiver Health] and Savvy Caregiver
have all been shown to have good out-
comes for not only the caregiver, but for
the person they’re caring for. One of the
major opportunities we have is to make
sure that these well-tested, packaged pro-
grams get out to the people that need
them.”
At the same time, regulatory changes
practical impossibility. With the availability of nurses becoming a real question mark, regulatory changes on the
labor front could dramatically reshape the
landscape.
The Bureau of Labor Statistics projects
that when the last Baby Boomer retires in
2030, there will be 35 million more jobs
in this country than there will be people
to fill them. This will exacerbate an already severe shortage of long-term care
nurses and nurses’ aides.
“That’s the support we need from
Capitol Hill, is to look at those issues
and say, ‘Hey, you know what? We can
While labor laws could open up the
faucet, it also will take work on the part
of the senior living industry to make its
case. “Unfortunately, [long-term care] is
not sexy, it doesn’t get people excited if
they’ve never been there before. I think
there is some education needed,” Allen
says. Not just newcomers but veterans of
the profession need a new understand-
ing of the delivery of care, he adds: “Too
often what we see, nurses feel like, ‘I can’t
give med management over to someone
else because then I become irrelevant.’
What they have to understand is they are
needed other ways.”
