Inadequate care

Each week as a pastor is different from the previous one. It is one of the things about my vocation that I enjoy and which keeps me engaged and learning. Last Sunday, the 1st Sunday of Advent was a clod and blustery day. To top it off, the bus driver who helps transport people to our church woke up sick and we didn’t have time to recruit and deploy a substitute, so the bus did not operate. It wouldn’t have been very full anyway because slippery streets and sidewalks were keeping some of our members safely at home. For those who did make it out the day turned out to be not too big of a challenge. Our snowplowing service had worked hard on Saturday to keep our lot clear for the annual Christmas Tea, so it was free of ice on Sunday. There was a performance of the community handbell ensemble in the afternoon and a late afternoon meeting with a local synagogue to commemorate the first night of Hanukkah, so the day was busy, even though the number of people attending events was fewer than we would have expected had the weather been a bit less chilly and snowy.

Sunday was also a communion Sunday and so this week I’ve been trying to squeeze in as many visits to folks to bring them communion as possible. Taking communion to individuals and small groups has always been one of the delights of my calling. I get a chance for a bit of conversation with people. Communion sparks memories and I usually hear some stories of faith in action. People are appreciative of my work and quick to thank me for coming.

While visiting the people of our church is a delightful experience, the institutions where some of them live often pose challenges. While a large number of people are able to live independently until the ends of their lives, there are others that need assistance with daily living. Institutional care is often the choice of families. In Rapid City is a retirement community and there are a lot of different centers that offer skilled nursing care, assisted living, memory care, and other services.

My impression after this week’s visits so far, however, is not good when it comes to the institutions that serve our people. One skilled nursing home in our community has recently gone through a sale and then another change in management. I have heard that it it is currently in receivership, though I haven’t been able to confirm it. Officially, it is run by a corporation that operates 22 centers in four states, and appears, from its website to have extensive experience and resources. The facility is physically well-maintained, but as I walked the halls yesterday, it was evident that I was seeing a lot of residents and rehabilitation patients, but very few staff persons. Outside of the clerk at the front desk, I was greeted by no other staff during my visit. I’ve visited in the facility and didn’t need assistance finding the patient I was visiting, but the building is a bit confusing for a first-time visitor and I wondered how others might feel. The person I was visiting happens to be a former director of that facility and so our conversation drifted to the issue of staffing. He reported that a typical response to pushing his button to call for assistance was well over a half hour and that he had been left without assistance in the bathroom for an extended period since he was a patient, something that never would have happened when he worked in the facility. He confirmed that the facility seemed to be woefully understaffed.

Another company that operates four facilities in our town is back after having sold the facilities, but the customer that bought them was unable to operate them and the company is now operating them, but clearly at a reduced level of staffing. It is unclear whether this is a temporary or permanent situation. Although they, too are woefully understaffed, the web sites of all of those facilities currently claim that there are no job openings at any of them at present. it makes me wonder if understaffing is a new normal for that type of facility.

There are two continuity of care facilities in our community and both have completed new construction in the past year. The facilities appear to be very well-maintained and offer modern amenities. But from the perspective of one who leads worship services in those facilities, I know that worship isn’t a priority. I’ve arrived to lead worship only to find staff surprised that I am there, the room unprepared, and sometimes other activities schedules for the space. In one facility where I held regularly scheduled services for more than 20 years, I was turned away when I arrived for a service saying that the service conflicted with other scheduled activities and that our service wasn’t on the schedule. While the residents want worship services, it certainly seems like the institutions don’t care whether or not they are available.

Worship isn’t about my convenience. My job is to serve people, and I’m willing to go through a bit of hassle to do it. I don’t mind rearranging furniture. I do a fair amount of that in my own facility. I understand that staffing is lighter on Sundays than on other days of the week. I also know that from the perspective of residents, weekends offer a lot fewer activities than weekdays.

There are a number of different assisted living facilities in our area, including several new ones. They provide a wide range of different services and a wide range of different management styles. Some of them are a real challenge for access for visitors, with locked doors and special procedures to gain access. I understand the need for security, but true security requires people. It can’t be accomplished by locks and cameras alone.

The number of people needing skilled nursing services and assisted living will continue to increase in the years to come. Clearly more staff are needed in our community. It remains unclear to me, however, whether or not the facilities are willing to pay a living wage to those who work in them. When profits are placed above care, it doesn’t leave a pretty picture.

Having just re-read this journal entry, I am aware that the words I have written are much less harsh than the thoughts I have had in the past couple of days. I wish I could offer solutions instead of criticism, but it is clear that this problem is bigger than me.

Copyright (c) 2018 by Ted E. Huffman. I wrote this. If you would like to share it, please direct your friends to my web site. If you'd like permission to copy, please send me an email. Thanks!