This Type of Dilemma is Not Limited to CCRCs

A recent article appearing in the Herald-Tribune in Sarasota, FL properly titled “An Elder’s Liberty vs. a Communities Duty” highlights an unfortunate struggle between the family of a former resident of Plymouth Harbor- a continuing care retirement community (CCRC) – and the staff over the issue of whether the resident should remain in independent living or move into the on-site healthcare facility.

The family felt that the resident, Mrs. Krinsk, should be allowed to stay in her independent living unit despite the fact that she has, as the article described, “progressive dementia” and that there had been a number of incidents of her wandering; one which resulted in her being struck by a car. The debate led the family to file a lawsuit against Plymouth Harbor that is still pending.

Life is full of tough situations and this is a good example of one such situation. Who can blame the family for wanting to avoid moving their mother into the nursing facility? They even offered to pay out of pocket for 24-hour care so Mrs. Krinsk could stay in the independent living unit. Yet, for the safety of Mrs. Krinsk and other residents of Plymouth Harbor the staff felt that it was their duty and responsibility to move Mrs. Krinsk from the independent living unit into the healthcare center. They are standing by their decision and plan to fight the lawsuit tooth and nail.

While I advocate every day for the importance of consumer education and transparency in senior living, I also feel compelled at times to speak up on behalf of the industry. There are three important points that I think consumers should understand as it relates to the article.

First, I want to point out a piece of misinformation. The author states that following the dispute Mrs. Krinsk moved from Plymouth Harbor into to Kobernick House, another CCRC where she paid a second entrance fee. According to their website Kobernick House is a rental-only community and does not charge entry fees. If this is the case then, technically, Kobernick House would not be considered a continuing care retirement community by the state of Florida. While Kobernick house does offer services spanning the continuum, including independent living, assisted living, and skilled care, the state of Florida recognizes CCRCs as entry fee communities that contractually guarantee a continuum of care. It is not clear from Kobernick House’s website if residents are guaranteed lifetime access to care. If that were the case then I suspect Mrs. Krinsk would have had difficulty meeting the health requirements for entry into an independent living apartment.

As an aside, I noticed that the healthcare facility at Plymouth House has a CMS rating of 4-stars while the facility at Kobernick House has a rating of 2-stars. Granted, there is some debate about the validity of these ratings but it’s worth noting given the topic of the article.

Second, I think there are some who automatically assume entry-fee CCRCs are evil and out to get everyone. (See reader comments at the end of the article.) Could it be possible that the staff at Plymouth Harbor did what they truly felt was in the best interest of the resident and the community as a whole? Certainly there are exceptions, as with any industry, but most CCRCs do a wonderful job looking after residents and meeting commitments. In fact, approximately 80% are not-for-profit, including Plymouth Harbor, and studies show that a large majority of adult children whose parents have lived in a CCRC would choose one for themselves. (Contrast that against the experience of most family caregivers who provide care for loved ones in their home.)

Lastly, it is important to recognize that situations similar to the one described in this article take place not only in CCRCs but in other settings as well. For example, several years ago my great aunt lived in a stand-alone assisted living facility and was told she could no longer stay there because the staff was not equipped to deal with her emotional swings and wandering. We initally disputed the staff’s assesment but ultimately determined that they were probably right. The difference is that they didn’t even have higher-levels of care available. She was out on the street. Had she been in a CCRC the transition likely would have been much easier for her and our family.

Situations are rarely perfect, especially when it comes to looking after elderly loved ones where emotions are involved. But such challenges are not confined to CCRCs; they can arise whether someone lives at home, in a CCRC, or in a care facility. Deciding when a loved when requires a higher level of care, as well as who makes that decision, is an important consideration no matter the setting. Ultimately you have to ask what the alternatives are and recognize the challenges that could arise under each one.

Please note that LifeSite Logics does not have any form of relationship with either of the communities mentioned in the article and has no knowledge of the incident at Plymouth Harbor beyond what is described in the Herald-Tribune article.