A middle-aged woman called a senior helpline crying. “I promised my mother I would never put her in a nursing home,” the woman sobbed, relaying her situation to Jennifer Curry, the Atlanta Jewish community’s new AgeWell Atlanta information and referral concierge/manager. The caller’s mother had Alzheimer’s, didn’t recognize her daughter, and was beating her with a cane, recalled Curry, who worked with a social service agency outside the Jewish community at the time.
The Jewish community is faced with the responsibility of making sure its seniors are receiving the best care available, and that starts with being familiar with the senior resources available to them.
We caught up with Harley Tabak, CEO of Jewish HomeLife, provider of senior housing and at-home care services, to discuss the results from two recent news investigations on senior facilities.
The Atlanta Journal-Constitution’s “Unprotected” exposé on the Georgia private-pay assisted living industry, released over the past few months, showed that The Cohen Home and Berman Commons Assisted Living and Memory Care received few violations during routine inspections between 2015 and 2018 compared to their competitors in Georgia.
Berman Commons scored 0.8 violations in the AJC’s reporting and The Cohen Home 1.5. Those numbers were well below the state average.
And the William Breman Jewish Home scored an overall rating of 4 out of 5 in the U.S. News & World Report Best Nursing Homes short-term rehabilitation ratings, based on data up until August. The Jewish Home received a 3 out of 3 rating for its short-term rehabilitation and 2 out of 3 for its long-term care rating.
In terms of the AJC study, Tabak said Berman Commons ranked “off the chart,” with one of the highest ratings in comparison to competitors within a five-mile radius. “The Cohen Home also scored better than all of its competitors [in that area] with the exception of two,” he said. “Jewish HomeLife communities did superb in the AJC story.”
He attributed that to being one of the few nonprofit assisted living facilities in the area with higher than required staffing levels and strong support from the Jewish community, including fundraising and more than 1,000 volunteers in its Auxiliary.
Jewish HomeLife received $532,757 from the Federation this year, according to the Philanthropic Giving Report.
While Georgia requires one caregiver for 15 residents during waking hours in assisted living facilities and one for 25 overnight, Jewish HomeLife staffs at a 1-to-7 ratio in its assisted living facilities and in the memory care unit at Berman Commons 1-to-5 during walking hours and 1-to-10 overnight. “The very significant difference in staffing is very important,” said Tabak.
Those assisted living facilities also receive high recognition – the Bronze National Quality Award – from the American Health Care Association and for their “I’m Still Here” dementia training.
In JHL assisted living facilities, 90 percent of its caregivers are certified nursing assistants, having to pass certain training requirements. In nursing homes, all the caregivers are required to be CNAs, but not in assisted living, he said.
“We try to apply higher health care standards because health care is our focus.”
In the News & World Report study, the Jewish Home received five stars for quality and four stars for staffing because it didn’t have as many registered nurses in the building as the federal government would like but is steadily increasing that number. LPNs have less education and training than registered nurses, he explained.
“There is absolutely no worry about the competency of the people in place,” Tabak said.
“We still are one of the most sought-after skilled nursing homes in the region for rehabilitation and long-term care.”
Tabak said he welcomed the push for more RNs by the government and the efforts toward more oversight of assisted living facilities, the result of the AJC’s investigation.
“I think more oversight ensures more confidence in the care provided.”
With greater assurances of safety, though, there are likely to be higher costs passed on to the consumer, he said. But Tabak concedes, “It’s probably warranted.”
Cost of Living
In terms of the cost of Jewish senior living services, he said, “We provide all levels of affordability.”
Tabak said care in the Jewish Home is $300 a day, supplemented by Medicaid for those eligible who can’t afford the care. Assisted living at The Cohen Home and Berman Commons ranges from $4,000 to $8,000 a month, depending on the level of care provided.
Nursing home care is probably more costly than others in the market because of the higher number of staff required, but the assisted living care is comparable, he said.
Affordable housing is one of the areas the Jewish community maybe lacking in its effort to keep up with the growing population of older adults living longer, healthier lives, said Amy Glass, director in Community Planning and Impact for the Jewish Federation of Greater Atlanta.
“We have not even begun to scratch the surface to address it.” She said the Federation is talking about how to change that, and continuing to explore the subject.
About a third of all calls received by the Aviv Older Adult Services of Jewish Family & Career Services are for affordable housing, said Deborah Zisholtz, director of the program.
A new offering that may help to address affordable housing is the home sharing service JF&CS expects to launch next year. It offsets the cost of rent or a mortgage, allowing older adults to stay in their homes longer, which is the desire of 80 percent of those age 50 and older, according to an AARP study last year. Home sharing also offers an alternative to social isolation, which leads to depression among seniors, Zisholtz said.
Active and Engaged
According to the ARC regional snapshot, “many older adults experience isolation, which has been shown to have adverse health effects on par with smoking 15 cigarettes per day.”
Assisted living facilities are also helpful when it comes to combatting social isolation, something the AJC study failed to show, said Shari Bayer, Jewish HomeLife’s chief marketing and communications officer.
Bayer said, “Providing meaningful, purposeful activities, especially for those with dementia, can prevent them from exhibiting dementia-related behaviors such as wandering off, being aggressive or agitated,” Bayer said.
“The alternative, such as watching a game show at home by themselves, does not help slow the progression of dementia,” she explained.
A study in the Journal of Biomedical Science last year found that lonely people had higher risk of developing Alzheimer’s disease compared to people who were not lonely. “We can prevent cognitive decline and delay the onset of AD if we keep mentally active and frequently participate in social activities,” the study found.
AgeWell Atlanta, the new information and referral service for the Jewish community, coordinates care between three Jewish communal agencies to help direct them to appropriate services, whether they be specialized care in the home, counseling, support groups, a friendly visitor, transportation, recreational activity, or other assistance.
It’s a collaboration funded by the Federation in partnership with Jewish HomeLife, Aviv Older Adult Services and the Marcus Jewish Community Center of Atlanta to provide services along the entire continuum of care for older adults, Glass said.
AgeWell Atlanta received $137,850 from Federation, according to its 2019 Philanthropic Giving Report.
A common misconception is that older adults need to be in a nursing home, Curry said.
“People don’t know there are options to help them stay in their own home.”
The purpose of the coordinated initiative, which developed over the past four years, is to avoid duplication of services by the participating agencies, operating independently; fill in where service gaps exist; and where an agency has a niche, to contribute to the continuum of care for older adults, Glass said.
AgeWell Atlanta also provides a single entry point to help seniors. In the past, Curry might have only been able to offer long lists of available options for callers to consider and they would have to manage their own search.
When anyone contacts AgeWell Atlanta, Curry will consult with the participating agencies to decide the best course of action, handle the search and follow up as needed. She will manage the client’s care, evaluating whether it is effective or whether it needs to be revised.
As the older adult population continues to grow, its needs will too, Glass said, and different areas will need the community’s attention. For now, new programs such as AgeWell and home sharing will help fill the void.