Is More Regulation Needed For Memory Care Services?

Assisted living memory care facilities are not subject to the same regulations that nursing homes must meet. Some believe the pandemic has shown that this can leave those in need of such services vulnerable to mistreatment.

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Experts on long-term care believe the pandemic has laid bare some weaknesses in the system. A South Windsor family said one example is how they believe the town’s former mayor was mistreated at an assisted living memory care facility.

A state investigation found procedural violations, but not abuse or neglect.

For years, Lincoln Streeter and his family served the town of South Windsor. He was on the town council, and was mayor from 1989-1993. A banner with his name was recently put up outside the community center.

Carolyn Streeter Mirek, at one time South Windsor’s mayor as well, said her family wanted her 81-year-old father, who was blind and suffering from late-stage Alzheimer’s, treated with dignity when he moved to The Residence at South Windsor Farms. It has assisted living and memory care services.

Family Photo

It started out well, but then Streeter Mirek said around the time the pandemic ramped up her father was moved to a memory care unit for his advanced Alzheimer’s disease. Eventually, the family was limited to FaceTime visits.

In January, relatives got to see Streeter in person, and were alarmed by what they found.

“They were horrified to find the condition he was in. My dad was always meticulously groomed, and he had a full beard, it was obvious he hadn’t bathed. The place reeked of urine, and when my brother went to hug him, he could feel the frailty in his bones,” Streeter Mirek told NBC Connecticut Investigates.

Streeter Mirek said the family asked the assisted living facility to keep closer track of her father’s feeding, bathing, and dressing.

“It happened for one day and then they said, they’re not allowed to do it because they’re not a nursing home,” Streeter Mirek said.

The Residence is an assisted living that also offers memory care services, which is not considered a nursing home. Skilled nursing facilities are required to provide more documentation than assisted living memory care facilities.

In February, Streeter Mirek said her father had a bad fall and was brought to the hospital. He was stitched up and also diagnosed with malnutrition. He was then transferred to a nursing facility, and passed away in March.

Family Photo

“It was a nightmare, and you know, it’s still very painful,” Streeter Mirek said.

The Residence declined an on-camera interview, releasing a statement that said, “First and foremost, our sympathies are with the Streeter family for their terrible ordeal with Alzheimer’s disease and the loss of their father. It is a very difficult thing for a family to go through. It is important to point out that after an extensive investigation the state’s highest healthcare authority, the Department of Public Health, found no evidence of neglect or other mistreatment in this situation. The same conclusion was reached by independent healthcare professionals and the local authorities. Nonetheless, we are fully supportive of the state’s efforts to maintain proper regulation of communities serving our senior population.”

NBC Connecticut Investigates found a copy of the DPH report on Streeter’s case. View the full report at the bottom of the page.

While the agency found no neglect or abuse, it called for a plan of correction to address procedural violations from an unannounced visit March 24 this year.

The facility pledged more staff training on recognizing and documenting changes in resident conditions, including body weight, and better communication with family members about the care plan of someone living at the facility.

A spokesman added The Residence does not have patients, and it is not a medical facility, but more like an apartment building that offers services.

NBC Connecticut Investigates asked state Long Term Care Ombudsman Mairead Painter about the issue. She said, “This is a national problem…for these units there isn't a prescribed amount of staffing or set up in the way that the individuals are going to provided support and that's where we saw extreme challenges during the pandemic.”

State Sen. Dr. Saud Anwar, a physician and former South Windsor mayor who said Streeter guided him in that role, explained regulation for memory care facilities needs to approach the level of scrutiny that nursing homes must answer.

“There was significant neglect and abuse I feel very strongly that what has happened should not have happened and we need to do whatever we can, so this does not happen to anyone else in our state,” Anwar said.

“My dad was always a champion for the little guy and what happened to him is just unacceptable and I just don’t want it to happen to anybody else,” Streeter Mirek added.

My dad was always a champion for the little guy and what happened to him is just unacceptable and I just don’t want it to happen to anybody else.

Carolyn Streeter Mirek

Lawmakers have proposed state and federal legislation on long term facilities which will guarantee at least two designated essential caregivers access to their loved ones during any public health emergency, and changes to the way contracts are written for long term facilities that advocates believe will bring more fairness and transparency for clients.

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