The Sentinel: Assisted Living

Expected growth is creating opportunities in senior home healthcare industry

StatePoint Media - Medical professionals, patients and their families are increasingly seeing the value of home care, and the industry is expected to grow. In fact, home health and personal care aide job openings are projected to grow 33% from 2020 to 2030, with experts predicting an estimated 8.2 million job openings in home-based care by 2028. Industry experts say that workers from all backgrounds, not just nursing, will be needed now and in the future.

"If you enjoy working with people and helping others when they need it most, a job as a home care or hospice nurse, home health aide, personal companion or caregiver could be a good fit for you," says Jennifer Sheets, president and chief executive officer of industry leader, Interim HealthCare Inc. "Likewise, if you're currently a medical professional seeking more flexibility and to be reminded of why you entered the field in the first place, home healthcare can offer greater job satisfaction and a much-needed change of pace."

To help potential job candidates understand this growing industry, Interim HealthCare is sharing some quick insights:

Why In-Home Care?

Home care describes personal care and support services provided to an individual in their home. Often referred to as senior care, it provides help with the activities of daily living as well as companionship to those who need support to maintain their independence at home. Home healthcare on the other hand, entails medical-based care to help patients recover from an illness or injury, or to provide in-home medical oversight and ongoing care for complex, chronic medical conditions. Many families and patients can testify to the various ways home care can be a game-changer, and a growing number of physicians and medical professionals are recommending home health services to patients of all ages because it delivers cost-effective, high-quality care in the setting where patients most often want to be -- home. Among these services are in-home nursing, physical, occupational and speech therapy, hospice care and bereavement services.

What Employers Want

Those in the know at Interim HealthCare say that being compassionate, trustworthy, dependable and having the ability to work independently can help you thrive in the field of home care. "Made for This," Interim's current recruitment campaign, highlights the company's need for registered nurses, licensed practical and vocational nurses, along with certified nursing assistants, home care aides, home physical therapists, occupational therapists and speech therapists. Veterans, with their track record of serving and protecting others, are encouraged to apply for a home care job, along with anybody who thrives in a job that offers variety, challenge and new faces and places.

What to Look for in Employers

Seeking a career in the field of home care? Be sure you work for a home healthcare organization with a positive work culture that has your best interests in mind. That includes offering good work-life balance, flexible schedules, rewarding assignments and competitive pay. The employer should also prioritize your continuing education and professional development by offering advanced learning opportunities and room for growth, along with additional perks like tuition discounts, to make it all possible.

For a home healthcare career guidebook, visit info.interimhealthcare.com/jobs-in-home-healthcare.

As demand for medical and personal care in the home grows, consider a career in this thriving field, whether you're entering the workforce for the first time or embarking on a career change.

Guest Commentary | It is worth it to buy a house

by Glenn Mollette, Guest Commentator

A retired minister and his wife had never owned a house. They had spent all their married lives living in housing provided by churches. At age 65, they bought a house and financed it for 15 years. They had been frugal and had saved a good down payment. They paid for the house by age 80. The value of the house increased over the years and at age 83 they sold the house and received a very nice check. The money from the sale was enough to help them fund their next ten years in a nice assisted living apartment. While taking on a mortgage at 65 appeared crazy to some it afforded them financial security further down the road.

Many years ago, I bought a modest new house that cost $151,000. I barely scraped together the nearly $30,000 down payment. The house was financed for 15 years. I began the laborious journey of writing a monthly check to the bank. After about eight years, I needed money to pay medical bills and was able to borrow $30,000 against my equity. It was nice that I had the equity because at that time I really needed the cash. Looking back, I would never do that again because it made the actual cost of my house increase to $181,000. For a couple of years, I had two payments to make to the bank. A couple of years later my wife passed. If I had needed to borrow $10,000 against my house, I could have done so to pay for funeral expenses. Fortunately, we had both taken out small insurance policies that covered that cost. Eventually I refinanced and consolidated the mortgages. By the grace of God I still paid for the house in 15 years.

I don’t like monthly payments or paying rent. For most of us, at some point in our lives there will be a monthly payment of some kind. I’ve lived in apartments on several occasions and even houses furnished to me by congregations I served. I didn’t care for either one. I’m not saying I wouldn’t do it again but my preference is to live in a place that is actually mine for as long as possible.

Renting a house or an apartment works for many at different stages of life. Buying a house is tough because it is a major financial commitment. You normally have to come up with 20% of the price to pay down as well as have the income to make the payments. That’s not always easy.

New houses in a nearby neighborhood are presently selling for $400,000. Most of them are modest three to four-bedroom houses. Having enough money to make the down payment and monthly payments is a lot for any person or family.

However, rent is expensive. Depending on where you live you may be paying $800 to $3,000 a month for a small apartment. You don’t have maintenance or property taxes but you’ll also never see that money again. A friend of mine sold her house at age 70 and moved into an apartment complex for people over age 55. She pays rent but she says the landlord treats her well and is timely with upkeep. A landlord who is very untimely with upkeep is very frustrating.

There are pros and cons to owning and renting. Choosing depends on your situation and personal preferences. A landlord can raise your rent and have rules pertaining to pets, painting, and more. However, it may be just exactly what you need. Typically, you don’t want to sink your money into property if you are going to move in three or four years. You might come out ahead if you buy a fixer upper and have the time and money to improve the property. You don’t want to make a bad buy. Buying property that you can’t resell is a bad idea, unless you love it and plan to live there a long time.

Keep in mind that a big chunk of most American’s wealth is in the house they own. If you pay for it and maintain it you can normally sell it to someone and recoup a lot of your money. You might even make a nice profit.

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Dr. Glenn Mollette is a syndicated American columnist and author of Grandpa's Store, American Issues, and ten other books. He is read in all 50 states. The views expressed are those of the author and are not necessarily representative of any other group or organization.

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This article is the sole opinions of the author and does not necessarily reflect the views of The Sentinel. We welcome comments and views from our readers. Submit your letters to the editor or commentary on a current event 24/7 to editor@oursentinel.com.

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Families are not happy with states requiring Covid tests for nursing home visits

This is a huge inconvenience, but what’s most upsetting is that no one seems to have any kind of long-term plan for families and residents

by Judith Graham, Kaiser Health News

As covid-19 cases rise again in nursing homes, a few states have begun requiring visitors to present proof that they’re not infected before entering facilities, stoking frustration and dismay among family members.

Officials in California, New York, and Rhode Island say new covid testing requirements are necessary to protect residents — an enormously vulnerable population — from exposure to the highly contagious omicron variant. But many family members say they can’t secure tests amid enormous demand and scarce supplies, leaving them unable to see loved ones. And being shut out of facilities feels unbearable, like a nightmare recurring without end.

Photo: Avelino Calvar Martinez/Burst

Severe staff shortages are complicating the effort to ensure safety while keeping facilities open; these shortages also jeopardize care at long-term care facilities — a concern of many family members.

Andrea DuBrow’s 75-year-old mother, who has severe Alzheimer’s disease, has lived for almost four years in a nursing home in Danville, California. When DuBrow wasn’t able to see her for months earlier in the pandemic, she said, her mother forgot who she was.

"This latest restriction is essentially another lockdown," DuBrow said at a meeting last week about California’s new regulations. "The time that my mom has left when she can recognize in some small locked-away part of her that it is me, her daughter, cleaning her, feeding her, holding her hand, singing her favorite songs — that time is being stolen from us."

"This is a huge inconvenience, but what’s most upsetting is that no one seems to have any kind of long-term plan for families and residents," said Ozzie Rohm, whose 94-year-old father lives in a San Francisco nursing home.

Why are family members subject to testing requirements that aren’t applied to staffers, Rohm wondered. If family members are vaccinated and boosted, wear good masks, stay in a resident’s room, and practice rigorous hand hygiene, do they pose more of a risk than staffers who follow these procedures?

California was the first state to announce new policies for visitors to nursing homes and other long-term care facilities on Dec. 31. Those took effect on Jan. 7 and remain in place for at least 30 days. To see a resident, a person must show evidence of a negative covid rapid test taken within 24 hours or a PCR test taken within 48 hours. Also, covid vaccinations are required.

In a statement announcing the new policy, the California Department of Public Health cited "the greater transmissibility" of the omicron variant and the need to "protect the particularly vulnerable populations in long-term care settings." Throughout the pandemic, nursing home residents have suffered disproportionately high rates of illness and death.

New York followed California with a Jan. 7 announcement that nursing home visitors would need to show proof of a negative rapid test taken no more than a day before. And on Jan. 10, Rhode Island announced a new rule requiring proof of vaccination or a negative covid test.

Patient advocates are worried other states might adopt similar measures. "We are concerned that Omicron will be used as an excuse to shut down visitation again," said Sam Brooks, program and policy manager for the National Consumer Voice for Quality Long-Term Care, an advocacy group for people living in these facilities.

"We do not want to go back to the past two years of lockdowns in nursing homes and resident isolation and neglect," he continued.

That’s also a priority for the federal Centers for Medicare & Medicaid Services, which has emphasized since Nov. 12 residents’ right to receive visitors without restriction as long as safety protocols are followed. Nursing homes could encourage but not require visitors to take tests in advance or provide proof of covid vaccination, guidance from CMS explained. Safety protocols included wearing masks, rigorous hand hygiene, and maintaining adequate physical distance from other residents.

With the rise of omicron, however, facilities pushed back. On Dec. 17, an organization representing nursing home medical directors and two national long-term care associations sent a letter to CMS’ administrator asking for more flexibility to "protect resident safety" and "place temporary visitation restrictions in nursing homes." On Jan. 6, CMS affirmed residents’ right to visitation but said states could "take additional measures to make visitation safer."

Asked for comment about the states’ recent actions, the federal agency said in a statement to KHN that "a state may require nursing homes to test visitors as long as the facility provides the rapid antigen tests, and there are enough testing supplies. … However, if there are not enough rapid testing supplies, the visits must be allowed to occur without a test (while still adhering to other practices, such as masking and physical distancing)."

Some relief from test shortages may be at hand under the Biden administration’s new plan to distribute four free tests per household. But for family members who visit nursing home residents several times a week, that supply won’t go very far.

Since the start of the year, tension over the balance between safety and residents’ rights to visitation has intensified. In the week ended Jan. 9, 57,243 nursing home staffers reported covid infections, almost 10 times as many as three weeks before. During the same period, resident infections rose to 32,061, almost eight times as many as three weeks earlier.

But outbreaks are occurring against a different backdrop today. More than 87% of nursing home residents have been fully vaccinated, according to CMS, and 63% have also received boosters, reducing the risk that covid poses. Also, nursing homes have gained experience handling outbreaks. And the toll of nursing home lockdowns — loneliness, despair, neglect, and physical deterioration — is now far better understood.

"We have all seen the negative effects of restricting visitation on residents’ health and well-being," said Joseph Gaugler, a professor who studies long-term care at the University of Minnesota’s School of Public Health. "For nursing homes to go back into a bunker mentality and shut everything down, that’s not a solution."

Amid egregious staffing shortages, "we need people in these buildings who can take care of residents, and often those are visitors who are basically functioning as unpaid certified nursing assistants: grooming and toileting residents, turning and repositioning them, feeding them, stretching, and exercising them," said Tony Chicotel, a staff attorney at California Advocates for Nursing Home Reform.

Nearly 420,000 staffers have left nursing homes since February 2020, according to the U.S. Bureau of Labor Statistics, worsening existing shortages.

When DuBrow learned of California’s new testing requirement for visitors, she arranged to get a PCR test at a testing site on Jan. 6, expecting results within 48 hours. Instead, she waited 104 hours before getting a response. (Her test was negative.) Eager to visit her mother, DuBrow called every CVS, Walgreens, and Target in a 25-mile radius of her home asking for a test but came up empty.

In a statement, the California Department of Public Health said the state had established 6,288 covid testing sites and sent millions of at-home tests to counties and local jurisdictions.

Photo: John Cameron/Unsplash

In New York, Democratic Gov. Kathy Hochul has pledged to deliver nearly 1 million covid tests to nursing homes, where visitors can take them on the spot, but that presents its own problems. "We don’t want to test visitors who are lining up at the door. We don’t have the clinical staff to do that, and we need to focus all our staff on the care of residents," said Stephen Hanse, president and CEO of the New York State Health Facilities Association, an industry organization.

With current staff shortages, trying to ensure that visitors are wearing masks, physical distancing, and adhering to infection control practices is "taxing on the staff," said Janine Finck-Boyle, vice president of regulatory affairs at Leading Age, which represents not-for-profit long-term care providers.

"Really, the challenges are enormous," said Gaugler, of the University of Minnesota, "and I wish there were easy answers."

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Money Matters: Three businesses that would be great to have in St. Joseph

by Jake Pence, Guest Columnist

As St. Joseph and small towns across the country face stagnation (lack of growth) it is important that they prioritize their local economy.

St. Joseph is a desirable place to live for many reasons. We have a great school system, small town values, a low crime rate, proximity to jobs and everyday necessities, the best El Toro in Champaign County and numerous local businesses. I could go on and on. However, if population growth isn’t a desired outcome then population retention is pivotal to the long-term livelihood of the community.

What’s the best way to improve the desirability and longevity of a small town? Create a thriving local economy that isn’t too dependent upon one industry.

That said, this article is dedicated to three businesses I believe would improve resident retention and add a welcomed vitality to the local economy in St. Joseph.

BUSINESS IDEA #1:
BBQ & Craft Beer Restaurant
Location: East of Jack Flash

Yes, we already have a great selection of restaurants in St. Joseph and this is by no means a knock against any of them. I thoroughly enjoy a burrito loco from El Toro, the frisco melt from Roch’s and anything on the menu at The Wheelhouse. I’ve also eaten my fair share of China King, Padano's, Scratch, Subway, Monical's, and Dairy Queen over the years.

Despite all of these options, what we're missing is delicious portions of pulled pork, beef brisket, burnt ends, cornbread, potato salad, coleslaw, and craft beer.

To scratch that itch, residents of St. Joseph and surrounding communities have to drive to Urbana or Champaign.

Have you heard of Burgers & Beer in Gibson City? How about Gross’ Burgers in Westville? I’m guessing you have heard of one if not both. What do those restaurants have in common? First, when my family drives past them we stop and eat. Second, they are demand drivers for their local economy.

I firmly believe that a BBQ and beer focused restaurant would develop into a staple of the St. Joseph food scene and drive demand to the rest of the local economy. For proof of concept, visit Edley’s next time you’re down in Nashville, TN.

BUSINESS IDEA #2:
Boutique Assisted Living Facility and Memory Care Center
Location: Southwest of the middle school or a new residential development

Based on the recent traffic I’ve seen at my proposed location, this could very well be in the works.

Why do most people live in St. Joseph? They grew up here and this is where their family lives; therefore, we should prioritize the health, housing, and livelihood of all residents from newborns to great grandparents.

One of the hottest trends in real estate is assisted living facilities because the baby boomer generation is approaching the age where this assistance may be necessary. Additionally, Alzheimer’s rates are rising and quality memory care facilities are becoming more important than ever.

The addition of a boutique assisted living facility and memory care center to the community would be ideal to provide a much needed service to the older generations of St. Joseph. Instead of having to drive to Champaign, Urbana or to other facilities in the surrounding area, families and caretakers could make a five minute drive across town to check-in and visit loved ones.

For proof of concept, check out my colleague Loe Hornbuckle at Sage Oak Assisted Living based in Texas - https://thesageoak.com/.

BUSINESS IDEA #3:
Home Remodeling General Contractor
Location: Vacant lot on 2nd Street south of the Kickapoo Rail Trail or your garage

How many of you have completed a home remodeling project during COVID-19? My guess is 50% of the people reading this article have done one or more improvements to their home. How many of you ENJOYED the process of completing your home remodeling project? I’m going to say 10% - and if you’re in that 10% then pay close attention.

In my opinion, St. Joseph has a housing situation that is bottle-necked by supply and demand issues. That has resulted in the village not experiencing the population growth many once thought it would thanks to stagnation. If we aren’t going to develop new housing – a topic for another day, then we must continue to revitalize and renovate the current housing supply.

There are already businesses in town that do this and do it well – a shoutout to Roger Beals - but these businesses are always booked out weeks, sometimes months in advance. There is a shortage in supply and a surplus in demand for contractors; therefore, there is an opportunity for a new company to balance out the market with a much needed service.

With minimal overhead costs, diligent customer service, and an active social media presence, I don’t think it would take long to create a thriving business with many opportunities to expand into nearby markets.

All of these businesses will take a certain level of industry specific knowledge and access to capital to start, but that can be acquired through partnerships, research, and over time. Entrepreneurship isn’t about reinventing the wheel or coming up with a Shark Tank-esque idea. It is about finding opportunities in the marketplace and taking action to meet an unfulfilled demand.

As an investor and entrepreneur, I am personally very interested in exploring all three ideas. There may be others in your circle who feel the same way. Start a conversation. Discuss the possibilities and the opportunities. Quite frankly, I think conversations about entrepreneurship and taking calculated risks aren’t talked about enough in our community, yet we are home to some of the brightest minds and hardest workers in the area.

It is time to make entrepreneurship a priority in St. Joseph. So let’s get to it!

About the author:

• Jake Pence is the President of Blue Chip Real Estate and a consultant for Fairlawn Capital, Inc.. A 2019 graduate from the Gies College of Business at the University of Illinois, he is a 2016 graduate from St. Joseph-Ogden High School where he was a three-sport athlete for the Spartans. You can view his latest acquisitions and advice on his YouTube channel here.