Ep 333 - DisElderly Conduct with Judy Karofsky

Macro N Cheese

If civilizations are judged by how they care for their elderly, our report card is already written. Should there be anyone left to judge us – should humanity exist long enough to judge us – we’ve flunked.

Steve’s guest is Judy Karofsky, author of 'DisElderly Conduct: The Flawed Business of Assisted Living and Hospice,' who provides a critical examination of the elder care industry. Judy discusses her own struggles with assisted living facilities and hospice care, highlighting the systemic issues driven by the profit motive and lack of federal oversight.

Assisted living is meant to be for seniors who don’t yet need a nursing home. The facilities are supposed to provide the dignity of independence with up to three hours of care per week. Unfortunately, that means from zero to three. Often, it’s zero – with no nurse on staff.

In many cases the move from independent living isn’t a health decision. It’s business. The assisted living business is about real estate investment, not the needs of our nation’s seniors.

"Big investors, big REITs, Real Estate Investment Trusts, and yes, private equity have seen the potential and they're investing and the decision-making moves farther and farther away from the individual facility and farther and farther away from the resident.”

Steve makes a case that will be familiar to our followers: that healthcare – and its federal oversight – are policy decisions, connected to ideology. It’s the belief that there is no public money.

”There is only private property and there's only private equity and there's only private capital. And that when you impose regulations, you're imposing undue constraints on capital to do what capital would like to do. We have to start thinking about the world differently.”

The episode illustrates the urgent need for reform in elder care. These challenges will one day touch everyone’s lives or those of their loved ones.

Judy Karofsky was a city council member and one of Wisconsin’s first women mayors (Middleton). During her term of office, she established a now-thriving senior center and emergency medical services. She served on the executive staff of a governor and held multiple roles in housing and economic development for a state agency, a nonprofit housing development organization, and her own research firm. Before organizing and providing care for her mother, Judy filled interim positions for a statewide women's network – focusing on elder economic security – and for a coalition of state aging groups. Serving on nonprofit and municipal boards, she participates in policy discussions and comments publicly on demographic trends and urban growth.