Democratic Underground Latest Greatest Lobby Journals Search Options Help Login
Google

About long term residential medical care for the aged, aka nursing home, who should pay?

Printer-friendly format Printer-friendly format
Printer-friendly format Email this thread to a friend
Printer-friendly format Bookmark this thread
This topic is archived.
Home » Discuss » Archives » General Discussion (1/22-2007 thru 12/14/2010) Donate to DU
 
hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:05 PM
Original message
Poll question: About long term residential medical care for the aged, aka nursing home, who should pay?
I think the odds are 1 in 4 right now that people over a certain age end up in a nursing home. I don't know of any practical way to predict at 45 what will happen to you at age 70. Is Alzheimer's in your future? A stroke? A trip or fall or car accident?

Right now your options are to

1. Purchase insurance at a time when you're trying to send the kids to school, pay off the mortgage and save for retirement.

2. Figure out a way to shelter your assets and have Medicare pay for it.

3. Sell off your assets to cover the first couple of monthly bills, then let Medicare pick up the tab.

The situation is so bad I've heard elderly people express the wish to die quickly rather than burden their survivors with bills. What changes would you like to see?

Printer Friendly | Permalink |  | Top
NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:09 PM
Response to Original message
1. I think there should be more home care options. Why don't policies cover more
of these programs? They are so much cheaper and can provide personalized care and keep families
engaged with their elderly members. I realize this isn't an option for everyone, but if there were more
services available to keep people at home, I think a lot more folks could do it.
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:29 PM
Response to Reply #1
11. New care models are on their way:
Printer Friendly | Permalink |  | Top
 
jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:00 PM
Response to Reply #1
28. Agreed. in MN we are at the point that most elderly in the nursing
homes are those who need intensive care while the rest do stay home with home health care. That goes for other disabilities also. One thing that could be changed is to help the family member that cares for the at home patient more.

Here if you are the parent of an adult person who needs home care you cannot do it yourself and receive any pay. Yet you give up a job to do this work.

For 45 years I took care of my severely disabled daughter for what they would give me from a welfare check - @ $.33 an hour. She is totally disabled and needs one-to-one assistance for all her functions. Instead of placing her in an institution which is high cost I decided that I should do it myself. I knew I was making a sacrifice. I worked low-income part time jobs when I could but my schedule had to adjust to hers. For the first 27 years of her life it was 24/7. After that MN had day care for 5 days a week for 6 hours a day. Until about 10 years ago I never had a vacation from her care. I am not complaining and I would do it again if I was called.

What I mean when I say we should help parents like me is (1)keep the home care programs going, (2) recognize that there is value in the person who stays home to care for a very sick relative, and (3) somehow include this as work under the Social Security plan. I live in poverty today because I could not work the hours/credits needed to be eligible for a ssa check that is big enough to live on.

Before someone says that parents are supposed to take care of their children I would ask how many people you know that are taking 24/7 care of their adult children?
Printer Friendly | Permalink |  | Top
 
NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 05:35 PM
Response to Reply #28
60. I am currently helping care for my mom who has Alzheimer's. My husband and I
Edited on Sun Jul-19-09 05:39 PM by NC_Nurse
both left our jobs and moved in with my parents because my dad was not able to handle her by himself. Since
I am a nurse, I found a job but my husband, a graphic designer, has not. If my dad gets sick I'll have to quit my job
to stay home and take care of both of them. My mom will not let my husband change or bathe her - who can blame her? He's
her son-in-law and half the time she's doesn't know my dad and I, much less him. Then we'll be without income or any type
of compensation for the care. Both of my parents have long term care insurance, but they won't cover anything but nursing homes.
It would be so much cheaper for them to pay me, but I doubt that will ever change. My brother is autistic, so he can't help and soon
he will be my responsibility too. I'm feeling pretty tired at his point. Never ending caregiving with no light in the end of the tunnel. :-(

on edit: I meant to let you know you're not alone. I hope this doesn't sound like I'm trying to one-up you on your situation. Taking care of a severely
disabled child is an incredibly tough and unappreciated job. My hat is off to you and I wish that both of us were getting the support we deserve. :hug:
Printer Friendly | Permalink |  | Top
 
InkAddict Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:37 PM
Response to Reply #1
46. Even if they did cover more "home" options, some
are so supremely stubborn, they would not utilize their benefits.

My FIL was not an "investor" despite our many discussions w/him. He had multiple chronic debilitating and eventually terminal diagnoses. My spouse was an only child who despite being "laid off" became legally responsible for his father's care. No court would have ruled FIL incompetent 24/7, yet he was extremely stubborn and child-like in his decision-making. We tried many options for his care...visiting nurse found him one day after he had fallen out of bed; he beat sepsis and recuperated in our diningroom turned bedroom...he had his own apartment, at his insistance and with a mistaken belief that he was well and would eventually be healed, for awhile until he left the water running in the sink overnight and had an electrolyte imbalance on top of his 80%-100% hearing loss...eventually he "agreed" to a very nice "private only" assisted living situation in which his health actually improved somewhat...the facilities "activities" were not to his liking and he REQUIRED his own craft tools and supplies. Even though his assets were meager, his income augmented by a working son's, he was able to stay for about 2-1/2 years...that all changed when his only child became unemployed...how does one tell a man who has worked 50 years w/a pension and SS income...that he will need to move and live in comparable squalor on $40 a month because his son can no longer foot the bill and his actions, when left alone, made living in ours an unacceptable option. Oh yes, we had hired a nurse when he had the apartment...his funds were adequate at the time...he fired her, a young newly married family friend of our daughter's who he know well and who was trained, trusted, and who he knew needed a better option than minimum wage while paying out the nose for childcare.

The solution in our case was just too simple - keep one American IT analyst working in America until a case could be made for skilled nursing care. It never happened...not the job for the only adult child nor meeting the criteria for skilled nursing criteria.
Printer Friendly | Permalink |  | Top
 
LaurenG Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:15 PM
Response to Original message
2. Make it part of a "Universal Health Care" program.
My parents and their parents never lived in nursing homes so it wasn't a problem. The last of the "elders" is living with me and hopefully won't need nursing home care but if she should she has very few assets to liquidate.
Printer Friendly | Permalink |  | Top
 
hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:18 PM
Response to Reply #2
5. What person has the assets to pay for more than a few months?
The way it is now, the patient runs through his or her assets and the government pays anyways.
Printer Friendly | Permalink |  | Top
 
Rosa Luxemburg Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:21 PM
Response to Reply #2
7. Yes seniors with large assets should contribute some
Dependent on assets although they shouldn't make it so they isn't anything left for the children in the will. People who have assets of millions should pay all.
Printer Friendly | Permalink |  | Top
 
elehhhhna Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 08:00 PM
Response to Reply #7
64. I don't get why the children are entitled to money that the parent NEEDS for their own housing
and care. Spousal assets are protected ==which is appropriate -- but the adult child has no divine right to Ma & Pa's "nest egg".
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:31 PM
Response to Reply #2
12. That's what Physicians for a National HEALTH Program say:
Printer Friendly | Permalink |  | Top
 
LaurenG Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:41 PM
Response to Reply #12
20. I think as we baby boomer's start to get up in our last years that
there will have to be a health program developed for those of us at the end of life. There will be so many of us slowly dying that we really need to figure out what we're going to do about it now.

Unless of course our kids want to take us all in...:P
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:55 PM
Response to Reply #20
24. The Director of Nursing with whom I work says the discussion NEEDS to be focused
on not so much what "we" will do during those "end of life" experiences.

She is a 20 year veteran who worked for a long time on the corporate side of long-term care. She says the discussion NEEDS to be much more focused on what happens during the years leading up to the end of life.

Many geriatric nurses strongly believe that the Elderly are being over medicated and that ALL of them need to live as active and as normally individual person-directed lives as possible, even in long-term care homes, they need to be treated like human beings, with good food, and good social activities and individual choices. This will result in a qualitatively DIFFERENT "end of life" experience with way less lingering when their decline comes.

There is research that says that the Elderly, even those in long-term care **HOMES**, who have more normal individual life quality, just go about their lives, even when that includes chronic or acute diseases, if they are allowed as normal and Person-Directed lives as possible, and are not medicated any more than absolutely necessary, they just go on (even those with disease) they just go on until they stop. And it's over with way less lingering and suffering.

I don't know if you know any nurses, but they are an EXTRORDINARY group of women. Geriatric and nurses in Long-Term care are even more so. NO! B---S---!! I feel privileged to work with them.
Printer Friendly | Permalink |  | Top
 
LaurenG Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:12 PM
Response to Reply #24
35. True - I have had to constantly monitor the meds my mom is on
for the last 10 years or so. Especially since she was sent to specialists at the drop of a hat. She has had duplicate prescriptions, and drugs that were not compatible and for a while we thought she was demented. It turns out she was over medicated and no one was paying attention to all the different prescriptions she was taking.

I totally agree with your DON, someone needs to take responsibility for the care of those we love. In my house it's me. I am very fortunate that my mom can still take care of her own needs and only needs me to make sure meals, housekeeping and laundry are done for her. If she had Alzheimer's, as someone stated above, it would be beyond my ability to take care of her, especially if I wanted to keep my job.

I also agree with your assessment of nurses, they truly do rock.

Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:22 PM
Response to Reply #35
41. I watched that go on with my Father, my Mother, and my Mother-in-Law.
It didn't work out so well for my Father and my Mother-in-Law, in fact, it WAS bad, especially the sorts of changes in care that I observed once my Mother-in-Law started showing evidence of Dementia.

But we learned more and that helped us, one of my sisters in particular, figure out how to manage my Mother, so, though she is a wheel-chair bound diabetic, she will be 90 in September.

Printer Friendly | Permalink |  | Top
 
InkAddict Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 04:27 PM
Response to Reply #35
58. You are not in control of keeping your job if you work for
another or a corporation. Good luck, it's going to get worse.
Printer Friendly | Permalink |  | Top
 
elehhhhna Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 08:03 PM
Response to Reply #24
65. I'll be swallowing tranq's & tying a plastic bag on my head on the ride to the "care facility"
as god is my witness.

Hubs too.
Printer Friendly | Permalink |  | Top
 
Rosa Luxemburg Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:17 PM
Response to Original message
3. I know someone who lives in a hotel because it's cheaper than assisted living
they check on her, free big breakfast, they clean the room, she can use all the facilities. They do a good rate.
Printer Friendly | Permalink |  | Top
 
joey5150 Donating Member (28 posts) Send PM | Profile | Ignore Sun Jul-19-09 12:18 PM
Response to Original message
4. Bark!
Medicare is a fed funded program that ppl ovr 65 (some, few exceptions not relevant here) use. MediCAID is a jointly state/fed admind progrm used by the poor/elderly. You "spend down" to qualify for Medicaid. Ad by SD i mean you virtually improverish urslf. virtually no assets are permitted. Medicare is age dependant. MediCAID approval is personal $$ basd. Bark!
Printer Friendly | Permalink |  | Top
 
hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:19 PM
Response to Reply #4
6. Thanks - I never can keep those two straight in my mind!
Printer Friendly | Permalink |  | Top
 
CountAllVotes Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:36 PM
Response to Reply #6
17. you need to keep them straight in your mind
Medicare is NOT need based. If you qualify for it (meaning you've worked long enough) you PAY for it and NO it does NOT cover long term care!

When my mother got sick with cancer, I paid the bill on her private care that last few months she was alive.

She had a private supplemental plan (Federal retiree mind you) and was required to be enrolled in Medicare.

Neither of the two insurances paid a red cent.

:dem:

Printer Friendly | Permalink |  | Top
 
jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:10 PM
Response to Reply #4
33. And it is medicaid that pays for most nursing home care as well as
most home health care services. Thank God for Medicaid.
Printer Friendly | Permalink |  | Top
 
Lone_Star_Dem Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:21 PM
Response to Reply #4
39. Yet without having purchased a PRIVATE supplemental which covers nursing home care
Those on Medicare still are reduced to selling off their assets and depending on Medicaid to pay for their long term care. They're also limited to a Medicaid approved facility, and it's not always easy to find one with a bed available which meets the specific needs of the individual.
Printer Friendly | Permalink |  | Top
 
InkAddict Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 04:36 PM
Response to Reply #4
59. Medicaid - What quality of life can one expect on $40 a month?
Edited on Sun Jul-19-09 04:37 PM by InkAddict
If the illness you have hasn't killed you yet, living on Medicaid will. The demented may not be aware of their circumstances, but those w/pensions and an income that allowed free choices of daily activities within the parameters of their illnesses will certainly notice.
Printer Friendly | Permalink |  | Top
 
pitohui Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:24 PM
Response to Original message
8. assisted suicide should be an option
Edited on Sun Jul-19-09 12:29 PM by pitohui
i have alzheimer's in the family, there is no way that i can work and save enough money to pay for my care should i get alzheimer's, the cost of being imprisoned in a nursing home w.out a brain is more than my lifetime earnings and that of my spouse -- i can't afford the insurance either, it's too high (not to mention it's unlikely that the insurance will be able to pay out for everyone expected to develop alzheimer's in the coming decades, it would be like a hurricane katrina that never ends for the industry because people w. this dx just don't die quickly -- i don't believe long term nursing care insurance will prove to pay out for younger boomers and subsequent generations, the math is not there)

there should be a right to legal assisted suicide if i receive that type of dx -- it's what i want for me, so i can die in dignity w.out putting my spouse at risk of arrest, rather than being tortured for years without being able to understand what is being done to me -- it's also good for society because the cost of keeping vegetables alive is just obscene

i can't believe god wants this, only hospitals and nursing homes benefit from keeping the hopeless alive

they even did it to ronald reagan, they did it to several members of my family, they'll do it to me if they can -- they are merciless vultures

you wouldn't keep a dog alive like this but for some reason it's okay to do it to a human being

with no legal assisted suicide option available for me, my only real option once dx'd is to go ahead and kill myself while i still have brain/quality of life left rather than waiting until it's too bad and i can't make rational plans

nursing homes are just cruel when they are used as warehouses for those w.out hope

also "spending down assets" means i must first divorce, or my spouse, who is younger, would be left destitute at an age when he is himself too old to work -- i think it is unnecessarily cruel and harsh to force long time spouses to divorce for financial reasons

children don't need to inherit but spouses certainly do

Printer Friendly | Permalink |  | Top
 
hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:35 PM
Response to Reply #8
15. I wonder how soon it will be before we can predict who is likely
to develop Alzheimer's and how many minutes after that insurance companies will decline to sell long term care policies to those people?
Printer Friendly | Permalink |  | Top
 
pitohui Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 03:19 PM
Response to Reply #15
55. they're working on it right now, some of the genes have been ID'd
this means i could be putting money into insurance for long term care -- only to get my policy cxl'd before i would be able to use it -- there is lots of research taking place to find the alzheimer genes and see how long you have, since there is no real good treatment, the only option is to find out if you have it, what gene you have, and how long you are likely to last

under many likely scenarios i am well and truly fucked

there is not a financial answer to my problem, so there needs to be a humane answer

euthanasia/assisted suicide is not for everyone, but it is the best option for me assuming i prove to have the gene(s) and eventually develop the disease, some of my female relations lived over a decade without a brain, to no one's profit except the nursing home and to their own misery because they did not understand what was happening to th em
Printer Friendly | Permalink |  | Top
 
hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 05:59 PM
Response to Reply #55
61. Genes aren't destiny. The saying is, heredity loads the gun, but
environment pulls the trigger. There is a lot of research going on to determine how to prevent Alzheimer's. What's very interesting to me is to see so much work being done on so many fronts. For example, are the plaques the cause of the disease, an accompanying side effect or perhaps innocent bystanders. Is it a prion disease? If so, is what is inherited an inability to eliminate prions? What role does stress, nutrition, exposure to viruses or chemicals play?

It wasn't so long ago that there was no treatment for Alzheimer's. Now two or three different pills are offered in heavy competition. I can't vouch for their effectiveness, but it's a start.
Printer Friendly | Permalink |  | Top
 
FarCenter Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:45 PM
Response to Reply #8
22. Do it yourself suicide is still an option
Like the traditional go outside and lie down in a snowbank.
Printer Friendly | Permalink |  | Top
 
pitohui Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 03:21 PM
Response to Reply #22
56. there are no "snowbanks" around here
Edited on Sun Jul-19-09 03:23 PM by pitohui
i saw snow once in 1989

seriously, dude, i should not have to go DIY and risk surviving but being rescued and kept alive in a terrible shape, at terrible cost to myself in pain and at terrible cost to my family financially

i've known people try suicide MULTIPLE times before they achieved success, suicide is not so easy as they make it look on teevee

imagine a person rescued from a snowbank, loss of limb and other horrible damage might mean they could not try again, they would simply be kept alive and tortured for the medical industry's profit

Printer Friendly | Permalink |  | Top
 
Lasher Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:25 PM
Response to Original message
9. This is important.
Developments such as estate tax reduction have made us more a nation of affluent dynasties. To make this even worse, end of life medical costs are wiping out what little the middle class would otherwise have left to their heirs. Both factors are working together to ensure the very rich families get even richer while the other 90% of us have little chance or heirs will get even a little seed money for that ivy league college education or for starting a business.

While middle class wealth has declined or remained stagnant for the past 2 decades at least, it is only the richest of us who have benefitted from productivity gains. This is one of the reasons why.
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:35 PM
Response to Reply #9
16. See below. New financing models ARE being discussed. nt
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:26 PM
Response to Original message
10. Also: New Public-Private Partnerships that combine State, Federal, and Individual Private Equity in
collaborative agreements similar to what you see in co-housing, with multiple levels of care and that protect private equity that can be, not only owned by the general public but also by employees and can also inherited, sold, or rented just like any other real-estate, as long as the basic "co-housing" contract is respected.
Printer Friendly | Permalink |  | Top
 
elocs Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:31 PM
Response to Original message
13. First, I don't accept the premise that 1 in 4 will end up in a nursing home
since only 4% of current seniors are in a nursing home now. The average lifespan after entering a nursing home is 6 months, so that is hardly long term. So many are afraid of ending up in a nursing home when that is a false fear and the vast majority do not end up in nursing homes except near the end of their lives.
Printer Friendly | Permalink |  | Top
 
hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:33 PM
Response to Reply #13
14. Which makes the current situation even worse, IMO. It's a reverse
lottery - get sick enough and a nursing home gets your lifetime's work.
Printer Friendly | Permalink |  | Top
 
elocs Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:41 PM
Response to Reply #14
19. How is this any different than it has ever been? If you cannot pay, they take what they can get.
My mother is an exception to the 6 month nursing home survival since she has been in one for over 12 years now with Alzheimers. The only thing she really had was her house and she lost that, but she has had good care and all of her needs served for 12 years now.
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:41 PM
Response to Reply #13
18. The home I work in is definitely low-end of the market and we routinely have long-standing residents
Edited on Sun Jul-19-09 12:42 PM by patrice
in the 90s, a few to 100 even. We also routinely have a long waiting list, while other homes have difficulty keeping their censuses up.

Money does not insure quality of care. It's all about the Staff, especially those providing the direct care. And it's also all about the Director of Nursing, i.e. the differences in their particular "philosophy" and practices of care.
Printer Friendly | Permalink |  | Top
 
elocs Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:46 PM
Response to Reply #18
23. To continue to work in a nursing home long term it must be a calling and not just a job.
In the 12 years my mother has been in a nursing home she has outlasted much of the staff and nearly all of the other residents who were there when she entered. Her nursing home is nice and clean and the staff are caring.
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:59 PM
Response to Reply #23
26. Absolutely!! (and I don't use that word too often).
We are working on this specific characteristic WITH the staff where I am. I love it.

Another aspect is the home's relationship with its Community . . . extremely important, that.
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:00 PM
Response to Reply #23
27. Something else we are doing is: the same staff takes care of the same residents all of the time. nt
Printer Friendly | Permalink |  | Top
 
jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:17 PM
Response to Reply #27
38. That is an excellent plan. My daughter's professional care group
all agree that she is doing so well because her care at home was consistent. I knew her. When your staff works like that they to will get to know the patients and be able to spot relevant changes in health etc. Hope that catches on across the nation.
Printer Friendly | Permalink |  | Top
 
elocs Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 02:54 PM
Response to Reply #27
53. I know. As it turns out a woman down the street from me cleans me mom's room
and has for years.

Also, in the same nursing home I discovered that the father of one of my best friends growing up was there. I would wheel my mom up and down the spokes of the home and even though she did not know me, he did and I would stop and speak with him when I went past his room. There was one Sunday when I was going to see my mom, but decided not to go that day and it turned out that was the day he passed away. A young lady who was his caregiver went to his funeral and she was more emotional about his death than his own family because she had become attached to him.
Printer Friendly | Permalink |  | Top
 
uppityperson Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:05 PM
Response to Reply #18
30. "It's all about the Staff, especially those providing the direct care.&it's also all about the DNS"
very wise words. Having a supportive DNS goes a long ways towards keeping good staff and having Great staff goes a long long ways towards keeping residents and their families content.

Speaking from many yrs working long term care also. Cheers to another long term care provider
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:10 PM
Response to Reply #30
32. We are educating one another about good communication and Respect.
Edited on Sun Jul-19-09 01:11 PM by patrice
Trying to elevate the status of Professionalism, especially amongst the CNAs, so we can talk about Respect for them as much as for our Residents.
Printer Friendly | Permalink |  | Top
 
shraby Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:43 PM
Response to Original message
21. Many many times the home care is not an option..
particularly with the male dementia or Alzheimers patients..they can tend to get violent toward other members of the family and often do. The medicine is outrageously expensive. A nursing home becomes the only option where they can get professional 24/7 care for the safety of the family that's left to see to their card.
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:04 PM
Response to Reply #21
29. My family is doing the family home care with my Mother, so I have the opportunity to compare.
Edited on Sun Jul-19-09 01:16 PM by patrice
We even have a few health professionals in our family to advise the LARGE group of siblings that it takes to do this sort of thing along with all of the state resources to support the effort.

Believe me, I can tell you horror stories of what can and does go wrong, under "the best of circumstances." And that doesn't even mention what it costs the family care givers, emotionally, psychologically and otherwise, to provide the care.

People think they want to do it this way, but it REALLY isn't for everyone.
Printer Friendly | Permalink |  | Top
 
kickysnana Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 12:56 PM
Response to Original message
25. Home health care is being decimated...
Here in Minnesota we have 45,000 Personal Care Attendants and Home Health Aids who work with the elderly and disabled in their homes and apartments. They generally earn between $8 and $12 an hour depending on how long they have worked. Most have no benefits. Most have to supply their own transportation.

They go into many situations, ones were they come in and there is no food in the house and 24 hour care is rare. They push those people into assisted living that ends up being as pricey as nursing home care and you hardly ever see the same caregivers.

Minnesota just took back the .42 COLA raises that they partially passed on to the caregivers. Those companies who work on small margins are taking back the money from 2009 in order to stay in business.

All clients had to be re-evaluated by July 15 by physicians, social workers, waiver programs and care giving agencies. If the paper work was missed or incomplete the agency may not get paid for hours in July and the same low margin agencies are warning workers that they cannot pay them if that happens. Some clients will lose there care and will have to appeal or make other arrangements. It took over a month for the paperwork to get finalized for my Aunt after she got home.

In 2010 people will be re-evaluated again and the new guidelines will make more lose their care. Those still getting care will have their hours of care cut in about half. In 2011 even more will lose care. These cuts were planned before Pawlenty's use of unallotments to balance the budget so there may be more we don't know about.

We were notified that we will have to purchase our own latex gloves as that money was cut by the state as unnecessary. Low income property tax circuit breaker is eliminated for 2009. For many it will force them to sell their homes in a depressed market as they do not have the cash flow to pay for the property tax which was never adjusted down after it when up during he bubble.
Printer Friendly | Permalink |  | Top
 
jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:23 PM
Response to Reply #25
42. Pawlenty has to go!
Printer Friendly | Permalink |  | Top
 
SmileyRose Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:09 PM
Response to Original message
31. If jobs paid enough to survive on one income this would be a mostly non-issue
Oh sure, there are going to be people with no kids or no youngsters willing to take care of grandma - or grandmas too sick to be taken care of at home -- but long term care has gained a huge importance in this country mainly because the daughters and daughter in laws HAVE to work to keep up with what is now the acceptable lifestyle of air conditioning in every home, 2 cars, each kid in their own room etc.
Printer Friendly | Permalink |  | Top
 
sarcasmo Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:10 PM
Response to Original message
34. How about taking care of our own? I am taking care of my wife who has Dementia
Edited on Sun Jul-19-09 01:11 PM by sarcasmo
And will not allow some nursing home Corporation to take care of her. When my parents become ill I will take care of them as well, pawning or elderly to health Corporations shows we have no soul.
Printer Friendly | Permalink |  | Top
 
patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:14 PM
Response to Reply #34
37. Some people are suited to this, others aren't. It's a Good thing that you are, but
just like professions such as teaching, it isn't for everyone. Even if they force themselves to do it, there are negative consequences.
Printer Friendly | Permalink |  | Top
 
kickysnana Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:22 PM
Response to Reply #34
40. Elder care should be available not for profit and affordable
You do deserve to be commended for taking care of your wife. It is sometimes very hard and thankless.

Some people are not suited to caregiving. Some adult children are not physically able to do caregiving. Some loved ones with dementia become violent (Verne Gagne). Many families need to work three jobs or have disabled children. Some elderly people were mean and verbally abusive before and are more so now.

It is great when family can take care of their own but sometimes it is not possible and to unilaterally condemn those who don't is shortsighted.





Printer Friendly | Permalink |  | Top
 
sarcasmo Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:28 PM
Response to Reply #40
44. I was not condemning anyone. Why are there so many for profit nursing homes who treat our loved ones...
Like shit? Because we allow our loved ones to be treated like shit.
Printer Friendly | Permalink |  | Top
 
jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:27 PM
Response to Reply #34
43. I applaud you efforts but wonder if you had to give up a job to do this?
If so you will sacrifice when it comes to social security. I am living in poverty and virtually homeless because I took care of my daughter for 45 years.
Printer Friendly | Permalink |  | Top
 
sarcasmo Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:33 PM
Response to Reply #43
45. The company I was working at closed and my wife now has a Disability Pension from where she worked
That will roll over to me when she passes, which allows me to take care of her with out worry, but the last year and a half prior to getting the Disability Pension is a whole other thread/nightmare.
Printer Friendly | Permalink |  | Top
 
jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 02:09 PM
Response to Reply #45
50. I think there are a lot of people who face this sacrifice when they want
to care for their own. It may be the real stumbling block.
Printer Friendly | Permalink |  | Top
 
pitohui Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 03:29 PM
Response to Reply #34
57. most people can't do this, for physical reasons i can't
Edited on Sun Jul-19-09 03:33 PM by pitohui
i am a tiny person, it is physically impossible for me to care for an alzheimer's person who has determined that i am stealing their food and starving them and cheating them (because they can't remember they were fed just five fucking minutes ago)

i had enough crap beat out of me as a kid, i'm not taking more physical and verbal abuse as an adult even if the person doing it can't stop themselves

this is let alone the fact that i should not have to give up my one and only life to torture someone who has no brain, who would not want to be an irrational person like that, and who has NO quality of life whatsoever -- so that two lives are ruined instead of just one

maybe i deserve to be in hell if i am willingly keeping them in my home just to get their $$$ or whatever, KNOWING they have no brain and can never recover

your situation may be different, maybe your wife's is one of those i'm told about who is supposedly childlike and peaceful with it, but this is not my experience

you are not guaranteed to be a nice, simple, easy going person just because you're losing your marbles, quite the opposite can and does happen, and you can become unmanageable for others who don't have a large strong man's physical strength -- some problems do need to be handled by trained, experienced professionals

i don't want my husband to lose everything and live in hell because *i* got a disease that can't be helped, i just want to go quietly, is that too much to ask?
Printer Friendly | Permalink |  | Top
 
kickysnana Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:13 PM
Response to Original message
36. Out of home care is broken too and costs thousands more a month.
My Aunt suffered a stroke and was in a nursing home for rehab for about 5 weeks. The aide to client rate was 35 to 1 aide. It meant that everyone who was unable to get to the bathroom themselves was declared incontinent. After waiting an hour past her scheduled time with her light on my Aunt's room mate who had shingles that had gone from the nerves in her ear into her brain used my aunt's cell phone (the phone system crashed at least once a day) to call the front desk for help.

Most aids spoke little English and some were mean (deliberately dropping people, putting things out of their reach) and when the clients complained acted like they misunderstood or that the client was racist. They had one week of on the job training. They would hide in the bathroom or outside to avoid answering calls. There was not enough supervisors to do discipline as they were handling medical emergencies 24/7. A few aids, foreign or not were excellent. There was more than one case of the elderly and disabled being abused in seemingly good nursing facilities.

Rules said that if my Aunt's blood sugar was already too low she should be given orange juice and cookies and then given her insulin anyway. The doctor in the hospital expected her diabetes to get better or go away if she did. Overloading on sugar is exactly wrong when you are trying to do this. It would take hours to get call backs from doctors to change or eliminate medicines. People would get their insulin and then the meal would be late and they would all get low blood sugar be unable to get to the dining room or feed themselves.

Does long term care insurance actually work. Nothing else does in America. I was just wondering. My Mom who had emphysema for 13 years spent 4 days in a nursing home. My folks had bought a long term care policy for her but not for Dad. His investments were stolen by the banksters and crooked business man. We will try to care for him but at his home and/or ours if he gets dementia I just know we will need someone big and strong around to allow us to care for him.
Printer Friendly | Permalink |  | Top
 
CountAllVotes Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 01:49 PM
Response to Reply #36
47. just another example of how disgusting nursing homes are
I swear, I'd rather be DEAD than end up in one of these hell holes!

My sister-in-law is legally blind. Her greedy son decided to dump her into a nursing home and sell her house out from under her.

Luckily her late husband was a police officer and a friend of his pulled some strings and demanded that the family be told of her whereabouts (the son had her neatly hidden away as he was planning to sell her house) or he'd be arrested and charged with kidnapping!

They found the son and he was advised to tell of her whereabouts or they'd be after him and his arsenal of guns (that is how they found the fucker btw) and oh, he got scared! He drove her back to her now empty house and dumped her on the floor.

Not a stick of furniture was left!

In any event, she is still living in the house and pays an attendant $18.00 an hr. 40 hrs. a week to come to help her out, etc. Cost is about $35,000.00 a year for this help.

And to think the family still bitches. BITCH BITCH BITCH BITCH BITCH while they all sit around and DO NOTHING!

:grr:

God this subject angers the shit out of me!!! :mad:


:kick:

Printer Friendly | Permalink |  | Top
 
sarcasmo Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 02:02 PM
Response to Reply #47
48. I get the anger, my wife's two brothers don't offer much help it's a tough thing to deal with.
Printer Friendly | Permalink |  | Top
 
CountAllVotes Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 02:08 PM
Response to Reply #48
49. my sister-in-law has NINE brothers & sisters
and where or where the fuck are they? Living in their little mansions picking away at the likes of me and their sister that is paying for help is where.

FUCK THEM.

:kick:

Printer Friendly | Permalink |  | Top
 
sarcasmo Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 02:11 PM
Response to Reply #49
51. I feel the same way about the wifes in laws.
Edited on Sun Jul-19-09 02:11 PM by sarcasmo
Printer Friendly | Permalink |  | Top
 
CountAllVotes Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 02:32 PM
Response to Reply #51
52. more problems have arisen recently here
and if it weren't for me, their other brother (my husband) would probably be in a god damn home somewhere as well as he has developed the same problem as of LAST FUCKING WEEK. :cry:

God damn this fucked up system!

And yes, we have insurance. Cost = ~$15,000.00 a year. :argh:

Printer Friendly | Permalink |  | Top
 
sarcasmo Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 03:05 PM
Response to Reply #52
54. Lucky we have insurance and if I wind up needing some help I hope to be able to call in Hospice.
This is her home, not some nursing home.
Printer Friendly | Permalink |  | Top
 
CountAllVotes Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-20-09 03:04 AM
Response to Reply #54
67. Hospice will only come if you have >6 mos. to live
well supposedly anyway.

You are so right and thank you for reminding me - I really needed to read that - it is his home too! If it comes down to it, I too will hire someone to help if necessary. Scary reality yes, but there is no place like home.

THANK YOU for that so very much! :D

:dem:
Printer Friendly | Permalink |  | Top
 
sarcasmo Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-20-09 01:04 PM
Response to Reply #67
68. I think you need to check into the whole 6months thing I don't think Hospice is that way.
Edited on Mon Jul-20-09 01:10 PM by sarcasmo
Printer Friendly | Permalink |  | Top
 
eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 07:38 PM
Response to Original message
62. HR 676 covers long term care n/t
Printer Friendly | Permalink |  | Top
 
kath Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 07:48 PM
Response to Original message
63. How is this handled in the civilized countries?
You know, all those ones that have national health care, parental leave, workers' rights, pensions, free (or low cost) university, lots of paid vacation and paid holidays, stuff like that??
Printer Friendly | Permalink |  | Top
 
Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jul-19-09 08:04 PM
Response to Original message
66. I think Howard Johnson's has an expansion opportunity. nt
Printer Friendly | Permalink |  | Top
 
DU AdBot (1000+ posts) Click to send private message to this author Click to view 
this author's profile Click to add 
this author to your buddy list Click to add 
this author to your Ignore list Fri Apr 26th 2024, 03:32 AM
Response to Original message
Advertisements [?]
 Top

Home » Discuss » Archives » General Discussion (1/22-2007 thru 12/14/2010) Donate to DU

Powered by DCForum+ Version 1.1 Copyright 1997-2002 DCScripts.com
Software has been extensively modified by the DU administrators


Important Notices: By participating on this discussion board, visitors agree to abide by the rules outlined on our Rules page. Messages posted on the Democratic Underground Discussion Forums are the opinions of the individuals who post them, and do not necessarily represent the opinions of Democratic Underground, LLC.

Home  |  Discussion Forums  |  Journals |  Store  |  Donate

About DU  |  Contact Us  |  Privacy Policy

Got a message for Democratic Underground? Click here to send us a message.

© 2001 - 2011 Democratic Underground, LLC