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Old 10-29-2018, 12:26 PM
 
Location: Tennessee
23,587 posts, read 17,582,380 times
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Quote:
Originally Posted by PriscillaVanilla View Post
People are living longer and the baby boomers are aging. Dementia and lack of elder care services is going to be a huge issue. I've been saying this for a long time. Nursing homes continue to refuse to pay caregivers more than $9 or $10 an hour which means there is a shortage of people to do this work, and even importing people from other countries isn't helping. CNAs and home health aides are paid less than a Wal Mart cashier.
It's a massive problem.

I'm not that familiar with the economics of nursing homes, but my girlfriend has been in the "rehab wing" of the nursing home for about a month after her two hip replacement surgeries. It's really eye-opening going into a place like that several times a week.

There seems to be a chronic shortage of personnel. If medicine is supposed to be doled out and taken at 7 AM, it's not uncommon for the patient to be waiting around well past 9 AM with no medicine. Meals aren't doled out on time, and trays aren't collected frequently. It can easily take a half hour for someone to respond to a call light.

The care certainly isn't prompt.

CNAs here get paid $9-$11/hr mostly. Chick-Fil-A is hiring $11/hr full time. "Vegetable choppers" at Panda Express make $11/hr. What would you rather do?
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Old 10-29-2018, 12:40 PM
 
Location: Raleigh
8,323 posts, read 6,173,206 times
Reputation: 11627
Quote:
Originally Posted by in_newengland View Post
I've been doing some reading ever since my cousin was diagnosed this past spring and mostly it says it's 1/3 genetic, 1/3 diet, 1/3 environmental. I THINK it said 1/3 diet.
I think you kind of have to lump diet and environment together. When they say "environmental" they don't just mean the air pollution in the environment, they refer to your lifestyle. So someone that's physically active and walks half a mile to the coffee shop through their retirement and BS's with the cashier and other folks along the way and has a chess game and a crossword puzzle might be less likely to develop it than a shut-in.


Quote:
Originally Posted by AtkinsonDan View Post
I'd like to believe 100% that dementia and Alzheimer's disease are caused by prescription drugs and chemicals in processed food because I can voluntarily avoid those things. I sometimes wonder if government bureaucrats consider people getting dementia at 75 or 80 to be a justifiable price to pay for the economic vitality of the prescription drug and processed food industries which impacts regulatory decisions?
That's absurd. Plato noticed a correlation between extreme old age and madness. I certainly concede that some medications can/do contribute, but to ascribe it to prescriptions specifically or even a primary cause for most people is daft. And, you have to remember that environmental/diet influences will skew the medications; meaning someone that's lived a fit and healthy life is less likely to need medications. That same person is less likely to develop Alzheimers.
Quote:
Originally Posted by harry chickpea View Post
There seems to be enough of a correlation of caregivers of Alzheimer pts. getting Az themselves that there are questions being asked if it may have a viral component. At this point, it is speculation only.
I wonder if it isn't simply the stress and isolation of such a long term job with no positive outcome, often undertaken by the spouse in their own old age, or a offspring that shares their DNA.
Quote:
Originally Posted by TheShadow View Post
Another important thing that can happen to cause TEMPORARY dementia-like symptoms, and this sounds weird, is a urinary tract infection. You need to go with them to their doctor appointment, and tell the doctor that they are having what seems like transient memory loss. They can easily take a urinalysis and check for a UTI, and also as someone else mentioned, check their medication list.
That, and Anesthesia.
Quote:
Originally Posted by grampaTom View Post
Remember folks: forgetting where you put the house key is not necessarily a problem. Standing at your door with the key in your hand and not knowing how to get in is.

There is a long continuum of cognitive decline and most of us are somewhere on the arc. Lord knows I am.

If you have concerns talk to a professional (as stated above).

Sorry OP -- almost forgot (not joking) we are definitely NOT prepared for the number of dementia patients soon to need help.
^^Good Points^^
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Old 10-29-2018, 01:51 PM
 
Location: Loudon, TN
5,787 posts, read 4,841,461 times
Reputation: 19468
Quote:
Originally Posted by Roselvr View Post
It's random things such as I put my daughters spare set of car keys down a week ago and can't find them. Normally I'd put them by my pocket book or where they belong, they're neither place. I've tried retracing my steps but couldn't and there wasn't that much time that went by. I did the same thing with the Desitin Saturday night. I walked back downstairs from my grandson's room, could have sworn I threw it where I keep it because I sat right down but it's where to be found.

Have issues finding words when talking. I stopped talking on the phone a few years ago because of it. I'm much better when I can type a reply via text or messenger because I can go back and read and edit. There are days where I leave spaces because I can't think of words.

I have a few very dear people that have passed away within the last 5 years but can't recall the dates or years. This is so not like me either to have to go to my family tree or their contact in my phone where thankfully I have the date.

I'm clueless what day it is besides Monday. I always knew that it was October 29th Monday (I cheated by looking at my watch)

Have issues with names unless they're right in front of me. Even with shows I watch. Takes me forever to learn names when I never used to be bad with that.

Even my own medical history which I've always known is not remembered now.

I do suffer from horrible chronic pain but have had it for 15 years.

I'm gonna do more gooling because what I've read I have some issues of different ones. I'm also having new serious sleep issues that I never had. I'm living on 4 to 5 hours sleep with a prescribed sleeping pill that normally knocks me out all night for at least a decent 6 hours.

I did do the SAGE test (1) and passed, except for the date.
A lot of the things you mention here are just very common things that we all start to forget as we get into our 50's and 60's. Not all that weird. Heck I lost my smartwatch the other day and still haven't found it...$150 down the drain!

We all start to lose brain cells as we age, the thing that is really indicative of early dementia is the inability to learn and remember NEW memories. Like getting a new washing machine, but not being able to remember the steps to operate it, even after it's been explained numerous times, and somehow still not being able to figure it out. Or asking "what's his name?" and then not remembering asking the question, or what the answer was, just 5 or 10 minutes later, so you repeat the question, and 10 minutes later you've forgotten it a third time. Or eating dinner a second time because you forgot you already ate. One of the big early indicators is the loss of navigational skills, such as not being able to find the exit in the grocery store, or not being able to find your way home from church or some other place you've been to often in the past.
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Old 10-29-2018, 01:55 PM
 
Location: Michigan
16 posts, read 5,360 times
Reputation: 52
I am new to the forum, so if this is not allowed please delete.


I have read quite a bit on some of the findings of medical marijuana and dementia. It seems they are finding that THC (the active ingredient in marijuana) has been tested to help remove the plaque in the brain that is known to be present in dementia and Alzheimer's brains. There have been studies by some of our nations top medical schools and not just fly-by-night pot-heads. If you google dementia and medical marijuana, you will find several articles on the topic. It is quite interesting and provides hope.


This makes me wonder...The population of those currently affected with these mental disturbances were from a time in our society that marijuana was greatly frowned upon. Many had the mindset that if they used marijuana they would become life long addicts to heroin or worse.. Really, Marijuana was largely discouraged for many, many reasons.


The generations that are now in their 50's, many of us have used marijuana a time or two (or more).
I can't help but wonder if the instances of dementia will decline due to the regular marijuana use of that generation. Only time will tell, but I look forward to the results.


I have sadly known and loved some who were lost to age related mental issues. I can't help but wonder...after all, look at Willie Nelson! If only it could be proven, what a miracle that would be. I am thankful that the studies can continue, because perhaps, just perhaps a preventive could be so simple.
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Old 10-29-2018, 02:23 PM
 
Location: Raleigh
8,323 posts, read 6,173,206 times
Reputation: 11627
Quote:
Originally Posted by Oblivia View Post
I am new to the forum, so if this is not allowed please delete.


I have read quite a bit on some of the findings of medical marijuana and dementia. It seems they are finding that THC (the active ingredient in marijuana) has been tested to help remove the plaque in the brain that is known to be present in dementia and Alzheimer's brains. There have been studies by some of our nations top medical schools and not just fly-by-night pot-heads. If you google dementia and medical marijuana, you will find several articles on the topic. It is quite interesting and provides hope.


This makes me wonder...The population of those currently affected with these mental disturbances were from a time in our society that marijuana was greatly frowned upon. Many had the mindset that if they used marijuana they would become life long addicts to heroin or worse.. Really, Marijuana was largely discouraged for many, many reasons.


The generations that are now in their 50's, many of us have used marijuana a time or two (or more).
I can't help but wonder if the instances of dementia will decline due to the regular marijuana use of that generation. Only time will tell, but I look forward to the results.


I have sadly known and loved some who were lost to age related mental issues. I can't help but wonder...after all, look at Willie Nelson! If only it could be proven, what a miracle that would be. I am thankful that the studies can continue, because perhaps, just perhaps a preventive could be so simple.
I can't wait for the "Weed Bubble" to die. Honestly, its being touted for curing everything there is. I'm not against it and I'm sure it has some medicinal purposes but a lot of this stuff gets ridiculous.
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Old 10-29-2018, 03:00 PM
 
13,916 posts, read 7,416,674 times
Reputation: 25410
Quote:
Originally Posted by Serious Conversation View Post
It's a massive problem.

I'm not that familiar with the economics of nursing homes, but my girlfriend has been in the "rehab wing" of the nursing home for about a month after her two hip replacement surgeries. It's really eye-opening going into a place like that several times a week.

There seems to be a chronic shortage of personnel. If medicine is supposed to be doled out and taken at 7 AM, it's not uncommon for the patient to be waiting around well past 9 AM with no medicine. Meals aren't doled out on time, and trays aren't collected frequently. It can easily take a half hour for someone to respond to a call light.

The care certainly isn't prompt.

CNAs here get paid $9-$11/hr mostly. Chick-Fil-A is hiring $11/hr full time. "Vegetable choppers" at Panda Express make $11/hr. What would you rather do?

This totally depends on the skilled nursing facility. The ones that are pretty much 100% Medicaid patients, yep. The average daily reimbursement for Medicaid at a skilled nursing facility is about $200. Medicare is more like $500 ($15K/month) which is typical as well for private pay. I imagine that in eastern Tennessee, any skilled nursing facility is primarily going to be Medicaid patients with a bit of post-hospitalization Medicare and almost zero private pay. They can't afford the staff to provide a reasonable level of care.



This is why having long term care insurance or enough cash to fund private pay for long enough that the nursing home is willing to bet the patient won't outlive their money is such a big deal. If you walk in the door as a Medicaid patient, the good places won't take you so you're pushed to the lousy places.
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Old 10-29-2018, 04:33 PM
 
Location: Verde Valley AZ
8,618 posts, read 9,687,274 times
Reputation: 10970
Quote:
Originally Posted by PriscillaVanilla View Post
People are living longer and the baby boomers are aging. Dementia and lack of elder care services is going to be a huge issue. I've been saying this for a long time. Nursing homes continue to refuse to pay caregivers more than $9 or $10 an hour which means there is a shortage of people to do this work, and even importing people from other countries isn't helping. CNAs and home health aides are paid less than a Wal Mart cashier.

The average here for a CNA is $15 hour. When I did it, ten years ago, it was $10 hour. Walmart cashiers start at $11.40 hour now.
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Old 10-30-2018, 03:59 AM
 
Location: NJ
10,708 posts, read 21,365,535 times
Reputation: 8919
Quote:
Originally Posted by TheShadow View Post
A lot of the things you mention here are just very common things that we all start to forget as we get into our 50's and 60's. Not all that weird. Heck I lost my smartwatch the other day and still haven't found it...$150 down the drain!

We all start to lose brain cells as we age, the thing that is really indicative of early dementia is the inability to learn and remember NEW memories. Like getting a new washing machine, but not being able to remember the steps to operate it, even after it's been explained numerous times, and somehow still not being able to figure it out. Or asking "what's his name?" and then not remembering asking the question, or what the answer was, just 5 or 10 minutes later, so you repeat the question, and 10 minutes later you've forgotten it a third time. Or eating dinner a second time because you forgot you already ate. One of the big early indicators is the loss of navigational skills, such as not being able to find the exit in the grocery store, or not being able to find your way home from church or some other place you've been to often in the past.
Thanks. I've never been like this so it's weird. My memory is always pretty sharp.

I especially worry because my mother had a touch of something as she got older. I don't know if she was ever diagnosed; we don't speak partly because of it after my dad passed. She's always remembered events totally different from what they happened; her version was always a new narrative opposite what 10 other people saw. She also had some comprehension issues. She's also believing a made up narrative of events from a sibling that didn't speak to my parents for 10 years that never happened

I'll just stay aware of it and if I feel it's worst will go see someone. I'd rather be safe then sorry and be able to be helped.
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Old 10-30-2018, 04:29 AM
 
20,775 posts, read 13,771,877 times
Reputation: 14431
Quote:
Originally Posted by Serious Conversation View Post
It's a massive problem.

I'm not that familiar with the economics of nursing homes, but my girlfriend has been in the "rehab wing" of the nursing home for about a month after her two hip replacement surgeries. It's really eye-opening going into a place like that several times a week.

There seems to be a chronic shortage of personnel. If medicine is supposed to be doled out and taken at 7 AM, it's not uncommon for the patient to be waiting around well past 9 AM with no medicine. Meals aren't doled out on time, and trays aren't collected frequently. It can easily take a half hour for someone to respond to a call light.

The care certainly isn't prompt.

CNAs here get paid $9-$11/hr mostly. Chick-Fil-A is hiring $11/hr full time. "Vegetable choppers" at Panda Express make $11/hr. What would you rather do?
Bad as those wages are for the work/responsibility nursing assistants have, those in nursing homes/skilled care facilities are at the higher end. Home care aides often make barely above minimum wage. and worse due to their assignment schedule (some work 24 hour and or entire weekend shifts) finding a second gig to make ends meet can be difficult.


NYT recently profiled one such person, and it isn't pretty: https://www.nytimes.com/2018/09/11/m...-homeless.html


When it comes to nursing assistant work top of the food chain is hospitals. They generally offer the best pay (relative), working conditions and so forth. Union nursing assistants in this area can earn $20/hr. with bennies. But this is a high COL place and not all assistants are union.


Hospitals also are cutting back on UAL (unlicensed assistant personnel), leaving nursing assistants scrambling. Most will have no choice but skilled nursing facilities, care homes, etc.


Bottom line is nursing homes, skilled care, home health, etc... all very well know that the caliber of assistants they employ is directly related to pay/benefits. The jobs pay often so little and working conditions so bad it is one of those jobs "Americans don't want to take" so to speak. Hence reason you find so many immigrants doing the job, and or perhaps those that really shouldn't.


As it relates to this thread, no; the USA healthcare system is not producing nor attracting anywhere near enough nursing assistants to deal with the coming explosion of seniors/elderly.


If the model is to "age in place" who is going to provide that care? Worse who is going to work at skilled nursing facilities or nursing homes.


Speaking to overall staffing, NYT recently filed this report: https://www.nytimes.com/2018/07/07/h...-medicare.html
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Old 10-30-2018, 06:37 AM
 
Location: Tennessee
23,587 posts, read 17,582,380 times
Reputation: 27677
Quote:
Originally Posted by BugsyPal View Post
As it relates to this thread, no; the USA healthcare system is not producing nor attracting anywhere near enough nursing assistants to deal with the coming explosion of seniors/elderly.

If the model is to "age in place" who is going to provide that care? Worse who is going to work at skilled nursing facilities or nursing homes.

Speaking to overall staffing, NYT recently filed this report: https://www.nytimes.com/2018/07/07/h...-medicare.html
At some point, something will give, if it isn't already "giving" already.

I live in a small metro area that has a regional state university. The school is kind of reinventing itself toward health sciences. There's a college of nursing (with graduate level nursing degree, FNPs, etc.), a medical school (a lot of PAs too - though I don't know if they are under the nursing or medical school umbrella), and a pharmacy school - perhaps some tangential stuff like PT/OT/SLP.

RN-BSNs only start out at $18-$19/hr here, before any premium pay codes/shift pay apply. They can go down to Knoxville's health system and start at around $25/hr. This area ends up with a constant churn of new grad nurses that leave once they get a year or two of experience on the hospital floor. Most of the hospital RNs are middle aged and older. Young people with skills and options aren't going to put up with a pay differential like that if they can help it. The PCTs/CNAs/LPNs probably wouldn't make enough of a difference elsewhere to make it worth the move.

The only RN I've seen at the nursing home my girlfriend is at is probably 70. There are a lot of young CNAs, but that's a month or two month long course at a community college. It is, at best, a paraprofessional role.

Quote:
Originally Posted by GeoffD View Post
This totally depends on the skilled nursing facility. The ones that are pretty much 100% Medicaid patients, yep. The average daily reimbursement for Medicaid at a skilled nursing facility is about $200. Medicare is more like $500 ($15K/month) which is typical as well for private pay. I imagine that in eastern Tennessee, any skilled nursing facility is primarily going to be Medicaid patients with a bit of post-hospitalization Medicare and almost zero private pay. They can't afford the staff to provide a reasonable level of care.

This is why having long term care insurance or enough cash to fund private pay for long enough that the nursing home is willing to bet the patient won't outlive their money is such a big deal. If you walk in the door as a Medicaid patient, the good places won't take you so you're pushed to the lousy places.
The nursing home my girlfriend is in is located in Virginia by a few hundred yards. She's technically in the "rehab" program, but the full-time skilled nursing and rehab patients are all in the same rooms together. She's had several roommates, all of whom were 90+, and from extremely impoverished small towns in southwest Virginia. That's going to be 100% Medicaid - none of those folks are likely to have any money.

Thankfully, this nursing home is part of a larger organization that has facilities throughout northern VA. I'm sure the dollars from northern VA pay the bills for the facilities down here.

Last edited by Serious Conversation; 10-30-2018 at 06:49 AM..
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