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Old 03-01-2010, 09:42 PM
 
Location: Tucson/Nogales
17,451 posts, read 21,289,337 times
Reputation: 24301

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Quote:
Originally Posted by MotleyCrew View Post
I agree. I don't want to be shoved into a skilled nursing unit to sit and wait for someone to change my adult diaper. I was so depressed when I would visit my mom when she was stuck there for 30 days. People sit in corners, drooling and messing themselves. This to me is not a quality life and I don't want any part of it. My mom has to endure whatever the doctors decide to do for her and she is not a happy camper.
I work in a LTC/Rehab facility, and when I started working there I swore I'd never, ever end up spending my last days at one.

But I've learned, over the years, it need not be that unpleasant.

What you need to do, to have your last days as comfortable and pain-free as possible,
is to learn how to work the system at one of these places. Many just don't know how to work the system and they suffer in silence.

If you feel like you're not getting sufficient pain medication, scream, yell,
disturb everyone else on your hall, turn up the TV as loud as you can, do whatever you have to do to get attention, in other words, more pain medication to put you into LaLaLand, where you won't know if you are on Planet Earth or Planet Neptune.

Suffering in silence will not accomplish anything. The Administrator or Charge Nurse walks down a hall, and who will they direct the CNA or Hall Nurse to?
The one that's causing all the disturbance. Whatever it takes to silence this patient, do it! Now!

Too many in there suffer in silence, fearful of asserting their rights and making a big scene. If you're one of these people who wishes not to join in on their organized activities, fine, that's your choice. If you choose to spend your last days all drugged up, fine, that's your choice.

If I land in one of these facilities one day, I'll scream and holler until I get exactly what I want, providing I'm in a position to do that. Unfortunately, there are those who can't even scream and holler. But, there are always other ways of communicating your desires to the staff.

Once in LaLaLand, will you even be concerned if your diaper hasn't been changed in 2 hours or 2 days? I once caught an elderly woman bragging on her cellphone to her brother: "You don't have any idea of what luxury is, until you come to a place like this. You can poop and pee in bed, put on the call light, and someone comes along to change your diaper!"

Last edited by tijlover; 03-01-2010 at 10:19 PM.. Reason: Add a line
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Old 03-02-2010, 06:18 AM
 
Location: Venice, Fl
1,497 posts, read 3,102,950 times
Reputation: 1389
Quote:
Originally Posted by Curmudgeon View Post
A few cautions regarding long-term care. First of all, not everything has to be liquidated if there is a spouse or there is another family member who has resided with the patient for several years. Under those circumstances a house is not at immediate risk and the spouse or family member can retain it until they move or die. Secondly, there are spousal protections for a non-hospitalized spouse which permit financial assets to a certain level as well as monthly income. Paying for in-home care in a long-term care policy only works if there is a primary caregiver in the home or you can afford one. The policies do not provide for 24-hour care. If you reach that stage without an available caregiver it's off to the home with you which the policy will pay for. Institutionalization is cheaper than 24-hour home care. Finally, if you have a state-based policy it will only pay in that state so if you moved to another, say, to be close to family, and require LTC you would have to move back to be covered.
First of all a family member does not exempt assets or the home, only the spouse does. Home health care does not pay in a facility, only in your home. Care at home can be cheaper than facility based care depending on the company providing the care, in Florida some nusring companies provide 24 hour care for $200 a day. The policies can and most do provide for 24 hour care. Lastly, your knowledge about partnership qualified plans is 100 % wrong. State partnership plans are filing , and have been since July 2009 when the partnerships were introduced so that states share reciprocity. Not all of the states do yet but most of them are filing for it. The states that do not reciprocate benefits will in time. The reason they do not is due to Medicaid programs varying from state to state.

You will need to do some homework to find which states reciprocate with your home state as none of the state Medicaid offices will have this information for you.

Last edited by Old Man Winter; 03-02-2010 at 06:19 AM.. Reason: typo
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Old 03-02-2010, 07:27 AM
 
Location: Oxygen Ln. AZ
9,321 posts, read 16,598,214 times
Reputation: 5692
Quote:
Originally Posted by tijlover View Post
I work in a LTC/Rehab facility, and when I started working there I swore I'd never, ever end up spending my last days at one.

But I've learned, over the years, it need not be that unpleasant.

What you need to do, to have your last days as comfortable and pain-free as possible,
is to learn how to work the system at one of these places. Many just don't know how to work the system and they suffer in silence.

If you feel like you're not getting sufficient pain medication, scream, yell,
disturb everyone else on your hall, turn up the TV as loud as you can, do whatever you have to do to get attention, in other words, more pain medication to put you into LaLaLand, where you won't know if you are on Planet Earth or Planet Neptune.

Suffering in silence will not accomplish anything. The Administrator or Charge Nurse walks down a hall, and who will they direct the CNA or Hall Nurse to?
The one that's causing all the disturbance. Whatever it takes to silence this patient, do it! Now!

Too many in there suffer in silence, fearful of asserting their rights and making a big scene. If you're one of these people who wishes not to join in on their organized activities, fine, that's your choice. If you choose to spend your last days all drugged up, fine, that's your choice.

If I land in one of these facilities one day, I'll scream and holler until I get exactly what I want, providing I'm in a position to do that. Unfortunately, there are those who can't even scream and holler. But, there are always other ways of communicating your desires to the staff.

Once in LaLaLand, will you even be concerned if your diaper hasn't been changed in 2 hours or 2 days? I once caught an elderly woman bragging on her cellphone to her brother: "You don't have any idea of what luxury is, until you come to a place like this. You can poop and pee in bed, put on the call light, and someone comes along to change your diaper!"
Pooping and peeing in bed is not my idea of luxury living, lol. One person's paradise may be another's hell I guess.
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Old 03-02-2010, 03:20 PM
 
Location: Near a river
16,042 posts, read 19,007,999 times
Reputation: 15649
Originally Posted by Curmudgeon
A few cautions regarding long-term care. First of all, not everything has to be liquidated if there is a spouse or there is another family member who has resided with the patient for several years. Under those circumstances a house is not at immediate risk and the spouse or family member can retain it until they move or die. Secondly, there are spousal protections for a non-hospitalized spouse which permit financial assets to a certain level as well as monthly income. Paying for in-home care in a long-term care policy only works if there is a primary caregiver in the home or you can afford one. The policies do not provide for 24-hour care. If you reach that stage without an available caregiver it's off to the home with you which the policy will pay for. Institutionalization is cheaper than 24-hour home care. Finally, if you have a state-based policy it will only pay in that state so if you moved to another, say, to be close to family, and require LTC you would have to move back to be covered.

Quote:
Originally Posted by Old Man Winter View Post
First of all a family member does not exempt assets or the home, only the spouse does. Home health care does not pay in a facility, only in your home. Care at home can be cheaper than facility based care depending on the company providing the care, in Florida some nusring companies provide 24 hour care for $200 a day. The policies can and most do provide for 24 hour care. Lastly, your knowledge about partnership qualified plans is 100 % wrong. State partnership plans are filing , and have been since July 2009 when the partnerships were introduced so that states share reciprocity. Not all of the states do yet but most of them are filing for it. The states that do not reciprocate benefits will in time. The reason they do not is due to Medicaid programs varying from state to state.

You will need to do some homework to find which states reciprocate with your home state as none of the state Medicaid offices will have this information for you.
Re: Curmudgeon's post, above--how is institutional care cheaper than in-home care at say $200/day? Most decent nursing homes start at $350/day (at least around here).

At $200/day, maybe we can pay a family member to take care of us (that's $1000/week) and preserve our home and any assets for that family member and others. This whole system in America is just plain ridiculous. Only those who are well off (and I commend those of you who are!) are able to afford to die in dignity. Others of us who worked just as hard and sometimes harder who did not have high paying jobs or family wealth are, well, you know, screwed. I'm thinking of a mobile unit for old age, with a 24 hour caretaker who will take care of me and drive me around the country at the same time in my final years. Hey, that's $1,000 a week for a private chauffeur who will make me meals and tend to some basic needs and meds, all while seeing the country. Sounds like there is a job niche for some savvy entrepreneurs here--MOBILE NURSING HOME, Inc. How much would liabiality insrance be for this kind of arrangement?

P.S.Searching for "nursing home alternatives" I found this:

http://www.medicare.gov/NHCompare/St...Tab=3&subTab=3

Last edited by RiverBird; 03-02-2010 at 03:32 PM..
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Old 03-03-2010, 10:03 AM
 
Location: SW US
2,224 posts, read 2,042,478 times
Reputation: 3839
Has anyone read "HAPPINESS IS GROWING OLD AT HOME"?

I'm wondering if it's worth buying since my parents are determined to stay in their home till the end.
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Old 03-03-2010, 01:50 PM
 
Location: Near a river
16,042 posts, read 19,007,999 times
Reputation: 15649
from Amazon?
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Old 03-05-2010, 05:26 PM
 
Location: Near a river
16,042 posts, read 19,007,999 times
Reputation: 15649
Did anyone see the PBS Frontline program last week on assisted suicide and if so what did you think

FRONTLINE: the suicide tourist | PBS
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Old 03-09-2010, 07:25 AM
 
Location: zippidy doo dah
895 posts, read 1,334,256 times
Reputation: 1928
Quote:
Originally Posted by newenglandgirl View Post
Did anyone see the PBS Frontline program last week on assisted suicide and if so what did you think

FRONTLINE: the suicide tourist | PBS
New England - thanks for the link here. Looks like I can watch the program now on the site so that will be a "break time" activity today.

I was reading the discussions on the "women retiring..." thread and saw your comment about posting the link for the show and so far no comments. However, the assertion of repeated posters about not accepting extended life at all costs keeps creeping into many forums- you wonder if it is generational or if is more specifically a variable of the type of people that are drawn to city data forums and these sort of discussions.

This makes me think back of when my daughter first got licensed to drive & her dad insisted on gifting her with a car (sigh....another story entirely). Her grandparents paid her insurance premium for the first year as a birthday present.

I advised her to put aside every month the money for the following year's premium.....with wide eyes, she gasped "I have to pay THAT amount EVERY year????!!!!! - that's rediculous - it's not fair". I laughed and responded "welcome to adulthood". Not long after that, she found out again and again just what a mixed blessing growing up and charting your own course can be. I may have already used that story on city data - if so, it's that aging thing......................

With that said, it seems many of us are expressing the same astonishment & indignation at the costs/reality of entering the seemingly-never-ending winter season of life. (Like this year, I expect the winter season of life to possibly equal the whole of spring, summer & fall). Except unlike a 16 year old who surely isn't going to reconsider the notion of driving, we, the reflective aging, are reconsidering just what constitutes living.

And I use "winter season" somewhat skeptically because I don't feel I'm at the end of my life but society's obsession with youth/with squirreling away everything for the elder years etc does make me feel like I was a bit of a grasshopper when i was supposed to be an ant. Yet I've always kept money in reserve/just not millions.

Regardless, I don't believe I would have done anything differently - in fact, I would have worried about everything less. I would have lived more in the present with normal prudence but not obsession for future security. I would not have wasted a single minute freaking out on things and i would have savored the uniqueness of every moment.

Younger posters on these forums are terrified they can't put enough away or they are starting to make the same "voluntary checking-out" comments that some of us are making. All the while, everyone is pounding how you need long-term insurance, retirement strategies for today, tomorrow and the day after, and bottomless pits for your future medical cost needs. I feel bad for everyone that this is scaring........ I must be taking really good drugs...........

I know this isn't the garden of eden - i know the men are supposed to toil & sweat and the women are supposed to suffer in childbirth and all that, crushing a few snakes along the way. but i somehow don't think this is necessarily what was intended. maybe it's getting real hard/almost impossible to properly insulate yourself against all these calamities for a reason....ponder that.

maybe there is a different way (and it probably isn't that the poor/single/less-prepared people kill themselves while the other 10% or so live in the ever-so-costly senior facilities of one sort or the other.) That's not finding fault with those who do feel called to prepare for every circumstance or with those who are talking about just not hanging around for a wretched life. It's just saying that the two approaches point to the inevitable crash of a system as we know it.

Something monumental will come out of all of this - a change in attitudes for sure because it could get a little weird if everyone who runs out of their pot of gold starts "offing" themselves. I have appreciated the posters who have repeatedly made it very clear that it isn't they didn't try/didn't punch all the boxes in the check list. it should squelch the bumper sticker responses of talk show hosts. And in reality, the people who weren't capable for whatever reason of punching the check list, are they any less our brothers and sisters??? Fascinating topics. In the long run, I think the answers will be fairly simplistic. maybe that's the point of this long-running SIM City production we're all participating in.................

ok, back to my hyper-focus on a non-avoidable situation................
(live in the present, live in the present, live in the present....breathe, breathe, breathe)
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Old 03-09-2010, 12:05 PM
 
Location: Monterey Bay, California -- watching the sea lions, whales and otters! :D
1,918 posts, read 6,246,084 times
Reputation: 2651
Quote:
triciajeanne: I know this isn't the garden of eden - i know the men are supposed to toil & sweat and the women are supposed to suffer in childbirth and all that, crushing a few snakes along the way. but i somehow don't think this is necessarily what was intended. maybe it's getting real hard/almost impossible to properly insulate yourself against all these calamities for a reason....ponder that.
I did watch that video -- it was very good and insightful. The only part that really saddened me was when he said he didn't want his children there because he would have wanted to keep talking with them. I think that with a disease like his, he knew that he was going to succumb all the way to not being able to even communicate at all -- that was his frustration. He knew there was no way out. But at the same time, I think there was sadness in making his decision at that point in time because he was still able to communicate. He seemed to enjoy life quite a bit and he was very bright.

If he could have waited a little longer, I think he would have felt happier, but it seems that with all the arrangements that had to be made and his disease progressing rapidly, he probably felt it was "now or never." I have a feeling there was some regret, but at the same time that he felt that the ultimate fate was his death and inability to communicate his wishes, thus, he would have no control over his own life.

It is very sad to contemplate this option, but I think it is realistic. When the only option is death, and if we truly are on tubes and not able to communicate or our mind is almost gone, well, then the inevitable end is basically already there.

Quote:
Maybe there is a different way (and it probably isn't that the poor/single/less-prepared people kill themselves while the other 10% or so live in the ever-so-costly senior facilities of one sort or the other.) That's not finding fault with those who do feel called to prepare for every circumstance or with those who are talking about just not hanging around for a wretched life. It's just saying that the two approaches point to the inevitable crash of a system as we know it.
I think that's the thing: "the inevitable crash of a system as we know it." The bottom line.

Just this morning I was thinking about America as a big Monopoly board -- why not just on a U.S. map stick on little plastic green houses and red motels? We seem to be run by the wealthy, and the monopolies and the conglomerates. The people making decisions for those of us who are not one of "them," are not in tune with "us." And it is part of a system that is crashing.

I doubt if we'll see substantial changes in our lifetime. I do, however, believe that the Baby Boomers will demand changes and they may start coming, but it could be a long time before they are accepted and implemented.

In other countries they revere the elderly, the wise...here, they just toss you aside like a bag of garbage (or that's how I feel).

At least that documentary showed how peaceful it can be. That was good. And I realize that down-the-road he'd have been agonized at not being able to communicate, much less move at all. For him, and that is what I think it is for many, if the ultimate trip is coming and almost here, then, why not up the speed just a little?

No matter which way you look at it, aging in America is not a lot of fun....
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Old 03-09-2010, 05:51 PM
 
Location: Near a river
16,042 posts, read 19,007,999 times
Reputation: 15649
I think it cost that PBS Frontline couple something like $4500 for the assisted suicide alone, plus airfaire and hotels. The interesting case was the other one on the frontline website, the couple that simply wanted to die togehter now (he has cancer, she is healthy). The Swiss physician said no. I agree with that.

On another note, it seems like any and all decisions made at the age of 60 or so have to be based on the reality of reaching the age of 75 or 80. There are options that feel really right for me right now, but do not feel right looking 10 years down the road. A person of means can do an about-turn at any point at any age, but those on a shoestring have to plan everything extremely realistically. Who should/can I live near for the older years? Where is there a good medical faciltiy, where are there specialist doctors for my personal needs, where is there a good support system for 70-80 year olds? HOw much driving is too much, just to get a good loaf of bread? When we were younger we never thought about those things, and gas was cheap, and so was bread. We never thought we would need to live in a handicap accessible place, or what we might do if we cou;dnt drive any more. It feels quite strange to have this whole new set of considerations to deal with, and so for some of us there is no easy answer about where and if to move and/or how to change our circumstances. Even couples making certain decisions at this age need to think, "what happens if one of us ends up alone, and doesn't have a lot of resources to make a change" (or a "move back" at that point)
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