The Cold Hard Facts?

[Jo Dirt]

I've been involved in nursing (in some form or fashion) for 11 yrs.. Recently, we took in my elderly father-in-law.

I believe I have "been around" when it comes to geriatrics and LTC. The more I look around at what is going on with this the more depressed and hopeless I feel. Time after time, you see these little old people lose everything they have to go in the nursing home, and their dignity and dreams of leaving anything to their children slip right down the drain. One old lady told me, if she knew she was going to wind up in "this" kind of shape she would have offed herself before it got to the point it was (she owned a big farm that neither of her children would be inheriting, and she was really too high acuity to be at home) I could have said, Oh now, Ms. Brown, you don't mean that, you shouldn't say such thing! but I couldn't bring myself to be that hypocritical. It's got me to thinking about when I get old, if I live that long.

Why should healthcare be to the point where the middle class must accept being reduced to paupers to receive any benefit from it? Are there really so many old and infirm people using the recources and putting a strain on the government that it drives up the cost of everything to the point only the extremely wealthy can afford it?

What's the point? Work and slave your whole life so the little bit of property/savings you were able to accumulate can be used to keep you hanging onto life a little while longer in a nursing home? Do you think those people worked and saved because they intended for their money to go to "the company"?

You see all kinds in the nursing home, the virtuous and the trash of society, and in the end no one of them are any better off than the other.

The nursing home equalizes everyone (before their time to be equalized comes).

It also got me to wondering about the real purpose for giving Dr. Kevorkian all the attention he got in the news. It's unknown to some people, but the government really does plan ahead. As cold and heartless as it sounds now, with more and more old and infirm being kept alive longer now, maybe all this technology has backfired on the government and perhaps this was to get society acclimated to the idea of human euthanasia? Of course, they had to bring about the idea in a more subtle way (Dr. Kevorkian) but you know they couldn't just push a law in our faces saying The nursing homes are full and you can't afford the services on your own, but now you can take Grandma down to the clinic and we can make this easier for everyone.

I honestly believe that is where this is heading, though.

Gives me a lot of hope for what the future holds for me...

[caroladybelle, BSN, RN]

Please don't say this is about selfishness. During the "good ole days" some women didn't work so they were able to be the care takers. What do you do when a family has children in college and both parents need to work to pay the mortgage and afford college? Even if tuition is not an issue, often both people need to work to make ends meet. I know if either one of my parents were to become ill to the point where they needed around the clock care, I am not in any shape whatsoever to stop working and care for them.

I am single and have never been married.

My parents got divorced, when my mother was 51 and she had to go back to work. She never went to college, and had a subsistance job, with limited retirement. Daddy's retirement, saved partially by her scrimping and saving, making our clothes, etc. for 25 years of marriage...went to the step witch at his death, and she changed the Will, so that everything went to her mother when she died. Momma owns her house, is the only way she makes it. House however is way too large for her to care for, and she has accumulated way too much (utterly useless) stuff to move. I try to clean in out and get a fight. She has several pets, but two have bad hygiene problems, and I cannot stand to be around them. Momma is also significantly overweight. When she falls at home, I physically cannot lift her. And it is getting to the point, that she needs me near by. The house needs serious repairs.

1

What do I do - move in (with my stuff in storage), fight with her to clear out the crap, screen the porch and move bad pets outside (breaking her heart) and have no life, not to mention get paid crap wages at the facility near her - repair the house - and if she gets sick, lose all the investment and have no home or life of my own?

2

Move nearby, and help out - a slightly more comfortable alternative, but may not be financially viable, if I am to repair the house?

3

Keep working heavier assignments away from home, pay for repairs, and hope that her health holds and worry?

I of course have all the lovely caring MARRIED w/ children health care couples which tell me how I need to move in and take care of Momma - to hell w/ me having so much as a date in the next 10 years or til she dies. And laying plenty of guilt trips on me. Let them try to lift her alone at night or try to get her to exercise.

I nearly lost it caring for her s/p rotator cuff repair. I was close to calling Kevorkian to TAKE ME out.

[General E. Speaking, RN, RN]

It is difficult when your folks get older. Currently, I am in the Sandwich Generation. Dealing with my teenager and my folks...

[CapeCodMermaid, RN]

So many issues all packed with emotion.

Years ago when Grandma was taken care of at home, Grandma died before she was 80 and didn't have major medical problems. Grandma probably took a vitamin and maybe an aspirin. Today, our old folks are much older and most take 9,10,11+++ meds a day--many of which have parameters. The average person just isn't equipped to take care of a sick elder. The state of Vermont has just come up with a plan to help people stay home..their kids' home...the caregivers get paid $10/hr to take care of their own family. My facility has 120 beds and MAYBE 10 of those people could go home IF the family member was there all day and IF they were trained.

I think it's unrealistic to equate taking care of a baby with taking care of an elder...MY son was big, but he didn't weigh 200 pounds. I could pick him up with out injuring myself.

Part of the problem is the theory of life at all costs. One of my patients had a birthday the other day. She is blind and has arthritis, but still has her mind. She told me to "burn the candle at both ends so you die while you're still young...it's no fun to get old and be sick".

I think Dr. Kevorkian is right. We all should be able to decide when to make our exit with dignity.

[Jo Dirt]

I am single and have never been married.

My parents got divorced, when my mother was 51 and she had to go back to work. She never went to college, and had a subsistance job, with limited retirement. Daddy's retirement, saved partially by her scrimping and saving, making our clothes, etc. for 25 years of marriage...went to the step witch at his death, and she changed the Will, so that everything went to her mother when she died.

1

What do I do - move in (with my stuff in storage), fight with her to clear out the crap, screen the porch and move bad pets outside (breaking her heart) and have no life, not to mention get paid crap wages at the facility near her - repair the house - and if she gets sick, lose all the investment and have no home or life of my own?

2

Move nearby, and help out - a slightly more comfortable alternative, but may not be financially viable, if I am to repair the house?

3

Keep working heavier assignments away from home, pay for repairs, and hope that her health holds and worry?

I of course have all the lovely caring MARRIED w/ children health care couples which tell me how I need to move in and take care of Momma - to hell w/ me having so much as a date in the next 10 years or til she dies. And laying plenty of guilt trips on me. Let them try to lift her alone at night or try to get her to exercise.

I nearly lost it caring for her s/p rotator cuff repair. I was close to calling Kevorkian to TAKE ME out.

I feel for you, carol. I'm sure I'm going to be the most cold heartless b&^%* in the world for saying this, but you should not be obligated to carry this burden on your own. I'm sure it's easy for those people to lay the guilt trips on you, they are not in your situation. It's always easy to advise someone on something you don't have to worry about doing yourself...tell them they can move in with her.

Yes, the family used to care for their own elderly and disabled, but times are different now.

I can't help it, I'm starting to feel a little resentful that I'm being expected to care for my father-in-law. I have never said anything about this to him, and i don't ever plan to, but the resentment is there. Of course, my husband, who is homebound because of being legally blind and not much more than an invalid himself, does not understand at all. He gets angry with me if I show the slightest frustration at not being able to be away from the house more than a few hours at a time, "because grandpa needs his dinner", or "because someone has to keep a check on Grandpa." Funny, they couldn't stand each other for years and years and now, all of a sudden, grandpa is the most precious thing he has and I should feel appreciative and grateful to have him around and wash his clothes and take him to his doctors appointments (and "Grandpa" is no sweet little old man, he's an opinionated snob who has nothing good to say about anyone, which doesn't bring any more joy to the situation)...furthermore"Grandpa" will probably live another 10+ yrs....and I'll be 10+ yrs. older.

Just know you are not alone, and no, you should not feel guilty.

[Mulan]

Part of the problem is the theory of life at all costs. One of my patients had a birthday the other day. She is blind and has arthritis, but still has her mind. She told me to "burn the candle at both ends so you die while you're still young...it's no fun to get old and be sick".

I think Dr. Kevorkian is right. We all should be able to decide when to make our exit with dignity.

A very valid point.

I think of the movie Soylent Green and how the people die, if anyone has seen it.

[Mulan]

I feel for you, carol. I'm sure I'm going to be the most cold heartless b&^%* in the world for saying this, but you should not be obligated to carry this burden on your own. I'm sure it's easy for those people to lay the guilt trips on you, they are not in your situation. It's always easy to advise someone on something you don't have to worry about doing yourself...tell them they can move in with her.

Yes, the family used to care for their own elderly and disabled, but times are different now.

I can't help it, I'm starting to feel a little resentful that I'm being expected to care for my father-in-law. I have never said anything about this to him, and i don't ever plan to, but the resentment is there. Of course, my husband, who is homebound because of being legally blind and not much more than an invalid himself, does not understand at all. He gets angry with me if I show the slightest frustration at not being able to be away from the house more than a few hours at a time, "because grandpa needs his dinner", or "because someone has to keep a check on Grandpa." Funny, they couldn't stand each other for years and years and now, all of a sudden, grandpa is the most precious thing he has and I should feel appreciative and grateful to have him around and wash his clothes and take him to his doctors appointments (and "Grandpa" is no sweet little old man, he's an opinionated snob who has nothing good to say about anyone, which doesn't bring any more joy to the situation)...furthermore"Grandpa" will probably live another 10+ yrs....and I'll be 10+ yrs. older.

Just know you are not alone, and no, you should not feel guilty.

Agree with this too.

It's unfortunate that your husband can't take care of his father himself. After all, it is HIS father, not yours.

[Simplepleasures]

It also got me to wondering about the real purpose for giving Dr. Kevorkian all the attention he got in the news. It's unknown to some people, but the government really does plan ahead. As cold and heartless as it sounds now, with more and more old and infirm being kept alive longer now, maybe all this technology has backfired on the government and perhaps this was to get society acclimated to the idea of human euthanasia? Of course, they had to bring about the idea in a more subtle way (Dr. Kevorkian) but you know they couldn't just push a law in our faces saying The nursing homes are full and you can't afford the services on your own, but now you can take Grandma down to the clinic and we can make this easier for everyone.

I honestly believe that is where this is heading, though.

Gives me a lot of hope for what the future holds for me...

You know I really think you are on to something.With the baby boomers, myself included, quickly approching old age, and with the mess that LTC is now in, I do think there will be a new field of medicine called:caduceus: Euthenasia, and it will be perfectly legal. What else will they do with all of us?

[New Horizons]

I am single and have never been married.

My parents got divorced, when my mother was 51 and she had to go back to work. She never went to college, and had a subsistance job, with limited retirement. Daddy's retirement, saved partially by her scrimping and saving, making our clothes, etc. for 25 years of marriage...went to the step witch at his death, and she changed the Will, so that everything went to her mother when she died. Momma owns her house, is the only way she makes it. House however is way too large for her to care for, and she has accumulated way too much (utterly useless) stuff to move. I try to clean in out and get a fight. She has several pets, but two have bad hygiene problems, and I cannot stand to be around them. Momma is also significantly overweight. When she falls at home, I physically cannot lift her. And it is getting to the point, that she needs me near by. The house needs serious repairs.

I really empathize with you and understand the difficult choices you have to make. I am also single with no children. One of my grandmothers died when I was in my late 20s. She finally died died after a year with COPD. During that year she was in and out of the hospital the family had to make decisions on what to do. One of the ideas that came up was maybe I could move in and take care of her. It didn't come to that, but just like you said in your post, my thoughts were will I have a chance to date again. I would like to have a family of my own. In that one year the family went through the gamit of looking at how to pay for help and what to do as the illness progressed. She stayed at my parent's house for a couple of weeks during the summer when my mother was on vacation At night, while everyone was asleep she would pull off the oxygen mask and try to walk around because she couldn't breathe lying down. She was confused , had problems seeing and could have hurt herself. She ended having to be readmitted to the hospital. Imagine if she had had Alzheimers.

I didn't mean to jump on the poster that mentioned people caring for families in the home. I guess the comment just hit a nerve because caring for your loved ones is hard.

Also, I wonder if the ole' days were as great as some of us want to think. People had the same problems that we do now, but they just had to deal with it. I really wouldn't be surprised if there was more elder abuse and neglect, because people had to "deal with it" and had no other outlet to de-stress.

[dream'n, BSN, RN]

Part of the reason for the problem is the view in society that the most invasive level of medicine must always be used with everyone, everytime. What I mean is that society stresses quantity of life over quality of life. I'm a very warm-hearted person, but I've taken care of elder, uncommunicative, contracted patients in end-stage alzheimers disease, where the families insist upon dialysis, chemotherapy, etc. These patients were already in a LTC facility because the family certainly couldn't care for them at home. What on earth were these families thinking? Whatever happened to dignity in death and providing comfort? I know the decision to say enough is enough is difficult for these families, but come on. I personally had to make this decision for my father, but I did make the choice for dignity, quality of life, and comfort, because I loved him.

[General E. Speaking, RN, RN]

Part of the reason for the problem is the view in society that the most invasive level of medicine must always be used with everyone, everytime. What I mean is that society stresses quantity of life over quality of life. I'm a very warm-hearted person, but I've taken care of elder, uncommunicative, contracted patients in end-stage alzheimers disease, where the families insist upon dialysis, chemotherapy, etc. These patients were already in a LTC facility because the family certainly couldn't care for them at home. What on earth were these families thinking? Whatever happened to dignity in death and providing comfort? I know the decision to say enough is enough is difficult for these families, but come on. I personally had to make this decision for my father, but I did make the choice for dignity, quality of life, and comfort, because I loved him.

good point. I heard a pulmonary doctor say something the other day that has been on my mind. He was speaking with a group of family members of an elderly patient with many comorbidities who had to have a bowel resection. Needless to say, they were having trouble getting her off the vent and her health was declining. The family wanted to know "how could this happen?" The doctor replied point blank, "Because she is very sick". He paused for a moment and try to let them absorb what he was saying. He went on to explain more, I thought his candid response was poignant.

We are not invincible, things wear out... It should be quality over quantity.

[JohnBearPA]

I fully agree that the days of taking care of our elderly in their own homes is probably long past. I also fully understand that it's not fair to them that they lose any and all of the precious things they worked their whole lives for to recieve proper care from the gov't. I've lived thru this first hand, and am in fact still paying off my mother's bills over a year after her death. What was Mom able to leave me from a lifetime of work? Not much, besides alot of good memories.

You all have heard my story already of how I had to take responsibility for my Mom's care, how she had Vulvar ca, was misdiagnosed, and told surgery was successful when it really wasn't. I went to nursing school, held down a job, and ran my own home while visiting Mom every day at the nursing home I had to place her in.

The reason I had to place her? I have three male dogs, Mom had a huge bleeding tumor in a delicate region, do the math. Also, the dressing changes, meds, and helping her in and out of the bathroom, and just the ADL's would have caused me to have to stay home full time, which was not feasible. Also, I'm male, so there was that issue, for her and my comfort. Mom hated the nursing facility, she was only 57, and everyone was much older, but it needed to be done. My younger sister chose to not take responsibility, and stay in another state working at an internship, because she couldn't handle it, so it was me or nothing for poor Mom.

We need to come up with something to help these poor elderly people. Healthcare should be a right in a country as great as ours, not a privelege of the upper classes. For God's sake, these people made our country what it is today, and they have to choose between filling a script or eating for the month. Let's get our priorities straight here, and protect these people, give them the care they need, and let them have something to pass on to their kids!

[jschut, BSN, RN]

It is difficult when your folks get older. Currently, I am in the Sandwich Generation. Dealing with my teenager and my folks...

Yep! Me too! Just moved Mom in, and I am her caretaker....brother doesn't help at all, and I am working nights now, full time school, full time family, and full time exhaustion.

Pretty soon, I'll be the one needing care.....