We fail our old people and it's heartbreaking

[JBMmom]

I recently had a patient who was admitted because a neighbor contacted the police when they realized she was living at home with a few pets in a house with no heat or running water. She's been admitted with a minor medical diagnosis, but it's been passed in report that we're just waiting on long-term care placement for her. She's in her mid 80's, has been living independently for many years, and she's pretty clear that she's going back to her house with her pets, because no one has told her otherwise. I've worked with many dementia patients over the years, even the ones that were pretty sneaky about it, and I honestly didn't see indications of dementia. She had some trouble with phone numbers, and these days no one has a phone book, so she was in the process of tracking some people down to help with the heat and water, according to her, before the neighbor called the police. If we had a system in place where elderly people could live in their home, have someone just check in on them for the basics, and they could retain some independence, that would be so beneficial. Now she'll end up in long-term care, potentially funded by the state depending on her financial situation, and she's one of those people that I'm pretty sure will just will herself to die in an institutional setting. And she's going to be one of the combative aggressive ones, too. That's the report I got from the previous nurse, but it's all about approach with her. If she feels empowered to make decisions, she's fine. As soon as she feels control has been taken away, she digs right in and will get feisty, and I don't really blame her. So what's the worst possible thing we could do for her? Long-term care placement. Breaks my heart to think that she'll never be home with her pets again and all she wanted all night was her dog on her bed. Sometimes I hate getting old.

[sunny time]

hold on sister, have you ever heard of life. maybe she had a plan but inflation happened and it wasn't enough

. maybe she had an older child that needed financial help and she did which left her without. don't preach stupid stuff when it is obvious you haven't seen real life. I have known women to marry a 2nd or 3rd partner to have his income to be able to live. get over yourself, if you think that Social Security and your pension is going to be enough to live on you had better think again. you may live past the amount you have saved. then what, so if you have a specific time you are going to die don't preach what you don't know

[dec2007]

I wish people would quit talking about how expensive long term care insurance is. It has already been established that if one buys in early it costs about $30.00 a month or a dollar a day. Skip on fancy coffee or fast food meal a week and it's paid for. Well worth the sacrifice I say. Quit blaming all this on the government or expecting the tax payer to pick up the cost of care. Be proactive. My family was a modest middle income family with 5 kids in it. My mom and dad lived within their means and managed to send all 5 kids to college and retire with over a million dollars in the bank which pretty much paid for my mother's long term care, People have to start taking responsibility for themselves early in their lives. At 55 I have two college degrees and have never taken out a student loan. I have never owned a brand new car, but I now own two houses and my debt is still quite manageable. My son will go to college without accruing debt as well because we have taught him how to live within his means. Oh by the way we do support local charitable endeavors as well. The American mindset both for liberals and conservatives can be pretty selfish and indulgent at times. If each person just took a little personal responsibility we would end up in these messes.

Hppy

This IS the actual "fix" for this problem, but unfortunately we have a whole generation that has not done any of these things and now need care, but have no way to pay for it. No one (including me) wants their taxes to go up to pay for these government programs. As you say, the answer is that people need to start taking personal responsibility for themselves, but we are currently in a situation where we have lots of folks who didn't do that and are now dependent on the state.

I truly don't know how we can provide adequately and compassionately for our current elderly population without taxing our current workforce to the point that they won't be able to save for their own old age. I am at a loss how to fix this for our parents' generation. To paraphrase Margaret Thatcher, eventually we run out of other people's money.

My parents-in-law are in this exact position now. They were hard working folks, but never contemplated how they would handle old age and disability. My husband and I try to do as much as we can to help, as we are the only family members in the same town. My husband's siblings try to help financially, but if my in-laws were childless they would have no way to cope at this point in their lives.

I wish I knew the answer.

[ponymom]

hold on sister, have you ever heard of life. maybe she had a plan but inflation happened and it wasn't enough

. maybe she had an older child that needed financial help and she did which left her without. don't preach stupid stuff when it is obvious you haven't seen real life. I have known women to marry a 2nd or 3rd partner to have his income to be able to live. get over yourself, if you think that Social Security and your pension is going to be enough to live on you had better think again. you may live past the amount you have saved. then what, so if you have a specific time you are going to die don't preach what you don't know

No you...who you respondin to???

[Susie2310]

I wish people would quit talking about how expensive long term care insurance is. It has already been established that if one buys in early it costs about $30.00 a month or a dollar a day. Skip on fancy coffee or fast food meal a week and it's paid for. Well worth the sacrifice I say. Quit blaming all this on the government or expecting the tax payer to pick up the cost of care. Be proactive. My family was a modest middle income family with 5 kids in it. My mom and dad lived within their means and managed to send all 5 kids to college and retire with over a million dollars in the bank which pretty much paid for my mother's long term care, People have to start taking responsibility for themselves early in their lives. At 55 I have two college degrees and have never taken out a student loan. I have never owned a brand new car, but I now own two houses and my debt is still quite manageable. My son will go to college without accruing debt as well because we have taught him how to live within his means. Oh by the way we do support local charitable endeavors as well. The American mindset both for liberals and conservatives can be pretty selfish and indulgent at times. If each person just took a little personal responsibility we would end up in these messes.

Hppy

The reality is that house prices have outpaced average salaries for years. And again, many of the jobs that existed for middle class and working class people no longer exist in this country in any substantial way. Final salary pensions no longer exist for the most part. The greatest tax burden also falls on the middle class. The tax structure is set in favor of the upper middle class and the wealthy. So yes, taking personal responsibility is to be encouraged, but people can only work within what is possible for them.

[sunny time]

I had a patient with long term insurance in LTC. How is that for justice.

[sunny time]

I had a patient with long term insurance in LTC. How is that for justice.

[Mini2544, ASN, RN]

I am living this nightmare right now and let me tell you it is hell.

My parents worked and saved, but all the money is tied up in their home.

4 months ago my mom was completely independent and my dads caregiver as he has severe arthritis with limited mobility. They would never discuss their finances because they "were fine and totally with it and capable of handling our affairs.

In 4 months my mother has become almost bed bound. Really that part happened within the last 6 weeks. Also somewhat confused now for the last 3 weeks. She has been diagnosed with a progressive neurodegenerative disease. The diagnosis is made by exclusion so you cannot even be 100% sure.

After the hospital she went to rehab. She is a 2 person plus sling assist to get out of bed to the toilet or WC. She is failing to make progress so rehab is kicking her out. Dad is trying to find an assisted living that offers transfer and ADL/toileting assistance. If we can find one that will even be capable staffing wise it will be about 10k per month. The house will be sold to pay for this until the money runs out. If he cannot find one then he insists on taking her home. This will be an absolute disaster. Without selling the house he wont have the money to pay for in home aids and since a 2 person transfer would need 2. This would cost about 20k per month which is unsustainable.

Mom really needs nursing home level care. The only nursing home in their area is 12k a month and dad refuses to put her there. To get medicaid he would have to line in the house which he cannot do alone. He needs assisted living without mom as caregiver.

Meanwhile mom had 1/2 the finances and all bill paying on her computer and no longer knows the passwords or how to use a computer.

My sibling and I both live in other states and have fulltime jobs and mortgages etc. so we cannot move. Try getting new jobs out in the sticks in your mid and late 50's. It would be financial ruin for both of us.

Every agency I contact tries, but really has no assistance at the level required.

It is just a soul sucking mess for all involved and their are no easy answers or good solutions. No one knows how long she may live, how fast things will progress, or even if this is truly the correct diagnosis although she has had wonderful care at a major university hospital with very good specialists.

I am just putting this out there because some comments on this thread seem to make it sound so easy to avoid this type of situation and it is not that simple.

I am so so sorry for you and your family. I can't imagine how you're feeling. I wish the best for your mom and family and I hope things work out for the best.

[brandy1017, ASN, RN]

I get it through my employer and get a group plan rate of $33 per month, with NO health requirements. (I signed up when I was about 48 years old). I don't consider that cheap, but it is not outrageous. We should work to get more employers to offer this type of insurance so that more people can get group rates at an affordable price.

I've never heard of such inexpensive insurance. From what I've read it is usually several thousands a year and of course women are charged more and it only gets more expensive as you get older. Granted at 48 you are on the young side to get it, usually recommend 50's to 60's to start.

Frankly the insurance companies have been counting on people cancelling their insurance before they actually need to use it. I've read some companies no longer offer it as they were losing money. Also have read of people having trouble actually getting the company to pay out when the time came. I just don't trust the insurance companies when I see what they are capable of with health insurance, not to mention I don't have thousands of dollars and certainly won't when I'm retired on a fixed income. I've read even state of CA employees were upset with rate increases on their LTC insurance, don't remember if it was union or govt sponsored benefit, that many had had for years. My employer offered it once but I was too young to sign up and they no longer offer it. I never checked what the rates were and don't know what happened to the people after the hospital stopped sponsoring it.

[Ruby Vee, BSN]

I've never heard of such inexpensive insurance. From what I've read it is usually several thousands a year and of course women are charged more and it only gets more expensive as you get older. Granted at 48 you are on the young side to get it, usually recommend 50's to 60's to start.

Frankly the insurance companies have been counting on people cancelling their insurance before they actually need to use it. I've read some companies no longer offer it as they were losing money. Also have read of people having trouble actually getting the company to pay out when the time came. I just don't trust the insurance companies when I see what they are capable of with health insurance, not to mention I don't have thousands of dollars and certainly won't when I'm retired on a fixed income. I've read even state of CA employees were upset with rate increases on their LTC insurance, don't remember if it was union or govt sponsored benefit, that many had had for years. My employer offered it once but I was too young to sign up and they no longer offer it. I never checked what the rates were and don't know what happened to the people after the hospital stopped sponsoring it.

I got my LTC insurance (currently $36/month) when the companies first started offering it. I was relatively young then, but the premiums haven't gone up that much.

[FranEMTnurse, CNA, LPN, EMT-I]

Thank God for my oldest daughter who has faithfully cared for me (7 days a week when I first got very ill.) I was eventually placed in assisted living by my nurse, and lived there for 27 very long months.I was even in hospice care for a while, but survived it.

Then when I came to the apartment complex which is HUD funded for seniors on low income 9 years ago, I have had to have home care service. I thank Almighty God for the legislators who created this service in the state where I live. No, it is not ideal, but it is much better than having to live in a long term place. in fact, I told my doctor that I REFUSE to be placed in a nursing home as long as I still have my mind. That would be a completely different story if I had advanced dementia.

I am also thankful that my daughter still helps me two days a week, and is an employee of PPL, which is a Social Services funded organization. Her two days a week also gives the agency a break, and I get to see her more often than I would otherwise, because she is a very busy wife and mother of 3 girls with 2 of them being teenagers, and are in numerous social activities, a volunteer with the school, and a scout leader. all of these things are true blessings, and I consider them as such.

[needlesmcgeeRN, ASN, RN]

Do you not have a local/regional Area Agency on Aging or Council on Aging? This is a great place to start!

[LonghornChic, BSN]

I've been on the other side of that fence...the neighbor calling authorities.

I have a very long history with my neighbor (his house burned down, he stayed with me while we helped with reconstruction, I am MPOA due to his own family issues, and sooo much more). He lived by himself with his dog for the last 3 years. I took him grocery shopping, his doctors appointments, and cleaned his little apartment weekly. Due to his worseing Parkinsons (partially wheelchair bound), I got home health and meals on wheels involved weekly also. His family started coming around this last year. By involved I mean coming around the 1st of the month and leaving around the 3rd...usually long enough to drain him of his monthly limited income. It got to the point where he could no longer pay his utilities or buy groceries because his family robbed him monthly. They literally robbed him (took his ATM card and withdrew hundreds).

I called APS four different times. They did nothing. Home health called APS. They did nothing. He started falling more often. The last time he fell I took him to the hospital TWICE in a week. He got discharged with "bruising" but no fractures. I finally called EMS and had him transported because he was in so much pain that he could no longer get out of bed. He was covered in feces/urine when they showed up.

He was admitted to the hospital with a minor diagnosis while waiting on LTAC. APS got involved and also agreed with going to LTAC. Honestly LTAC was the best thing that could happen to him given all the things that were happening. He was of sound mind and understood that LTAC was the best thing for him. He was there for about 2 months until he found out his family was trying to sell his home. He discharged himself from LTAC (bribed his son to come "sign" him out) and is now back in the same condition he was before. We still check on him daily. I take him food daily. I am very afraid that he will be dead one of these days. Unfortunately being at home by himself, no matter how much he missed his home/animals, is not the best thing for him. He needed LTAC.