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.
The law is on the side of people who want to live independently, even if the living conditions are very far from ideal. Unfortunately the line between mere eccentricity and dangerous dementia is extremely fine.
The pt was found covered in feces and urine and yet soon thereafter, he was deemed to be of "sound mind".
My particular region has a large incidence of elder exploitation. Family members convince social services that they are providing care for the elderly family member, and thus get paid by the state for being a "caregiver"; however, they rarely follow through with actual care. It is a money making scheme. We see the same little old folks come in admitted repeatedly malnourished and lacking personal hygiene since they are unable to care for themselves. Public agencies are unable or unwilling to intervene, since the family members swear they only want to "keep Grandma in her home".
Specializes in CrItical Care, Street Medicine/PHM, School nurse.
Can someone be "of sound mind" but not physically able to take care of themselves?
APS seems to think so. My neighbor is 83 years old and moves at a snails pace due to his parkinsons BUT he moves, even if it does take him an hour to get out of bed and into his wheelchair. He can apperantly feed himsekf also even if that means a loaf of bread and old ham slices for breakfast, lunch, dinner. He doesn't shower for days (I am sure its more like weeks on end), BUT he showers.
I do believe the percentage of the population whose income is low enough that no federal taxes are due approaches or slightly exceeds 50%.
Of course, these people still pay some taxes. Just no federal taxes.
Twenty years ago , my husband and I had no children, and we both had decent, but nothing special middle class jobs. Our federal tax rate was only about 10%.
I am pretty sure such couples making 50 or 60k now with a child or two, owe little or no federal taxes. As it should be
Out of curiosity, (and WITHOUT debating which segment of society pays the most taxes or who is at fault) how much would you each be willing to increase your taxes to provide free quality elder care? Currently my take home pay is 55% of my gross pay. What about everyone else? How do the numbers shake out where you all live?
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.
But will that insurance go with you if you leave your employer? I had a similar reasonably priced policy that disappeared when my employer changed ownership. The money I paid in isn't recoverable and the policy couldn't be converted to another policy in my name that wasn't attached to the employer's group policy.
Out of curiosity, (and WITHOUT debating which segment of society pays the most taxes or who is at fault) how much would you each be willing to increase your taxes to provide free quality elder care? Currently my take home pay is 55% of my gross pay. What about everyone else? How do the numbers shake out where you all live?
55% sounds very low. Some of those deductions are probably not taxes, but things like health and life insurance?
Oldmahubbard
1,487 Posts
The law is on the side of people who want to live independently, even if the living conditions are very far from ideal. Unfortunately the line between mere eccentricity and dangerous dementia is extremely fine.
The pt was found covered in feces and urine and yet soon thereafter, he was deemed to be of "sound mind".
Sounds about right. So sad.