Are The Elderly A Burden To Society?

This moron Taro Aso (pronounced "as-hohl"), who happens to be Japan's finance minister, thinks so:

"Why should I have to pay for people who just eat and drink and make no effort? I walk every day and do other things, but I'm paying more in taxes"  {via The Guardian}.

Oh my.  I'm glad As-hol is a healthy 72 year old and not in need of assistance or medical care. And let me be clear: I do believe there are situations where prolonging life that lacks quality can be burdensome, not just financially, but from a humane perspective as well.  Aso's comments, however, are sadly reflective of notions of deservedness which run rampant in Western society as well.

Who defines what "quality of life" means?  And more importantly, who decides who deserves health care and who should just "hurry up and die"?  Believe me, I get that in the U.S. a lot of government spending in health care (in the form of Medicare and/or Medicaid) is distributed to our older population.  I'm not sure what long term care looks like in Japan, but when we in the U.S. talk about "exploring innovative ways to finance services for the elderly", and the never-ending chatter about cutting back programs like Medicare and Medicaid, it seems like we're shooting ourselves in the foot.

Image via: http://www.nyspltc.org/rates.htm

Do people realize how difficult it is for elderly people living at home to receive home health aide services?  Medicare (in NY anyway) will only pay for *maybe* 8 hours of aide service per week. And home health aides and visiting nurses are spread thin enough as it is...its pretty hard to attract people to these professions when pay is typically so poor. Yet, some elderly people would benefit greatly from having access to more home health services, which if they could receive, would keep them home longer. And guess what? Medicare and Medicaid would actually save money for covering home health services vs paying for long term care for seniors. In NY state alone, the average monthly cost for a skilled nursing home resident is between $8000-$9000 per MONTH. The government doesn't even start to cover costs of long term care until the resident has exhausted all of their personal resources. At $9000 a month, that doesn't take very long.

Instead of threatening to cut Medicare and/or Medicaid benefits to the elderly (because let's face it, with the expense of long term care, the government allocates a good chunk in Medicaid benefits for the aging population), why not expand home health care benefits?   Programs like Meals on Wheels and Adult Day Care Centers are much more doable financially and do heighten quality of life for many elderly people committed to remaining at home as long as they can. Home health care including ongoing physical therapy, social services and daily aide services would undoubtedly make a difference in whether a person could stay home (and save money/not need to tap into government aid so hard) vs moving into skilled nursing where the care costs are exorbitant.

Of course, people like me would be out of a job if the elderly stayed home and never moved to a nursing home. I realize what I propose affects the bottom line of for-profit long term care.  Still, who but a small percentage of business owners benefit from the current system in which we care for our elderly?  Why shouldn't options for how we spend our later years be wider in scope? After all, aging is the great equalizer.  

ElderNews

Apparently Bradford County's Area Agency on Aging had been allowing criminals to fulfill community service requirements via programs that cater to elderly residents such as Meals on Wheels.

While it is reported that all volunteers for the Agency on Aging programs are screened prior to providing services, the agency's policy for accepting volunteers is now under review.

Celebrating A Life With Alzheimer's

I found this touching letter written by a man battling Alzheimer's.  The author's son submitted the letter, which was written by his father nearly 10 years ago at the onset of the disease.

...if I fight it and think positively maybe I can conquer this Alzheimer fellow . It would be a pleasure to laugh at him and say goodbye. Think of what you have achieved in the past years and these thoughts will help. You have raised children, and they have loved you and you are so fortunate. Appreciate what you have. You have to be strong, I realize, but you can do it! I volunteer at two hospitals and enjoy taking people to their destinations in the hospital. I sometimes (actually quite often) joke with them. As I am leading patients upstairs, I will humour them a bit by telling them "I am taking you first to Las Vegas" and then we will go up in the elevator. They always laugh and say, "Oh please!" It makes them feel good and I feel good also. Another casualty of the fiendish Mr. Alzheimer is the family. My family takes good care of me but sometimes I feel they are at fault because they are being overprotective. They mean well but it makes me feel like a nothing. In my case, I am on the borderline of Alzheimer’s. I say this because, I am not that bad. I forget names, that is all! I was advised not to drive but I still feel that I can drive better than all the hot-shots on the road to-day. I have not seen the statistics of my condition and on my next visit to my doctor I will ask him to show me the results of my tests. I still play a great game of tennis, I bowl and do all the normal other things that people do, and yet I have this Alzheimer’s’ stigma. Maybe if they (whoever they may be) could live with me and see how I act daily I wouldn't be put in this category.

To read the entire piece, check out The Birthdays Continue Despite Alzheimer's Disease.   It will make you smile.

What Alzheimer's Disease Has Taught Me (so far)

I've been in long term health care for 15 years now.  I've worked with and cared for numerous individuals and families who have been touched by the heartbreaking disease known as Alzheimer's.   There have even been a few of my own relatives who have lived with AD--few aunts and uncles.   Then, a couple years ago, my dad was diagnosed with Alzheimer's-type dementia.

My knowledge base has grown and grown over the years I've worked in geriatric care.   More than most anyone, I am well trained and equipped on what to expect and how to handle the myriad of twists and turns that accompany AD.   Still, as anyone will tell you, when it's *your* close family member who is part of the Alzheimer's equation, all bets are off.   It's impossible not to be emotionally invested in whatever happens on this journey.

Granted, I'm a pretty easy-going person.  I try to look for the positive and the lessons that can be found in any situation, no matter how hard, sad or devastating.  (I get this trait from my dad, I believe).  And while my dad is in the early stages of AD at the moment, I realize things can change quickly and that there is no more taking things for granted where he is concerned.

The Alzheimer's Association has a wonderful online support forum filled with tons of people who either are caring for someone with AD or who are dealing with the disease in some way, shape or form.   I  recently was inspired to add to a great thread where forum posters list what they've learned from Alzheimer's Disease.

Here are just a few of the lessons I've learned so far:

• Many people with AD can still keep their sense of humor through most of the disease process. Looking for the humor in those not-so-great moments can be a life saver!

• People will forget what you say and what you do for them, but they will never forget how you made them feel.

• Hugs and kisses go a long way, especially when you don't know what to say.

• We're a society that prides ourselves on our "intellect" and we are trained to live in our heads. Perhaps AD is here in part to teach us to live in and with our hearts more.

I wish this disease did not exist, but I continue to remain open to what it has to teach on an individual and collective level.   The lessons are always there, you just have to be open to finding them.

ElderNews You Can Use (4-24-10)

ElderNews is a semi-weekly round up of links around the web that touch on topics of aging, death/dying and health care.

• Cognitive stimulation therapy helping dementia patients in the UK.    In the facility where I work, the recreation department has a daily structured program in place that is very similar to this concept for our more severely cognitively impaired residents.  I can tell you the program  does seem to aid in reducing agitation and some other dementia-related behaviors.  It would be interesting to gauge as to whether or not CST has any effects on improving our resident's overall cognitive capacity.


• How the Class Act is seeking to set up a Class Program to assist caregivers in managing their loved one's care at home.  While every bit of financial assistance is a wonderful thing, I would suggest a minimum cash benefit of $100 a day for those with more skilled care needs.   It already costs around $300 per day to reside in a long term care facility, so that would still be a huge savings.


• I love the insights, tips and glimpses into the world of Alzheimer's Speaks.  This blog is a beautiful narrative depicting the love a daughter has for her mother who has AD and resides in a nursing facility.  Her post about the "surprises" one can encounter when loving and caring for an Alzheimer's individual is truly touching.


• Only about 30% of adults create an Advance Directive.  Doctor's need to step it up and encourage more of their patient's to name health care agents and outline their health care wishes before a catastrophic medical event occurs.   More importantly, Advance Directives should be drawn up before an elderly loved one is no longer able to articulate his or her wishes.


• The American Geriatric Society Foundation for Health & Aging lists tips to ensure caregivers find good long term care placement for their loved ones.

Is Death More Taboo Than Sex?

It amazes me to think how far Western society has come in terms of medical advancement and technology.  Sometimes I question whether so much "advancement" is necessarily a good thing, but overall, there are a great deal of positives that come with our evolution in health and medical care.

Yet, for all the progress we have made, we're often unable to face the one very real and unavoidable fact that no medical advancement can prevent indefinitely.

We can't escape death and dying.  I don't care who you are or what you do, the end result for each and every one of us is the exact same thing.

Why then, are so many afraid to talk  or even think about the subject of death and dying?   This palliative care nurse believes that death has become more of a taboo topic than sex.   I am inclined to agree.

Is it that we think by avoiding the subject, we'll never have to deal with it?  If we run from death, we can escape it?  Deep down inside, we are all connected to one another because of this simple, democratizing truth:  we will all die someday.

(I'm full of sunshine, rainbows, and puppies today, aren't I?) :P

If we can start to recognize the ways that death binds us to all humanity, maybe we can overlook some of those trivial frustrations and annoyances that keep us from really appreciating the various people who make their way into our daily rounds.   More importantly, if we break the taboo grounds that seem to underlie conversations about aging, death and dying, we can live in a world that's just a little more peaceful.

Acceptance instead of struggling.  Embracing rather than avoiding.  Looking toward the inevitable (and unknown) with a sense of tranquility as opposed to distress.

ElderNews You Can Use

ElderNews is a semi-weekly round up of links around the web that touch on topics of aging, death/dying and health care.

• Few are prepared for the heavy financial burdens of long term care. 


• Tips for planning elder care strategies and initiating discussions on end of life issues.  Remember, these conversations are best held while your loved on is still relatively healthy and able to communicate their needs and wishes to you.


• Forget Me Not Club works together to make lasting memories from ceramics class participants with dementia.


• 31 year old woman with rare form of  Alzheimer's Disease gives birth.