Posted on 10/22/2011 4:28:52 AM PDT by Kaslin
Last week, the Obama administration dropped one of the signature provisions of its healthcare plan. The CLASS Act (Community Living Assistance Services) was intended to provide affordable insurance for long-term care to individuals who, because of infirmity or age, could no longer care for themselves. But the reality that not enough healthy Americans would sign up to make it self-supporting finally doomed the program.
Many opponents of Obamacare will no doubt cheer this turn of events because it confirms the view that we cannot afford to, in essence, nationalize health care. I agree --but I also recognize that the problem that the CLASS Act was trying to address is a legitimate concern for which we now have no workable solutions.
The nation faces a looming crisis in caring for the elderly, whose life expectancy often exceeds their ability to live independently. Millions of Americans need long-term care, but we currently have no system that adequately provides it a cost that most Americans can afford.
This topic holds more than public policy interest for me. Three years ago, my then-87-year-old mother came to live with me when it became clear that it wasn't safe for her to continue to live on her own. Although in good health, my mother is virtually blind and quite frail. She values her independence, prepares all her own meals, has excellent long- and short-term memory and follows the news avidly. But without daily assistance, she could not shop for food, get to the doctor or clean her own living space.
Last week, however, her situation changed dramatically. After returning from a doctor's visit, my mother fell on the last step of a steep climb down from the car to our home. I was just a few feet away from her when I heard her hit the floor. In that instant, her life and future changed dramatically. She broke her hip -- the scourge of the elderly -- and within 24 hours had undergone partial hip replacement surgery. Three days later, she was released from the hospital.
Medicare provides coverage for up to 100 days in a rehabilitation facility so long as the patient needs daily services that can be provided only by a doctor or nurse or is receiving the rehabilitation therapies provided and making progress. But when the 100 days are over, the patient is on his or her own. My mother is now in an excellent rehabilitation center in Boulder, Colo. -- but it's unclear what will happen when she's released.
If you're very wealthy and can afford upwards of $60,000 a year in private, long-term care, the alternative of an assisted living facility is available. But what if you don't have those means? I would gladly take my mother back into my home, but I don't think it's feasible for her to continue to live there. If we can manage to get her down those same steep stairs and into the house again, she'll be trapped there indefinitely, unable to go to the doctor, grocery or anywhere else except to the hospital if she falls and injures herself again. And she'll need someone with her 24 hours a day.
Since my mother has never owned a home or any other assets -- only a meager Social Security and Veterans' pension and the help I've provided since my father died -- she is eligible for Medicaid. And unlike Medicare, Medicaid does provide coverage for long-term care. But having visited the local facilities that accept Medicaid, I can tell you the decent ones have long waiting lists -- a year or more -- and the ones that don't have waiting lists break a daughter's heart. I simply cannot imagine putting her in one of these crowded, dreary, hopeless places.
Currently, 40 million Americans are age 65 and older, and of these, nearly 6 million are 85 years of age or older. One in 5 elderly Americans are currently considered dependent, but the proportion will grow to nearly 40 percent by 2050. We continue to expand the frontiers of life expectancy, but we have yet to figure out how to care for our ever-growing population of older Americans.
The administration's failure to come up with a feasible plan to solve the problem is no cheering matter. We must find a way -- not only for our parents but for all of our sakes.
Hubby and I were just talking about this. He’s said that he doesn’t want to live if he loses his mind.
I told him that this is how a rational person might think. If he ever truly loses his mind *he won’t know it*.
From his perspective, he’ll be fine.
The idea of putting down the mentally broken elderly sounds humane to idiots. The idea of losing your sanity may sound horrifying.
But I’m telling you, my grandmother *loves* her life. She has no desire to die. She’s not suffering at all. She blames her confusion on all of the ‘stupid, thieving liars’ around her and carry’s on with perfect confidence.
Hubby laughed and agreed. he probably wouldn’t want to die either if he’s ever in that situation.
****************
We’re building our retirement house in about ten years. We’ve already gotten the design finished. First of all, it’s one story. We’re putting in extra-wide doors, wheel chair rams in the front and back, easily modifiable sinks to be lowered for wheelchair access, pull bars, a shower with a low, sloped curb, etc. We’ve even designed the ceiling rafters to go in with the thought of adding a lift if needed.
We’re not going anywhere.
Not a popular perspective here at Free Republic, aka NormanRockwell.com, but thank you for posting it. My mother had many of these symptoms late in her life - fortunately while living with me she remained somewhat self-sufficient until the last few months.
And unfortunately for these elderly, the economic collapse that is looming will very likely result in a great breakdown of social order, and there simply isn't going to be any kind of support infrastructure for them - government-funded or otherwise. They will be among the first victims of the new economic reality.
Kids should take care of their elderly parents.
What an interesting and innovative perception. Thank you for telling me that I had a blessing when I thought I was cursed.
Your post made me cry. My dad has just started to have serious short term memory loss. I dread the path.
Lol!!
This reminds me. My parents and their friends, another couple, were having a discussion about this, on the beach in hawaii, and the two women were so sure they didn’t want to burden their kids that they decided that when the time was right, they’d just get into a kayak and row alone out to sea. Then they wondered, hey, well, if we are strong enough to kayak, why would we leave? But if we stay until we are too far gone to kayak, how will we get out to sea?
Immediately both husbands cheerily said, “we’ll row you out!”
They still laugh over this.
For the "family should do it" folks, medicare and insurance studies show that fully 50% of nursing home residents have no living relative--anywhere. They are literally alone in the world.
In large part, medicaid is the payor for long term care. Many of the recipients could live at home or in a cheaper assisted living facility, at one third the cost, if medicaid adjusted its policies. Some states, like Ohio, are attempting to do this now, but the nursing home industry is a powerful lobby. There are thousands of nursing homes and they all are competing for residents to keep their beds full.
Most nursing home residents if they had their druthers would not be there, they would be in their own homes. Medicaid could make that happen for many of them, and save a boatload of money, if the states simply get the political will to pass enabling legislation.
Both of you are blessed to have each other. You project the image of what marriage really is all about.
One of the great things about the long term care I have is that it pays for someone to care for you in your home, even your own family.
That is much cheaper than a facility. Hopefully you would never have to go to a facility but it also pays for that.
How do you get someone with fragile bones who can not climb up a steep flight of steps? They have to be carried.
One major problem is the place when she is living. I would suggest she think about moving. Not only because of her mother but because if she would ever fall she would have the same problem.
One major problem with housing is that it is not designed for the handicapped. We have lots of stairs, split levels, narrow hallways, crowded bathrooms, there are a whole slew of issues.
It is actually smart to start looking at houses with that in mind once the kids are gone
It WAS a curse. You’ve been blessed to find a way to survive and transcend it.
I have known people with abusive mothers. They’re usually too messed up to care for themselves, neither mind anyone else. You sound like a walking miracle by comparison.
We are proudly an “E-Harmony” couple! God certainly had a hand in our meeting.
After seeing how my kids treat their dogs, boyfriends, and parents, I am putting my hope in the rapture!
Seems to me she’d be “in good health...virtually blind and quite frail” and “without daily assistance, she could not shop for food, get to the doctor or clean her own living space” in ANY setting. No more trapped living with her daughter than she would be anywhere else. Except she’d see much less of her family, and if she had any complaints she’d be thinking very carefully before mentioning them.
While she could still walk I would hold her arm, then she needed a cane, then a walker, finally a wheelchair. But she still loved the mall and the parks in good weather. She liked to smell all the good things even if she had trouble seeing them. And she loved going to Arby's for a Beef and Cheddar. And then to the Donut Den where she could sit and feel and hear the people. Sometimes we would stay there a couple of hours.
If there had been no way for me to get her out of the house I could not have done any of those things with her. My uncle though, modified his house so she could get in and out. Stairs, much less steep ones, were out of the question so he put in a ramp.
I don't know if that is possible in this case, I suspect not which is why I made the suggestion that she should think about moving.
Suddenly, my memory hearkens back to James Michner’s most uncharacteristic work, his semi-autobiographical “Fires of Spring”.
In that novel, the hero grows up indifferently raised by his aunt (Michner referred to himself in interviews as a “foundling” abandoned by his parents—Mom told me that in olden times most illegitimate children were given over to orphanages or put up for adoption as that was better than growing up a bastard in a small town [how many classic short stories or country songs have that as a bitter theme?]). The protagonists’ cruel aunt runs a “poorhouse” which according to the author’s description is where farmers would dump their aged parents when they took over the spread. I recall thinking as I read it that this did not exactly fit in with the image of the Good Old Days.
As the boomers retire and reap the legacy of divorce and bad parenting we’re really going to be in for it as I do not think for a hot minute that most of us Gen-X’ers feel the slightest obligation to parents who walked out on them or neglected/abused/molested them. Those chickens will be coming home to roost as the right-on Reverend Wright said.
You need to take a closer look at said cultures. You might not like what you find.
Of course it’s possible, if one WANTS to do it. Linda Chavez thinks her mother would be “trapped” but more likely it’s Linda who’d feel trapped with her mom around. If she wanted to she could build a ramp. You don’t put your mother in an institution because of a flight of stairs.
I will have to read that one when I finish “Alaska.” :)
I have helped fix up homes several times so so an elderly parent could be moved in. Some homes are easy to modify. Some are more difficult and some are flat out impossible. In those cases we recommend the family move if possible.
If Linda felt so "trapped" she never would have moved her mother in in the first place. But she has had her there for three years.
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