care for elderly

[Andrew35]

One of my favorite blogs, "Marginal Revolution," ran an interesting article the other day.

Essentially it's that nursing homes frequently prescribe antipsychotic drugs simply to control the elderly under their care; even though many of those treated have no psychiatric disorders and the treatments themselves have a host of negative, physical effects.

I asked my brother about this, as he is a professional in the elder care industry. He told me it's much worse than described. He said that medication is particularly overprescribed for larger males, since many of the workers are afraid of them. Furthermore, chemical castrations (mostly estrogen treatments) are a common means of ensuring minimal sex scandals.

He concluded by telling me that everyone knows nursing homes are basically prisons; but the good ones are interested trying to make the imprisonment as comfortable as possible.

After hearing all this, I began to wonder:

The same God who declared "thou shalt not kill" (abortion), and "show no partiality" (racism), also declared "honor thy father and mother."

I know this isn't news to anyone here. Nonetheless, when we speak of judgment coming on our nation for one or the other, are we missing a huge, cultural blindspot of our own?

Ultimately, when our civilization is weighed in the balance, will dishonoring our elderly have played a much larger role in our judgment than most of us realized?

 

[arapahoepark]

That's disturbing...explains so much of what my great grandmother went through.
I just hope it's dealt with and not some sort of BLM-esque publicity.

 

[Jerusalem Blade]

The NYTimes had an article on this a few days ago – it's a well-known phenomenon.

 

[NaphtaliPress]

I did not know this. We had resolved to keep my mother at her home. This involved significant sacrifice and its own difficulties, but the above just adds to the aversion of such places and confirms the right decision.

 

[py3ak]

In my immediate circle, there are a number of people in long-term care facilities of one kind or another. As with many things, the answer is that it's complicated. One lady without immediately family made the decision to be moved into a facility. Mostly, she's very thankful for it; but she has some legitimate complaints especially about the food. She thanks God for the place and the workers there very frequently.

Another lady has been bounced from one institution to another. They have gotten court orders to medicate her against her will, or even snuck drugs into her oatmeal when she's refused a pill or an injection. She was living on her own; but she was not allowing people in to help, was not allowing her little dogs outside or cleaning up after them properly; and was living in fear of chemical hazes from the vents and lasers from the TV. I can't say that she's better off now, but I can't say that she's worse.

Another lady was in a group home until she died. They had high turnover, because a no-nonsense senior worker fired assistants who were not very careful in dealing with the residents. It was a blessing because her family and I were able to visit fairly freely for all but a couple of weeks during the pandemic. When she was at home, she would ask her husband to take her home, and her proneness to fall was depriving him of sleep and undermining his health substantially.

Another man just moved group homes, and now it's on lockdown for visitors. Other factors are good, but the restrictions on family coming in to see him are breaking his heart.

Another couple recently moved to a new facility, which is the nicest I've ever been to. No restrictions on visiting, very fine staff, good food. They are having a difficult time adjusting, the lady because her memory is largely gone and so she has to process things over and over. One day she didn't know why she had so much sorrow to carry around when there had been no upheavals in her life recently--apparently she temporarily lost all recollection of the past 12 months. The man is struggling because he went from malnourished and stressed out dealing with his wife's issues to falling and losing independence.

Only one of these people asked to live with family instead, and she often seemed to change her mind -- they'd take her back to her house and she'd ask to return to the care home; some of them explicitly refused that. In visiting with the individuals themselves, and in walking with the families through these changes and deaths, there are three things that I take away.

1. The decline of life is extremely hard. We may not end on a cross like Peter, but if we survive long enough the experience of someone else girding us and taking us where we would not is basically unavoidable.

2. There is not one situation that will be optimal for everyone. In choosing between admittedly rotten alternatives, it has to be customized to the individual.

3. A facility will give better care, and residents will be more cheerful, if there's significant contact with others and visiting is frequent. The use of drugs to control behavior is widespread in our society--we do it to children also. Care-home workers are receiving training in how to deflect knife attacks without hurting their attacker; incidents of a sexual nature do happen, with residents as well as staff being the objects. There was an incident with a lady I know, that another resident came into her room and accosted her with displays and words. I realize it may be hard on him to drug him--but it's also hard on her to leave the issue entirely unaddressed because he doesn't seem capable of rational interaction.

 

[Edward]

As with many thihgs, money can make a bid difference. One should have different expectations between a medicaid facility and one that runs $5-$10k per month or with a very large upfront payment and lower monthly (or not). Independent living is cheaper - under $5k a month around here.

 

[Deleted member 11889]

In my immediate circle, there are a number of people in long-term care facilities of one kind or another. As with many things, the answer is that it's complicated. One lady without immediately family made the decision to be moved into a facility. Mostly, she's very thankful for it; but she has some legitimate complaints especially about the food. She thanks God for the place and the workers there very frequently.

Another lady has been bounced from one institution to another. They have gotten court orders to medicate her against her will, or even snuck drugs into her oatmeal when she's refused a pill or an injection. She was living on her own; but she was not allowing people in to help, was not allowing her little dogs outside or cleaning up after them properly; and was living in fear of chemical hazes from the vents and lasers from the TV. I can't say that she's better off now, but I can't say that she's worse.

Another lady was in a group home until she died. They had high turnover, because a no-nonsense senior worker fired assistants who were not very careful in dealing with the residents. It was a blessing because her family and I were able to visit fairly freely for all but a couple of weeks during the pandemic. When she was at home, she would ask her husband to take her home, and her proneness to fall was depriving him of sleep and undermining his health substantially.

Another man just moved group homes, and now it's on lockdown for visitors. Other factors are good, but the restrictions on family coming in to see him are breaking his heart.

Another couple recently moved to a new facility, which is the nicest I've ever been to. No restrictions on visiting, very fine staff, good food. They are having a difficult time adjusting, the lady because her memory is largely gone and so she has to process things over and over. One day she didn't know why she had so much sorrow to carry around when there had been no upheavals in her life recently--apparently she temporarily lost all recollection of the past 12 months. The man is struggling because he went from malnourished and stressed out dealing with his wife's issues to falling and losing independence.

Only one of these people asked to live with family instead, and she often seemed to change her mind -- they'd take her back to her house and she'd ask to return to the care home; some of them explicitly refused that. In visiting with the individuals themselves, and in walking with the families through these changes and deaths, there are three things that I take away.

1. The decline of life is extremely hard. We may not end on a cross like Peter, but if we survive long enough the experience of someone else girding us and taking us where we would not is basically unavoidable.

2. There is not one situation that will be optimal for everyone. In choosing between admittedly rotten alternatives, it has to be customized to the individual.

3. A facility will give better care, and residents will be more cheerful, if there's significant contact with others and visiting is frequent. The use of drugs to control behavior is widespread in our society--we do it to children also. Care-home workers are receiving training in how to deflect knife attacks without hurting their attacker; incidents of a sexual nature do happen, with residents as well as staff being the objects. There was an incident with a lady I know, that another resident came into her room and accosted her with displays and words. I realize it may be hard on him to drug him--but it's also hard on her to leave the issue entirely unaddressed because he doesn't seem capable of rational interaction.

This is one of the most well-put summaries I've read on this matter. Permission to share privately with some friends?

 

[py3ak]

This is one of the most well-put summaries I've read on this matter. Permission to share privately with some friends?

Of course! Glad it was helpful.

 

[Andrew35]

3. A facility will give better care, and residents will be more cheerful, if there's significant contact with others and visiting is frequent. The use of drugs to control behavior is widespread in our society--we do it to children also. Care-home workers are receiving training in how to deflect knife attacks without hurting their attacker; incidents of a sexual nature do happen, with residents as well as staff being the objects. There was an incident with a lady I know, that another resident came into her room and accosted her with displays and words. I realize it may be hard on him to drug him--but it's also hard on her to leave the issue entirely unaddressed because he doesn't seem capable of rational interaction.

That reminds me: my friend sent this to me recently. Really ruined my morning, the jerk. I think it's older, but hadn't seen it before. Don't believe it's real Watterson either; a pastiche most likely.

 

[VictorBravo]

That reminds me: my friend sent this to me recently. Really ruined my morning, the jerk. I think it's older, but hadn't seen it before. Don't believe it's real Watterson either; a pastiche most likely.

View attachment 8368

Too poignant. For some reason I flashed back to Harry Chapin's "Flowers are Red."

The discussion hits home for me. My wife has dementia that seems to be progressing faster than the normal path. We remain at our home, but it increasingly becomes a game of triage. New and ever more creative disasters, as it were.

I remain healthy and fairly resilient, notwithstanding the 4 herniated disks in my lower back that keep me from lifting things like I used to.

On the other hand, I sort have adopted the Calvin (cartoon character, not theologian, although I read him assiduously too) attitude: go with the flow; this looks fun; WHY NOT??!!

Especially if the melatonin doesn't work and my sweetie thinks coffee and bacon at 1 AM is exactly the right thing to do. When I think about it, maybe it is....

I keep hearing a voice, my own internal lecturer: "Do you really have anything better to do?" I have to acknowledge that, no, I don't. Lots of things I want to do, but not better to do.

But if it weren't for my digital calendar, I'd be just as disoriented as my dear wife. I'm learning a lot about order and the loss of it. I can't fathom what would happen to her if she didn't have the garden and cats to occupy her. It may well be that I will have to find out...God knows and I can only press on.