Comments on Digital Doorway: The Future of Elder Care, Part I

Nice post

2008-04-21T05:28:00.000-04:00

To anonymous: informal caregiving is not all stres...

2008-04-14T17:54:00.000-04:00

To anonymous: informal caregiving is not all stress and burden, there are rewards, however one thing that is stated over and over again is that people tend to access help, respite and self-care after they've past the breaking point.

Find out what resources are out there, both for the MIL and yourself before you need them. The Caregiver's Alliance is a good starting place, also the National Family Caregivers Association (http://www.nfcacares.org/index.cfm)

And I'm not saying that there isn't good care out there, but it is a place of great health disparities for both residents and care providers.

Yeah, good conversation. Thanks Keith!

Sorry if this comes up twice. I tried to post thi...

2008-04-14T13:52:00.000-04:00

Sorry if this comes up twice. I tried to post this comment already and it didn't get through.

Check out this article on the problems in Minnesota with long-term care funding http://www.in-forum.com/News/articles/197859. It's not just private institutions that have trouble.

BTW, the url of the National Family Caregivers Ass...

2008-04-14T12:47:00.000-04:00

BTW, the url of the National Family Caregivers Association is: http://www.nfcacares.org/

This is a great conversation, one which I hoped my...

2008-04-14T12:45:00.000-04:00

This is a great conversation, one which I hoped my post would generate.

I agree with both Marachne and Reg----the system is somewhat broken and dysfunctional, but there still is decent care out there. However, in terms of "the haves" and "the have-nots", there is a huge difference in the quality of care available.

That said, I hope that this next elder generation will, 1) demand improvements, and 2) demand more equity for those who have less financial means. #2 is a rather idealistic notion that I think will go unfulfilled. However, with a relatively wealthy generation coming "of age", perhaps something good will emerge

As for the comment by "Anonymous", I encourage you to visit the website of the National Family Caregivers Association, linked on the first page of this blog on the lower right column. Thanks for your comments, and good luck!

Great post. We are in the process of building a m...

2008-04-14T12:10:00.000-04:00

Great post. We are in the process of building a mother-in-law suite in our house. My mom-in-law is a very active and healthy 71 years old. What's been interesting and challenging are the family discussions around this. I find that the family hovers between an attitude of offering to help her whenever she deems she requires it -- to an attitude that "we" (her children") know what's best for her (a rather paternalistic and occasionally insulting attitude).

That's a rather bleak picture you paint.Sure there...

2008-04-14T12:07:00.000-04:00

That's a rather bleak picture you paint.

Sure there are of problems with the geriatric care system, as well as the entire health-care system, but nothing's perfect, and nothing's unfixable. There are still plenty of ways to get good quality care, and plenty of ways to fix the system so getting quality care is easier.

As a nurse who is getting her PhD with a focus on ...

2008-04-13T16:04:00.000-04:00

As a nurse who is getting her PhD with a focus on family caregivers at EOL and currently looking at the issues related to long-term care, here's just a few things to add to the mix:

1) Nursing Homes, as they are now designed and regulated are a disaster.

2) This disaster is being exacerbated by the fairly recent phenomena of large corporations buying up nursing homes FOR THEIR REAL ESTATE VALUE, and then doing everything possible to cut services to below regulation and safe levels

3) Another place where the gap between rich and poor widens: most assisted living is for-profit and, even if there are Medicaid waivers, the reimbursement is so low that it becomes mostly private pay. So, those w/money get the "nice" surroundings, those using public funding are in the NHs.

4) Looks ain't everything. the AL facilities often have great "atmosphere" but the staffing ratios are crazy and 99% of care is being done by unlicensed, untrained staff--is that who you want passing meds?

5) AL offers the promise of "aging in place" but cannot support that with care

6) Family caregivers continue to be expected to do more and more with less and less -- currently it is estimated that family caregiving is worth between $149 and $483 BILLION A YEAR. That doesn't include the costs of lost wages or the health costs that incur from providing care. And lets not get into the disparity between the number of people aging and the number of younger people able to care for them, or the role that our ability to mange chronic illness makes for more older, sicker people in need of care.

7) Negotiated risk. We "allow" 20-somethings to engage in all kinds of risky behavior, but insist, even when they are capable decision-makers, that older adults must stop doing things because they are dangerous. I'm not talking driving, which affects others, but things like living in their own home. Boomers are not going to go quietly or as dictated to.

8) Just to change things around a bit more, here's another social justice issue to think about: The combination of Globilization, Women's Migration and the Long-Term-Care Workforce (to steal a title from the latest issue of The Gerontologist (http://gerontologist.gerontologyjournals.org/cgi/content/abstract/48/1/16)
More and more people (women) who are providing care in LTC settings are immigrant women...who are coming from countries with their own aging population.

As you can imagine, I could go on, but I'll stop here for now.