How did elder care used to work?

[Tenaj]

11 hours ago, mjbucks1 said:

This is so interesting that you bring this up.  My grandmother was born in 1905 and passed away when she was 96 in 2002 (I was in my 30's then).  She often talked about her or her mom going and caring for people who were sick.  About 2 months ago I found a tape recording of my grandmother talking about various things she experienced throughout her life.  One thing she said was that when someone needed care, the entire community would pitch in.  If an older man was ill, the men of the community would take one night a week and stay with the ailing man.  She really talked about how the entire community would help.  Of course there were not the number of doctor's appointments, etc. 

So we have found ourselves getting re-involved in the care of our neighbor lady with dementia the last few days.  A few years ago she developed Alzheimer's and before her husband had full-time help move in she was wandering the neighbor -mostly to our house.  Now she has just spent a month in the hospital (Covid and then kidney failure from what I understand) and cannot walk.  She was sent home with a catheter and is bedridden but the ordered hospital bed hadn't arrived so she is ensconced on an old couch that sags so much that if she turns on her side she slides into the floor.  

Husband is having his own health problems, financial problems and really struggles to communicate or understand medical personnel.  Right now he has no phone so has been using ours.  I was there for an hour last night while he tried to solve the phone issue and came home furious and frustrated with the situation.  She slid off the couch while I was there - her catheter bag was so full it was backing up into the tube. I could not lift her back onto the couch but helped him do it when he returned and he has to wrench her shoulders so hard to move her that she cried (she is basically no responsive most of the time)! Where is the social support and medical support for this family?  What social worker sent them home like this?

I'm waiting for him to come and get me to watch her again this morning while he again tries to solve the phone problem.  I'm almost in tears thinking about returning but I can't refuse.  He needs someone to care.

Something has broken down in our elder care system!

Edited March 4, 2022 by Tenaj
Clarity

[HS Mom in NC]

10 hours ago, Jean in Newcastle said:

I don’t either. Which is why I am pro advanced directives  etc. But I do think the idea that people should stop having routine medical care after age 60 (not brought up by you) is extremely short sighted. For one thing, that routine medical care can (in many cases, not all) lessen the chance of having something like a serious stroke. 

You're not reading carefully enough.  I said I'm choosing to opt out at 60, not that everyone should be denied care at 60.  This conversation is very complex and nuanced, it's on everyone participating to be careful and precise when discussing.

Edited March 4, 2022 by HS Mom in NC

[HS Mom in NC]

9 minutes ago, Tenaj said:

So we have found ourselves getting re-involved in the care of our neighbor lady with dementia the last few days.  A few years ago she developed Alzheimer's and before her husband had full-time help move in she was wandering the neighbor -mostly to our house.  Now she has just spent a month in the hospital (Covid and then kidney failure from what I understand) and cannot walk.  She was sent home with a catheter and is bedridden but the ordered hospital bed hadn't arrived so she is ensconced on an old couch that sags so much that if she turns on her side she slides into the floor.  

Husband is having his own health problems, financial problems and really struggles to communicate or understand medical personnel.  Right now he has no phone so has been using ours.  I was there for an hour last night while he tried to solve the phone issue and came home furious and frustrated with the situation.  She slid off the couch while I was there - her catheter bag was so full it was backing up into the tube. I could not lift her back onto the couch but helped him do it when he returned and he has to wrench her shoulders so hard to move her that she cried (she is basically no responsive most of the time)! Where is the social support and medical support for this family?  What social worker sent them home like this?

I'm waiting for him to come and get me to watch her again this morning while he again tries to solve the phone problem.  I'm almost in tears thinking about returning but I can't refuse.  He needs someone to care.

Something has broken down in our elder care system!

So the obvious question is, why are the neighbors' relatives not involved in their daily care or involved in getting them into a facility?

[Tenaj]

39 minutes ago, HS Mom in NC said:

So the obvious question is, why are the neighbors' relatives not involved in their daily care or involved in getting them into a facility?

Father is in his mid-eighties and lives across the street.  He barely functions for himself and is taking care of his girlfriend who has numerous health issues.  No other family anywhere nearby.

There is definitely a mental health issue involved with the husband.  Per his interpretation as conveyed to me he was told that a nursing home would require him to sell the truck that the wife owns, hand over her disability check and half of her pension.  I tried to tell him that it makes perfect sense to do those things but he got angry.  It's a mess and in the meantime this poor lady in the throes of dementia and a failing body  is paying the price.

 

[Jean in Newcastle]

2 hours ago, Tenaj said:

So we have found ourselves getting re-involved in the care of our neighbor lady with dementia the last few days.  A few years ago she developed Alzheimer's and before her husband had full-time help move in she was wandering the neighbor -mostly to our house.  Now she has just spent a month in the hospital (Covid and then kidney failure from what I understand) and cannot walk.  She was sent home with a catheter and is bedridden but the ordered hospital bed hadn't arrived so she is ensconced on an old couch that sags so much that if she turns on her side she slides into the floor.  

Husband is having his own health problems, financial problems and really struggles to communicate or understand medical personnel.  Right now he has no phone so has been using ours.  I was there for an hour last night while he tried to solve the phone issue and came home furious and frustrated with the situation.  She slid off the couch while I was there - her catheter bag was so full it was backing up into the tube. I could not lift her back onto the couch but helped him do it when he returned and he has to wrench her shoulders so hard to move her that she cried (she is basically no responsive most of the time)! Where is the social support and medical support for this family?  What social worker sent them home like this?

I'm waiting for him to come and get me to watch her again this morning while he again tries to solve the phone problem.  I'm almost in tears thinking about returning but I can't refuse.  He needs someone to care.

Something has broken down in our elder care system!

He needs someone to call Elder services to report her neglect. They can’t provide him services that they don’t know are needed. 

[HS Mom in NC]

2 hours ago, Tenaj said:

Father is in his mid-eighties and lives across the street.  He barely functions for himself and is taking care of his girlfriend who has numerous health issues.  No other family anywhere nearby.

There is definitely a mental health issue involved with the husband.  Per his interpretation as conveyed to me he was told that a nursing home would require him to sell the truck that the wife owns, hand over her disability check and half of her pension.  I tried to tell him that it makes perfect sense to do those things but he got angry.  It's a mess and in the meantime this poor lady in the throes of dementia and a failing body  is paying the price.

 

Call adult protective services or the non-emergency police number TODAY, explain the situation,  and they'll get social services out there. This is exactly what adult protective services is for. No one involved in that situation is capable of providing adequate care.

[Spryte]

1 hour ago, Jean in Newcastle said:

He needs someone to call Elder services to report her neglect. They can’t provide him services that they don’t know are needed. 

This.

@Tenaj That situation is unsustainable. Your help is kind, and wonderful, but there’s no way you can provide enough.

She should not be home, but I understand how it happened. The pressure to take people home from the hospital or rehab facility is intense. I learned the hard way once, when agreeing to take my mother in after a hospital/rehab stay. I knew she wasn’t ready to leave, and I cried picking her up because I knew her care needs were beyond me. There was no other choice that I could see, and after 8 months of 24/7 care, doing all the ADLs for her, I was exhausted. It took that long to get her to a reasonable level of health. I learned later that the other “choice” was to say no. Firmly. It is so hard to do that when a loved one is involved! The next round, a few years later — I said no. Firmly. No, I cannot have my completely immobile mom live/toilet in our living room, open to the kitchen, where we homeschool. No, I cannot provide 24/7 care. The SW muttered some guilt-inducing words about my “lifestyle choice” and I just said no again. No. Over and over. It was gut wrenching, and I felt tremendous guilt, but I knew it was impossible.

I’m sure the neighbor faced similar pressure. The wife should probably be sent to to ER, then hospital, then on to a rehab facility. Medicare will pay for a few months, likely, and they can apply for Medicaid. He needs to speak to a Medicaid specialist because a spouse can indeed apply for Medicaid while the assets of the other are preserved. A LTC facility will have someone who can take care of the application process for the neighbor. But, Tenaj, you can’t fix this, and you can’t make all that happen. Getting her into a rehab/LTC facility might get the ball rolling though, and that could be triggered by a call to elder care services.

 

[Tenaj]

51 minutes ago, Spryte said:

This.

@Tenaj That situation is unsustainable. Your help is kind, and wonderful, but there’s no way you can provide enough.

She should not be home, but I understand how it happened. The pressure to take people home from the hospital or rehab facility is intense. I learned the hard way once, when agreeing to take my mother in after a hospital/rehab stay. I knew she wasn’t ready to leave, and I cried picking her up because I knew her care needs were beyond me. There was no other choice that I could see, and after 8 months of 24/7 care, doing all the ADLs for her, I was exhausted. It took that long to get her to a reasonable level of health. I learned later that the other “choice” was to say no. Firmly. It is so hard to do that when a loved one is involved! The next round, a few years later — I said no. Firmly. No, I cannot have my completely immobile mom live/toilet in our living room, open to the kitchen, where we homeschool. No, I cannot provide 24/7 care. The SW muttered some guilt-inducing words about my “lifestyle choice” and I just said no again. No. Over and over. It was gut wrenching, and I felt tremendous guilt, but I knew it was impossible.

I’m sure the neighbor faced similar pressure. The wife should probably be sent to to ER, then hospital, then on to a rehab facility. Medicare will pay for a few months, likely, and they can apply for Medicaid. He needs to speak to a Medicaid specialist because a spouse can indeed apply for Medicaid while the assets of the other are preserved. A LTC facility will have someone who can take care of the application process for the neighbor. But, Tenaj, you can’t fix this, and you can’t make all that happen. Getting her into a rehab/LTC facility might get the ball rolling though, and that could be triggered by a call to elder care services.

 

I spent two hours there today.  I found out that they do have the hospital bed in the process of being delivered, a nurse/health care worker is coming several times a week to check on the catheter and to bathe her.  He is actually calling hospice today to see if they can help.  I feel a tiny bit better about their situation now that I see there is some help starting up. 

Evidently a lot of this was delayed mostly because he hasn't had a phone ever since she was released from the hospital early this week.  He had made some calls using our phones which had helped a bit but not enough.  The phone situation is resolved and I am planning on stepping back again.  She was content to watch a movie and sleep today and was well-centered on the couch so no problems there.  Nurse had been in this morning so clean bedding and attention to catheter had been taken care of.  

Their full-time helper should also be back on duty by tonight he told me and she seems to really be a good influence over there.  I think last night may have just been a low point in the process of adjusting to her being back home.

[Spryte]

3 minutes ago, Tenaj said:

I spent two hours there today.  I found out that they do have the hospital bed in the process of being delivered, a nurse/health care worker is coming several times a week to check on the catheter and to bathe her.  He is actually calling hospice today to see if they can help.  I feel a tiny bit better about their situation now that I see there is some help starting up. 

Evidently a lot of this was delayed mostly because he hasn't had a phone ever since she was released from the hospital early this week.  He had made some calls using our phones which had helped a bit but not enough.  The phone situation is resolved and I am planning on stepping back again.  She was content to watch a movie and sleep today and was well-centered on the couch so no problems there.  Nurse had been in this morning so clean bedding and attention to catheter had been taken care of.  

Their full-time helper should also be back on duty by tonight he told me and she seems to really be a good influence over there.  I think last night may have just been a low point in the process of adjusting to her being back home.

Oh, that’s good to hear. I’m glad there is help coming in, and a nurse to see what’s going on.

Hospice will be a big help, too.

 

[KungFuPanda]

I wonder if having children at an older age affects the physical difficulties for the caregivers? Caregiving is hard work and doing it when you’re ten years older can’t be easier. Or maybe it evened out because people didn’t live as long? I have no clue, and I’m sure people had children at all ages all along, but it seems that having fewer kids later in life would have SOME impact. 

[Grace Hopper]

On 3/5/2022 at 11:16 AM, KungFuPanda said:

I wonder if having children at an older age affects the physical difficulties for the caregivers? Caregiving is hard work and doing it when you’re ten years older can’t be easier. Or maybe it evened out because people didn’t live as long? I have no clue, and I’m sure people had children at all ages all along, but it seems that having fewer kids later in life would have SOME impact. 

Good observation. IME, both factors were at play: [….snip out personal details]

I heard this statement the other day, not for the first time, and it had me nodding along: society rests on the uncompensated work of women. While this is highly altruistic in many cases, it is something far different when it is thrust upon us by the inability to choose. 

 

Edited March 6, 2022 by Grace Hopper

[KungFuPanda]

1 hour ago, Grace Hopper said:

Good observation. IME, both factors were at play: being an older mom myself and having an elder on a life sustaining pharmacological regimen. It put me directly in the pressure cooker. Caring for a medically sensitive elder with dementia at the same time as home schooling a middle schooler…. unsustainable. 
 

I heard this statement the other day, not for the first time, and it had me nodding along: society rests on the uncompensated work of women. While this is highly altruistic in many cases, it is something far different when it is thrust upon us by the inability to choose. 

 

I know in my heart that if men were required to do an equal share of child and elder care then we would have MUCH more social support. 

[katilac]

While the multi-generational, didn't-move-as-much stuff holds true in some cases, it doesn't always. For every Walton staying put on the mountain, there was an Ingalls headed to new territory.