Is there a way for us as a society to do better for our elderly and disabled?

[DawnM]

Something HAS to change somewhere.   I mean, I know there are facilities that accept medicaid and medicare, but what about those who are semi-needing help?   I mean, they can function on their own somewhat but need help and have no money.

I have a dear friend who lives an 8 hour drive away.   She had a stroke a few years back.   She cannot drive and has trouble walking without falling due to one side not really working well.   Her boyfriend helps her but he has early onset dementia and things are going South rather quickly for him.

Since she can't drive, and her boyfriend doesn't drive (long sorted tale on that one), she relies on the disability bus for transportation to her appointments.   They often confirm but then dont' show and claim, "We had a driver call in sick" or whatever, and they don't even let her know!   She just gets ready, sits there waiting, and then has to chancel her appointment.   She has been dropped by two doctors (a dentist and specialist) for no shows even though they aren't her fault.

I really don't know what to do from here that can help her.   I do send her things periodically (like door dash or a grocery order for delivery) but the rides are a real problem.

She does have grown kids, but they are very busy with full time jobs, kids in sports, and such, and can't take off in the middle of the day to take her to appointments.   I would say she has 2-3 per week!   Therapies and doctors, etc...

ETA:   And just for reference, this is the friend I posted about when she had the stroke.   It was 4.5 years ago.   She is like a sister to me.   Her mom and my mom were friends in college!   She was born 6 months before I was born, but we have known each other almost since birth!~.  She is my oldest friend in that regard.   I say all that to say, this is why I feel it is "my business" to worry about her!

 

Edited May 15 by DawnM

[prairiewindmomma]

Of course we can do better. We have chosen, instead, to give tax breaks to the rich and to not fund sufficient support for low income individuals.

[Scarlett]

7 minutes ago, DawnM said:

Something HAS to change somewhere.   I mean, I know there are facilities that accept medicaid and medicare, but what about those who are semi-needing help?   I mean, they can function on their own somewhat but need help and have no money.

I have a dear friend who lives an 8 hour drive away.   She had a stroke a few years back.   She cannot drive and has trouble walking without falling due to one side not really working well.   Her boyfriend helps her but he has early onset dementia and things are going South rather quickly for him.

Since she can't drive, and her boyfriend doesn't drive (long sorted tale on that one), she relies on the disability bus for transportation to her appointments.   They often confirm but then dont' show and claim, "We had a driver call in sick" or whatever, and they don't even let her know!   She just gets ready, sits there waiting, and then has to chancel her appointment.   She has been dropped by two doctors (a dentist and specialist) for no shows even though they aren't her fault.

I really don't know what to do from here that can help her.   I do send her things periodically (like door dash or a grocery order for delivery) but the rides are a real problem.

She does have grown kids, but they are very busy with full time jobs, kids in sports, and such, and can't take off in the middle of the day to take her to appointments.   I would say she has 2-3 per week!   Therapies and doctors, etc...

 

Doesn’t she have any friends?  We have several elderly in our congregation who don’t have kids to help for one reason or another.  We take turns driving them to appointments etc.  A lot of times they won’t ask for help though.  Maybe your friend is like that.

It is one of the reasons I only work part time.  I spend a lot of time taking my parents to appointments.  

 

[Ottakee]

I would have her call her medical insurance for rides to medical appointments.  
 

But yes, our elderly and disabled fall through the cracks.

[annandatje]

A blind family friend lived with us for two years.  I can vouch for what your friend said about the ride to appointments being a no-show.  Her state insurance plan was supposed to provide transportation's as one of the benefits. The volunteer ride program was a joke.   At the time, I was still working so we often had Uber or Lyft take her and just paid for it ourselves.  I can empathize but have no consistently reliable solution.

Providing resources for the low income elderly and disabled frankly have always been a low priority in our profit driven society.

My blind friend moved to a Millennia managed subsidized apartment.  It took years but Millenia finally got out of the subsidized housing business last year.  They were constantly in court dragging their feet and claiming that by end of next month, the issues would be resolved. The apartments were without air conditioner over a month in hottest part of year, had bedbug and other creepy crawly infestations, without reliable heat in winter, and there was often feces and urine in common spaces.  It had been stepped in and tracked across common spaces.  That may be hard to believe but I saw it with my own eyes and have videos of it.

[KSera]

33 minutes ago, prairiewindmomma said:

Of course we can do better. We have chosen, instead, to give tax breaks to the rich and to not fund sufficient support for low income individuals.

This. We should do much better, but every time I read about any kind of new program being offered to help low income people, the comments are a barrage of people calling anyone taking advantage of such programs free loaders and that people should pay for it themselves. A large portion of the people who don’t need such help and could afford to help others think they deserve to have better things than other people because clearly they must have earned it and anyone else could have the same if they just cared to. 

[prairiewindmomma]

When I speak of rich people, I am not talking of people who make less than 600,000/year. Returning the corporate tax rate and the tax rate for those who make over 1,000,000/year to historical levels would solve many issues.

[prairiewindmomma]

I also think restoring capital gains taxes would incent companies to do fewer stock buybacks and pay out more dividends instead which would make companies behave more responsibly. We’d see more long-term decision making behavior and fewer layoffs for employees and price hikes for consumers in the short term. We know how to be better citizens, and we’re choosing not to because we dont vote with common sense.

Edited May 14 by prairiewindmomma

[TechWife]

In addition to what others have said about funding supports, employers play a role as well. There must be a combination of scheduling predictability and flexibility for family members. Predictability would help with routine or follow up appointments and flexibility would help with emergency situations. Another factor is overall time off without jeopardizing jobs. Thirty days FMLA is simply not enough for the long term. 

[prairiewindmomma]

11 minutes ago, KSera said:

This. We should do much better, but every time I read about any kind of new program being offered to help low income people, the comments are a barrage of people calling anyone taking advantage of such programs free loaders and that people should pay for it themselves. A large portion of the people who don’t need such help and could afford to help others think they deserve to have better things than other people because clearly they must have earned it and anyone else could have the same if they just cared to. 

They’ve been conditioned for years to think poor people are the problem so that they don’t point their fingers at the ultra rich who dont pay their fair share of taxes and who benefit from the labor and taxes paid by the middle class instead. 
 

We are always going to have a % of people who are mentally ill, physically disabled, elderly, and otherwise in need of help. 

[Faith-manor]

51 minutes ago, prairiewindmomma said:

Of course we can do better. We have chosen, instead, to give tax breaks to the rich and to not fund sufficient support for low income individuals.

Spot on.

In terms of what we need, more community cleaning and housekeeping services for seniors. More public transport that is reliable and handicap accessible. Geriatric doctors that make house calls. (Totally a thing in France. My mom has gotten sick twice while visiting my sis, and sis just calls her doc, and he sends someone over. Not kidding. $50 for her as a non-resident, and they apologize that they have to charge her because they don't like healthcare being passed on individual ability to pay, but they are required to charge non residents.)

We could have more senior centers, more senior meals. Our county has funding for only ONE senior meal a week at the one and only community center in the county in the one and only place in the county that has a handicap accessible bus. We could have more subsidized senior housing for semi- independent folks, but we don't because "amassing wealth in the hands of a few".

[Faith-manor]

52 minutes ago, Scarlett said:

Doesn’t she have any friends?  We have several elderly in our congregation who don’t have kids to help for one reason or another.  We take turns driving them to appointments etc.  A lot of times they won’t ask for help though.  Maybe your friend is like that.

It is one of the reasons I only work part time.  I spend a lot of time taking my parents to appointments.  

 

A lot of people do not have these resources. Most families cannot afford for a spouse or adult contributor to the household to move to part time work or quit all together in order to care for elderly relatives. It isn't a feasible option. Even other fairly healthy still driving 65 year olds in my area who could drive for older folks are still working full time and can't afford to quit or scale back.

[SKL]

I think people need to file a series of complaints and take other actions related to the local senior transportation people.

In the mean time, schedule the rides to arrive early, and if they don't show up, use Uber or a taxi service.

Or schedule appointments for when the kids can give her a ride.

Some health providers will come to your home.  Maybe explore that option too.

[Faith-manor]

Just now, SKL said:

I think people need to file a series of complaints and take other actions related to the local senior transportation people.

In the mean time, schedule the rides to arrive early, and if they don't show up, use Uber or a taxi service.

Or schedule appointments for when the kids can give her a ride.

Some health providers will come to your home.  Maybe explore that option too.

Rural communities do not have taxis, uber, or lyft. So that is an option in the city, but not for a bunch of folks.

[SHP]

Our society does not like people with disabilities. 

[TechWife]

Just now, SKL said:

I think people need to file a series of complaints and take other actions related to the local senior transportation people.

In the mean time, schedule the rides to arrive early, and if they don't show up, use Uber or a taxi service.

Or schedule appointments for when the kids can give her a ride.

Some health providers will come to your home.  Maybe explore that option too.

Complaining doesn’t solve funding problems, which is the root of the inconsistent service. 
Uber & taxis cost a lot of money and can’t always transport people with medical equipment needs, such as walkers, wheelchairs & oxygen. 
Not everyone has children living locally and those that do don’t always have work situations that allow for frequent time away from work. 
There are very few providers that come to the home and home RN, PT, OT, ST, HHA visits are only covered by insurance (including Medicare & Medicaid) under specific circumstances for limited amounts of time. 

[prairiewindmomma]

People who are living on SSI or SSD or Medicaid don't have Uber/taxi levels of money. Many-most are already making decisions about food versus bills versus medication. There's a reason they've been taking the free-$3 subsidized rides. Or, they are wheelchair bound, and need a service able to handle a motorized chair. Ubers and taxis usually don't have wheelchair lifts.

[Bootsie]

I think the solutions are highly localized.  What is needed and what will work is very different in New York City than in Houston suburbia than in a small west Texas town.  

[SKL]

20 minutes ago, TechWife said:

Complaining doesn’t solve funding problems, which is the root of the inconsistent service. 
Uber & taxis cost a lot of money and can’t always transport people with medical equipment needs, such as walkers, wheelchairs & oxygen. 
Not everyone has children living locally and those that do don’t always have work situations that allow for frequent time away from work. 
There are very few providers that come to the home and home RN, PT, OT, ST, HHA visits are only covered by insurance (including Medicare & Medicaid) under specific circumstances for limited amounts of time. 

Right, but making it about the evils of rich people always solved every problem.  😕

Scheduling medical appointments is challenging at all ages and income levels.

The whole point of local elderly transportation service is to address this specific issue.  That's were the focus needs to be IMO.  If the issue is funding (which it may or may not be), then figure out a way to fund it or fund an alternative that works.

[frogger]

Car dependency certainly harms those who struggle with disabilities. Locally, I continue to advocate for better transportation options. My brother has tried to rely on provided transportation for those with disabilities and it did not go well. He was missing a lot of work! He moved where he can walk to work and a few other places. He has Down Syndrome. 

That being said having a network for care makes more sense but fewer people invest in building community and networking. If I have a friend who happens to work the day her mother's appointment is she puts out a group text to 5 or 6 people and someone picks her up. This type of thing happens all the time. Our church has many times had a sign up for care rotation of people who needed 24 hour care and we are often able to cover a set amount of hours every single day of the week. Last time it was 3 hours a day but when another ladies father had cancer we managed to cover 9 hours a day while she was at work. I think this happened for close to a year so it wasn't long term but of course no one knew how long it would last. This spreads out the work. You really need a really invested community who cares to do that and I know not everyone has that. 

I don't know how or if government can do that much, not as well as having relationships in your community. I also know not everyone has that built up. I do think we as a society don't recognize the value of that enough though. When we tell people to just sell their home in an expensive place and retire somewhere else for example, we devalue all those connections which are super important to the elderly. 

 

Government can make more assisted living facilities. Getting enough workers will be a challenge as our demographics change. This will force people who need assistance in specified locations. I can't imagine that tax payers should be required to have a worker drive 3 hours to my Grandma's home when she lived on a ranch in the middle of nowhere for example. We did move her to assisted living closer to family as she was so far from anyone who can help her but you also need enough people willing to take those jobs. 

There are programs where people come in to help those with disabilities with cooking, cleaning, or driving to errands but each state is different so I cannot tell you what you have locally available. 

Thank you for being a friend and trying to help!

[PeterPan]

It's very hard to help someone from out of state. You're reliant on the accuracy of the information, and you work with the hope they have fully utilized local resources. Sometimes people delay doing paperwork or resist options that would give them better access to services. 

Fwiw, I would contact the *county board on aging* for where your friend lives and talk it through with their social worker to see what the options are. They may have ways to compel the family to be more involved or to bring forward options. Ironically, it seems like the people with *some* property, etc. are in the hardest position, which those who are completely indigent do in fact get the more complete care you seem to be wishing for for your friend. Thing is, you wouldn't like what that looks like, just saying.

I hope the social worker can compel the family members to be more involved and sort out who is the POA and get things in order.

[Scarlett]

1 hour ago, Faith-manor said:

A lot of people do not have these resources. Most families cannot afford for a spouse or adult contributor to the household to move to part time work or quit all together in order to care for elderly relatives. It isn't a feasible option. Even other fairly healthy still driving 65 year olds in my area who could drive for older folks are still working full time and can't afford to quit or scale back.

Well yes I know. My point was because it is such a concern we have made sacrifices to be sure I can help when needed. I realize not everyone has my options though. 

[maize]

1 hour ago, Ottakee said:

I would have her call her medical insurance for rides to medical appointments.  
 

Is that a thing? I've never heard of it.

[Katy]

9 minutes ago, maize said:

Is that a thing? I've never heard of it.

It depends on the state. We’ve lived in 5 places since I’ve been on the board. In three of them I was contacted to be asked if I needed assistance getting my children who had subsided adoptions (and therefore secondary medicaid) to medical appointments. 

[Pawz4me]

2 hours ago, DawnM said:

Something HAS to change somewhere.   I mean, I know there are facilities that accept medicaid and medicare, but what about those who are semi-needing help?   I mean, they can function on their own somewhat but need help and have no money.

 

If she receives Medicaid then she (or someone on her behalf) needs to carefully research what services are covered in her state. Recently I was poking around on behalf of someone in need and found out that our state has a program aimed at keeping people on Medicaid who have complex medical needs in their home as long as possible. Part of that includes providing a decent amount of in-home services, both medical and personal care. The goal is to keep the person at home as long as possible, which in most cases is significantly less expensive than a skilled nursing facility.

[kbutton]

2 hours ago, TechWife said:

In addition to what others have said about funding supports, employers play a role as well. There must be a combination of scheduling predictability and flexibility for family members. Predictability would help with routine or follow up appointments and flexibility would help with emergency situations. Another factor is overall time off without jeopardizing jobs. Thirty days FMLA is simply not enough for the long term. 

This is so important, and TBH, healthcare workers have some of the worst inflexibility. My DH is lucky if he can pee and eat in a shift, and if he doesn’t work, he doesn’t get paid. 

1 hour ago, Bootsie said:

I think the solutions are highly localized.  What is needed and what will work is very different in New York City than in Houston suburbia than in a small west Texas town.  

Definitely.

I also think we need to realize that people are not always aging near family anymore. Even when family can help, need is great; it’s multiplied when people don’t have that support. Sometimes the support is from siblings too—not everyone has support from a different generation, and we need to help all the kinds of caregivers.

1 hour ago, Scarlett said:

Well yes I know. My point was because it is such a concern we have made sacrifices to be sure I can help when needed. I realize not everyone has my options though. 

I have even considered trying to get a job doing some of this stuff professionally, but workers don’t have flexibility for their own family’s needs, and I am not sure I can handle caregiving for strangers when I already do a lot of caregiving at home. I am not sure I can handle a lot of extra frustration with wheelchair access, old people who can’t hear, etc. I just don’t have the bandwidth.

I love that you make yourself available via your congregation. I might be able to do something like that someday if I got reimbursed for gas/car wear and tear. I would know better what I was getting into.

[City Mouse]

I think relying on the government to take care of everything isn’t going to work. It will have to be a combination of government agencies, volunteer agencies, and family/community members helping. On top of that, the elder has to be willing to ask for and/or even be willing to use the services that are available. I have seen both sides - the elderly person who doesnt want to burden others so doesnt ask for help from anyone until there is a crisis that requires intervention, the elderly person who only wants specific people or person to provide all assistance and refuses all government and community services until a crisis happens and she has no choice, and then there is the elderly person who refuses to admit that any assistance is needed. 
 

There is no way to make the “system” work for every person.

[Faith-manor]

6 minutes ago, City Mouse said:

I think relying on the government to take care of everything isn’t going to work. It will have to be a combination of government agencies, volunteer agencies, and family/community members helping. On top of that, the elder has to be willing to ask for and/or even be willing to use the services that are available. I have seen both sides - the elderly person who doesnt want to burden others so doesnt ask for help from anyone until there is a crisis that requires intervention, the elderly person who only wants specific people or person to provide all assistance and refuses all government and community services until a crisis happens and she has no choice, and then there is the elderly person who refuses to admit that any assistance is needed. 
 

There is no way to make the “system” work for every person.

True. No system will be perfect. But we also do not have to have a system that is so NOT a system that it is abjectly abysmal for so very many people. Don't let perfect be the enemy of good.

[frogger]

3 hours ago, kbutton said:

I have even considered trying to get a job doing some of this stuff professionally, but workers don’t have flexibility for their own family’s needs, and I am not  I can handle caregiving for strangers when I already do a lot of caregiving at home. I am not sure I can handle a lot of extra frustration with wheelchair access, old people who can’t hear, etc. I just don’t have the bandwidth.

 

This is very job dependent. For example, there is a program where I live called Hearts and Hands where people are matched up (the person needing help chooses depending on who is available and scheduling) and they might meet up once or twice a week to pre-prep meals together, go to an event, or run errands. It is paid but nothing you could actually live off of so they need people that might just want a little side income or do it just because they want to help. I have known 3 people locally that did work through it and of course how stressful, flexible it was depended on the client. I don't know anyone who did it full time. People usually just have one or two clients and work a few hours a week.

 

Less involved than a paid full time caregiver for sure! But of course, I don't know what you have available locally or how it is structured and it isn't a big money maker by any means. 

Here is our local place 

https://heartsak.com/enrollment/

Unless this is the one I am thinking of 

https://www.heartsandhandsofcare.com/employment/

 

 

Edited May 14 by frogger

[kbutton]

1 hour ago, frogger said:

This is very job dependent. For example, there is a program where I live called Hearts and Hands where people are matched up (the person needing help chooses depending on who is available and scheduling) and they might meet up once or twice a week to pre-prep meals together, go to an event, or run errands. It is paid but nothing you could actually live off of so they need people that might just want a little side income or do it just because they want to help. I have known 3 people locally that did work through it and of course how stressful, flexible it was depended on the client. I don't know anyone who did it full time. People usually just have one or two clients and work a few hours a week.

 

Less involved than a paid full time caregiver for sure! But of course, I don't know what you have available locally or how it is structured and it isn't a big money maker by any means. 

Here is our local place 

https://heartsak.com/enrollment/

Unless this is the one I am thinking of 

https://www.heartsandhandsofcare.com/employment/

 

 

Oh, I was thinking of an outright medical transport company. Something like this might be a good fit! I had kind of forgotten that we have some things like that here. 

[Teaching3bears]

6 hours ago, SHP said:

Our society does not like people with disabilities. 

I have two kids with disabilities.  Everybody is very nice to them: members of the public, service provides.  Family not so much.

[Teaching3bears]

It’s not always about money.  I am not able to use all of the funding for my kids because there are not enough programs for which they qualify or that can handle their high needs.  The programs that exist get little and uneven funding and they often take place in buildings that do not meet their sensory needs at all because they don’t have enough money for a nice building.  The camp they’ve gone to for years lost its funding this year.  Sometimes it’s hard to get personal care workers who show up on time.  They are sometimes hours late or they sit and chat with each other while I give my adult kids baths.  

[SHP]

6 hours ago, SKL said:

Scheduling medical appointments is challenging at all ages and income levels.

 

Those with means are not worried that missing a day of work for an appointment will mean their income will drop and they will worry about having enough food.

Those with means will have more options for medical providers, including those closer to their home. 

Those with the means can drive or take private transportation to their appointment vs public transportation. The difference can be 20 minutes vs 90 minutes, and I am being generous in some areas.

Rescheduling a work meeting and spending, maybe an hour of the day, commuting to and from and being seen without the additional worry about food is a HUGE privilege. 

[Ausmumof3]

Does she have the funds to use Uber or get a taxi when the bus doesn’t turn up? 

[TechWife]

6 hours ago, SKL said:

Right, but making it about the evils of rich people always solved every problem.  😕

Scheduling medical appointments is challenging at all ages and income levels.

The whole point of local elderly transportation service is to address this specific issue.  That's were the focus needs to be IMO.  If the issue is funding (which it may or may not be), then figure out a way to fund it or fund an alternative that works.

How do you propose a safe, consistent transportation service be funded? 

[TechWife]

7 hours ago, Faith-manor said:

… Even other fairly healthy still driving 65 year olds in my area who could drive for older folks are still working full time and can't afford to quit or scale back.

And there’s always talk about raising the SS eligibility age, so this isn’t likely to change. 

[TechWife]

31 minutes ago, Teaching3bears said:

It’s not always about money.  I am not able to use all of the funding for my kids because there are not enough programs for which they qualify or that can handle their high needs.  The programs that exist get little and uneven funding and they often take place in buildings that do not meet their sensory needs at all because they don’t have enough money for a nice building.  The camp they’ve gone to for years lost its funding this year.  Sometimes it’s hard to get personal care workers who show up on time.  They are sometimes hours late or they sit and chat with each other while I give my adult kids baths.  

What you’ve just described is about money though. Funding is money. 

[SKL]

2 hours ago, TechWife said:

How do you propose a safe, consistent transportation service be funded? 

We don't even know that funding is the issue.  Have you never heard of programs where people take the money meant for project A and (a) use it for unauthorized purposes, (b) embezzle / steal it, or (c) simply mismanage it?

There is apparently a funded program that is meant to provide transportation but is failing.  The first step in fixing that is to find out why it's failing.  Pouring more money into a program without accountability isn't going to help the people who are sitting waiting for their ride to the doctor.

Maybe they really are operating on a shoestring and can't afford to pay for a backup plan.  Or maybe someone just isn't doing his/her job.  Maybe the wrong people are in charge.  Maybe the squeaky wheel gets the grease and nice non-complainers get their share last (if ever).

[I had an extremely short stint as a nursing home aide.  Nearly every worker was high on pot all day long and they did maybe 25% of the work they were being paid to do.  They really only took care of the people who (a) had the ability and the balls to complain or (b) had visitors every day.  It taught me a lot about elder care.]

Edited May 15 by SKL

[Teaching3bears]

2 hours ago, TechWife said:

What you’ve just described is about money though. Funding is money. 

It is about the money that goes to the organizations.  My sons aren’t spending a great deal of the money they are allocated because there is nowhere to spend it that will accept them.  When there is somewhere to spend it, I have to spend so much time on the reimbursement process because it’s so complicated.

[bookbard]

There are a couple of different options for community transport.

a) in some European countries, public transport is publicly funded and free. I think this is a good option.

b) in Australia, people with disabilities and the elderly get Taxi vouchers so taxi services are subsidised up to 50%.

c) there are in many countries free community transport schemes which are run by charities (who often get funding from the government). So you book your hospital appointment, tell the community transport and they get you there. There are issues with flexibility I find.

d) transport can be funded as part of a NDIS (Disability) package or the equivalent for aged care, Home Care. This a government thing where they issue X amount of money per year and you or your coordinator work out how much money is to be spent on each thing (you can get funded food, cleaning, anything that helps you live independently in your home). I think in that case the person who does the transport gets the money directly from the government. 

The problem with the NDIS, Home Care, subsidised stuff is that there are always a billion hoops to jump through to get there. I think the ideal would be free and accessible public transport for most people, and flexible community transport for those who have accessibility issues. It is hard rurally where there's no public transport, but I have to say, people really have to think seriously about moving in those circumstances. There's no point living remotely if you need constant medical care. On the other hand, it's very expensive if you have to move from a rural to an urban setting. 

Edited May 15 by bookbard

[TechWife]

44 minutes ago, SKL said:

We don't even know that funding is the issue.  Have you never heard of programs where people take the money meant for project A and (a) use it for unauthorized purposes, (b) embezzle / steal it, or (c) simply mismanage it?

There is apparently a funded program that is meant to provide transportation but is failing.  The first step in fixing that is to find out why it's failing.  Pouring more money into a program without accountability isn't going to help the people who are sitting waiting for their ride to the doctor.

Maybe they really are operating on a shoestring and can't afford to pay for a backup plan.  Or maybe someone just isn't doing his/her job.  Maybe the wrong people are in charge.  Maybe the squeaky wheel gets the grease and nice non-complainers get their share last (if ever).

[I had an extremely short stint as a nursing home aide.  Nearly every worker was high on pot all day long and they did maybe 25% of the work they were being paid to do.  They really only took care of the people who (a) had the ability and the balls to complain or (b) had visitors every day.  It taught me a lot about elder care.]

You didn’t answer the question. You said “If the issue is funding, then figure out a way to fund it.” So, how do you propose  a safe, consistent transportation program be funded? Where does the money come from? How is it allocated? Who makes those decisions? What accountability systems need to be in place? All of that is part of providing a safe & consistent service. So, how do you fund it? 

 

[Arcadia]

2 hours ago, bookbard said:

There's no point living remotely if you need constant medical care. On the other hand, it's very expensive if you have to move from a rural to an urban setting. 

Satellite clinics were very useful in my country of origin. The specialists would have two days a week at the satellite clinics so people who live in more rural areas do not have to take public transport long distance for their appointments. My eye specialist schedule was some days at the university hospital and some days at a satellite clinic near my childhood home. So I would schedule my appointments for when my eye specialist was at the university hospital since I could walk there from my dorm.

[frogger]

4 hours ago, SKL said:

  Pouring more money into a program without accountability isn't going to help the people who are sitting waiting for their ride to the doctor.

 

Obviously, there are great people out there but yes, sometimes it feels like customer service isn't a thing because there is an attitude of "they are disabled so their job isn't that big of deal". Or they aren't smart enough to complain or they can't fire me because they have nowhere else to go. It is frustratung.

[Laura Corin]

1 hour ago, Arcadia said:

Satellite clinics were very useful in my country of origin. The specialists would have two days a week at the satellite clinics so people who live in more rural areas do not have to take public transport long distance for their appointments. My eye specialist schedule was some days at the university hospital and some days at a satellite clinic near my childhood home. So I would schedule my appointments for when my eye specialist was at the university hospital since I could walk there from my dorm.

I live in a town that is about 40 minutes from two major hospitals in Scotland.  Specialists rotate through my town,  using a space in the town rehab hospital building which also houses GP practices and a dentist.

You are sent to the main hospital if major equipment  - beyond x-rays - is needed, but otherwise you are seen locally. The local hospital is served by several bus routes and also a public shared taxi-bus, which you book in advance by phone. My mum used that system and it was OK.

I believe specialist transport can be booked for people with disabilities, and there are also charity groups, but I don't know how well that system works.

[Melissa in Australia]

1 hour ago, Arcadia said:

Satellite clinics were very useful in my country of origin. The specialists would have two days a week at the satellite clinics so people who live in more rural areas do not have to take public transport long distance for their appointments. My eye specialist schedule was some days at the university hospital and some days at a satellite clinic near my childhood home. So I would schedule my appointments for when my eye specialist was at the university hospital since I could walk there from my dorm.

I guess it really depends on the size of the country

Specialist here do go to satellite clinics. People still need to travel 100 km plus to reach those.

The local health centre has volunteer drivers who use a fleet car to drive frail people to their  specialist appointments.

[Arcadia]

47 minutes ago, Melissa in Australia said:

Specialist here do go to satellite clinics. People still need to travel 100 km plus to reach those.

My friend volunteer to be a flying doctor in Australia for many years. However, the helicopters and other equipment still requires generous donations to sustain. 

[Melissa in Australia]

We also have angel flights. Which  are basically a pilot who has their own small plane volunteer to fly people to medical appointments. The angel flight charity funds the fuel and the government doesn't charge the landing fee.  You do have to have enough mobility,  however, to be able to climb onto the wing of the plane to board.

 I have used them in the past for twin 1 when he needed specialized treatment at the Royal Children's hospital every 2 weeks for a 6 week period.

[DawnM]

22 hours ago, Faith-manor said:

Spot on.

In terms of what we need, more community cleaning and housekeeping services for seniors. More public transport that is reliable and handicap accessible. Geriatric doctors that make house calls. (Totally a thing in France. My mom has gotten sick twice while visiting my sis, and sis just calls her doc, and he sends someone over. Not kidding. $50 for her as a non-resident, and they apologize that they have to charge her because they don't like healthcare being passed on individual ability to pay, but they are required to charge non residents.)

We could have more senior centers, more senior meals. Our county has funding for only ONE senior meal a week at the one and only community center in the county in the one and only place in the county that has a handicap accessible bus. We could have more subsidized senior housing for semi- independent folks, but we don't because "amassing wealth in the hands of a few".

I would add in disabled centers and disabled meals.   She is not a senior.

[DawnM]

23 hours ago, Ottakee said:

I would have her call her medical insurance for rides to medical appointments.  
 

But yes, our elderly and disabled fall through the cracks.

She is on medicare.   They gave her the number to call for her rides.   However, she has to use two different groups.

One is through insurance, and one is through disability.   The disability one she schedules but there are unlimited rides per year.    The one through her insurance has like 3 rides per month max or something like that.   She uses the insurance one for the ones in town, 45 min. away, as much as she can.   But there is a limit.

The other thing that irks the heck out of me?   WHY do we make things so complicated for our more vulnerable?   

Since we went through fostering Andrew and then adopting, we had to deal with so much bureaucratic nonsense and I had to call the social worker more than once to figure out the forms and what they were asking for.   And I consider us to be reasonably intelligent people who are native English speakers, etc....I can't imagine being from another country, not speaking English well, maybe not as educated, and trying to get help from our "system."

 

[SKL]

12 hours ago, TechWife said:

You didn’t answer the question. You said “If the issue is funding, then figure out a way to fund it.” So, how do you propose  a safe, consistent transportation program be funded? Where does the money come from? How is it allocated? Who makes those decisions? What accountability systems need to be in place? All of that is part of providing a safe & consistent service. So, how do you fund it?

Well first of all, I would build on what already exists.  Some organization exists with people on staff and presumably vehicles, office space, paperwork done, reporting processes in place, etc.  The first question is, what can be done to fix the problems with that already existing, paid for system.  If it turns out that the problem is insufficient funds (which is not a given), then the first line of attack would be the one that can be done soonest and with the most effectiveness.  This will vary based on many factors.  What we don't want is a lot of ineffective talking and blaming and proposing solutions that can't take effect until the current users have passed from old age.

The OP says her friend's disability insurance pays for an unlimited number of rides.  That's great.  So the problem is somewhere else in the system, and it's probably local.

Not related to the OP, but I tend to agree with other posters that there's a limit to how much people can expect the government to extend costly benefits based on choices the user makes.  In particular, the decision to live in a location without reasonable access to health care.  My folks live in a rural village with no plans to ever move out, but they have a number of younger relatives who could help them if needed.  They also have a local GP (covered by medicare) who visits their home, since my mom's mobility is severely limited.  But if they lived in a location without reasonable access, and had chronic health issues, then they would probably have to make a decision to sell their house and move to a location with access.

And yes, I agree that things are too administratively complicated for older folks.  I've been ranting about this for years.  All I can suggest is that we get our affairs in order and get POAs set up while we have the mental and physical ability to do so.  I personally think older people with modest incomes shouldn't be required to file tax returns among other things.  For things that really require legal forms, there should be better access to social workers or whoever ... and the medicare system should make sure everyone is informed of the availability of this kind of help (and exactly how to access it).

Edited May 15 by SKL