Sunday, October 1, 2006

 

I am just beginning to catch up on journal reading...

...specifically journals that are listed over to the right in my Honorable Caregiver Blogs section. Last night I caught myself up on Karma's journal, JewBu Quest. I'm glad I did. Nothing like a dose of hard reality to strengthen one's resolve. The link connected to the words "hard reality" is to her September archive, which describes her extraordinary difficulties in monitoring the bleak and insufficient level of care her mother has been receiving in an assisted living facility. In order to get the full effect I recommend reading back from the time Karma's Mom was placed in this facility, which happened in early May of this year. The entire time frame provides a lesson in what can happen when one places one's loved one in an assisted living facility; not to mention a nursing home, which, ostensibly, provides, by law, better intense needs care but, well, I had some problems similar to those of Karma's with the one Mom was in for two weeks in August of 2004 for short term therapy and can not only imagine but have documented that many of the problems Karma is having and to which she refers through other articles cannot be counted out in nursing homes. The only difference seems to be that there might be, in one's home state, better, more available "remedies" through state oversight, if such a word can be used.
    Karma also lists some on-point links that I'm going to repeat here, simply because I expect most of my readers who haven't traveled over to JewBu Quest won't read Karma "from cover to cover", so to speak, and may miss these important links:
  1. SmartMoney.Com's review of 10 Things Your Assisted-Living Facility Won't Tell You
  2. A short personal review and verification, at AlzHub, of the above mentioned article
  3. Further documentation, courtesy of AlzHub, of horrifying experiences at the hands of assisted-living facilities; read the comments on this one, especially this one, a rallying cry, which has been posted on at least one other website.
    These timely links were put into particularly sharp perspective for me because I read them not 24 hours after reading an optimistic short article in the Goldman Mature Market Report talking about the Green House Project, a nursing/assisted living facility alternative that has also been championed by Dr. William Thomas, author of What Are Old People For?. The article quotes Mr. Robert Jenkins, president of the NCBDC, that "within 10 years double-occupancy nursing homes will be 'obsolete.'" That sounded a little too optimistic for me, so I decided to punch "Green House Project" into Google. Up came 13,800 entries, among them this story on the AARP website that mentions: "The nation's 16,000 nursing homes have reason to experiment: Their number has fallen by 800 in the last several years, and they still have an 11.5 percent vacancy rate. Though industry-wide change can come at a glacial pace, especially when it requires reinvestment, 20 facilities around the country have announced plans to build Green Houses. Even before the study results were out, nursing home personnel from across the country were coming to Tupelo for monthly training seminars." As well, in comparing the Green House in Tupelo, Mississippi, with a traditional nursing home across the street, despite the many quality related differences: "What do private rooms and a staff-to-residents ratio double that of the Cedars do to operating costs? The national average monthly fee in a nursing home tops $5,000. In Tupelo, Green Houses cost about the same. Medicaid covers the cost for 90 percent of the residents." In other words, quality care costs the same as inadequate, dehumanizing and clearly dangerous institutional care. Initial constructions costs, the article mentions, are what will slow down the pace of industry wide change.
    Let's hope, against the backdrop of the depressing topical links above which I borrowed from Karma's website, optimism is warranted.
    All in all, my hard dose of reality involves a rhetorical question Karma asks in her journal, after experiencing the insane level of frustration over monitoring assisted living facility care for her mother: "How do in-home caregivers do it?" [paraphrased, as I'm not sure exactly where she asks this]. After reading of her trials, I have to say, I have a feeling my frustrations and anxieties are nothing compared with hers. When the day is done I am here, with my mother, knowing exactly what kind of care she is getting, why she's getting this kind of care, and who's ultimately responsible: Me. There are lots of circumstances about which I can do little or nothing: The medical-industrial complex; reluctant relatives who've become afraid of my vociferocity on behalf of my mother's and my life; my society's and my government's misunderstanding and lack of support of my companionship of my mother, my motives and my desire to continue; the V.A.; etc. Finally, though, because I'm my mother's side-by-side, hand-in-hand, in-home companion, the quality of my mother's life comes down to me, and I can always do something about me. Always. It may seem as though I have "given up a lot", both in the present and future, to do this but, you know, I've got peace of mind. Those who know and love my mother have peace of mind regarding her life, regardless of any annoying, ephemeral vagaries of relationship that my frustrations create between me and each of these acquaintances and loved ones. It's this overall peace of mind that keeps me on track and continuing at my mother's side moment by moment, day by day. Call me crazy, call me misdirected, call me completely unrealistic and due for a miserable post-caregiving afterlife, but I, truly, wouldn't trade this for anything.

Comments:
Originally posted by Karma: Mon Oct 02, 09:37:00 AM 2006

Wow, what an honor that you've posted about my blog. Sometimes I wonder if anyone reads it at all, so I really appreciate this post.

I'm also optimistic in that, I think that things could get a whole lot better. And, I also find that being able to give back to my mom some of the wonderful care that she gave me all these years, well its a blessing. It is easy to forget that its a blessing, but it really changes the dynamic. So, thanks for the reminder.


Originally posted by Mona Johnson Tue Oct 03, 03:56:00 AM 2006

Thought-provoking as usual, Gail. I notice Dr. Thomas has a new book out - In The Arms of Elders: A Parable of Wise Leadership and Community Building. I guess we shouldn't be too optimistic until books like his don't have to be parables...


Originally posted by Patty McNally Doherty Tue Oct 03, 08:00:00 PM 2006

Gail,

Your experience with your mother is so similar to one I had with my father. My mother, my sister and I shared the care of my father for eleven years. At home, in the neighborhood, on the street he lived for 25 years. He slept in his own bed, ate in his own kitchen and constantly challenged us to come up with creative ways to deal with this ever-shifting disease. What worked one day wouldn't the next and back to the drawing board we would go. Even with all this support and all this help, it became an overwhelming task for us. How DOES one brush a grown man's teeth? In the grand scheme of things, just how bad IS it to sleep with your shoes on, like my father always insisted. These were strange days, but when I suspended my concept of time, and dwelled in the moment we were in, it became an incredibly rich journey. Some people will understand that, and others won't. I learned more about myself in those eleven years than I had in the previous 40.

I recongnize much of what sustained me in your description of peace of mind, knowing that whatever happened, happened with you beside your mom. Going through it, though, was heartbreaking. We are totally and completely, as a country, unprepared to handle this disease. Things will have to change in groundsweeping ways.

My husband had just posted on www.theunforgettablefund.blogspot.com the information he researched on the actual cost of nursing home care. You might be interested to know the MetLife Mature Market Institute sites the average cost of nursing home care in 2005 to be around $203 per day. That's the AVERAGE cost. And that's last year...

I think this will be an important issue in upcoming elections. If it's not, we need to make it one.

Thank you so much for posting as you do. Your site is immense. I look forward to reading more and wish you every word you'll ever need to keep telling us about it.

Patty
 
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