Silver Planet™ Help Your Parents Age in Place.

Last week I spent three days straight with some of the nicest people in the world, people who work in adult day care and adult day health care centers. The First International Adult Day Services Association Conference was held in Seattle, Washington, and men and women from across the United States and Canada attended the three-day event. 

My mother, Reva (Nemoff) Myers, was born October 4, 1918, in Detroit, Michigan, of then-recent Russian immigrants. That year, Mae West was a scandal on Broadway, and the War to End All Wars ended after four years of intense horror. In August of 1918, influenza exploded into a worldwide pandemic that killed over 25 million people in six months. In Russia, murder and starvation were widespread, and pogroms—manufactured riots directed against Jews—were in full force.

I want to throw my purse at long-term care facility administrators who say, because of financial restraints, that they cannot intentionally and successfully address what Dr. Bill Thomas calls the “three plagues” of long-term care: loneliness, helplessness, and boredom. Their thinking goes, if facilities would only take in more money, there would be enough resources to deal with those problems. Claptrap. It’s not about money—it’s about culture and priorities.

A shout out to those who shared their caregiving experiences related to residents’ boredom in long-term care.

A few weeks ago, I wrote about my concern for my mother (Help! My Mother Is Dying of Boredom). She receives excellent care but seems quite bored. Not sure what to do, I asked readers to send in their take on the subject and a few suggestions for how they have dealt with the issue.

I have job, a full-time job. Since I manage two adult day service associations—Washington Adult Day Services Association and National Adult Day Services Association—it sometimes feels like I have two full-time jobs. (I’m absolutely not complaining; my architect husband has been out of work since January.) And I have been managing my mother’s finances and care for about two years, which means I essentially have three jobs.

My mother appears to be quietly fading. I understand the process of dementia, but she seems so vacant, partly because of the relentless boredom she lives with. 

One proposed strategy to lower Medicare costs is to reduce the number of rehospitalizations. Armies of policy advisors and consultants have been deployed to present at conferences and testify at hearings to explain the problem and offer solutions—more of the former than the latter. An aside: I know they are not doing this for free. Who is paying these people? Politicians, health care experts, and hospital administrators talk to each other as if no one else is in the room.

Here’s the truth. Health care in the last year of life is significantly more expensive than the cost of health care in preceding years. Almost 30% of Medicare spending is paid out for patients in the last year of their lives.

Strange but true, Medicare will pay for care for some health problems but not for others. For example, if you break your leg or have a heart attack, Medicare will cover the doctors, nurses, hospital, and short-term rehabilitation.

Given the strong probability of some kind of health care reform, I read as much as I can about proposals that could impact the provision of long-term care services. Billions of dollars are at stake, and the politically influential have kicked into high gear. Real concern should be generated when policy makers, politicians, and political idealists, who have little personal experience with family caregiving, assume authority over the structure, payment, and delivery of long-term care.

The intent of end-of-life planning mangled beyond recognition

Definition, caregiver: A person with knowledge of, the patience for, and an interest in taking care of old or disabled adults and who does so with kindness and compassion. Not everyone who takes care of an old or disabled adult is a caregiver.