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Willa Rogers
Mar 11, 2005

Smythe posted:

cool part about dementia is you're too far gone to know when you're too far gone. pretty epic for me and half my living and dead relatives. ive read all kinds of stories about "assisted suicide pacts" between parents and children dealing with dementia and they make me very sad. soon this burden will inevitably fall upon me, and then to my kin. pretty based. great disease.

:glomp:

It is one area in which the medical advancements are coming along & will prolly be useful by the time you're an old. One of the studies I read recently said vitamin D can help stave it off.

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Willa Rogers
Mar 11, 2005

Dreylad posted:

Yeah I have no doubt. COVID devastated these places. In Ontario they had to call in the army to help in a few residences. Privatization meant that old people were left in bed for over 24 hours without any check-in. I heard a few stories from a couple of relatives who work in the industry and it's terrible. My mother-in-law currently works in a nursing home and I'm convinced she's immune to COVID because she's been exposed like a dozen times because residents are transferred on to her floor and no one tells her or the other staff that the new person tested positive for COVID.

I still have 50 bookmarks from 2020 on the massacres in elder & congregate living, thanks to the governors who allowed for-profit nursing home owners to write their emergency executive orders.

There's a pulitzer there if someone ever has the stomach to write it.

Nocturtle
Mar 17, 2007

McCracAttack posted:

Not that it will do any good for folks in the US, but what are some countries that are handling this correctly? Or at least better?

I mean, I know it's silly to ask because the answers will involve healthcare systems and social safety nets we can only dream of.

This is something I'm wondering about. Are they any places that don't just leave it up to individuals to pay for incredibly expensive care? Or more realistically in the US context, most individuals don't pay for the necessary care because they can't afford it and instead receive inadequate care or no care at all.

Weka seemed to suggest that New Zealand capped aged care costs, which seems like a good start.

Weka posted:

Anyway I live in a country where the government does things so it's illegal to charge more than $800 a month for rest home care.
However looking into it and it appears the cap is more like $1250 NZD (~$750 USD) per week, or $5000 NZD per month (~$3000 USD).

quote:

Maximum Contribution Applying in Each Territorial Local Authority Region From 1 September 2022
Under section 53 of the Residential Care and Disability Support Services Act 2018, the Director-General of Health is required to notify the maximum contribution that applies in each region for long-term aged residential care.

The maximum contribution is the maximum weekly amount (inclusive of GST) that a resident assessed as requiring long-term residential care (through a needs assessment and service coordination agency) is required to pay for contracted care services provided to them in the region in which their rest home or continuing care hospital is located.

The maximum contribution is the same for all residents regardless of the type of contracted care services they receive.
It is equivalent to the rest home contract price applying to residential care facilities in each territorial local authority region.
It looks like the "District Health Boards" are responsible for paying the difference between the individual contribute and the real cost of care, so essentially the govt is covering a lot of the cost. It also looks like that people that can't cover the cost can receive a subsidy or loan.

Not sure if I'm getting the details right but at first glance this appears much much better than the US case, where average monthly nursing home costs can be up to ~$10000 and that might not even be a great level of care. Maybe there are downsides, for example capping individual costs might not necessarily translate into good care quality. Also worth asking whether such a care price-cap system could be implemented in places like the US or Canada.

Koishi Komeiji
Mar 30, 2003



Willa Rogers posted:

There's a pulitzer there if someone ever has the stomach to write it.

Why would you win a pulitzer for that? No one gives a poo poo about mass boomer death in old folks homes. That's why they got put there in the first place. It's also why no one lifted a finger to help them when covid hit.

damn horror queefs
Oct 14, 2005

say hello
say hello to the man in the elevator
Former premier of Ontario, Mike Harris, is the chair of Chartwell Retirement Residences, the largest for-profit retirement home provider in Ontario.

Covid-19 cut a swath through these homes and some 80% of all the initial covid deaths in the 2020 wave in Ontario were from Chartwell homes.

He personally gutted the public healthcare system during his tenure as premier and then profited off the deaths of seniors during the pandemic.

He was awarded the Order of Ontario in 2020 and has suffered absolutely no ill consequences whatsoever from his lifetime of enriching the wealthy at the expense of the public purse.

Seniors are hosed. So are the rest of us.

Smythe
Oct 12, 2003

Willa Rogers posted:

:glomp:

It is one area in which the medical advancements are coming along & will prolly be useful by the time you're an old. One of the studies I read recently said vitamin D can help stave it off.

drat i hope so lol

Willa Rogers
Mar 11, 2005

drat horror queefs posted:

Former premier of Ontario, Mike Harris, is the chair of Chartwell Retirement Residences, the largest for-profit retirement home provider in Ontario.

Covid-19 cut a swath through these homes and some 80% of all the initial covid deaths in the 2020 wave in Ontario were from Chartwell homes.

He personally gutted the public healthcare system during his tenure as premier and then profited off the deaths of seniors during the pandemic.

He was awarded the Order of Ontario in 2020 and has suffered absolutely no ill consequences whatsoever from his lifetime of enriching the wealthy at the expense of the public purse.

Seniors are hosed. So are the rest of us.

80 percent of minnesota's initial covid deaths were in nursing home; 60 percent of pennsylvania's.

Other congregate living situations--prisons, agricultural dorms, group homes--were also hit hard.

And the isolation imposed on congregate living situations for the elderly & developmentally disabled meant that there was no gatekeeping/watchdogging against abuse, whether from in-person state inspections or family members (who are usually better at whistleblowing than the regulatory captive state agencies).

Even now, three years later, thinking or reading about this is incredibly distressing, more so bc it's been memory-holed.

lumpentroll
Mar 4, 2020

Smythe posted:

drat i hope so lol

can you even pass a cognitive now?

Pepe Silvia Browne
Jan 1, 2007

Pepe Silvia Browne posted:

my grandma just got out of the hospital with COVID and Pneumonia. She's coming up on 90 soon and seems to have lost a lot of joy from her life, she basically constantly talks about how she was ready to die in the hospital and kind of expected to. kinda sucks that she can't just choose to OD on heroin in a safe way imo.

thread update: grandma dead, glad she's no longer suffering
https://www.youtube.com/watch?v=VMYAEHE2GrM

ArmedZombie
Jun 6, 2004

https://www.youtube.com/watch?v=HDiLfQUBnyA

Harold Fjord
Jan 3, 2004
When I was in Medicaid administrative law judge regularly heard various issues surrounding long term care for seniors and disabled adults.

The rules aren't that complicated but local agencies love to gently caress them up and not give people benefits they are entitled to. Don't even get me started on the private companies charged with ensuring everyone is cared for as cheaply as possible

TehSaurus
Jun 12, 2006

a boomer, sowing: hahahaha yes!

a boomer, reaping: this sucks what the gently caress

seriously though with the ever accelerating pace of climate change I’m quite confident that elder care will not exist by the time I need it in thirty or so years. assuming I’m not dead already, that is.

sucks how even the most benign measures like legal assisted suicide are somehow perverted to (literally, for once) murder the poor and disabled while enriching those at the top of the pile. someone should do something

Skinnymansbeerbelly
Apr 1, 2010

Medicare tests a solution to soaring hospice costs: Let private insurers run it posted:

For the last four decades, Medicare has covered hospice services – including grief counseling, spiritual support and pain management – for terminally ill people. The benefit has helped more than 25 million Americans die more on their own terms, often at home, with the support of chaplains, social workers, nurses and others.

Research shows hospice can reduce unwanted medical interventions, improve families' satisfaction and, in some cases, save Medicare thousands of dollars.

Now Snider and others believe this popular benefit, whose structure has remained largely unchanged since its debut in 1983, is in the early days of an inexorable overhaul. Critical aspects of the 40-year-old policy no longer fit the needs of the people using the service – or the providers delivering it. Concerns about access, fraud and runaway costs – which topped $20 billion in 2019 – dog the program.

In response, Medicare has begun a federal pilot project to test handing the reins of some hospice care over to private insurers, giving them more flexibility to reign in costs while also expanding access. The experiment, which began in 2021, involved several thousand patients in its first year, but multiple experts told Tradeoffs they believe it is likely to eventually become national policy and reshape the hospice care available to roughly 30 million Americans.

...

The other major shift being tested is an expansion of hospice's eligibility criteria. Private insurers can choose to offer hospice care to people still pursuing chemotherapy or other curative treatments – and they can offer some services to seriously ill people with more than six months left to live. They can even give patients additional funds for nontraditional help, like carpet cleaning and rent – two uses Humana's McComic said the insurer has tested.

The privatization is obviously a scam, but I think expanding eligibility to people still under treatment is a great idea because right now dying patients are incentivized to avoid hospice until the very last moment.

bedpan
Apr 23, 2008

no idea how someone explicitly in the game for making as much profit as quickly as possible is going to address "soaring" costs

Willa Rogers
Mar 11, 2005

The feds have filled the insurance troughs via ACA & "Medicare" "Advantage" and by privatizing Medicaid so I guess we should've expected insurers to find yet another way to fatten themselves with taxpayers' money.

And of course it's under the auspice of "fraud" even though the most fraudulent schemes have been under MA.

actionjackson
Jan 12, 2003

my parents are both at the upper age limit of boomers, my bad was literally born jan 1946, my mom july 1948

I don't think my dad will be around for many more years just based on family history and health conditions. But it's possible of course. On the other hand, my mom's mother and grandmother lived to 91 and 99 respectively, so I expect she'll stiill be around for another 15+ years. They do have long term care insurance, but I don't know all the details. She was a public school teacher and retired at 55 with a full pension, and they've had plenty of money to go on fancy trips since they retired almost 20 years ago. I'm an only child and don't have children, so it is a bit nervewracking.

TehSaurus
Jun 12, 2006

actionjackson posted:

my parents are both at the upper age limit of boomers, my bad was literally born jan 1946, my mom july 1948

I don't think my dad will be around for many more years just based on family history and health conditions. But it's possible of course. On the other hand, my mom's mother and grandmother lived to 91 and 99 respectively, so I expect she'll stiill be around for another 15+ years. They do have long term care insurance, but I don't know all the details. She was a public school teacher and retired at 55 with a full pension, and they've had plenty of money to go on fancy trips since they retired almost 20 years ago. I'm an only child and don't have children, so it is a bit nervewracking.

sorry homie. that sounds likely a tough position to be in. wish this wasn’t hellworld

Turtle Sandbox
Dec 31, 2007

by Fluffdaddy

Weka posted:

I didn't read that whole article but do you really need a qualification to wipe an old nutters arse? Just get a nice illegal immigrant to come and stay with you or something.

Anyway I live in a country where the government does things so it's illegal to charge more than $800 a month for rest home care.

I have no qualifications other than being family, but I'm currently to full time caretaker of my parkinson's the and dementia riddled grandmother.

Pays better than any job I've had the last decade and it's still a bargain based on cost of in home care or a memory care facility that won't just let her rot due to negligence.

Good thing social bonds are super strong in this great land of ours...

actionjackson
Jan 12, 2003

TehSaurus posted:

sorry homie. that sounds likely a tough position to be in. wish this wasn’t hellworld

I mean it might be fine, I have no idea. I'm still pretty lucky overall, because as I mentioned my mother got a full pension, and my dad had a relatively high paying job (though he retired earlier than he wanted to).

Nocturtle
Mar 17, 2007

I was curious about the aged care situation in different countries. There's some surprising variation though it appears individuals are generally responsible for the costs with varying degrees of state support:
-United States: individuals must pay, medicare/medicaid will pay an inadequate amount if someone doesn't have enough income or assets
-Canada: province dependent, individuals generally pay costs but for example in Ontario the "co-payment' costs are capped
-UK: people generally must pay for their care themselves but local councils will cover the costs if someone doesn't have enough assets
-Australia: individuals must pay but the govt will cover the costs if someone doesn't have enough income or assets
-New Zealand: individuals must pay for care but the maximum amount any care home is capped and district health boards cover the outstanding costs. Also support for low income, assets people.

It looks like New Zealand is the only state that limits what care homes can charge ever. Probably getting some of the details wrong, the financial details can be confusing IMO.

There's a cost overview on wikipedia too.

A quote from the UK aged care page I found:

quote:

Dementia Care
Leading UK dementia charity Alzheimer’s Society estimates that the cost of care for someone suffering with dementia resides between £100,000 and £500,000 a year, more than ten times the cost for regular elderly care.

This is because patients that suffer from dementia may require more attention than others, subsequently demanding more skilled staff with appropriate levels of expertise.
Guessing most people need the council to help pay for that.

wash bucket
Feb 21, 2006

actionjackson posted:

I don't think my dad will be around for many more years just based on family history and health conditions. But it's possible of course. On the other hand, my mom's mother and grandmother lived to 91 and 99 respectively, so I expect she'll stiill be around for another 15+ years. They do have long term care insurance, but I don't know all the details. She was a public school teacher and retired at 55 with a full pension, and they've had plenty of money to go on fancy trips since they retired almost 20 years ago. I'm an only child and don't have children, so it is a bit nervewracking.

I'd recommend you and your parents sit down and talk about all this well before it becomes a pressing issue. Talk about their wishes, what you're willing to do, financials, etc. It's easier to have these conversations ahead of time instead of when you're in a hospital waiting room wondering, "Well what are we going to do now?"

actionjackson
Jan 12, 2003

McCracAttack posted:

I'd recommend you and your parents sit down and talk about all this well before it becomes a pressing issue. Talk about their wishes, what you're willing to do, financials, etc. It's easier to have these conversations ahead of time instead of when you're in a hospital waiting room wondering, "Well what are we going to do now?"

for sure, I already have a bunch of paperwork, I just need to look it over some more

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Nocturtle
Mar 17, 2007

Turns out this thread topic is obsolete, Biden has taken action to address the long-term care problem:
https://twitter.com/WhiteHouse/status/1648458482474180608
The order is long and I don't really understand it but I think it amounts to directing agencies to check if any discretionary funds can be used to provide long-term care benefits to federal workers. No actual specific money is being directed to address long-term care costs.

It's a good thing that Biden did this because long-term care costs are bad. Here's a nice webpage that allows you to see how much various long-term care options cost in your area, if you're in the US:
https://www.genworth.com/aging-and-you/finances/cost-of-care.html
Note that this page is produced by a company that provides long-term care insurance and retirement related financial services. They're kind of saying "look how expensive long-term care can be (so buy some of our insurance)". That being said the median nursing home cost in my area is apparently ~$13000 a month. Would say it's weird that necessary old-age care is apparently a luxury good, but it's honestly not that weird in the American context.

Nocturtle has issued a correction as of 18:58 on Apr 19, 2023

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