This is a bit of rant.....

My uncle had polio when he was a child.  He wore braces and received treatment and grew into adult hood.   He held a very physical job until retirement about 8 years ago.

Once he retired he was diagnosed with RA.  The RA was painful enough he didn’t want to move, so he gained copious amounts of weight until his 5’4” frame reached 300 pounds.  Needless to say, he couldn’t walk.  He was confined to a wheel chair and needed a walker to use the bathroom.

My aunt, his wife, who has terminal lung cancer and is on chemo, was taking care of him.  As long as he could use the toilet by himself they struggled along.  They only called for help once, when he fell and she, two uncles and a cousin couldn’t lift him.  When they tried he screamed in pain so the fire department came, ignored his screams, and lifted him back into the wheel chair.

About 6 months ago he took a staph infection and was bed ridden.  There was no way my aunt who is sick as a dog from chemo can run in and change his diaper every few hours (the staph causes severe diarrhea).  The man can’t even roll over in bed and is very demanding.  He yelled at all hours of the night for my aunt to get up and come to him so she could hand him the tv remote.  Seriously.

The staff infection sent him to the hospital where they discovered his bladder is “dead” and put in a catheter which he will have for the rest of his life.  His kidneys only have 20% function, if they fall lower he will need dialysis every single day.  He has no control of his bowels (gross I know but there is a point to it) and he’s so large a metal lift is the only thing which can get him out of bed.  And finally, the staph he has, he will always have…they can’t get rid of it.

The Dr said there was no way my 140 pound chemo laden dying aunt could care for him.  They sent him to a nursing home and said when he can use the toilet on his own, he can go home.

A week later he was diagnosed with Post-Polio Syndrome.  Long story short, he will most likely not walk again, even on a walker.  Barring a miracle, he will never go back home.

The Dr’s say he can live another 20 years or so just like this.

I should include here that my uncle is smart like a fox and is still mentally clear and sharp.  His mind is willing but his body isn’t able.  His mouth is though, heh, but that’s another story.

Ok.

I began researching nursing homes.  I did my homework first and checked out ombudsmen sites, family complaint sites, and the Medicare site.  They each list nursing homes in a state and how they do on impromptu inspections, scheduled inspections, etc.

My uncle pays @$275 a day for basic care, then diapers, medication, gloves, soap, all that is added on.  So an average month is between $7500-$9000, for the sake of brevity I’ll say $8000 a month.

A side note.  My uncle saved his entire life for retirement.  He is now using all his retirement to pay for this care.  Which is as it should be.  His sister in law is also in the same facility, and she pays NOTHING.  She gets the same care, the same everything, but because she and her husband were careless with their money and never owned anything, her care is free.

Once his retirement is gone, my aunt must sell everything but their home and one vehicle and give 50% of the fair market value to pay his bill.  Once she dies then the house is sold to pay for his care.

This means they can’t leave anything of their substantial assets to their son and grandson.  People gave them all kinds of “ways to get around” this…but once consulting a lawyer these ways were discovered to be all talk.

So while they watch everything they ever worked for disappear, my uncle’s sister in law is receiving the same exact care in the same facility.

As you can imagine they are both lamenting working their lives away.  My aunt says people like her sister in law who never worked and lived off the system, is in the end as well off as people who worked hard their whole lives.

It’s hard to pay $7500-$9000 a month for something you know someone else gets for free, the same real estate so to speak.

So back to the nursing home.

We researched and visited and finally found the best nursing home in the area.

The place is beautiful.  Decorated by professional designers, a grand piano in the foyer of every floor, molding on top of molding, large plasma tv screens throughout, Starbucks coffee and treats FREE on every floor, a day care on the bottom floor, a beauty parlor, a barber shop, on and on.

What decided it for us was the internet research.  Of all the nursing homes with violations (and every single one in the country has them) we found the one which would cause the least harm.  Yes, you read it right.  The least harm.  They ALL seem to cause harm in some degree or another.

I thought maybe it was their area, so I started searching (out of curiosity) across the country.  It’s the same story.

When I visit my uncle and his sister in law, I stay for hours and sometimes the entire day.  Sometimes I come late in the day and stay well into the night.

The crux of the problem imo is nursing homes are for profit.  While that sounds good to the capitalist inside me, when it comes to actual hands on care, it doesn’t seem to be working.

How much would you charge to change a 300 pound man’s shitty diaper at least 5 times a day?  I am using the word shit because I can’t convey the smell, the utter repulsive odor of infected diarrhea that seems to be the norm in so many nursing home inhabitants.  And because shit is exactly what it is when handling a stranger’s defecation.

Back to the question.  How much would you charge JUST for that service?  Not to mention changing bedding, being a water jug gopher, a maid, bathing, cleaning up puke , rubbing lotion into dry skin, etc.  How much?

The average aid makes about $9-$10 an hour.  http://www.payscale.com/research/US/Job=Nurse_Aide%2c_Orderly%2c_or_Attendant/Hourly_Rate

So, the pay is not equivalent to the job.  And when messy jobs pay little money they attract what types of people?

It’s my observation that only two types of people will do this kind of work for this kind of pay.  The first, people who are truly compassionate and dedicated to the elderly.  I have yet to meet one of them, but I am sure they exist.  The second type are people who don’t seem to have any skills, some have not finished high school, they take the aid class and test, then start working.  Not out of any love for the elderly, but because it’s a little more than McDonalds.

Some nursing homes don’t do background checks.  Why?  Expense.

My uncle’s nursing home does background checks and uses that as a selling point for the home.  Yet, the aids are still what my aunt calls “scum bags.”

What does that mean?

Well, let me use the aids from the background checking nursing home.  The home with the least violations within a 50 mile area to my aunt’s home.  The one my uncle now occupies.

I have talked at length with the six aids who take care of my uncle over a 24 hour period.  I stand outside the door sometimes, when they don’t know I am there, and listen to how they speak to my uncle, who is in his “right” mind.

I also watch how they treat the others in their care.  The ones who have dementia, who maybe don’t know what is happening to them all the time.

Without exception, after the aids change a diaper, they throw the dirty thing up on the bedside table/tray while putting on a new diaper.  (They also do this with the jugs they empty the catheter bags into.)  Then when they leave they take it with them.  That is the same table the bed ridden EAT ON.

The aids talk down to every single person they help.  They speak to patients as if they are wayward children.  “Now Mr. D. did you go and shit in your diaper again?  I just changed you 30 minutes ago!  I should let you sit in it!”  (Of course most of the dialog is filled with double negatives, slang, and speech which screams…NOT EDUCATED!)

One man, with prostate cancer, was in pain from sitting too long in a wheel chair.  (Another thing they do is put people in wheel chairs and leave them ALL day.  Usually sitting in the hall, or out by the piano.  Nothing to drink, nothing to do, just sit.)  I was in the room when he buzzed and asked to be moved to the bed.  His answer?  “We’re busy getting everyone to the dining room, you’ll have to wait.”  So he did, but not before he puked up his breakfast from being in so much pain.  Then he sat in it until they came about an hour later.

My uncle’s roommate right now is dying.  He’s 96 and not lucid at all.  He often lays in shit for hours because the aids only check on him once in awhile.  He isn’t able to tell them he needs changed and doesn’t have family there to ensure he is changed.  So he gets no care.  But he still pays for it.

Another example.  My uncle’s SIL, Erma, comes across the hall on a walker every night to see him.  She is lucid, makes it to the bathroom, she just can’t take care of herself.  She came into the room and sat down and started talking to us.  Except it was all gibberish.  She almost fell out of her chair several times.  It was 10pm and I went to look for a nurse because no one was answering the call button.  (But most of the “sitters” (people placed in wheel chairs all day in one spot) were still up and sitting in the foyer.)  Couldn’t find a nurse or aid.  It took about 15 minutes to find the nurse and then she said “I’ll be down that way in awhile with the pill cart, I’ll check her then.”

I insisted she come RIGHT NOW.  I was pretty sure Erma had a stroke.  She came, checked Erma’s vitals and called an ambulance.  Erma did have a stroke and her blood pressure was 225/155.

Some aids steal.  My uncle was given some things for Christmas that are now gone.  He is bedridden and the only people who come into his room besides family are aids.

I could go on and on, but I think you get the picture.  And the sad thing about all this is, this is considered a GOOD nursing home.

So nursing homes are in it to make a profit.  Ok.  The problem is, supply (nursing homes) aren’t meeting demand (old folks needing care).  Add to that the fact a lot of people can’t afford $8000 a month for years, and the gov. gets involved and to some extent mandates pricing.  So the whole supply/demand chain gets jacked up.

I don’t know how to fix it.  But it does need fixing.

I do know with the type of money offered, the “dregs” of society seem to gravitate toward aid positions.

I’ve learned two important lessons with this experience.

1.      Long Term Health Care

a.     Helps defer the cost of a nursing home, and is cheaper if you buy it young.

2.      If you don’t have a family coming all day every day to ensure you are getting the service you pay for, a nursing home is not for you long term.

http://www.medicare.gov/NHCompare/Include/DataSection/Questions/SearchCriteria.asp?version=default&browser=IE%7C7%7CWindows+Vista&language=English&defaultstatus=0&pagelist=Home&CookiesEnabledStatus=True

http://www.ltcombudsman.org/static_pages/ombudsmen.cfm