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Now that I am in my sixth month of residence in a convalescent care facility I am prepared to offer up a very Republican solution to long-term medical care: Privatization.

The facility where I am currently residing charges a hefty $5500 a month to place me in a double-occupancy room with a shared toilet. The room offers no television and no phone service beyond that which the residents are able to provide. Compare this to the nearby Holiday Inn, which can somehow provide single-occupancy rooms with far more amenities for about a $1000 a month less. Things like internet access, a fridge and desk work area remains in a dream for me.

What the nursing home has in abundance is heat. I am talking about oppressive, thirst-inducing, sweat-generating heat. Somehow many residents still have to bundle up their elderly bodies against the cold.

In contrast, occupying a room at the Holiday Inn would allow me to pick a temperature more to my liking.  It would allow me blessed privacy and I could enjoy meals served at somewhere above room temperature, all for less money than it is costing me now.

I suppose I could understand the premium pricing of the long-term care at the home if I could see where the money is spent. But there is little evidence of investment when meals are served tepid and overworked aids respond to calls for assistance at a pace most charitably described as stately.  

I could even understand the high cost of a nursing home if special effort had been made to make the facility accessible to those with disabilities. Such is not the case. When my roommate and I are preparing to get ready for the day, it requires an intricately choreographed wheelchair ballet to avoid collisions. This is because most of the rooms lack sufficient space to meet the American’s with Disabilities Act’s guidelines of 10 feet for two wheelchair users. At present in my room there is no way a 10 foot circle could be delineated without striking a wall, a piece of furniture, a door, a wheelchair or a patient.

Nor is the lack of space in rooms the only apparent violation of ADA policy. The doors to several restrooms are considerably narrower than standard. It is possible to squeeze a wheelchair through the doorway but navigating to a urinal is well-nigh impossible. Rookie physical therapists have expressed astonishment that some of the doors in the facility are not automated. Once I finished laughing, I rubbed my thumb across the tips of my fingers in that gesture that has become a universal symbol for money.

My modest solution for cutting the cost of housing long-term residents in a convalescent facility obviously isn’t for everyone. Many who live here spend too much time in their own world to successfully live without supervision. But for those of us whose needs aren’t so great this could save money and help protect their mental health.

Originally posted to Left of Calvary on Wed Dec 13, 2006 at 07:23 PM PST.

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Comment Preferences

    •  Here's where we had my mom (3+ / 0-)
      Recommended by:
      SarahLee, murrayewv, dsjwriter

      It was designed for those who needed extra help, on a variety of levels. Has mostly one-room with private bath, but some room are a bit larger, and include a private shower. EVERY door in the place is wheelchair sized.

      EVERY sink is designed for wheelchair accessability.

      Has laundry room, with hair salon sink. Has greenhouse off the back, where a porch used to be.

      3 staff during day, 2 in evening, 1 at night, and I am here to tell you that person is UP and WORKING all night!

      Oh... for about 9-10 residents. I'm  not kidding.

      Yes, you could have your furniture in your own room. We had my mothers' dressers, and her cabinet with her glass collection. And some other stuff, too. All rooms have a window.

      3,000 sq ft up, 3,000 down for the owners and their offices. (Separate dwelling.) One person even has their dog in their room -- stroke victim.

      They change the decorations constantly, because they care. Group meals, possibility of games with staff or residents.

      I'm not saying "Move to it", but I sure as heck would if I wasn't getting frequent visits from local family. There is no where better than a city in the middle of a "rural" state, to find caring people.

      http://www.mothersandothershome.com/
      316.945.2028, Ask for Karen.

      Mothers and Others Nursing Care
      234 S. Anna St.
      Wichita, Kansas 67209
      Phone 316-945-2028

      Be good to each other. It matters. Bill Sali

      by AllisonInSeattle on Wed Dec 13, 2006 at 09:17:24 PM PST

      [ Parent ]

      •  Oh yeah, we yanked her out of another place (1+ / 0-)
        Recommended by:
        dsjwriter

        and then put her in here after extensive searching, both times.

        Be good to each other. It matters. Bill Sali

        by AllisonInSeattle on Wed Dec 13, 2006 at 09:20:22 PM PST

        [ Parent ]

        •  I knew this, I knew this, but now, woe is me . . (1+ / 0-)
          Recommended by:
          AllisonInSeattle

          and my mom.

          There is no where better than a city in the middle of a "rural" state, to find caring people.

          I knew this, but I could not pry my parent(s) out of the L.A., area, even though my mother, is, coincidentally, from northeastern Kansas.

          The choices in L.A. are so horrible, so dismal, so "middle ages," even worse (from what I've seen) than what our dear diarist describes. There are "better" places, even good places, but they all have very expensive price tags, or very long (2 years) waiting lists.

          "wrong" it's the new Right.

          by Green Queen on Fri Dec 15, 2006 at 10:07:31 PM PST

          [ Parent ]

  •  QE2 (10+ / 0-)

    There was a woman who lived on the QE2 in fine luxury. Her sons had done the math and figured that living on the QE2 and cruising the world was cheaper than a nursing home (and the medical facilities on the QE2 are very fine, indeed).

    I met another woman, British, Ann, traveling by herself on the QE2 at 93, who said the trip was cheaper than a UK nursing home.

    I'm not saying I'm in favor of privatization because I haven't done my homework, but I did once work at a county nursing home, and I'd take the Holiday Inn or the QE2 any day.

  •  If you are in a nursing facility (5+ / 0-)

    then I am assuming that you are in need of skilled nursing care, no?
    Not to be dismissing your valid complaints about the amenities, but skilled nursing facilities aren't apartments or hotels.

    Is there an ombudsman where you are living?  Sounds like you need a good advocate to address the concerns you are bringing forward.

    Good luck.  If I lived near you, I'd be over there to kick some ass on your behalf.

    Memo to James Carville: sit down and shut up!

    by Radiowalla on Wed Dec 13, 2006 at 07:47:11 PM PST

    •  This is all very fine and well . . . (0+ / 0-)

      But I was scared to death to leave my mom, even overnight, in the so-called skilled nursing facility where the hospital sent her after her second stroke. She would've died of mortification if nothing else. Believe me, you'd rather be in an old rickety Motel 6 on the second or third floor walk-up than in this place, which is called Astoria, in Pacoima or Sylmar, CA. Privatize, privatize, anything! (But not that place!) I brought my mom home tout suite, and though she is somewhat demented, she's lived a good two and a half years since the system put her in a room right next to the dumpster. You've got to have some self respect!

      "wrong" it's the new Right.

      by Green Queen on Fri Dec 15, 2006 at 10:16:31 PM PST

      [ Parent ]

  •  Recommended (2+ / 0-)
    Recommended by:
    AllisonInSeattle, AntKat
    We have similar struggles in Macon, where the Medical Center of Central GA is the monopoly bully against two Charter HCA hospitals and a third private hospital sitting defiantly on the corner of the medical center's property. The MCCG claims a monopoly on all trauma, cardiac and cancer treatment to the detriment of the community.
  •  A colleague of mine (8+ / 0-)

    did this study which was actually published in a scholarly journal.

    Bottom line was cruise ship was no more expensive than nursing home and could provide similar services that nursing homes did, except for those patients with the highest nursing needs, such as bedridden patients.  

    Got an issue, here's a tissue - Will & Grace

    by Flinch on Wed Dec 13, 2006 at 08:04:39 PM PST

  •  I sure wish the MSM would pick this up! (4+ / 0-)

    Thanks for this diary

    My mom had knee repalcement surgery 2 years ago and the room at the rehab facility had 3 patients, and not enough room to sit, had to stand to visit, 1 bathroom and all around dismal environment.

    *Needed* A Dem who can win PA-18 in 2008!

    by AntKat on Wed Dec 13, 2006 at 08:11:32 PM PST

    •  The MSM has covered this a lot (2+ / 0-)
      Recommended by:
      AntKat, dsjwriter

      unfortunately, the children of the elderly don't listen and learn the hard way as i did. My intention is to use the settlement from winning my case to create a blog for children of seniors. This blog would cut through the incredible red tape that makes understanding options nearly impossible. In  my opinion this is the really major problem. If a senior does not have an informed advocate they are doomed as nthe homes pick on them first.

  •  I thought of that (2+ / 0-)
    Recommended by:
    AllisonInSeattle, dsjwriter

    Some years ago, when my dad was in a nursing home. I would want it for myself---blessed privacy.  
    I hope you get to go home or to a better place; here, one option is an assisted living facility. It is much nicer and has more privacy, but less help.
    It might not suit your needs.

    War is not an adventure. It is a disease. It is like typhus. - Antoine De Saint-Exupery

    by Margot on Wed Dec 13, 2006 at 08:20:01 PM PST

  •  Not a bad idea! With some visits from health (2+ / 0-)
    Recommended by:
    AllisonInSeattle, dsjwriter

    care aides you might actually do a lot better! Interesting how systems get so mucked up that they cost more than a much better system.

    I sympathize about the heated rooms driving you nuts. You didn't say that but that's how it'd make me feel. I hate getting overheated. For me, after a certain age my thermostat got out of whack and there's nothing to get me upset like being too hot, especially when it's cool out.

    It sure would be good to get this into the newspapers if possible.

    We will never eliminate poverty in America unless we do it comprehensively and nationally....no more incrementalism. - John Edwards

    by Gorette on Wed Dec 13, 2006 at 08:27:52 PM PST

  •  I had a case at work where a 45 year old with no (2+ / 0-)
    Recommended by:
    AllisonInSeattle, dsjwriter

    short term memory was in a skilled nursing facility completely payed for by MediCal.  He was moved in 2002 to a private facility dedicated to rehab of persons with brain injury.  One RN on staff, who was not there at night.  The rest of the staff were LVNs and CTAs (20 hrs. of training requiredz).  Cost was $636/day.  The facility did not accept MediCal.  

  •  Similar facilities do exist in real life (2+ / 0-)
    Recommended by:
    AllisonInSeattle, dsjwriter

    My mother-in-law is a resident at a facility in a large 250 facility chain that is operated by Holiday Retirement Corp.

    My mother-in-law's facility is an absolute marvel. Wonderful facilities and great management at a remarkably reasonable price.

    There are very clean and attractive studio apartments available with housekeeping and full meals for as little as $1000/mo. Yes, that is right. $1000/mo. for a lovely room and 3 good meals/day. Rentals are month to month. No long leases.

    Each facility has about 100 apartments and a common kitchen/dining area. Everything is fully procedurized and designed. Two couples work in shifts as live-in managers 24/7/365.

    Residents can book space at any other facility on the continent for up to 10 days for free. Visit the kids, but retain your independence. Some residents have RVs and make regular circuits around the grandkids.

    The trick is that the facility does not provide any medical care. It proves that lodging and services can be provided for seniors very reasonably. It is the medical service that costs an arm and a leg. However, although it explicitly does not offer any medical care, it doesn't object if residents make private arrangements. We contract privately with a care-giver. The combined cost is a small fraction of a competing full-service nursing home.

    I can't say enough good about the facility and the company. I think it validates the premise of the diary.

    Disclaimer: I have no affiliation or interest in Holiday Retirement Corp, except my mother-in-law's residency.

    -2.38 -4.87: Maturity - Doing what you know is right even though you were told to do it.

    by grapes on Wed Dec 13, 2006 at 09:55:59 PM PST

    •  hmmm, but 1000 bucks? That's less than . . . (0+ / 0-)

      I'd pay for a shack next to the railroad tracks here in California.

      Anyway, I think the point is that people, everyone, do/does eventually need medical care, and lots of it. One chain, here in California, Sunrise (I think they are national actually) operates with what they call a "hospice waiver." That is to say, you can live there, an "assisted living facility" and eventually die there, but all of what is in fact the "extra care" needed is contracted out to third parties, and billed to self/family whatever.

      But I think this raises a totally relevant point. So much of what is NOT really good medical care at nursing homes is of the CYA variety (cover your ass). Personally, I have a special bone to pick with people who dump their soon-to-be-ancestors in nursing homes and then sue when they discover "neglect." Such suits, and the CYA activity that results really does serve to both raise the cost of nursing home care, AND lower the expectations of everyone involved. Real "care" suffers, and Judge Judy should send these suing children to nursing homes to spend a couple of months. (But please, no one attack me. I know there are lots of people who for whatever many reasons cannot take care of their old folks, and that there is lots of genuine, flagrant inexcusable neglect out there.)

      "wrong" it's the new Right.

      by Green Queen on Fri Dec 15, 2006 at 10:37:06 PM PST

      [ Parent ]

  •  Folks, this guy's diaries are incredible (1+ / 0-)
    Recommended by:
    dsjwriter

    Do yourself a favor and go read them.

    W.O.W.

    Congratulations, sir, you really can write.

    Be good to each other. It matters. Bill Sali

    by AllisonInSeattle on Thu Dec 14, 2006 at 12:25:42 AM PST

  •  The Overheated rooms is to cause Dehydration (1+ / 0-)
    Recommended by:
    dsjwriter

    My guess is, based upon your description where you are, you are in a "for profit" facility. These facilities are the new normal and major conglomerates like General Electric are the owners.

    I should know. My father had a massive coronary which lead to his death during the only 10 days in 3 years I was out of town and could not visit him.

    Why would patients be purposefully dehydrated? Because it leads to a host of other problems, the most common being ulcers on feet, limbs and buttocs - even the healthy ones. When the ulcers are bad enough (can take between 3-5 days) the patient is sent to a hospital for testing - a three day stay. This 3 day stay automatically kicks in an extra $100 a day for 6 months to the facility - which goes to the bottom line.

    For Profit homes have the highest mortality rates as well as the highest number of lawsuits by family members. I won mine, but I would gladly give it back double to have my father, who I loved dearly, back.

    Currently Erin Brokovitch has made this her new crusade. She is filing a class action suit in California - where I live - and Medicare has joined her in the suit as they are obviously being ripped off by the worms that run these homes.

    I am not trying to scare you. On the contrary, I have learned to have and hold seniors and all others in homes with the highest respect. My advise, however, is to research the group owner where you are and their history of litigation. From what you have described, which I have seen way to often, its a place like the one you are in that is the most deceptive. You might want to high tale it out of there based upon what you learn. Best of luck.

    •  Good info. Thanks, and I love E.B. (0+ / 0-)

      Fortunately (and also somewhat unfortunately) I have not yet been able to, or disposed to check my 92 year old mom into a nursing home (her doctors have long been quite willing).

      This diary seems to be developing into my support center. Keep posting comments!

      "wrong" it's the new Right.

      by Green Queen on Fri Dec 15, 2006 at 10:41:46 PM PST

      [ Parent ]

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