Friday, August 22, 2014

Where's The Transparency? Who's Really Protecting Our Older Population?

Another part time job ended and I'm back making applications. Daughter still has a job but we both need to be working to keep our home, put food on the table and just provide for the everyday bill paying.

Thoughts return about what we, daughter and I, gave up to be full time care givers. Not an ounce of regret but frustration with how we couldn't get support or assistance and we tried, how we tried, so many agencies and so many "systems". It was a full time job, seeking to find ways to try to provide for two progressively medically challenged people.

Time after time we were told the organization had only one hour of "respite" they could provide, ran out of money for whatever we requested (including assistance with getting the incontinence supplies Mom needed and was using at a rate that purchasing across the counter was taking away from what we needed for shelter, food and transportation) and so many other exclusions, limitations and just plain lack of availability.

NEW THOUGHTS COME TO MIND:  each year people who qualify for Medicare receive an announcement about choosing a plan for the following year. They then have the ability to look over plans and make selections. What happens to this choice when someone enters a Long Term Care facility?  Who makes the choice? Is there a choice?

CARE PLANNING MEETINGS.  Why isn't there a directive, a regulation, care plan meetings have to provide a specified type of written report given to both the individual (if competent) and to the family members who attend? Many times we left with only the notes we took. And, we were basically told the meeting was "to make decisions" about Mom's care but we never received any written follow up saying what exact plan was put into place.

SCHEDULED AND EMERGENCY VISITS BY THE DHSS.  Why isn't there a mandated posting in a specific area within a facility where residents and family members are advised the State is on site doing an evaluation and inviting anyone interested in contacting them or speaking with them. Why isn't the State following up directly with responsible parties with requested reviews of the facility/ratings and inviting questions or inquiries at least twice a year?

TRANSPARENCY ON THE PART OF THE DHSS RE SERVICES AND BUDGETS for our elderly. I never could get a clear idea of what my State DHSS could/should be able to provide using Medicaid yet I know they had to have a list and that list had to have price tags attached. I always was told abstractly "Well, you're not quite at the level we allow for Day Care provision" or for whatever. Trying to get a budget, a schedule, a list of what we could try to get help providing Mom was never forthcoming.

PUTTING THE ELDERLY AT RISK AND THEIR FAMILIES.  Choosing to support through care in your home of an elderly relative comes at a high cost. Sure, there are people who abuse the system, but there are many more who care for the elderly, those of all ages with significant mental and physical limitations and challenges, who literally break their backs and their bank accounts trying to provide a semblance of quality of life.

What does society in general do? Turns their collective backs. Or, allows someone to enter into the situation and claim "elder abuse" or even "child abuse" without anyone with any real knowledge of the medical/mental challenges and that means more than working in "the field" or "having a degree". As with so much in life, there are self appointed "experts" who truly don't have a clue about what to do and are just putting in time and getting paid for doing it.

FAMILY COUNCIL.  According to Federal Law of 1987, each facility should have both a Resident's Council and a Family Council. In the State of Missouri, State Law itemizes a Resident's Council but makes no mention of a Family Council. Why not?  What about your State? Easy to access info on your State's regulations for Senior Care Facilities or call your local DHSS and ask them. Personally, I think we should all begin to flood our DHSS with emails, cards and letters asking for specific information about Eldercare in facilities.

DEMENTIA UNITS.  What specific laws govern these "lock down" facilities?  Are our elderly being treated like animals in cages -- "for their own good".  Again, go to YouTube and enter in Teepa Snow, an amazing advocate for the rights of people with Dementia. These facilities claim to be progressive but have you ever visited one?  Unannounced?  Try it some time.

RATIO OF STAFF TO RESIDENTS.  Based on medical "needs" assessed by the facility.  As we know from experience, the facility tries to assess their residents at far higher abilities than they actually have. Why don't you try waiting for twenty to thirty minutes to get help to go to the bathroom when you really have to go and see how this makes you feel. Ladies who've been pregnant understand when your bladder says go, you can't always say I need to wait any length of time. Compare it also to your water breaking -- did you feel comfortable about that?

BREAKS TAKEN "TOGETHER".  We noticed esp during the later evening hours staff would take their breaks "together" to socialize. When there are only two CNA's on duty and they both go together, how quickly do you think forty people will be assisted or even three or four of that group.

OLD PEOPLE ARE OUT FOR THE NIGHT.  Really?  Medical studies show as we grow older we tend to sleep less and sleep lighter. The only time I saw people "out for the night" was due to medications given specifically for that purpose or that had that as a side effect scheduled specifically for the later hour.



EACH OF US ISN'T GETTING ANY YOUNGER and when it's my time and your time, will we just be another statistic, another addition to the "growing aging population" so many believe are "milking our economy" and "costing more than we produced"? THAT'S AGEISM.