This is more fallout from the zero risk mentality that has permeated our society.

Eldery people must be *protected* at all costs, including being immobilized with drugs for both their own good and so the mega billion dollar nursing home industry can be allowed to extract any of their remaining assets.

This is where all the elderly are headed unless you have loving younger relatives, and friends who will save you from this fate.

I guess that is why all you childless people are pushing so hard for assisted suicide. You believe it gives you control over your own destiny.

Aren't most people in nursing homes there because their children PUT them there?

A childfree old person at least has a decent chance at being left alone to die in peace, especially if they don't have much money.

"Aren't most people in nursing homes there because their children PUT them there?"

Your children cant put you in a nursing home, unless you agree to it.
And unless you have lost control over your affairs, because you are not of sound mind, you would have to agree.

Better beware the bureaucrats and busybodies in the Department of Human Services, though.

I push for assisted suicide becasue

A) its a persons right to die on their own terms
B) there are too damn many H. sapiens sapiensrunning around
C) I advocate for all non violent population control measures

But I plan on killing myself before I the need help to do so

So my grandmother, who has loving younger relatives who saved her from that fate for years until she broke her hip and was unwilling/unable to recover her mobility afterwards, has been cared for in the nursing home for the past year. Because at least there she won't fall and hurt herself anymore as she needs 2-person assist to do anything. The problem I see with nursing homes is that the care is being handled by a fruit basket turnover of people who aren't that qualified. The administration in the homes needs to pay them better, to be able to weed out the bad employees, reward the good ones. Medicaid/Medicare needs to pay more for the care. If they did, then over-medication would not be a problem. Most of all, though, every person needs loved ones who see about them daily. Because it is they who understand immediately when something is wrong. I don't see that over-medication is a widespread problem. Just be involved in your loved ones care. That's the biggest thing I can vouch for.

The administration in the homes needs to pay them better

So pay them more money for your grandmothers care already, so they can pay their employees more

Medicaid/Medicare needs to pay more for the care

Fuck you, I already pay to much for your grandmothers care, pay more yourself asshole and stop expecting me to do it via more taxes.

there are too damn many H. sapiens sapiens running around ~ Posted by: lujlp at December 11, 2014 11:39 AM

It always irks me when someone says this. It smacks of smarmy self-righteousness.

First of all, if one is so sure there are too many homo sapiens on the planet, one is free to immediately reduce the number by one and set an example for the rest of us. However, the one making that statement usually feels that the gifts he bestows upon the world are too important to be lost to mankind and others should be the ones to depart in his place.

Second, I always wonder if the person saying something like that intends to reduce the number of homo sapiens on the planet by force. That (and the self-righteousness of the statement) makes me want to avoid such a person.

Third, it smacks of Malthusian delusions of limited resources and a lack of ability (in mankind and the planet) to adapt to changing conditions.

Fourth, it's the first step in implementing authoritarian policies such as One Child in which government bureaucrats are empowered to act against their fellow man in order to "save" the planet with no restrictions on their actions due to the urgency of their mission.

We're warehousing our (usually drugged) children in government schools, why not warehouse our parents in old people warehouses?

It always irks me when someone says this. It smacks of smarmy self-righteousness.

I do it based on numbers, name one species of mammals that has nearly ten billion individuals.

Hell name one species on an order of complexity higher than an insect, or a fish that does.

Humanity can survive quite readily at less than 0.01% of our current numbers

Humanity can survive quite readily at less than 0.01% of our current numbers

Posted by: lujlp at December 11, 2014 2:38 PM

Lead by example lujlp. You go first.

One of several billion wont change anything, which is why I said I support all non violent population control methods

"One of several billion won't change anything"

Gotta start somewhere!

Right, someone always gets mad and says, 'You go first' because they take it personally, as opposed to seeing when something is simply an observation about math.

I agree with lujlp completely. No, I'm not going to kill myself, because it wouldn't make any difference. And no, I absolutely do not advocate reducing the human population by force or in advocating authoritarian policies like One Child. There are many (too many, in my view) statists in this world, and I am not one of them.

It took us tens of thousands of years to get to one billion people, back around the year 1800. Another 100 years to reach two billion. But we've added 5 billion people in the last 85 years and the planet is not getting any bigger. I think "infinite growth" is the delusion.

But no, I'm no advocate for forced sterilization or any other Orwellian solution. I'm perfectly content to live out the remainder of my life as best I can and then leave the rest of humanity to its own devices. I'm not having children, so at least I am not making the problem worse, nor am I forcing offspring into existence to fight with ten billion other humans over the last drop of clean water.

It's true I don't have a rosy view of the future, but that is not a personality flaw - it's knowing how to use a calculator.

Maybe people will get smart enough (or uncomfortably crowded enough) to figure this out on their own someday - I don't know, nor do I particularly care, because I can't really do anything about it. But if it took a top-down One Child policy to save humanity, then humanity is not worth saving. They'll either figure it out on their own and live good lives with a sustainable population, or they won't. It's perfectly okay with me if humanity screws itself out of existence, and I'm content to let it do that, if that's what it chooses. I'm the last person to want to force anyone to do or not do something "for their own good."

I've taken various antipsychotics for about a decade.

Sometimes they make you want to kill yourself. Some because they make you suicidal but others because they make you want to grab a knife and slice your skin off.

I don't mind the experiences where I wanted to die because they made me delusional. That happens to me from time to time without meds so I'm used to it.

The ones that made me want to die because it was physically torturing my body and I wanted to slice my skin off or stab my legs to provide some relief is the stuff of my nightmares.

It feels like a chemical implosion in your fucking brain that is burning certain areas of your body and you kinda wanna cut that body part off as painfully as possible.

Fortunately I can articulate what is going on and get a script for some beta blockers, or some Parkinson's meds and titrate off the antipsychotic.

Now think about this, they love using this shit on people who can't talk much like autistics, elderly, and schizophrenics that don't talk much.

But if it took a top-down One Child policy to save humanity, then humanity is not worth saving. They'll either figure it out on their own and live good lives with a sustainable population, or they won't. It's perfectly okay with me if humanity screws itself out of existence, and I'm content to let it do that, if that's what it chooses. I'm the last person to want to force anyone to do or not do something "for their own good."

Posted by: Pirate Jo at December 11, 2014 3:32 PM

I agree, which makes it kind of curious when someone throws in a "too damn many people" argument in a discussion about how we treat our elderly.

It is a total non sequitur unless you are advocating for some sort of totalitarian Logan's Run solution to both problems.

Just as an FYI to anyone who has a loved one in a nursing home or assisted living facility, I have a friend who worked in an assisted living facility for many years and she told me that if your loved one suddenly starts acting differently, delusional etc...check them for dehydration or a UTI. Many elderly people either forget or refuse to drink enough water bc it is a hassle to use the restroom. Those two conditions can mimic dementia pretty quickly. My husbands' great aunt had become delusional and when we had her checked, it turned out she was dehydrated. Once she got enough fluids, she was back to her old self.

Just as an FYI to anyone who has a loved one in a nursing home or assisted living facility, I have a friend who worked in an assisted living facility for many years and she told me that if your loved one suddenly starts acting differently, delusional etc...check them for dehydration or a UTI. Many elderly people either forget or refuse to drink enough water bc it is a hassle to use the restroom. Those two conditions can mimic dementia pretty quickly. My husbands' great aunt had become delusional and when we had her checked, it turned out she was dehydrated. Once she got enough fluids, she was back to her old self.

Posted by: Sheep Mom at December 11, 2014 4:23 PM

My mother had a UTI after surgery about four years ago. She went from fine in the hospital to completely crazy for about a week in the rehab facility. She needed both antibiotics, and a transfusion before she was strong enough to come home.

She remembers almost nothing about the two weeks she spent in rehab.

Logan's Run is not the solution to overpopulation.

Death Race 2000 - that's a solution!

"Right, someone always gets mad and says, 'You go first' because they take it personally, as opposed to seeing when something is simply an observation about math."

He wasn't simply making an observation about math. He isn't read to die just yet, and so is taking this issue just as personally.

Medicaid/Medicare needs to pay more for the care. If they did, then over-medication would not be a problem. Most of all, though, every person needs loved ones who see about them daily. Because it is they who understand immediately when something is wrong. I don't see that over-medication is a widespread problem. Just be involved in your loved ones care. That's the biggest thing I can vouch for.

Posted by: gooseegg at December 11, 2014 11:45 AM

My full time job is staying at home to care for an immediate family member who is middle-aged, terminally ill, and on a variety of medications, round the clock, including an antipsychotic medication (for an off-label use) that causes delusions. A friend on the opposite coast is in a very similar situation with an elderly parent who has the same terminal illness.

In the last two months, I have slept elsewhere on only two nights, and those nights did not go well in ways I could have prevented had I been present. I am a lynchpin in her care, which requires at least two, ideally three people present at all times.

The family and friends who provide care and assistance need to know her intimately, because the intermittent delusions and dreaming while awake have her speaking articulately and intelligently about realities we need to piece together some times using personal references gained over years of knowing and sharing life with her. This is essential to giving her a coherent experience of existence, which is essential to her emotional and physical well being (upset people are less likely to voluntarily take medication, and lack of medication can result in unbearable pain and nausea). Not the same as dementia, but from what I've seen with elderly neighbors, instructively similar.

The family could afford professional caretakers, but it is not possible for strangers to care for her in a way that will allow her to be both conscious and content if left with strangers for even 8 hours a day - being unwell or even less capable does not make one undiscerning, but being discerning does not make one rational.

Most people are not this fortunate. If I live to old age, even I am unlikely to have this same support network (smaller family).

Hey luj, I never said we needed to pay more in taxes or specifically that you needed to. I said Medicare/Medicaid needs to REIMBURSE BETTER for these services. Comprehend that a little before you go cussing somebody out, asshole. I'm saying that's an underpaid job. If you saw what LPNs are doing for the squat amount their making, you'd say so too. Reform maybe? Better privatizing of that sector? It's a hard, expensive thing to properly care for the aging population. But I do strongly believe that they have paid in their taxes and should be able to have good quality care in their last years. We all should.

Gooseegg-where do you think reimbursement comes from? To reimburse more...means more of ALL of our tax money.

"I said Medicare/Medicaid needs to REIMBURSE BETTER for these services. "

Medicare doesn't coving nursing homes, and Medicaid reimburses what it does because it is a government program paid for with tax payer dollars.

Not only that but it doesn't even close to cover the cost of taking care of those people who are in nursing homes.
This is why the paying patients, those with savings are paying 8 thousand dollars a month or more and those nursing homes that are mostly medicaid patients are lousy shit holes.

'Aren't most people in nursing homes there because their children PUT them there?'

MIL is in a hospital and has been since she progressed far enough with Lewy Body dementia to need her throat suctioned out several times a day. She has a severe risk of aspiration and chocking. I took care of her before that, at home. first in her own home and then in mine, but she's too ill now. There are legitimate reasons for care in a facility. We avoided a nursing home because they generally suck, she's in a private hospital.

"The family and friends who provide care and assistance need to know her intimately, because the intermittent delusions and dreaming while awake have her speaking articulately and intelligently about realities we need to piece together some times using personal references gained over years of knowing and sharing life with her. This is essential to giving her a coherent experience of existence"

Yes! This is very important. There are four main people who care for MIL and they asked for information, so they can keep in step with her conversations. Whenever someone new comes into her delusions, I figure out who it is (because often she just yells 'Auntie!' or 'Sister!' when she wants someone) and we all talk to her about that person by name. I bring her photos if they exist and write up some of the family stories involving the person and have those in her room. It calms her, when people know what she's talking about.

Aren't most people in nursing homes there because their children PUT them there?

Reading between the lines, I assume the author of this comment means to imply that this is some sort of terrible decision. In which case, the author either has some sort of martyr complex, or else has not cared for a seriously disabled relative.

Take your elderly person with advanced dementia. Change theyr diapers, bath them, feed them like a small child, follow them around the house to make sure they don't do something dangerous - 24 hours a day, 7 days a week.

Let's go to the other extreme. Take a child, disabled from birth. The parents care for their child into adulthood and beyond; at a huge cost to their other children. The disabled child never learns to live outside the family. The parents will likely die first; leaving the adult child utterly stranded.

Alternatively, take your relative with advanced diabetes combined with a serious case of denial. Measure their blood sugar, give them their insulin shots because they cannot be trusted to do so, grab that candy bar out of their hand, meanwhile performing peritoneal dialysis because they've destroyed their kidneys, and holding your nose while you try to care for the gangrene on their feet.

I've seen all of these situations, some remotely, some up close and far too personal. Sometimes, if you don't put people in a home, all you are doing is destroying two, or three, or four lives.

Crella, that sounds great (all things considered).

ARG, good points - we're living through them now. We hid the iron, and after an early morning (attempted) drive, collected the car keys. I'm glad it's winter and that the extreme cold causes nausea - it's the one thing that has going outdoors alone for a walk be unlikely. The 'round the clock aspect remains.

Regarding care homes and federal/ state financed assistance, I think what's available varies by state. The place to start research is your Area Agency on Aging.

Michelle, I feel for you. It can be overwhelming.

Once the weather gets better, a dark carpet in front of the front door may stop ant escape attempts...with the visual disturbances of dementia, it looks like a hole in the floor, or similarly, a white curtain drawn across the door can make the door ' disappear'' should the rug prove frightening.

ARG, so right.

Reading between the lines, I assume the author of this comment means to imply that this is some sort of terrible decision. In which case, the author either has some sort of martyr complex, or else has not cared for a seriously disabled relative.

No, I was disputing Isab's claim that "This is where all the elderly are headed unless you have loving younger relatives, and friends who will save you from this fate."

Because as you illustrated so thoroughly, friends and relatives usually do not have the ability to deal with this. Just being able to lift someone in and out of bed, for example.

It's not just the childless people who would prefer to die before they get to this point. I would imagine that many people with children - BECAUSE they love them - would prefer to exit before they destroy "two three, or four lives."

I'm with luj - I'm going to make sure I don't last that long. Assisted suicide would make it easier and more comfortable, but people have been committing suicide without assistance for centuries. But that is still several decades away, at least for me.

"It's not just the childless people who would prefer to die before they get to this point. I would imagine that many people with children - BECAUSE they love them - would prefer to exit before they destroy "two three, or four lives."

You seem to think that a patient with Alzheimer's has some sort of * ah ha* moment where they realize they are losing their grip. And can take pro active steps to end their life, just like someone with terminal cancer can.

This is a dangerous fantasy.

And Pirate Jo, I don't see caring for my 90 year old mother as *destroying my life* I view it as her rightful turn to assistance and care, as she cared for her parents, me, and my children.

If I am fortunate, one or both of my children will do the same for me, if I need it.

This is what families are for.

Crella, thanks for the tips.

You're welcome, Michelle.

Michelle, do you have/know about the bed alarms available? They're a pad that goes on the bed, and it makes a sound if they get up in the middle of the night. Those just occurred to me.

Crella, I encountered them in the hospital (lived in one for about three weeks - long enough for the sound of alarms to be woven into my dreams) but didn't think to wonder whether there's a silent version available for home use.

Right now my dream purchase is a silent alarm system (even clock alarms) with a vibrating wrist band. I was only able to find one vibrating wrist clock-alarm on Amazon, and it got crap reviews. After the time and money I spent finding and buying what turned out to be a suboptimal vibrating alarm-clock, I'm wary of going down the internet search hole yet again.

By any chance can you recommend a silent alarm system with a wearable vibrating alert? Bonus if I could buy it through Amy's Mall.

Fortunately I can articulate what is going on and get a script for some beta blockers, or some Parkinson's meds and titrate off the antipsychotic.

Now think about this, they love using this shit on people who can't talk much like autistics, elderly, and schizophrenics that don't talk much.

Posted by: Ppen at December 11, 2014 3:37 PM

Ppen, your ability to do this is remarkable. I say this as someone who has watched my own loved one fight through pain, exhaustion, fear, and overwhelm to articulate her experiences and get medical personnel to cooperate with her long enough to verify her ideas about what is happening medically. She has often been right.

Between her experiences, my own two recent biopsies, and the stories shared by friends, I'm seeing that the barriers to communication, to quickly creating a working partnership with a health care practitioner to get and consider pertinent information, often takes something.

You often have insights into the cultural experiences that shape peoples' decision making processes. If you have any insights regarding the medical professional culture that could help outsiders such as myself figure out the terrain and take a better approach in communicating, I would appreciate the perspective.

Michelle, I'd have to look them up, I don't rememvpbervif they go off in the room,or over a monitor. It's been a while, I just remembered that they have something for home use. I will look around!

Thanks Crella!

Sorry Michelle my experience is limited to psychiatrists who are akward and Aspergery with inferiority complexes since their field is viewed as close to quackery by other MDs. Their technology, pills and treatment plans are stagnated in the 1950s.

All they are doing is giving me random pills and hoping we hit the jackpot and don't destroy my organs in the process. That's why I know I can redirect them in an indirect manner since they're just guessing themselves. But keep in mind I do not ever associate with public psychiatrists, who are jaded, uninterested in patients and will not comply with redirection.

My understanding is the majority of geriatric psychiatrists who prescribe antipsychotics in nursing homes fall under the non-compliant category. The few I've spoken to dont even know what pills I'm taking because they're too new.

Ppen, unfortunately the problems you've described are, or are similar to, problems I've recently encountered with other health care professionals. That might be due in part to our region's older population which came of age at a time when patients did not question the judgment or authority of doctors, combined with the fact that the primary diagnosis my family member received is one usually given to people age 70 or older.

I asked a neurologist about an antiemitic drug called emend, and he said, "I haven't heard of it - it must be herbal." I told him it was a pharmaceutical recently taken by a friend at a hospital before a surgery. Then I emailed him the pharmaceutical information and asked him to get back to me. I never heard from him again. (We were the youngest people in the waiting room.)

We've learned the hard way that a lot of the drugs prescribed can cause the very problems they're meant to alleviate - the zofran and compazine caused vomiting, ativan caused agitation. Haldol and gabapentin are my new favorite meds. There's a lot of guessing even when it comes to prescribing the old stuff.

Over the past several months of navigating health care bureaucracies and protocols, I've used a lot of what I've learned in Amy's blog, regarding the design of human beings, to understand and work with limits - mine and other people's. The interviews with the authors of the books on will power and on effective listening (and hostage negotiation) have been especially helpful.

The guy who wrote in about his dating life after losing his legal job - Amy's advice to him came to mind when I was laying on my back waiting to get my first biopsy. I'm over my needle phobia, but still need to manage for hypersensitivity. The guy who prepped me said he couldn't use topical lidocaine because the needles would be inserted so deeply that a topical cream would not numb the burning and pinching. Then he used the word "strangle." When he left the room I got off the table and found myself pumping my arms up in the air to boost my confidence and focus enough to advocate for myself. I was standing up, focused, when the physician assistant walked in to do the biopsy. I told him what I needed and why, asked him to remind me to breathe, and all went well. An understanding of basic economic concepts helped me make rational choices about diagnostic options after the first biopsy and the first round of the second biopsy were not adequate to be conclusive.

Your ability to redirect someone in an indirect manner takes the ability to assess someone else's mental terrain, including one's motivation/ what they find rewarding / how they see and want to see themselves. Knowing whom to work with and whom to skirt or release is a vital skill (one I took too long to learn). There's a lot that goes into doing what you do so well, and it's likely to be very useful as a transferable skill set.

Michelle, I found a bed alarm with a pager. That would seem to be the quietest option, unfortunately it's also the most expensive option, at $179.95 on Amazon. The others all have beeping monitors that can be heard everywhere, and you don't need that in a quiet house in the middle of the night.

http://www.amazon.com/Wireless-Monitor-Pager-Alarm-Patients/dp/B008UXZ608

Crella, thank you. I followed the link to the Jawbone fitness device Amy linked to on her blog, and noticed that it is compatible with something called the SmartThings Smart Home Starter Kit (the name should link to the Amazon listing, ideally through Amy's Mall, but this evening I just learned that today is the first day of Hanukkah, not the third, so I have to admit to being more bleary eyed/ less functional than I thought).

The sensor system seems both discreet and adaptable, which could be helpful. I hesitated before shelling out the money in the wee hours of the morning, too tired to research it much, but later this morning a family member slipped and fell before I even knew she was out of bed. She's okay, but she spent the day sleeping it off - so if this works it will be worth every penny.

Amy - thank you, for everything.

I really appreciate your comments Michelle. I too hope that biopsy went well.

I'm really amazed by the list of medications you provided. They're all hardcore stuff I wouldn't touch due to the side effect profile. But I see your relative is terminally ill and doesn't have
much choice.

Thanks Ppen.