Posted in Family, Life

This is No Way to Run A Health Care System

My back is aching again, after a long afternoon and evening of being my mom’s primary caretaker. I’m a little too old for this, I think. I can’t keep up with the physical demands of a personal care aid with medication-dispensing responsibilities thrown in for good measure. I’ve figured out how to put on a blood pressure cuff, so a machine can read my mother’s blood pressure and heart rate. I dispense medication which, thank God, I don’t have to sort out every week into a set of pill containers. I apply and remove pain and nitro patches and change wound dressings. I’m a pro with disposable rubber gloves and I don’t even want to say what I need them for.

My mother’s taking at least 10 different medications, especially for her blood pressure which is quite high in the morning, although it tapers off when the meds kick in. Without them she’d probably have a stroke. She also has bouts of senile dementia when she’s institutionalized (hospital or nursing home), although that clears up rather quickly once she’s home. Put her in a nursing home and you may as well just bury her. So, we’re trying to keep her home.

My sister has spent the last six months jumping through hoops to qualify my parents for Medicaid. This is the US government health insurance program designed for the poor. Unfortunately, longer life spans means that many elders – my parents for example – end up spending down their savings paying for health care and basic living expenses. Thus, my mother at 86 and my father at 91 basically have no more money for long-term elder care.

My brother and sister (and now me) have racked up some hefty bills, which we’re hoping the Medicaid program will reimburse. Once the massive amounts of of paperwork have been hauled off and filed, we should be able to start with round-the-clock assistance that won’t come out of my back or my pocket.

I’m absolutely appalled at what Medicaid puts you though to qualify for assistance. Some people end up having to wait for up to a year and even then make endless rounds of phone calls to various agencies and private contractors just to keep things moving along.

Then there’s the stuff that each person is allowed to do. A health care aide can’t handle medication of any kind (prescription or over-the-counter). They can’t even put protein powder into a beverage or item to eat. An aide can help a person ambulate, move from a sitting to a standing to a laying position. That person can also wash and dress a person. My mother needs that, plus four rounds of pills a day, in addition to other meds she takes separately. She needs her blood pressure taken 2 – 3 times a day. She has three or four different types of eye drops, since she recently underwent corneal transplants to correct her vision. Oh, and the aide can talk to the person, to keep them mentally active.

Oh, but here’s the best one: an aide cannot assist a person if they have fallen to the floor, or have been laid onto the floor by that aide. My mother has suffered a number of falls in the last few months. She gets dizzy and faints then…CRASH! It’s off to the hospital, the nursing home and a pile of misery, for us and especially for her.

It’s difficult for me to see my mother in pain. She’s recovering from a vertebrae fracture in her lower back and is in constant discomfort. It’s improving, but it’s pretty sore most of the time now. In-home physical and occupational therapy, which we do receive via private insurance (I think…) leave her weak and exhausted. It’s important to her recovery, though.

So, here’s a question: how do other countries deal with long-term elder care? What about you, Australian readers? Any Brits out there? Canadians? Folks from Europe? Great Britain? I’m very curious to know what other countries besides the US do to make sure their senior citizens live long and healthy lives without bankrupting themselves and/or their children.


Writer, Walker, Entrepreneur, baby-boomer

2 thoughts on “This is No Way to Run A Health Care System

  1. In India, it is slightly easier. Since the population is explosive, and the population is spread across social strata ranging from street-dwellers to multimillionaires, the options are varied. Government caters to the poor – government hospitals are almost free. Private doctor practice (“family doctors”) continues to exist, which caters to the middle class (our doctor has been serving our family from the time I was a baby and now I take my daughter to him when she is sick), and high end hospitals for the affluent.

    As for help, what I have noticed is that among the economically disadvantaged, family and friends do a lot to support the invalid. As the economics improves, help can be hired at all price ranges since India has an incredibly strong labor market. For a very nominal monthly payment, you can choose hired help for a variety of activities – “ayas” for the toilet functions, “nurses” for medicine dispensing, cooks, maids for housekeeping etc. My octogenarian grandmother on the average spends Rs. 10000/month on hired help (~$200 – sounds small in dollars, but the rupee is certainly the pushing edge of middle class), but she can afford it. Again, these hired help are most often not formally trained, but do it out of experience, which seems to work fine here.

    My grandmother recently had a heart attack. She could afford treatment in a reasonably priced hospital. For people who can’t afford it, there are lower level hospitals, which may not be fancy, but are good enough.

    We don’t traditionally have the concept of “nursing home” although, there are a few now, thanks to Western influence. There are “old age homes” where old people with no family or money can go. These homes obviously have in-house geriatric services.

  2. There is a great deal of effort to keep people in their homes as long as possible in Australia. With a doctor’s recommendation they can get Meals on Wheels, carers to bath them, someone to clean their house, do their shopping with them. The ambulance service will take them to necessary medical appointments. If they are on a full pension (poor) they get free eye glasses and medicines as well as doctors visits. Carers can give medication (usually they get packed into blister packs in the various doses for each day. I think carers would pick someone up off the floor if not too heavy, but in a lot of cases the ambulance is called for assistance. They don’t automatically take to hospital.

    Mum has gone into care and it is income tested. At the moment they are taking just over $500 a fortnight from her govt pension. When we sell her house she may have to pay more, but they are giving us time so that we don’t have to sell at a low price. We have applied to the govt and if they agree we won’t have to sell the house at all (our parents only thing to leave to their children)

    New laws are coming into next year to stop fire sales of houses. However we have a shortage of old people’s homes and to enter most of them a person has to be accessed as high care by the govt and then basically wait for someone to die to empty a bed. There are independent living villages, with onsite care which the more wealthy can buy into. The theory is that the unit will be resold when the old person dies and the money given back to the family, but it is not seen as an investment in any way!

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