elder-care

NEWSHOUR: Has overmedicating seniors become ‘America’s other drug problem’?

An increasing number of elderly patients nationwide are on multiple medications to treat chronic diseases, raising their chances of dangerous drug interactions and serious side effects. Often the drugs are prescribed by different specialists who don’t communicate with each other. 

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five things i know for sure.

1) No one should be in jail for marijuana.

2) The quality of public education you receive shouldn’t be dependent on what kind of jobs your parents have.

3) Neither should your access to medical care. (And no one should have to throw a fundraiser because they get cancer, or hit by a drunk driver, or lose a limb in a terrorist bombing.)

4) Student loans are a crime and an expensive college education should not be a requirement for most entry-level jobs.

5) The way we treat old people in this culture is abhorrent. 

A Helping Hand

Tunkhannock, PA

My girlfriend’s 100-year-old grandfather.  He has a number of medical complications which have rendered him mentally and physically unable to take care of himself for several years now.  In many ways he is similar to a toddler, though here he wears a look of contemplation. The hand on the right is that of his daughter-in-law, my girlfriend’s mother, who does the bulk of the work looking after him.  It is difficult, but she continues, day after day, to do what needs to be done, including feeding him his daily medications.

I never met the man before his current state, so I’m left to hear a few stories about it and wonder.

© Pollux Rua, all rights reserved

See more from the photographer and follow at Concrete and Light

A Swan’s Eldest Granddaughter

He refers to her fifty year sojourn in the country where he was raised as “an adventure,” and he’s declared it to be over: her “adventure” is over, because she is almost ninety and her vertebrae are crumbling, her “adventure” is over, because she had one minor heart attack, her “adventure” is over, he is selling her home and making her sort through her belongings, fifty years of memories, taking away her private, personal space, her friends, he is downsizing everything and moving her to his island, the island where she was never happy, the island she lived on for eleven years, fifty years ago, in an unhappy marriage with a man who verbally abused her, called her lesser than, tried to convince her she was nothing, would never be anything-

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She’d created assisted living to help people like her mother, Jessie, live a better life, and she’d shown that it could be profitable. But her board and Wall Street wanted avenues to even bigger profits. Her battles escalated until, in 2000, she stepped down as CEO and sold all her shares in the company she’d founded.

They didn’t even recognize their ignorance in this regard. They might have called the service they provided assisted living, but no one seemed to think it was their job to actually assist him with living—to figure out how to sustain the connections and joys that most mattered to him. Their attitude seemed to result from incomprehension rather than cruelty, but, as Tolstoy would have said, what’s the difference in the end?

“Dressing somebody is easier than letting them dress themselves. It takes less time. It’s less aggravation.” So unless supporting people’s capabilities is made a priority, the staff ends up dressing people like they’re rag dolls. Gradually, that’s how everything begins to go. The tasks come to matter more than the people.

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We went to calyxaomphalos’s brother’s house to pot up some dracanea she’s been proliferating for him. She got her first one when I made her take one I had when I left CA.

The lovely older lady is Calyxa’s mom, Alice. Mom turned 88 last week. I first met her twenty years ago, the year Calyxa and her husband were married. She’s at the stage where forming new memories is getting tough and I had been told she would repeat questions. She did remember me and was just as amazed by my being a tattooed and modified person as ever.

I’m glad I got the chance to talk and joke with her, and she seems to be adjusting to her life changes fairly well.

Police lock up elderly in care crisis: Watchdog report reveals OAPs' ordeal
  • A 90-year-old dementia sufferer was held when carers phoned 999 after row
  • Another person aged 75 was detained despite health warnings from doctor
  • Taken into police custody after officers were drafted in by care home staff
  • Insider said it was becoming a ‘default option’ when carers could not cope 

Vulnerable pensioners are being locked in police cells when care home staff cannot cope with them.

A shocking official report reveals that a 90-year-old dementia sufferer was put in custody after he rowed with his carers and they dialled 999.

In another desperate case, a 75-year-old with multiple health problems was detained even against the advice of his doctor.

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The examples were uncovered by watchdogs investigating police treatment of the elderly, the mentally ill and children.

They found that frontline officers frequently took emergency calls from staff at hospitals and care homes.

And police often ended up dealing with the troubled pensioners because social service and NHS staff were not available.

Dru Sharpling of HM Inspectorate of Constabulary, which drew up the report, said custody was becoming a default option.

‘The public would be surprised to learn that police cells are often full of vulnerable adults and children, rather than suspects accused of serious crimes,’ she said.

‘I am particularly concerned to find that on occasions when officers were left with no other option, they resorted to detaining vulnerable people in police custody in order to get them the support they needed.

‘Each public service must fully discharge its responsibilities to ensure that police custody does not become the default option for vulnerable people in need of care.’

Home Secretary Theresa May called in the police watchdog last year amid concerns over the use of police custody.

The Inspectorate’s officials studied five police forces across England and Wales, as well as in three London boroughs, and found that elderly people were being detained because there was nowhere else for them to go.

The 90-year-old dementia patient was arrested after being violent toward staff and damaging property.

He spent the night in a police cell after refusing to leave the home voluntarily. Officers found him a hospital bed the following day and took him there by squad car.

Overall, the report concluded that taking elderly people, children and the mentally ill into police custody was the wrong approach in many cases.

Officials said it had a ‘detrimental impact on their health and wellbeing’.

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Experts praised the compassion of officers but pointed that police were largely trained to deal with criminals.

There were also questions over whether a lack of investment in care staff training and the increasing use of agency workers had led to increased pressure on police.

Caroline Abrahams, of the charity Age UK, said: ‘If all the services supporting older people with health and care issues like dementia were working effectively, it would be very unlikely that these kind of crisis points would be reached.

‘The report shows examples of health and care services failing to accept their statutory responsibilities and failing to co-operate effectively.’ 

George McNamara of the Alzheimer’s Society said: ‘It is deeply worrying that the police are becoming an arm of social services.’

And Dave Tucker of the College of Policing said officers were too often the first resort. ‘The decision to arrest a vulnerable person is often taken reluctantly by police officers,’ he added.

‘The report highlights examples where officers feel they are often left with no option but to take people into police custody as a place of safety because there is no alternative health care provision, this includes young people and the elderly.

‘A police cell is not an appropriate place for someone suffering a mental health crisis of any age, and certainly not a vulnerable person who hasn’t committed a crime.’

Last year the Daily Mail revealed that police are routinely being called to restrain dementia patients in care homes because poorly trained staff cannot cope.

CHILDREN ARRESTED BECAUSE THEIR PARENTS CAN’T COPE

Police are increasingly being called out to discipline unruly children, with experts blaming a breakdown in traditional families for the increase.

Officers have been called to homes by parents left unable to cope after seemingly minor incidents such as a row over a TV remote, the HMIC study revealed.

In one case a 13-year-old boy was arrested for common assault for attacking his sister, 11, while another boy, 17, was arrested for pushing his stepfather and damaging the garden fence.

A girl was arrested after rowing with her sister over the remote control for the TV, and a 15-year-old girl was taken into custody when she attacked her mother during a meeting at school.

Some experts suggested that the increase could be explained to single mothers being intimidated by their own teenage children, and a breakdown in extended families where grandparents were traditionally used to help guide youngsters.

Others blamed the police’s target-driven culture which leads officers to take a 'blanket’ approach to any incidents classed as domestic violence - meaning they are keen to arrest someone even if the only 'suspect’ is a child.

… researchers at the University of Minnesota identified 568 men and women over the age of seventy who were living independently but were at high risk of becoming disabled because of chronic health problems, recent illness, or cognitive changes. With their permission, the researchers randomly assigned half of them to see a team of geriatric nurses and doctors— a team dedicated to the art and science of managing old age. The others were asked to see their usual physician, who was notified of their high-risk status. Within eighteen months, 10 percent of the patients in both groups had died. But the patients who had seen a geriatrics team were a quarter less likely to become disabled and half as likely to develop depression. They were 40 percent less likely to require home health services.
— 

Atul Gawande,

(2014-10-07). Being Mortal: Medicine and What Matters in the End (p. 44). Henry Holt and Co.. Kindle Edition.

I went downstairs to get some water, and gran has continued to talk. She’s been talking for hours at a time for about two weeks now. Slurred nonsense, mostly, but also heartbreaking things about her mama and daddy. Mom said she talked for 10 hours straight today. That’s not unusual.

If you speak with her, she has a hard time understanding you, and sometimes her words make sense but often they don’t. You can ask her to rest her voice, say it’s time to be quiet and sleep, but she usually starts back up again. She takes her clothes off and throws her blankets off, so you have to constantly try to put them back on. She gets very angry and swears at you when you do that, and shakes her fists at you, and it’s horrible because she’s so upset and has no way to use words to express it or the ability to understand why she needs to wear clothes or at least have a blanket.

We gave her prescription sleeping pills and they stopped working. Tried benadryl on doctor’ s okay. Won’t work. Mom has to use a sound machine to sleep over gran’s constant talking. Trying to get something different from the doctor. Gran’s not eating well. I think she needs a hospital stay to be checked out, but mom has gotten paranoid about her catching some kind of infection and is hesitant to take her. She also gets manic and fights with the doctors and nurses whenever gran is hospitalized, so it’s miserable for her, too.

It’s just her advancing dementia. There’s nothing you can do but speak gently and reassure her that she’s safe and it’s time to sleep. And cherish moments of quiet because it means she’s resting. This is supposedly the stage where a lot of home caregivers throw in the towel. That’s not an option for us. But if she were in a facility, she’d still be like this. We just wouldn’t be there to hear and see it and to try to calm her.

This is the most fucked up thing. The most fucked up, horrible thing. She is so… Something. And I try so hard, we both do, and it will never, ever be okay. Or at least that’s what it feels like. And then you get up and go to work and almost forget, almost feel normal, but she’s there and sometimes it almost seems worse than if she were not.

This is what I have been dealing with that has been making me hurt.

I talked to her about 15 minutes ago and she is quiet. I just hope she gets some sleep. So we can too.

Old people auctioned off to care homes on the internet: Anger over 'cattle markets for grannies' as councils accept lowest bids to save cash
  • At least a dozen local authorities are listing vulnerable people’s details
  • Ages and care needs including medication sent to up to 100 care firms
  • They pick which people to bid for - and cheapest offer nearly always wins
  • Expert Ros Altmann: ‘eBay-style’ system 'awful’ and 'just uncivilised’
  • Health group leader: 'It’s an absolute disgrace - it’s like a cattle market’


The elderly and disabled are being ‘put up for auction’ by local councils on ‘eBay-style’ websites, with care firms then bidding to offer them a bed.

At least a dozen local authorities are listing vulnerable people’s details – including their age and what care and medication they need – before inviting bids from care homes in the area.

The bidding is sometimes open for only a few hours, at other times it can last for two or three days. The cheapest offer often wins.

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Critics last night said the system was akin to ‘auctioning your granny’ and a ‘cattle market’, saying sensitive decisions about an elderly resident’s final years are being made by a computer programme that is only interested in costs.

It also means the patient or their family often does not see the care home, and that those running the home do not see the patient before they arrive.

One council has boasted of reducing care costs by almost a fifth using the system.

The auction-style process allows councils to circulate anonymised details of individuals to a large number of suppliers who then bid in an online auction for the contract.

As many as 100 providers can bid before the software produces a shortlist of the most favourable bids. Shortlisted bidders are then told where they are ranked in the process.

If they are in second position, they can adjust their bid – either by lowering the price or offering extra care services – so that they can move up to first.

Councils say quality is the first consideration, but figures obtained under a Freedom of Information request show 92 per cent of care packages commissioned on the system over a six-month period were awarded to the bidder with the lowest price, BBC 5 Live revealed.

Ros Altmann, a Government adviser and independent expert on care for the elderly, said: ‘These eBay-style sites highlight the funding crisis for elderly care. It is awful. The idea of bidding for a person is just uncivilised. These are not parcels, they are people.’

Janet Morrison, chief executive of the charity Independent Age, said: ‘Do we really want to treat older people as a “product” to be bought and sold this way? We are concerned that older people’s needs will lose out to price as the main reason for selecting a home.’

At least 12 councils use the auction-style systems. They include Kent County Council, Devon County Council, Southend Borough Council and Birmingham City Council. Dozens more are expected to follow suit.

Care companies bidding to offer a place have to state what services they can provide and at what cost before a computer system decides which company is the winner of the ‘contract’. Councils say the winning home is not forced upon patients, and that it is not always the cheapest bid that wins, with quality of care being the main consideration.

Birmingham has been using an online auction system since 2012 and says it has reduced its spending on care by almost a fifth.

It uses a software called SProc.Net, which has been devised by Matrix SCM, a company based in Milton Keynes which last year said it was in talks with 30 other councils.

Radio 5 Live also found that in some cases in Birmingham elderly people were being sent to homes which won the online auction despite being ‘zero-rated’ by the council on its own 0-100 scale of care quality – where scores under 60 are ‘poor’.

Les Latchman, chairman of the Birmingham Care Consortium, which represents care homes in Birmingham and commissioned the FOI request, said the system was forcing providers to offer lower and lower prices to secure the contract.

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‘This reverse tendering is something that compromises quality and undermines ethical practice,’ he said. ‘If you are going to keep lowering the price, something has got to give.’

Mike Gimson, chairman of Moundsley Healthcare Group, said: ‘It’s an absolute disgrace what is going on in Birmingham. It is more like Hereford cattle market than it is a caring service for the elderly.’

A Birmingham council spokesman said: ‘The well-being of all our service users is paramount and we only award care packages to providers who are able to demonstrate that they can meet the needs of individuals.’

Another critic of the system is Emma Knight, whose brother James, 46, has learning difficulties and had lived in the same care home in Exeter for 28 years. When it closed, Devon County Council circulated his details by emails to care homes which were then invited to bid to offer him a place.

The details on the email included information about his ‘mood and well-being’ and medication. His family say other information which could easily identify him was also included.

Miss Knight, 44, of Ottery St Mary, said: ‘We had no idea his details were being shared. This sort of tendering should be stopped.’

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