Friday, October 19, 2012

The Future of Elder Care

As I've mentioned before, I have the privilege of working with the elderly. It's not the most glamorous group to work with, but I generally find it rewarding. I learn a lot. Unlike school, I can acquire wisdom, not just knowledge. Good stuff. I've met the people I want to grow up to be like. Sure, God willing, we'll all get to the age of 80. But not all of us will do it equally well. 

I came to the realization at work yesterday that I'm worried about the future of caring for the elderly. I think we have a growing problem that isn't being discussed yet in our field. And I blame it on airplanes.

Stay with me here for the explanation. I worked with 4 different patients yesterday (only 4, it was a short day, and one required a lengthy evaluation). They were all in their 80's. They all lived in their own homes. But only with the assistance of family. 

One was married, but had health problems that require a significant amount of assistance from her husband. He's thankfully healthy enough to provide the care. If he gets ill, they have adult children and grandchildren in the area to help. One of those granddaughters was there at lunch when I visited her. If it weren't for the family members, the lady would need to be in a nursing home.

One patient was never married. He lived a simple life in a menial job. He was retired and doing fine until his health problems began. He'll be fine when he goes home, even if he has lingering cognitive problems. His nephew lives next door. His niece lives one town over. They already were helping him. In fact, his nephew visited at the hospital today. But without his family, I would recommend discharging him to a nursing home.

Two patients had lost their spouses, and were now a widow/widower. They have varying health problems that require ongoing care when they go home. They both have very involved adult children who will help care for them at home, and are already very involved in their hospital care. Without the family members, they would be discharged to nursing homes.

Without local family, all of these patients would end up in nursing homes. They are not people of means. They might have a few resources, but the money would dry up in a year or two, with the taxpayer then picking up their nursing home tabs. You and me. People need nursing homes, and we need to help pay for them. This is a fact. But more people will need these nursing homes in the future.

Our generation is one that has grown up with reasonably affordable air travel. It's no big deal to pick up and move a few time zones away from family. We can always fly home at the holidays. Many of us have moved to cities and settled down among strangers, far away from family and friends. Right now, we're young and relatively self-sufficient. We don't need someone to check in on us and make sure we've had at least one square meal and our daily assortment of medications. But the day will come in the future when we will depend on the help from others for our survival. And if our habit of moving far from family continues, who will come check on us? It's frequently the case that having one supportive family member will make the difference between leaving the hospital to go home vs. leaving the hospital to move into a nursing home. If families keep moving away from each other and more people age alone, we will run out of nursing homes. 

The older I get, the more I see the wisdom in having large extended families settled in the same area. We definitely suffer from not having grandparents, aunts, uncles, and cousins in the area. And I'm sure that the older we get, the more we will suffer. 

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