[humanser] How Do We Care for the Elderly

[Steven Johnson]

Great article, and it nails it right on the head, not only for the elderly,
but for people with physical and developmental disabilities as well.  In
Wisconsin, we have a program, rather 2 programs, that use Medicaid dollars
to keep individuals in the least restrictive setting, which as we all know,
is many times their home.  What a better way to continue to have life
quality.  However, this past July, our state legislature put a cap on these
programs, known as Family Care and IRIS.  The only way persons can now get
into these programs, is through attrition; disenrollment by another member,
or death.  We are fortunate that in our county, we have been able to keep
from putting persons on a wait-list, but in our 3 partner counties, this is
not the case.  We have had full-entitlement to this program in our county
since 2000, and it has saved our State and the Federal Government literally
millions upon millions of dollars by simply providing necessary supports and
services in persons homes instead of more restrictive settings such as a
nursing home.  A report was just releasd that looks at the financial
savings, and the average cost to provide these services was something like
$1800 versus the cost of a nursing home, which many times will far exceed
$5, 6 or even $7000 a month.  
I am very familiar with these programs, as I provide intake as a Social
Service Specialist for the four counties our Aging and Disability Resource
Center serves.  I should mention that the difeference between these programs
is that the Family Care program, connects a member with a Case Manager
(Social Worker), and a Registered Nurse, while the IRIS program, which
stands for Include, Respect, I Self-direct, is a self-directed support
program in which a monthly and annual budget are estimated by our SW staff.


Steve Johnson



-----Original Message-----
From: humanser-bounces at nfbnet.org [mailto:humanser-bounces at nfbnet.org] On
Behalf Of Mary Ann Robinson
Sent: Saturday, October 22, 2011 1:15 PM
To: Human Services Mailing List
Subject: [humanser] How Do We Care for the Elderly

How Do We Care for the Elderly?
  Linda Chavez
  Last week, the Obama administration dropped one of the
signature provisions of its healthcare plan.  The CLASS Act
(Community Living Assistance Services) was intended to provide
affordable insurance for long-term care to individuals who,
because of infirmity or age, could no longer care for themselves.
But the reality that not enough healthy Americans would sign up
to make it self-supporting finally doomed the program.
  Many opponents of Obamacare will no doubt cheer this turn of
events because it confirms the view that we cannot afford to, in
essence, nationalize health care.  I agree --but I also recognize
that the problem that the CLASS Act was trying to address is a
legitimate concern for which we now have no workable solutions.
  The nation faces a looming crisis in caring for the elderly,
whose life expectancy often exceeds their ability to live
independently.  Millions of Americans need long-term care, but we
currently have no system that adequately provides it a cost that
most Americans can afford.
  This topic holds more than public policy interest for me.
Three years ago, my then-87-year-old mother came to live with me
when it became clear that it wasn't safe for her to continue to
live on her own.  Although in good health, my mother is virtually
blind and quite frail.  She values her independence, prepares all
her own meals, has excellent long- and short-term memory and
follows the news avidly.  But without daily assistance, she could
not shop for food, get to the doctor or clean her own living
space.
  Last week, however, her situation changed dramatically.  After
returning from a doctor's visit, my mother fell on the last step
of a steep climb down from the car to our home.  I was just a few
feet away from her when I heard her hit the floor.  In that
instant, her life and future changed dramatically.  She broke her
hip -- the scourge of the elderly -- and within 24 hours had
undergone partial hip replacement surgery.  Three days later, she
was released from the hospital.
  Medicare provides coverage for up to 100 days in a
rehabilitation facility so long as the patient needs daily
services that can be provided only by a doctor or nurse or is
receiving the rehabilitation therapies provided and making
progress.  But when the 100 days are over, the patient is on his
or her own.  My mother is now in an excellent rehabilitation
center in Boulder, Colo.  -- but it's unclear what will happen
when she's released.
  If you're very wealthy and can afford upwards of $60,000 a year
in private, long-term care, the alternative of an assisted living
facility is available.  But what if you don't have those means? I
would gladly take my mother back into my home, but I don't think
it's feasible for her to continue to live there.  If we can
manage to get her down those same steep stairs and into the house
again, she'll be trapped there indefinitely, unable to go to the
doctor, grocery or anywhere else except to the hospital if she
falls and injures herself again.  And she'll need someone with
her 24 hours a day.
  Since my mother has never owned a home or any other assets --
only a meager Social Security and Veterans' pension and the help
I've provided since my father died -- she is eligible for
Medicaid.  And unlike Medicare, Medicaid does provide coverage
for long-term care.  But having visited the local facilities that
accept Medicaid, I can tell you the decent ones have long waiting
lists -- a year or more -- and the ones that don't have waiting
lists break a daughter's heart.  I simply cannot imagine putting
her in one of these crowded, dreary, hopeless places.
  Currently, 40 million Americans are age 65 and older, and of
these, nearly 6 million are 85 years of age or older.  One in 5
elderly Americans are currently considered dependent, but the
proportion will grow to nearly 40 percent by 2050.  We continue
to expand the frontiers of life expectancy, but we have yet to
figure out how to care for our ever-growing population of older
Americans.
  The administration's failure to come up with a feasible plan to
solve the problem is no cheering matter.  We must find a way --
not only for our parents but for all of our sakes.
  Linda Chavez is chairman of the Center for Equal Opportunity
and author of Betrayal: How Union Bosses Shake Down Their Members
and Corrupt American Politics.
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