[pachyderm]

Column: The real health care fight is coming, and it's about seniors' access | PBS NewsHour

Medicare and Medicaid are the two safety-net programs we now have to provide the care we will need. Unless you’ve been living in an unwired biosphere, you might have noticed that these programs are the subject of many Republican proposals that would dramatically change them. The common theme of these proposals is a big cut in funding, and thus care, in comparison with current program rules and government spending commitments.

...

But to be fair, Republicans are admitting one very compelling point that many Democrats have been politically hampered from acknowledging: As things presently stand, we cannot afford to pay for all the care that older Americans will need.

[Travelinglady]

It might get to be a moot issue. I'm finding fewer and fewer doctors are taking Medicare, anyway. It's a good thing I have Blue Cross as a supplement.

[Gus1234U]

i read once that over 60% of medical care dollars are spent in the last 6 months of life....

i believe we need a serious re-assessment of 'end of life' care and the prolonging of treatment at any price...

[riptide53]

Originally Posted by pachyderm

Column: The real health care fight is coming, and it's about seniors' access | PBS NewsHour

Well, sure, we're just going to die anyway, right? Look, there are so many places the government misuses or throws hard earned tax dollars at. We, who have worked and been productive members of society are just going to roll over and let this happen when if budgeted correctly, would not be a 'problem' Not on my watch!

[Little Lulu]

I agree with Gus1234U. Using what we have judiciously is more the issue than not having enough.

[hermitbydestiny]

I agree. I live in a state that supports dignity death. The backlash against this law has produced more availability to palliative care. Finding the balance in between is each of our choices.

I am 70 and have no fear of a cancer diagnosis like I once did when I was younger. I've already decided to see the diagnosis as a 'friend' saving me from Alzheimer/dementia in my old, old years. Instead, I will have comfort care, not chemo/radiation, and when I am considered terminal I will exercise my right to dignity under the law. Rather than taking on what I call a slow-drip chemo death, I will take one last 'final medication,' go to sleep and not suffer nor have my family watch my suffering. Nor will my husband have to file bankruptcy afterwards from chemo medical bills not covered under Medicare.

My children know my adamant stance on this, which is important because even though an elder has a Do Not Resuscitate in affect, many adult children cannot find the conviction to honor their elder's legal prearranged decisions. Thus, the elder is put on dialysis, etc. if they are too ill or feeble to speak up and end up with many more months of suffering before finally being able to die. Families need to talk about end stage decisions before end stage dynamics appear.

[Gus1234U]

thank you Sooooo Much for adding your thoughts on this issue, Hermit~!! i too have a Medical Will and a DNR, Code 3. i added the codicil that i have hospice care and never ever go to a nursing home~

i am envious that your state recognizes your right to choose, while mine is still hide-bound.

[Skeezyks]

Well... I don't live in an unwired biosphere (obviously.) But I do make a positive effort to avoid watching or reading about the news. There's nothing I can do about any of it anyway. And I find that it all just upsets me needlessly. So I don't know much of anything about this.

I guess I am fortunate to live in a state where residents, for the most part, are pretty-well cared for... & about. I'm pushing 70 now &, as far as I'm aware, I'm pretty healthy... well physically at least. I'm not a person who cares to live to be 100. I'll keep going as long as I can without requiring a lot of intensive (& expensive) medical interventions. When I can't do that anymore... I'll pull the plug. I've donated my body to our state university's medical school.

[Travelinglady]

I've signed the form about what I want and do not want to prolong my life (advance directive). A lot of those medical procedures are likely a waste of effort and money when our bodies really start to conk out. But I resent docs who don't take Medicare patients, even though I know their compensation for doing so is poor.

I tell my sons it's okay to put me in a nursing home, though. Home care is ultimately more expensive and problematic. I would hope to go to an assisted living place was long as I could,however. I don't care for strangers coming into my home to look after me.

[hermitbydestiny]

I have a special designation in my doc's computer medical chart saying I do not want to go into intensive care, which I believe will better ensure that I not be 'accidentally' intubated.

Also, I think nursing homes are a wonderful idea--my mother in one, was treated well, loved the place, and gave me a much needed break from her continual care which was overwhelming me; however, read your state's report before checking in a loved one. Visit often; be an advocate.

I was recently told by our aging rep. that nursing homes are going in a new direction: quick rehab specialties, like after joint replacement, which is paid for by Medicare for a limited period of time, and 2) for hard cases, like neurological disorders, namely MS and ALS, not necessarily dementia. Our state has adult foster care facilities, which are homes in neighborhoods which are converted to care homes for up to six people and are cheaper than nursing homes. We are encouraged to not rely on a nursing home, but to save for assisted living (can't afford) or adult foster care (more affordable) and/or stay in our own home and hire bonded caregivers (currently $15-25 hr.).

Note: 37 states have recently reenacted an old familial law on their books, which goes after family to recoup financial costs after a person in a nursing home dies and has no collateral. This law sees children as collateral. (See the AARP articles on people this has happened to.) There's been a backlash. Four states have backed down from enforcement. Not all states are enforcing, but they can anytime they want to because of this law. Boooo. However, the costs are enormous, so someone has to pay.

I see it from both sides: The baby boomers are tripling the numbers needing services so do we up the taxes for everyone and keep Medicaid alive? Most people in nursing homes run out of funds, so about 45% have to rely on state help because they are living longer and longer. However, if our state came after my mom's children, we'd all be terribly compromised in our own retirement--as in poor and would be a burden to our adult children. We simply couldn't afford it...her bill was around $8.000 a month and she was in care for three years. YIKES!

End stage decisions are everyone's problem and needs to be discussed openly and thoroughly. For those wanting to support laws towards death with dignity, go online and join those in every state who are trying to bring this about for those who want a better choice regarding terminal suffering.

[Gus1234U]

i have had 'in-home care', and the quality of service depends greatly on the caregiver... you're right about having strangers in the home, many of them feel that YOU have to conform to THEIR standards and ways~ !

as for going after the family, that is likely in violation of some federal law, and anyone accosted like that should look into filing a federal law-suit. maybe even a class action suit,, but at the very least challenging the law in court as unconstitutional. gads, what will they think of next ?

i searched the 'Death with Dignity' laws for my state, and it was passed just a year ago~! it appears that only 3 states have passed it,,, ? here's a link:

https://www.google.com/search?q=deat...hrome&ie=UTF-8

[hermitbydestiny]

From what I understand, it is up to each state in how they fund Medicaid. Some states do so on a lottery basis; however, elders in our state have had first priority. I don't think the feds are involved in how the state handles dispersion of their alotted funds.

The familial law has been on the books for a very long time; it actually came over with the settlers from England, but without modern enforcement. In 2007 or 2012 (fact check on that) those 34 states dusted off the old law and brought it up to speed for current enforcement. Four states have withdrawn. But several states have actually began recouping funds. (It's been awhile since I've researched this, so my dates might be rusty.) The AARP newsletter/mag has had articles of those adult children who have gotten the bill. Seems like Tennessee and Pennsylvania were the states sending the bills, but again, please fact check.

Thanks but I found yr reference. It helped when I spells filial properly. FYI... There is also now a federal statute. Thanks again



?QUOTE=hermitbydestiny;5949249]From what I understand, it is up to each state in how they fund Medicaid. Some states do so on a lottery basis; however, elders in our state have had first priority. I don't think the feds are involved in how the state handles dispersion of their alotted funds.

The familial law has been on the books for a very long time; it actually came over with the settlers from England, but without modern enforcement. In 2007 or 2012 (fact check on that) those 34 states dusted off the old law and brought it up to speed for current enforcement. Four states have withdrawn. But several states have actually began recouping funds. (It's been awhile since I've researched this, so my dates might be rusty.) The AARP newsletter/mag has had articles of those adult children who have gotten the bill. Seems like Tennessee and Pennsylvania were the states sending the bills, but again, please fact check.[/QUOTE]

[Gus1234U]

from what i've heard from residents, TN has a terrible record on health care. they severely restrict pain management meds, and all kinds of eligibilities....

(what is the Federal Law on Filial Responsibility ?)

Originally Posted by Gus1234U

from what i've heard from residents, TN has a terrible record on health care. they severely restrict pain management meds, and all kinds of eligibilities....

(what is the Federal Law on Filial Responsibility ?)

Check out
Pakula,Matthew (2005) A Federal Filial Responsibility:A uniform Tool to Help Combat the Wave of Indigent Elderly
Family Law Quarterly, ABA, 39(3):859-877. JSTOR 25740525