Wednesday, July 27, 2016

Nursing Home Blues

They had been married sixty years, though the question remains: aren’t they still married? Because they are both alive, and were never divorced: the marriage remains, right?

Ummm…not so much.

Or maybe it does, because the wife has learned, well in her 80’s, to use a tablet computer. And given that she never learned to drive, that’s quite an achievement for an aged lady. But she did it, because even though the nursing home is supposed to be excellent, and is definitely expensive, well, who knows if they are treating her husband right? So she lies awake most nights, and looks at the tablet that is showing her the live feed of her husband. He’s in the nursing home, and sleeping: she’s at home, and monitoring his care.

Nothing about old age is easy, but this particular scenario is especially heartbreaking. Twenty years ago, there would have been no way to know what the night shift was up to in the nursing home, and that might have been a good thing. But now, the elderly wife—who is only technically not a widow—is calling the nursing in the middle of the night, to say that it’s been several hours since her husband has been turned in bed.

I had assumed, by the way, that the nursing home business is booming: happily, I am wrong. According to an article in the Huffington Post, the nursing home industry is projected to decline by 20% by the year 2021. Why? Well, the Baby Boomers haven’t quite gotten to needing nursing homes, and the federal government has gotten the message: it can be cheaper to keep people in their homes.

In fact, 90% of nursing home revenues come from Medicare and other government programs. So what about the other 10%? Surely it has to come from the pockets of the elderly residents, right?

Well, yes, generally speaking, but the question is how. Because consider this quote, from The New York Times:

In a random, anonymized sample of 700 guardianship cases filed in Manhattan over a decade, Hunter College researchers found more than 12 percent were brought by nursing homes.

The human interest in the Time’s article concerns an Italian-American man who was locked into a dispute with the nursing home in which his wife lives. The man, Palermo, had been dealing with Medicare, which was dragging its feet. In the meantime, the bill for his wife’s care kept rising, and eventually reached $10,000. That’s when, on one of his daily visits to the home, he saw a six-page legal document on his wife’s bed. The nursing home was asking the court, in the name of a Carmelite nun, to be appointed legal guardian of Palermo’s wife’s assets.

The court may or may not go along, but that’s hardly the point. Palermo is 82 years old, and has never been sued in his life. And now, all of a sudden, he had to find a lawyer, supervise a legal strategy, and fend off sharks, hiding behind the habit (if not the skirts) of a Carmelite nun. So even if the court says no, Palermo is being strong-armed.

In the case of my friend, monitoring her husband in the nursing home…well, she’s moderately well off. She doesn’t, however, feel well off, but then, who does? So she has strategies for saving money: she has decided, for example, that the coffee from the coffee machine at Walgreens is really much better than the espresso from the café. So she save 63 cents on her cup of coffee, or some such, and better yet, grabs a handful of napkins, since they’re right out there for the taking, and Walgreen’s doesn’t actually say how many napkins you can take. See? So she hasn’t bought napkins for several years now, and that’s a saving of about $10—maximum—per year!

This is, of course, how the rich get rich, and stay rich, and very likely get richer. But it’s also how poor people stay poor. And while the wife is liberating napkins from Walgreen’s, the nursing home is charging somebody about $7,000 a month for her husband’s care. Yes, the same care that the wife is monitoring every night via her tablet.

The daughter of the man and wife comes from overseas to see her father—and console her mother. I know how it feels: I had to visit my mother in a nursing home, but only because she was recovering from operations, and needed physical therapy. But you take a deep breath, you square your shoulders, and you tell yourself that you will leave in….wait, how can you even think that? That’s your mother in there, and you are calculating how long you must spend before you can decently leave? What kind of beast are you?

And so you stay, and it’s not so bad, especially since your mother has wrangled a private room. Well, actually, I wrangled the room, since I had called the nursing home from Puerto Rico, and my mother had been there before. So they knew her, and they liked her, and they agreed: as long as they could, they would not give my mother a roommate. But then the day came when they had to use that bed, and the roommate was a perfectly nice lady, with a perfectly nice family. And the first thing the roommate did?

Turn on the TV!

Well, you don’t want to miss your soaps, do you?

Well, in my mother’s case…yes. But she was wise in the ways of the world: she knew that if she complained to the staff, it would fall on deaf ears. Yes, I had wanted to bring in a boom box, and all of the Wagner Ring Cycle that it could play, but my mother demurred.

Yes, it was a nightmare, but as nightmares go, it wasn’t too bad. I didn’t have it as bad…

…as Mr. Palermo!  

   



Nursing Home Blues

They had been married sixty years, though the question remains: aren’t they still married? Because they are both alive, and were never divorced: the marriage remains, right?

Ummm…not so much.

Or maybe it does, because the wife has learned, well in her 80’s, to use a tablet computer. And given that she never learned to drive, that’s quite an achievement for an aged lady. But she did it, because even though the nursing home is supposed to be excellent, and is definitely expensive, well, who knows if they are treating her husband right? So she lies awake most nights, and looks at the tablet that is showing her the live feed of her husband. He’s in the nursing home, and sleeping: she’s at home, and monitoring his care.

Nothing about old age is easy, but this particular scenario is especially heartbreaking. Twenty years ago, there would have been no way to know what the night shift was up to in the nursing home, and that might have been a good thing. But now, the elderly wife—who is only technically not a widow—is calling the nursing in the middle of the night, to say that it’s been several hours since her husband has been turned in bed.

I had assumed, by the way, that the nursing home business is booming: happily, I am wrong. According to an article in the Huffington Post, the nursing home industry is projected to decline by 20% by the year 2021. Why? Well, the Baby Boomers haven’t quite gotten to needing nursing homes, and the federal government has gotten the message: it can be cheaper to keep people in their homes.

In fact, 90% of nursing home revenues come from Medicare and other government programs. So what about the other 10%? Surely it has to come from the pockets of the elderly residents, right?

Well, yes, generally speaking, but the question is how. Because consider this quote, from The New York Times:

In a random, anonymized sample of 700 guardianship cases filed in Manhattan over a decade, Hunter College researchers found more than 12 percent were brought by nursing homes.

The human interest in the Time’s article concerns an Italian-American man who was locked into a dispute with the nursing home in which his wife lives. The man, Palermo, had been dealing with Medicare, which was dragging its feet. In the meantime, the bill for his wife’s care kept rising, and eventually reached $10,000. That’s when, on one of his daily visits to the home, he saw a six-page legal document on his wife’s bed. The nursing home was asking the court, in the name of a Carmelite nun, to be appointed legal guardian of Palermo’s wife’s assets.

The court may or may not go along, but that’s hardly the point. Palermo is 82 years old, and has never been sued in his life. And now, all of a sudden, he had to find a lawyer, supervise a legal strategy, and fend off sharks, hiding behind the habit (if not the skirts) of a Carmelite nun. So even if the court says no, Palermo is being strong-armed.

In the case of my friend, monitoring her husband in the nursing home…well, she’s moderately well off. She doesn’t, however, feel well off, but then, who does? So she has strategies for saving money: she has decided, for example, that the coffee from the coffee machine at Walgreens is really much better than the espresso from the café. So she save 63 cents on her cup of coffee, or some such, and better yet, grabs a handful of napkins, since they’re right out there for the taking, and Walgreen’s doesn’t actually say how many napkins you can take. See? So she hasn’t bought napkins for several years now, and that’s a saving of about $10—maximum—per year!

This is, of course, how the rich get rich, and stay rich, and very likely get richer. But it’s also how poor people stay poor. And while the wife is liberating napkins from Walgreen’s, the nursing home is charging somebody about $7,000 a month for her husband’s care. Yes, the same care that the wife is monitoring every night via her tablet.

The daughter of the man and wife comes from overseas to see her father—and console her mother. I know how it feels: I had to visit my mother in a nursing home, but only because she was recovering from operations, and needed physical therapy. But you take a deep breath, you square your shoulders, and you tell yourself that you will leave in….wait, how can you even think that? That’s your mother in there, and you are calculating how long you must spend before you can decently leave? What kind of beast are you?

And so you stay, and it’s not so bad, especially since your mother has wrangled a private room. Well, actually, I wrangled the room, since I had called the nursing home from Puerto Rico, and my mother had been there before. So they knew her, and they liked her, and they agreed: as long as they could, they would not give my mother a roommate. But then the day came when they had to use that bed, and the roommate was a perfectly nice lady, with a perfectly nice family. And the first thing the roommate did?

Turn on the TV!

Well, you don’t want to miss your soaps, do you?

Well, in my mother’s case…yes. But she was wise in the ways of the world: she knew that if she complained to the staff, it would fall on deaf ears. Yes, I had wanted to bring in a boom box, and all of the Wagner Ring Cycle that it could play, but my mother demurred.

Yes, it was a nightmare, but as nightmares go, it wasn’t too bad. I didn’t have it as bad…

…as Mr. Palermo!