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      Abbreviated rules   07/28/2017

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Bus Driver

Fuck the Elderly and Infirm

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My first volunteer EMT ambulance company we worked A LOT---  A LOT---  of nursing homes. Some had top notch staff and some seemed to be in converted homes with patients floundering in their own shit- literally.

It happened to be in an area that went big from Trump.  

So, perhaps those folks are getting what the voted for?

 

 

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27 minutes ago, Clove Hitch said:

 

It happened to be in an area that went big from Trump.  

So, perhaps those folks are getting what the voted for?

 

 

And they need more of what thy voted for. Bigly.

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3 hours ago, Clove Hitch said:

My first volunteer EMT ambulance company we worked A LOT---  A LOT---  of nursing homes. Some had top notch staff and some seemed to be in converted homes with patients floundering in their own shit- literally.

It happened to be in an area that went big from Trump.  

So, perhaps those folks are getting what the voted for?

 

 

1

Bringing back Merry Christmas...and Bed Sores!

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There's not enough information in the article.

Sometimes having to comply with many regulations really does diminish the time staff can spend on their primary role.

But Trump's track record is to slash for the sake of slashing, without any new policy or even any understanding of a sector.

Elderly people in residential care need an advocate they can trust to do the best for them..not the shareholders.

 

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6 hours ago, Bus Driver said:

So is that a bad thing or a good thing or is he lying and it's not a thing at all?

---------------------------

"The American Health Care Association, the industry’s main trade group, has complained that under President Barack Obama, federal inspectors focused excessively on catching wrongdoing rather than helping nursing homes improve.

“It is critical that we have relief,” Mark Parkinson, the group’s president, wrote in a letter to Mr. Trump in December 2016."

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44 minutes ago, cmilliken said:

So is that a bad thing or a good thing or is he lying and it's not a thing at all?

---------------------------

"The American Health Care Association, the industry’s main trade group, has complained that under President Barack Obama, federal inspectors focused excessively on catching wrongdoing rather than helping nursing homes improve.

“It is critical that we have relief,” Mark Parkinson, the group’s president, wrote in a letter to Mr. Trump in December 2016."

Would you expect the spokesperson to say anything else?

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Just now, cmilliken said:

 

So I'll put that down as 'he's lying?"

 

You can put it down as anything you’d like. 

IMHO, when the spokesperson for a particular organization speaks, we hear what that person was paid to say. In this case, we heard what the nursing home industry wanted said. 

If you want to take that as anything more than a paid advertisement, don’t let me get in your way. 

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14 minutes ago, Bus Driver said:

You can put it down as anything you’d like. 

IMHO, when the spokesperson for a particular organization speaks, we hear what that person was paid to say. In this case, we heard what the nursing home industry wanted said. 

If you want to take that as anything more than a paid advertisement, don’t let me get in your way. 

 

Obviously, the reason I pointed it out was because of your 'spokesperson' like title :)  It was just such a ridiculous characterization that felt like poking fun back. 

It's a short week!  Have a good day.

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3 minutes ago, cmilliken said:

 

Obviously, the reason I pointed it out was because of your 'spokesperson' like title :)  It was just such a ridiculous characterization that felt like poking fun back. 

It's a short week!  Have a good day.

Speaking as someone who learned about the mistreatment of my Godmother in a nursing home, I am rather sensitive to the subject. 

If President Trump has a plan for how to go about governing, that isn’t just “do the opposite of Obama”, I’d like to see it. 

Short of that, this move DOES fuck the elderly and infirm.  

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4 minutes ago, Bus Driver said:

Speaking as someone who learned about the mistreatment of my Godmother in a nursing home, I am rather sensitive to the subject. 

If President Trump has a plan for how to go about governing, that isn’t just “do the opposite of Obama”, I’d like to see it. 

Short of that, this move DOES fuck the elderly and infirm.  

I'm sorry that your Godmother was mistreated.  That shouldn't happen to anyone, particularly when they're at their most vulnerable.

 

 

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24 minutes ago, cmilliken said:

I'm sorry that your Godmother was mistreated.  That shouldn't happen to anyone, particularly when they're at their most vulnerable.

 

 

Thank you.

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2 hours ago, Bus Driver said:
3 hours ago, cmilliken said:

So is that a bad thing or a good thing or is he lying and it's not a thing at all?

---------------------------

"The American Health Care Association, the industry’s main trade group, has complained that under President Barack Obama, federal inspectors focused excessively on catching wrongdoing rather than helping nursing homes improve.

“It is critical that we have relief,” Mark Parkinson, the group’s president, wrote in a letter to Mr. Trump in December 2016."

Would you expect the spokesperson to say anything else?

Right.

The spokesperson for the National Association of Bank Robbers says "The police are only interested in arresting us, they have proven time and time again that they are unwilling to help with the problem of access to funds."

-DSK

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15 minutes ago, Steam Flyer said:

Right.

The spokesperson for the National Association of Bank Robbers says "The police are only interested in arresting us, they have proven time and time again that they are unwilling to help with the problem of access to funds."

-DSK

 

You're actually equating the The American Health Care Association (https://en.wikipedia.org/wiki/American_Health_Care_Association) to a criminal organization?  After all, they are such a horrible, disreputable people. 

"The American Health Care Association (AHCA) is a non-profit federation of affiliated state health organizations, together representing more than 10,000 non-profit and for-profit assisted living, nursing facility, developmentally-disabled, and subacute care providers that care for more than 1.5 million elderly and disabled individuals nationally. AHCA was founded in 1949 and is based in Washington, D.C. The National Center for Assisted Living (NCAL) is part of AHCA."

Here's what they're currently advocating:

AHCA/NCAL's current advocacy issues include:

1. Protect and Preserve Medicaid Funding for Long Term

2. Stable Medicare Funding Essential for Quality Care

3. Extended Observation Stays Constrain Medicare Beneficiaries' Access to Skilled Nursing Facility Services

 

Clearly, they are evil fuckers who should be ignored prima facie.  This is a silly thread.  Happy New Year all :)

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27 minutes ago, cmilliken said:

 

You're actually equating the The American Health Care Association (https://en.wikipedia.org/wiki/American_Health_Care_Association) to a criminal organization?  After all, they are such a horrible, disreputable people. 

"The American Health Care Association (AHCA) is a non-profit federation of affiliated state health organizations, together representing more than 10,000 non-profit and for-profit assisted living, nursing facility, developmentally-disabled, and subacute care providers that care for more than 1.5 million elderly and disabled individuals nationally. AHCA was founded in 1949 and is based in Washington, D.C. The National Center for Assisted Living (NCAL) is part of AHCA."

Here's what they're currently advocating:

AHCA/NCAL's current advocacy issues include:

1. Protect and Preserve Medicaid Funding for Long Term

2. Stable Medicare Funding Essential for Quality Care

3. Extended Observation Stays Constrain Medicare Beneficiaries' Access to Skilled Nursing Facility Services

 

Clearly, they are evil fuckers who should be ignored prima facie.  This is a silly thread.  Happy New Year all :)

And they're complaining that gov't oversight focuses on arresting wrongdoing. Why?

Their goals are front-and-center to secure funding for themselves. Not one mention of patient / client advocacy. What do -you- want to see a professional organization provide? Guaranteed flow of cash into their own pockets, or or oversight of the profession? Would you rather, for example, hear the American Medical Association spokesperson say "We intend to ensure doctors maximize their income" or would you rather something like "We provide education to doctors so they will reduce medical mistakes."

These guys don't even pretend to be in the business of improving quality. It's not even mentioned in their list of goals, they don't even pay lip-service. If it were up to me, I'd kick the bunch to the curb and start over.

-DSK

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8 hours ago, B.J. Porter said:

Bringing back Merry Christmas...and Bed Sores!

Elderly become less mobile or immobile. Bedsores happen when people can't move.much. Nursing homes seem to have an aweful lot of immobile people.

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15 minutes ago, warbird said:

Elderly become less mobile or immobile. Bedsores happen when people can't move.much. Nursing homes seem to have an aweful lot of immobilw people.

Words of wizdome from Capt Oblivious.  Did you know that hospitals have an awful lot of sick people?

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Speaking from personal experience the level of care your parents/elders receive is directly related to two things. The first is the amount of money they saved in the course of their lifetime to ensure end of life care. The second is the family's choices and involvement of overseeing that the proper care is given. We used to attend regular meetings to meet with the nursing home staff and go over our mother's plan of care and current state of health. That is to say we were active in her care management. People who are left in squalor one would have to presume are not being directly managed/overseen by family. So whose fault is that?

Now not everyone is in a financial position to afford the finest of care or even really good care. And in most cases those that are in these sorts of homes are the ones who are being cared for under Medicaid. So one has to ask if Medicaid, government sponsored care is worth the cost.

There has been much debate, but not nearly enough in reality about scrapping Social Security. It would be interesting to see if the monies set aside on average for Social Security, Medicare and Medicaid would be better off invested in the private sector. I suspect they would by a good long deal. Personally I have an annuity, some IRA's and the like and do not include Social Security in my retirement plans. If it is there and I am eligible, fine, but if it is not I know I have my private investments to cover our later years. Now I know a good deal of you like to cry out loud that the market is not something one should bank on due to market fluctuations. However with regard to my annuity (and my spouse's) they are guaranteed to pay out at the market high amount they attained. So say the account peaked at $278k, that is its guaranteed value upon surrender. So even if the market dropped to say $205k for a current value of that annuity at a given moment when we need the money, the amount we can access is $278K. This feature costs a whopping 2% per year fee.

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9 minutes ago, d'ranger said:

Words of wizdome from Capt Oblivious.  Did you know that hospitals have an awful lot of sick people?

I visit my,uncle regularly at a county home. Approximately 1/2 the homes here are county run. The care seem pretty good. But , uncle does not bother to get up and walk arround, sits and watches his TV. He gets bedsores. Any surprise? 

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10 minutes ago, BillDBastard said:

Speaking from personal experience the level of care your parents/elders receive is directly related to two things. The first is the amount of money they saved in the course of their lifetime to ensure end of life care. The second is the family's choices and involvement of overseeing that the proper care is given. We used to attend regular meetings to meet with the nursing home staff and go over our mother's plan of care and current state of health. That is to say we were active in her care management. People who are left in squalor one would have to presume are not being directly managed/overseen by family. So whose fault is that?

Now not everyone is in a financial position to afford the finest of care or even really good care. And in most cases those that are in these sorts of homes are the ones who are being cared for under Medicaid. So one has to ask if Medicaid, government sponsored care is worth the cost.

There has been much debate, but not nearly enough in reality about scrapping Social Security. It would be interesting to see if the monies set aside on average for Social Security, Medicare and Medicaid would be better off invested in the private sector. I suspect they would by a good long deal. Personally I have an annuity, some IRA's and the like and do not include Social Security in my retirement plans. If it is there and I am eligible, fine, but if it is not I know I have my private investments to cover our later years. Now I know a good deal of you like to cry out loud that the market is not something one should bank on due to market fluctuations. However with regard to my annuity (and my spouse's) they are guaranteed to pay out at the market high amount they attained. So say the account peaked at $278k, that is its guaranteed value upon surrender. So even if the market dropped to say $205k for a current value of that annuity at a given moment when we need the money, the amount we can access is $278K. This feature costs a whopping 2% per year fee.

There are a variety of policies designed to cover nursing home care. They are cheap to buy when you are 45. They get pricey when you are 65. Lacking that, even $500k in savings disappears pretty fast, then the house or half the house if a surviving spouse exists.IIRC

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I don’t disagree with many of the comments.

The care my Godmother received was sub-standard and I only became aware after she was taken to an ER for infected bedsores. She was less than ambulatory, as Warbird mentioned, and I live 3 hours away. But, for the money they received from her insurance company, they damned sure should have done a better job. 

That said, cutting back on regulations and the ability to police the homes, while relying on them to do the best on their own volition is foolhardy, IMHO. 

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That's what it's all about, isn't it? MAXIMIZING PROFITS. 

Regulations get in the way of profits, Slash them!

Morality gets in the way of profits, justify your money grab, while pointing fingers at 'Them'

Taxes  cut into profits, buy some new loopholes. 

If we can do it by bilking those who can't fight back, all the better. 

All that counts is Money, and how can I get more. 

It's the REPUBLICAN WAY!

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6 minutes ago, Bus Driver said:

I don’t disagree with many of the comments.

The care my Godmother received was sub-standard and I only became aware after she was taken to an ER for infected bedsores. She was less than ambulatory, as Warbird mentioned, and I live 3 hours away. But, for the money they received from her insurance company, they damned sure should have done a better job. 

That said, cutting back on regulations and the ability to police the homes, while relying on them to do the best on their own volition is foolhardy, IMHO. 

I am guessing the "care" regulations are not changing.  

I used to meet 1 or 2 times yearly with a MSHA inspector. He would spend a day showing us how we could do better in various areas the write "fix in 30 day notices" on a couple of areas rather than write citations. An active campaign to improve rather than to cite.

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2 hours ago, warbird said:

I am guessing the "care" regulations are not changing.  

I used to meet 1 or 2 times yearly with a MSHA inspector. He would spend a day showing us how we could do better in various areas the write "fix in 30 day notices" on a couple of areas rather than write citations. An active campaign to improve rather than to cite.

If the risk of being caught providing substandard care, or not correcting problems identified, is removed, do you believe in the inherent goodness of corporate bigwigs to do the right thing?

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38 minutes ago, Bus Driver said:

If the risk of being caught providing substandard care, or not correcting problems identified, is removed, do you believe in the inherent goodness of corporate bigwigs to do the right thing?

Before getting up in arms about the issue we should know what the citations written are about. Was the jello 3 degrees too cold? Was the hourly temperature log kept in a data base rather than a paper sheet.

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31 minutes ago, warbird said:

Before getting up in arms about the issue we should know what the citations written are about. Was the jello 3 degrees too cold? Was the hourly temperature log kept in a data base rather than a paper sheet.

so you don't care about temp control and are all about falsifying records easily.

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1 minute ago, Mismoyled Jiblet. said:
32 minutes ago, warbird said:

Before getting up in arms about the issue we should know what the citations written are about. Was the jello 3 degrees too cold? Was the hourly temperature log kept in a data base rather than a paper sheet.

so you don't care about temp control and are all about falsifying records easily.

Anything less would be getting in the way of making more money.

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8 hours ago, Bus Driver said:

Speaking as someone who learned about the mistreatment of my Godmother in a nursing home, I am rather sensitive to the subject. 

After learning of this neglect did you step up and move her into your house?

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22 minutes ago, Moderate said:

After learning of this neglect did you step up and move her into your house?

No. I am not a licensed healthcare professional and her care was beyond my capabilities. But, I became her advocate and things got significantly better. She lived in NJ, from which she did not want to move. 

Oh, and go fuck yourself. 

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1 hour ago, warbird said:

Before getting up in arms about the issue we should know what the citations written are about. Was the jello 3 degrees too cold? Was the hourly temperature log kept in a data base rather than a paper sheet.

Yep. That is exactly to focus of the article. 

Oh, and this -

“In September 2016, for instance, health inspectors faulted Lincoln Manor, a nursing home in Decatur, Ill., for failing to monitor and treat the wound of a patient whose implanted pain-medication pump gradually slipped over eight days through a ruptured suture and protruded from her abdomen. The patient died.

The Centers for Medicare and Medicaid Services fined Lincoln Manor $282,954, including $10,091 a day for 28 days, from the time the nursing home noticed the problem with the wound until supervisors had retrained nurses to avoid similar errors. An administrative law judge called the penalties“quite modest” given the “appalling” care.

The fines were issued before the new guidelines took effect; if the agency had issued a one-time fine, the maximum would have been less than $21,000.”

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I have some sympathy for aged care providers, Staff are generally poorly paid and old people can be difficult to please and make a lot of trivial complaints about food, staff etc.

My Mum's in a top end facility and she's never stopped complaining, literally about everyone and everything...about them buying food from Woolies was her last one. (exactly where she used to shop):rolleyes:

It's hard to balance resources between providing extra advertised comforts and top nursing care..so they choose the latter.

OTOH, it's too easy for these places to prioritize the other way around..promoting the "face" of the place while hiding the substandard nursing care as many relatives only visit during the day and can't see behind the scenes.

THIS is where regulation and regular inspection should be focused. Fines for trivia should be discouraged and regular "improvement" notices issued and monitored..All these places should be inspected without notice every 3 months at least.

Health and safety infringements OTOH should be fined hard and fast..with the reports available to the public.

It's hard enough finding a good place for your elderly relatives without feeling that regulations are being cut

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5 hours ago, BillDBastard said:

Speaking from personal experience the level of care your parents/elders receive is directly related to two things. The first is the amount of money they saved in the course of their lifetime to ensure end of life care. The second is the family's choices and involvement of overseeing that the proper care is given. We used to attend regular meetings to meet with the nursing home staff and go over our mother's plan of care and current state of health. That is to say we were active in her care management. People who are left in squalor one would have to presume are not being directly managed/overseen by family. So whose fault is that?

Now not everyone is in a financial position to afford the finest of care or even really good care. And in most cases those that are in these sorts of homes are the ones who are being cared for under Medicaid. So one has to ask if Medicaid, government sponsored care is worth the cost.

There has been much debate, but not nearly enough in reality about scrapping Social Security. It would be interesting to see if the monies set aside on average for Social Security, Medicare and Medicaid would be better off invested in the private sector. I suspect they would by a good long deal. Personally I have an annuity, some IRA's and the like and do not include Social Security in my retirement plans. If it is there and I am eligible, fine, but if it is not I know I have my private investments to cover our later years. Now I know a good deal of you like to cry out loud that the market is not something one should bank on due to market fluctuations. However with regard to my annuity (and my spouse's) they are guaranteed to pay out at the market high amount they attained. So say the account peaked at $278k, that is its guaranteed value upon surrender. So even if the market dropped to say $205k for a current value of that annuity at a given moment when we need the money, the amount we can access is $278K. This feature costs a whopping 2% per year fee.

I'm with you on your comments.....my dad was just admitted to a long term care facility and you're right, there needs to be a lot of planning and funding to do it correctly.  One of my parents priorities was long term care insurance, even though it was a major expense for them.  It will fund $35,000+/yr for him which goes a long way.  In addition, they paid a lump sum of $7000 to a senior planning service to assist them with their elderly care choices.  Both of these are paying dividends for them now......  The senior planning service was invaluable in working through the questions and details in arranging for his long term needs.  I'm not sure how someone works through these issues without that kind of support.  They were able to work with my mom to get him into a great facility and work with them regarding exposed assets vs. protected assets as time goes on.  The staff has been outstanding so we are fortunate.  I had discussions with the nurses that was enlightening.  It is a regulated industry and everything they do is against a backdrop of regulations, regardless of whether it makes sense or not.  I'm more than happy to see better patient focused results than rigid regulated requirements.  A reasonable level of regulation can be helpful in that industry, but excessive regulation can be problematic.  From my understanding, it is over regulated.

Also, like you our financial adviser has a percentage of our assets in annuities.  The annuities will pay out double the income should long term care be required without an end date.

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1 hour ago, d'ranger said:

Weird - where are all the free markets free peeps at?

Busy trying to find an ice floe for Grandma.

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7 hours ago, BillDBastard said:

Speaking from personal experience the level of care your parents/elders receive is directly related to two things. The first is the amount of money they saved in the course of their lifetime to ensure end of life care. The second is the family's choices and involvement of overseeing that the proper care is given. We used to attend regular meetings to meet with the nursing home staff and go over our mother's plan of care and current state of health. That is to say we were active in her care management. People who are left in squalor one would have to presume are not being directly managed/overseen by family. So whose fault is that?

Now not everyone is in a financial position to afford the finest of care or even really good care. And in most cases those that are in these sorts of homes are the ones who are being cared for under Medicaid. So one has to ask if Medicaid, government sponsored care is worth the cost.

There has been much debate, but not nearly enough in reality about scrapping Social Security. It would be interesting to see if the monies set aside on average for Social Security, Medicare and Medicaid would be better off invested in the private sector. I suspect they would by a good long deal. Personally I have an annuity, some IRA's and the like and do not include Social Security in my retirement plans. If it is there and I am eligible, fine, but if it is not I know I have my private investments to cover our later years. Now I know a good deal of you like to cry out loud that the market is not something one should bank on due to market fluctuations. However with regard to my annuity (and my spouse's) they are guaranteed to pay out at the market high amount they attained. So say the account peaked at $278k, that is its guaranteed value upon surrender. So even if the market dropped to say $205k for a current value of that annuity at a given moment when we need the money, the amount we can access is $278K. This feature costs a whopping 2% per year fee.

Brief search suggests that the public run [state, county,city) recieve fewer citations than the for profit and not for profit homes.

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2 hours ago, d'ranger said:

Weird - where are all the free markets free peeps at?

I'm still wondering how fitting an average of fifty pages of new rules per day into their schedule is working out for care givers?

7 hours ago, warbird said:

Elderly become less mobile or immobile. Bedsores happen when people can't move.much. Nursing homes seem to have an aweful lot of immobile people.

Bedsores are the result of improper care. Immobile people must be turned and bathed. It's one of those jobs that must make people think how much fun it would be to work in an animal shelter and kill puppies all day. Yet there are loving people who do it. Some of them just did for my MIL. And yes, my wife and other family were able to check daily.

There are other people who look at each bit of attention someone like that gets as a cost to be minimized. I'm not sure thousands of pages of rules, with 50 or so added each working day, will change them. Strike that, I'm sure it won't.

It can at least provide for punishment and the topic of this thread is in part reducing fines. Yes, some of them levied for things that had already been corrected. I'm not sure "I fixed it before you caught me" is really a good excuse.

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Brief google search. 2007. There were 5.7 -7.2 citations per home in the US in 2007.  While some incidents are disturbing, like the OP, I ask are all of these horrible incidents of anguish and pain or are they largely administrative/reporting errors?

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11 hours ago, Bus Driver said:

Speaking as someone who learned about the mistreatment of my Godmother in a nursing home, I am rather sensitive to the subject. 

If President Trump has a plan for how to go about governing, that isn’t just “do the opposite of Obama”, I’d like to see it. 

Short of that, this move DOES fuck the elderly and infirm.  

Maybe not.  

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Just now, Rockdog said:

Maybe not.  

Well then why don't you try it out on your mother first and get back to us?

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3 minutes ago, SloopJonB said:

Well then why don't you try it out on your mother first and get back to us?

Our family has always cared for their elderly at home until the absolute end.  She will be treated the same.   I’ve never understood why kids can’t take turns caring for their own parents other than they may not have had a good relationship while growing up.

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Well, sometimes they live in different countries, or cities or there's only one of them and they have to work 2 jobs etc. etc.

Your combination of narrow ignorance and self righteousness is a really nasty combination.

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2 hours ago, Huggy Bear Brown said:

I'm with you on your comments.....my dad was just admitted to a long term care facility and you're right, there needs to be a lot of planning and funding to do it correctly.  One of my parents priorities was long term care insurance, even though it was a major expense for them.  It will fund $35,000+/yr for him which goes a long way.  In addition, they paid a lump sum of $7000 to a senior planning service to assist them with their elderly care choices.  Both of these are paying dividends for them now......  The senior planning service was invaluable in working through the questions and details in arranging for his long term needs.  I'm not sure how someone works through these issues without that kind of support.  They were able to work with my mom to get him into a great facility and work with them regarding exposed assets vs. protected assets as time goes on.  The staff has been outstanding so we are fortunate.  I had discussions with the nurses that was enlightening.  It is a regulated industry and everything they do is against a backdrop of regulations, regardless of whether it makes sense or not.  I'm more than happy to see better patient focused results than rigid regulated requirements.  A reasonable level of regulation can be helpful in that industry, but excessive regulation can be problematic.  From my understanding, it is over regulated.

Also, like you our financial adviser has a percentage of our assets in annuities.  The annuities will pay out double the income should long term care be required without an end date.

My parents have long term care insurance.   Insurance is battling hospice and stalling, hoping he dies before they have to pay for any nursing care or nurses aids.    Meanwhile he gets weaker, diaper changes and bandage changes get harder for my mom, and I can only get there so many overnights  (almost 6 hour round trip)  to help.   All so some executive can get a larger yearly bonus.  Like every insurance, the primary goal is making sure they make more than they pay.   

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34 minutes ago, SloopJonB said:

Well, sometimes they live in different countries, or cities or there's only one of them and they have to work 2 jobs etc. etc.

Your combination of narrow ignorance and self righteousness is a really nasty combination.

We put our life on hold as mom failed. Cooking, cleaning, laundry..... Chemo and the effects..... Surgery and the effects..... 

One sib drove 1500 miles one way 14 times in moms last year, stayed 4 to 8 days each visit.

2 sibs made 6 hour drives oneway 18 times in the last year.

She insisted on staying home. We covered her 24/7 till the end. We needed professionals to assist in the end. She had nurses daily and a live in care specialist at the end. 

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Well good for you.

When you say We put our life on hold as mom failed. what does that mean? You gave up sailing? You gave up your jobs? Where did the money come from? Did you move to be near? Did you move her to be near? How many of you were there? What ages?

Your particular situation does not fit everyone nor is it even possible for everyone.

That "family & neighbours should look after each other" theorizing that right wingers are so fond of is just great when & if it's possible.

Usually it isn't - which is why social programs were created in the first place. That's what you right wingers just can't grasp with your blind focus on ideology. "Anyone who doesn't do what we did is just a heartless & uncaring lib".

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9 hours ago, BillDBastard said:

Speaking from personal experience the level of care your parents/elders receive is directly related to two things. The first is the amount of money they saved in the course of their lifetime to ensure end of life care. The second is the family's choices and involvement of overseeing that the proper care is given. We used to attend regular meetings to meet with the nursing home staff and go over our mother's plan of care and current state of health. That is to say we were active in her care management. People who are left in squalor one would have to presume are not being directly managed/overseen by family. So whose fault is that?

Now not everyone is in a financial position to afford the finest of care or even really good care. And in most cases those that are in these sorts of homes are the ones who are being cared for under Medicaid. So one has to ask if Medicaid, government sponsored care is worth the cost.

There has been much debate, but not nearly enough in reality about scrapping Social Security. It would be interesting to see if the monies set aside on average for Social Security, Medicare and Medicaid would be better off invested in the private sector. I suspect they would by a good long deal. Personally I have an annuity, some IRA's and the like and do not include Social Security in my retirement plans. If it is there and I am eligible, fine, but if it is not I know I have my private investments to cover our later years. Now I know a good deal of you like to cry out loud that the market is not something one should bank on due to market fluctuations. However with regard to my annuity (and my spouse's) they are guaranteed to pay out at the market high amount they attained. So say the account peaked at $278k, that is its guaranteed value upon surrender. So even if the market dropped to say $205k for a current value of that annuity at a given moment when we need the money, the amount we can access is $278K. This feature costs a whopping 2% per year fee.

So, you’ve never heard of insurance companies going broke? You trust one random insurance company? Smart.

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21 minutes ago, warbird said:

We put our life on hold as mom failed. Cooking, cleaning, laundry..... Chemo and the effects..... Surgery and the effects.....

She insisted on staying home. We covered her 24/7 till the end. We needed professionals to assist in the end. She had nurses daily and a live in care specialist at the end. 

Not everyone has kids...

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19 minutes ago, warbird said:

We put our life on hold as mom failed. Cooking, cleaning, laundry..... Chemo and the effects..... Surgery and the effects..... 

One sib drove 1500 miles one way 14 times in moms last year, stayed 4 to 8 days each visit.

2 sibs made 6 hour drives oneway 18 times in the last year.

She insisted on staying home. We covered her 24/7 till the end. We needed professionals to assist in the end. She had nurses daily and a live in care specialist at the end. 

Mom’s doing chores aids aren’t allowed to do, dealing with surgical complications.   Why don’t they let Residents sleep again?   If I had four days off very often I’d think I worked for the government.    Was the guy taking 8 day trips on welfare?   My dad doesn’t need guilt of my going bankrupt as well as being a burden for his final weeks / months.    My brother has been handling all the short notice stuff.   

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16 minutes ago, Raz'r said:

So, you’ve never heard of insurance companies going broke? You trust one random insurance company? Smart.

Where did I say that?

You seem to read a lot of things into posts that were not said.

Its not so much that you are wrong, as just not terribly smart.

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21 hours ago, Clove Hitch said:

My first volunteer EMT ambulance company we worked A LOT---  A LOT---  of nursing homes. Some had top notch staff and some seemed to be in converted homes with patients floundering in their own shit- literally.

It happened to be in an area that went big from Trump.  

So, perhaps those folks are getting what the voted for?

 

 

Yes, the same experience I had when I was an EMT.  There was one notorious nursing home in particular that looked like something out of Dante's Inferno, I never saw anything like that in my life.  And I worked in in and outpatient mental health before that and thought I had seen some shit.

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20 minutes ago, BillDBastard said:

Where did I say that?

You seem to read a lot of things into posts that were not said.

Its not so much that you are wrong, as just not terribly smart.

Short term memory loss? That must suck. (Post #21 about “guarantees”) 

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1 hour ago, warbird said:
1 hour ago, SloopJonB said:

Well, sometimes they live in different countries, or cities or there's only one of them and they have to work 2 jobs etc. etc.

Your combination of narrow ignorance and self righteousness is a really nasty combination.

We put our life on hold as mom failed. Cooking, cleaning, laundry..... Chemo and the effects..... Surgery and the effects..... 

Not everyone has that option.

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52 minutes ago, Raz'r said:
1 hour ago, warbird said:

We put our life on hold as mom failed. Cooking, cleaning, laundry..... Chemo and the effects..... Surgery and the effects.....

She insisted on staying home. We covered her 24/7 till the end. We needed professionals to assist in the end. She had nurses daily and a live in care specialist at the end. 

Not everyone has kids...

And some people have kids. And those people have kids. And jobs with limited vacation time. And/or mortgages and bills.

If you are just barely keeping your head above water, the odds are pretty slim you can provide full-time care in your home for a parent that needs it.

 

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1 hour ago, SloopJonB said:

Well good for you.

When you say We put our life on hold as mom failed. what does that mean? You gave up sailing? You gave up your jobs? Where did the money come from? Did you move to be near? Did you move her to be near? How many of you were there? What ages?

Your particular situation does not fit everyone nor is it even possible for everyone.

That "family & neighbours should look after each other" theorizing that right wingers are so fond of is just great when & if it's possible.

Usually it isn't - which is why social programs were created in the first place. That's what you right wingers just can't grasp with your blind focus on ideology. "Anyone who doesn't do what we did is just a heartless & uncaring lib".

Sucks to be you....

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1 hour ago, Mismoyled Jiblet. said:

When someone says "bedsores happen" it touches on the competence issue. 

It also touches on the patient willing to move, get off his ass. I do not feel sorry for my uncle in this regard. I and sibs have tried time amd again to get uncle to move exercise. Schizophtenia and paranoia are a real impediment.

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23 minutes ago, B.J. Porter said:

And some people have kids. And those people have kids. And jobs with limited vacation time. And/or mortgages and bills.

If you are just barely keeping your head above water, the odds are pretty slim you can provide full-time care in your home for a parent that needs it.

 

When a parent is failing I would assume kids are in thier 50's ??????

If kids in thier 50s are barely keeping heads above water.........

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3 hours ago, Huggy Bear Brown said:
10 hours ago, BillDBastard said:

Speaking from personal experience the level of care your parents/elders receive is directly related to two things. The first is the amount of money they saved in the course of their lifetime to ensure end of life care. The second is the family's choices and involvement of overseeing that the proper care is given. We used to attend regular meetings to meet with the nursing home staff and go over our mother's plan of care and current state of health. That is to say we were active in her care management. People who are left in squalor one would have to presume are not being directly managed/overseen by family. So whose fault is that?

Now not everyone is in a financial position to afford the finest of care or even really good care. And in most cases those that are in these sorts of homes are the ones who are being cared for under Medicaid. So one has to ask if Medicaid, government sponsored care is worth the cost.

There has been much debate, but not nearly enough in reality about scrapping Social Security. It would be interesting to see if the monies set aside on average for Social Security, Medicare and Medicaid would be better off invested in the private sector. I suspect they would by a good long deal. Personally I have an annuity, some IRA's and the like and do not include Social Security in my retirement plans. If it is there and I am eligible, fine, but if it is not I know I have my private investments to cover our later years. Now I know a good deal of you like to cry out loud that the market is not something one should bank on due to market fluctuations. However with regard to my annuity (and my spouse's) they are guaranteed to pay out at the market high amount they attained. So say the account peaked at $278k, that is its guaranteed value upon surrender. So even if the market dropped to say $205k for a current value of that annuity at a given moment when we need the money, the amount we can access is $278K. This feature costs a whopping 2% per year fee.

I'm with you on your comments.....my dad was just admitted to a long term care facility and you're right, there needs to be a lot of planning and funding to do it correctly.  One of my parents priorities was long term care insurance, even though it was a major expense for them.  It will fund $35,000+/yr for him which goes a long way.  In addition, they paid a lump sum of $7000 to a senior planning service to assist them with their elderly care choices.  Both of these are paying dividends for them now......  The senior planning service was invaluable in working through the questions and details in arranging for his long term needs.  I'm not sure how someone works through these issues without that kind of support.  They were able to work with my mom to get him into a great facility and work with them regarding exposed assets vs. protected assets as time goes on.  The staff has been outstanding so we are fortunate.  I had discussions with the nurses that was enlightening.  It is a regulated industry and everything they do is against a backdrop of regulations, regardless of whether it makes sense or not.  I'm more than happy to see better patient focused results than rigid regulated requirements.  A reasonable level of regulation can be helpful in that industry, but excessive regulation can be problematic.  From my understanding, it is over regulated.

Also, like you our financial adviser has a percentage of our assets in annuities.  The annuities will pay out double the income should long term care be required without an end date.

I've identified the problem.

You're both financial illiterates.

Do the math on  annuities. Of course your "financial advisor" told you to get one, he makes a commission on it. And a 2% surcharge is very high when it's coming off the top of a fund earning 5% or for that matter even 8%. I've been advised several times to get annuities; when I looked into the math, the returns were less than even down-year middle-of-the-road index funds and the benefit is "guaranteed income." For the sake of this "guaranteed income" we are supposed to hand over a big chunk of capital and somehow not miss it for X years until it starts paying out it's paltry returns. Well guess what, Social Security is a 'guaranteed income' and you guys seem to hate that.

I have not seen a combined annuity + long term care insurance but I find it hard to believe it's more cost effective than a good investment and a long-term-care policy bought when one is young(ish) and healthy.

A lot of people don't have anything but Medicare and similar low-paying publicly-funded benefits. That's what happens when you work punching a time clock all your life, and you have kids. It's always possible to save but sometimes those savings don't add up to much against the $35K+/yr costs. Although there are less expensive options, they are not attractive. Some years ago, I looked into graduated care facilities for my mother...... the ones that take you in for your SocSec and Medicare and nothing else, were like barracks for old sick people. You'd be better off in jail, at least you'd only have to share a toilet with 2 or 3 other inmates and you'd get better medical care.

-DSK

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1 hour ago, warbird said:

We put our life on hold as mom failed. Cooking, cleaning, laundry..... Chemo and the effects..... Surgery and the effects..... 

One sib drove 1500 miles one way 14 times in moms last year, stayed 4 to 8 days each visit.

2 sibs made 6 hour drives oneway 18 times in the last year.

She insisted on staying home. We covered her 24/7 till the end. We needed professionals to assist in the end. She had nurses daily and a live in care specialist at the end. 

Your family sounds selfless, which is wonderful.

What I’ve seen is most often one kid gets stuck with the burden, which really tears things apart.

How would you encourage other families to act as your’s did?  Would you have done the same if you’re mother had remarried after the death of you’re dad, and he was still alive, but too frail to care for your mom?  Would you take care of a stepdad after your mother died?  What would you ask of a dying surviving parent who’s only child had been killed while on military duty?  

 

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7 minutes ago, Steam Flyer said:

I've identified the problem.

You're both financial illiterates.

Do the math on  annuities. Of course your "financial advisor" told you to get one, he makes a commission on it. And a 2% surcharge is very high when it's coming off the top of a fund earning 5% or for that matter even 8%. I've been advised several times to get annuities; when I looked into the math, the returns were less than even down-year middle-of-the-road index funds and the benefit is "guaranteed income." For the sake of this "guaranteed income" we are supposed to hand over a big chunk of capital and somehow not miss it for X years until it starts paying out it's paltry returns. Well guess what, Social Security is a 'guaranteed income' and you guys seem to hate that.

I have not seen a combined annuity + long term care insurance but I find it hard to believe it's more cost effective than a good investment and a long-term-care policy bought when one is young(ish) and healthy.

A lot of people don't have anything but Medicare and similar low-paying publicly-funded benefits. That's what happens when you work punching a time clock all your life, and you have kids. It's always possible to save but sometimes those savings don't add up to much against the $35K+/yr costs. Although there are less expensive options, they are not attractive. Some years ago, I looked into graduated care facilities for my mother...... the ones that take you in for your SocSec and Medicare and nothing else, were like barracks for old sick people. You'd be better off in jail, at least you'd only have to share a toilet with 2 or 3 other inmates and you'd get better medical care.

-DSK

Here, private rooms at the county facilities...

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17 minutes ago, Steam Flyer said:

I've identified the problem.

You're both financial illiterates.

Do the math on  annuities. Of course your "financial advisor" told you to get one, he makes a commission on it. And a 2% surcharge is very high when it's coming off the top of a fund earning 5% or for that matter even 8%. I've been advised several times to get annuities; when I looked into the math, the returns were less than even down-year middle-of-the-road index funds and the benefit is "guaranteed income." For the sake of this "guaranteed income" we are supposed to hand over a big chunk of capital and somehow not miss it for X years until it starts paying out it's paltry returns. Well guess what, Social Security is a 'guaranteed income' and you guys seem to hate that.

I have not seen a combined annuity + long term care insurance but I find it hard to believe it's more cost effective than a good investment and a long-term-care policy bought when one is young(ish) and healthy.

A lot of people don't have anything but Medicare and similar low-paying publicly-funded benefits. That's what happens when you work punching a time clock all your life, and you have kids. It's always possible to save but sometimes those savings don't add up to much against the $35K+/yr costs. Although there are less expensive options, they are not attractive. Some years ago, I looked into graduated care facilities for my mother...... the ones that take you in for your SocSec and Medicare and nothing else, were like barracks for old sick people. You'd be better off in jail, at least you'd only have to share a toilet with 2 or 3 other inmates and you'd get better medical care.

-DSK

You're a dumb ass.....re-read the post.

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26 minutes ago, warbird said:

When a parent is failing I would assume kids are in thier 50's ??????

If kids in thier 50s are barely keeping heads above water.........

People who are laid off in their 50’s routinely find getting comparable re-employment very difficult.  It’s a growing problem.  It’s just too expensive for businesses to rationalize when profitability or shareholder value is the highest value.  You, more than most people here should know and agree with this.  

If you have a business, can you have senior employees taking off with short notice?   For indefinite lengths of time?  If you say ‘no’ to them how would they react?  Would you ask anyone in their 50’s you hire if they have parents who are failing?  Do you believe that would be legal?  Maybe you believe it should be?  And if it were, why would anyone hire anyone in their 50’s?

 

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I talked to a 90 year old escapee from a nursing home in New Orleans in a Katrina shelter. She told me how one of the nurses put as many patients as she could fit into her car and took off just ahead of the rising water. The owners and the rest of the staff had fled the area and AFAIK the rest of them drowned. They weren't human to the staff, just livestock for profit :(

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4 minutes ago, Amati said:

People who are laid off in their 50’s routinely find getting comparable re-employment very difficult.  It’s a growing problem.  It’s just too expensive for businesses to rationalize when profitability or shareholder value is the highest value.  You, more than most people here should know and agree with this.  

If you have a business, can you have senior employees taking off with short notice?   For indefinite lengths of time?  If you say ‘no’ to them how would they react?  Would you ask anyone in their 50’s you hire if they have parents who are failing?  Do you believe that would be legal?  Maybe you believe it should be?  And if it were, why would anyone hire anyone in their 50’s?

When you are in your fifties, you should be able to say, project A needs these steps, project B needs this refinement. I ll return Tues to review. Or say FMLA demands that....... 

 

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11 minutes ago, Amati said:

People who are laid off in their 50’s routinely find getting comparable re-employment very difficult.  It’s a growing problem.  It’s just too expensive for businesses to rationalize when profitability or shareholder value is the highest value.  You, more than most people here should know and agree with this.  

If you have a business, can you have senior employees taking off with short notice?   For indefinite lengths of time?  If you say ‘no’ to them how would they react?  Would you ask anyone in their 50’s you hire if they have parents who are failing?  Do you believe that would be legal?  Maybe you believe it should be?  And if it were, why would anyone hire anyone in their 50’s?

Most parents are not going to die at home.. That is a given. But most parents deserve 15 Denver to Wisconsin trips in a year in thier end years. They deserve projects at home and work advancement to be put on hold...

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9 minutes ago, warbird said:

When you are in your fifties, you should be able to say, project A needs these steps, project B needs this refinement. I ll return Tues to review. Or say FMLA demands that....... 

 

That’s a cop out, and you know it.  If you just had had a heart attack, would you have gone and taken care of your mother?

If you had a diagnosis of prostrate cancer, would you put off treatment to take care of your mother?

Life throws us curve balls.  What if the sibling with the 1500mile commute had suffered an accident?  What if one of your sibling’s business was involved in something that demanded their presence?  

What you’re  asking for with your justifiable desire for visits to a dying loved one is what many countries, in a loving way, give their citizens, as a matter of law, which are accepted as a Christian duty by everyone involved.  It’s hard for me to see you looking at it any way but a gift worth shouldering outside the family-  the family becomes our country.  

And if you want to get mushy, the world becomes our family.  The family of man.  

Its Christmas, Warbird.  C’mon, lower your shield just a little....

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46 minutes ago, warbird said:

It also touches on the patient willing to move, get off his ass. I do not feel sorry for my uncle in this regard. I and sibs have tried time amd again to get uncle to move exercise. Schizophtenia and paranoia are a real impediment.

You, sir, are a first class dick, or just an ignorant asshole.

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51 minutes ago, warbird said:

Sucks to be you....

Thoughtful.

I can see you put as many synaptic firings into that as you put into everything else you "think" about.

 

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45 minutes ago, warbird said:

When a parent is failing I would assume kids are in thier 50's ??????

If kids in thier 50s are barely keeping heads above water.........

Looks like “ignorant asshole.”

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Just now, Raz'r said:

You, sir, are a first class dick, or just an ignorant asshole.

He's a very small mind that is simply unable to comprehend circumstances beyond his personal experience.

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5 minutes ago, Raz'r said:

You, sir, are a first class dick, or just an ignorant asshole.

Uncle was certain hos TV reception was affected ny neighbors "fucking with me"  .  Double checked the oil level on the dipstick after an oil change to ensure they didn't screw him out of 1/2 a quart of oil. Checked the washer fluid level(and transmission) to insure they hadn't syphoned some off. Could not get him to walk arround the block on a nice day.

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5 minutes ago, warbird said:

Uncle was certain hos TV reception was affected ny neighbors "fucking with me"  .  Double checked the oil level on the dipstick after an oil change to ensure they didn't screw him out of 1/2 a quart of oil. Checked the washer fluid level(and transmission) to insure they hadn't syphoned some off. Could not get him to walk arround the block on a nice day.

Taking your vast experience of one aged dude and applying it to the millions who can’t get out of bed? Ignorance. Made worse by world-class assholiness. Many are saying it.

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19 minutes ago, SloopJonB said:

He's a very small mind that is simply unable to comprehend circumstances beyond his personal experience.

At my Mother’s remembrance, the quip that got the most toasts (with alcohol, of course) was:

”She was cruel, but she was fair”

Along with hails of derisive laughter.  (Bruce)

And now we are living in a country ruled by a man (and his followers) who believe that is their motto.

’Cruel but Fair!’  

Clink.

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14 minutes ago, Amati said:

At my Mother’s remembrance, the quip that got the most toasts (with alcohol, of course) was:

”She was cruel, but she was fair”

Along with hails of derisive laughter.  (Bruce)

And now we are living in a country ruled by a man (and his followers) who believe that is their motto.

’Cruel but Fair!’  

Clink.

There is that :D

Just because they are old don't mean their are nice.

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15 minutes ago, Amati said:

At my Mother’s remembrance, the quip that got the most toasts (with alcohol, of course) was:

”She was cruel, but she was fair”

Along with hails of derisive laughter.  (Bruce)

And now we are living in a country ruled by a man (and his followers) who believe that is their motto.

’Cruel but Fair!’  

Clink.

With Trump, that's about as fair as a Brent Swain hull.

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10 hours ago, Huggy Bear Brown said:

You're a dumb ass.....re-read the post.

I'm a dumb-ass who can do math. And I've done the math on annuities at least a dozen times. They don't pay (at least, not to the customer)

-DSK

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See, this is why we need to bring back death panels.  :ph34r:

 

 

In all seriousness, this is a huge issue that is looming for me personally.  My mother is 77 and in reasonable health, despite still smoking a pack a day.  But increasingly I can see her declining rapidly just in the last few years.  She recently fell and broke her upper arm and was in a cast for 3 months.  At that point she as almost a prisoner in her own home as she couldn't drive, dress, shower or other basics for the first 6 weeks.  Fortunately, she has a great network of friends and neighbors that were able to come help get her to phys therapy, help her dress and such.  But I dread the day when she gets worse and may need more care.  We've both spoken about it and she says NO WAY she will go to a nursing home.  She was a career nurse and specialized in geriatric care.  She started off in Miami working as a home care nurse tending to the elderly on South Beach back before south beach was a "thing".  Then she got into managing and running nursing homes as the chief nurse manager.  Later, she was the "hammer" and was the traveling Quality Assurance nurse that would go in and inspect homes in the corporation for rules compliance.  She said even the best funded homes are a challenge.  You just can't be 100% perfect unless you have a really boutique home with very few residents where the fess are outrageous.  Anything else and the level of care is often directly proportional to the amount of involvement of the family.  These homes really rely on family to fill in some of the gaps as they can't be everywhere all the time.  Mom said the homes she ran were higher end and generally gave excellent care.  But at the end of the day, they were still FOR PROFIT corporations with all the baggage that entails.  

Mom is alone (Dad died of cancer 17 yeas ago) said that if she ever got to the point of dementia or was immobile the point where she was not self-sufficient and could not live at home with a decent quality of life, that she wants someone to just smother her with a pillow while she sleeps.  And she's dead serious about it.

And I don't completely disagree.  I think one of the issues in this country and society is we make end of life care too difficult.  Modern medicine has prolonged lifespans, but I don't think they necessarily improve quality of life beyond a point.  I think there comes a point where we need to stop valuing granny's life so much while she's hooked up to a ventilator for the last couple of years of her life.  Just because modern science can prolong life, I'm not convinced its always in the best interest of the patient or of society as a whole.  YMMV

Edited by Shootist Jeff

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