I take Attenolol for high blood pressure and Lipitor (actually, I think they use the generic Zucor here). I also take a sinus congestion medication. My doctor prescribed the first two, to be taken daily. An odd thing happens here. One or two days a week, I don't get the pills.
Various nurses give me the pills, so the issue can't be that only one or two nurses know I get them. I'm not sure what the deal is. If it's in my file that I get these things at all, which it clearly is, surely it also says I get them every day. I don't think it's anything systemic, anyway, because there seems to be no pattern to the missed days. I can get them any time throughout the day, or even after supper, so I can't really zap an email to the unit manager telling her I didn't get my meds. I don't know I'm not going to get them on a given day until I go to bed not having gotten them.
I don't think it's a big deal that I miss a day or two a week, but I find it curious such routine tasks can be repeatedly flubbed in a place like this.
Friday, March 30, 2012
Thursday, March 29, 2012
Aide Approaches
In dealing with a number of different aides, I've noticed various approaches. Each has her own way of doing things. Sometimes I try to tell a new aide how to proceed, but usually I let them take the lead and see how things go.
Individual aides emphasize different aspects of their work. Some just do the minimum required; they are the least interesting. Some strip and wash me each morning; others only take my shirt off. Some brush my teeth, while others do not. Within that activity, some do a thorough job brushing my teeth, and some slap dash. A couple go so far as to brush my tongue. Some give me an Ensure every morning. Others don't. Still others give me part of an Ensure, but not all of it. Some only put my shoes on me if I ask them to do so.
It's that way through the day. Some have more patience feeding me than others. Some put me at my computer in my wheelchair because it's easier for them. Some open my bed at night, and others leave that to me.
Of course, individuals are different. I would've thought that professionals would approach a job like this with some common basic standards, however. Maybe they do, but there's wide variation from aide to aide.
In my own home, dealing with fewer aides, my life would be more consistent and predictable, allowing me to focus on other things.
Individual aides emphasize different aspects of their work. Some just do the minimum required; they are the least interesting. Some strip and wash me each morning; others only take my shirt off. Some brush my teeth, while others do not. Within that activity, some do a thorough job brushing my teeth, and some slap dash. A couple go so far as to brush my tongue. Some give me an Ensure every morning. Others don't. Still others give me part of an Ensure, but not all of it. Some only put my shoes on me if I ask them to do so.
It's that way through the day. Some have more patience feeding me than others. Some put me at my computer in my wheelchair because it's easier for them. Some open my bed at night, and others leave that to me.
Of course, individuals are different. I would've thought that professionals would approach a job like this with some common basic standards, however. Maybe they do, but there's wide variation from aide to aide.
In my own home, dealing with fewer aides, my life would be more consistent and predictable, allowing me to focus on other things.
Wednesday, March 28, 2012
My Bed
As I understand it, Medicare (or Medicaid, I get them confused) technically pays for my bed here-- literally the bed, not the room-- and requires the bed be a hospital bed, that is, a bed that can be raised and lowered and manipulated in various ways. No doubt that's useful, but it also has a down side.
I often use the urinal in bed at night. A couple times recently I've had to use it, and the pee has come out of the urinal. I think that has to do with the bed. It's not flat. It sinks in the middle a bit, for example, so I assume if we don't get the urinal placed correctly beside me on the bed, the thing spills.
Hopefully, a new home would include a simple, flat, comfortable bed.
I often use the urinal in bed at night. A couple times recently I've had to use it, and the pee has come out of the urinal. I think that has to do with the bed. It's not flat. It sinks in the middle a bit, for example, so I assume if we don't get the urinal placed correctly beside me on the bed, the thing spills.
Hopefully, a new home would include a simple, flat, comfortable bed.
Tuesday, March 27, 2012
Lunch
I haven't eaten breakfast in years; it's simpler that way. Here, I haven't asked to have lunch early since I don't have breakfast; I go along with when they give it to me, which is generally somewhere around 12:30. A regular schedule seems to be established for the moment. On Monday, Wednesday, Thursday, and Friday high school girls who train here give me lunch, and they do a good job. What happens with them when school is out for the summer, I don't know. On Tuesday, Saturday, and Sunday, the aide I have that morning generally gives me lunch.
Today is Tuesday. The aide I had this morning didn't bring my lunch until well after one. Maybe she was legitimately busy with somebody else, but other aides virtually always get to me well before that. I think it's another function of a large staff at a large nursing home, a bureaucratic instinct. The staff members know the residents will be here whenever they get to us, so some of them may not really push to keep some kind of schedule.
In my own home, with aides focused on me, I could set my own daily schedule.
Today is Tuesday. The aide I had this morning didn't bring my lunch until well after one. Maybe she was legitimately busy with somebody else, but other aides virtually always get to me well before that. I think it's another function of a large staff at a large nursing home, a bureaucratic instinct. The staff members know the residents will be here whenever they get to us, so some of them may not really push to keep some kind of schedule.
In my own home, with aides focused on me, I could set my own daily schedule.
Monday, March 26, 2012
My Menu
I get to plan my menu from a limited number of choices. Sometimes I even get what I order. Actually, they do better than that. This morning, an aide brought in menus for the next week so she could help me mark them. I told her I'd already done it-- I had, with another aide-- but she said we would do it again-- I don't know if she thought I was wrong, or fibbing, or stupid, or what-- so we did it again. Maybe she thought one might get lost, so it was better to have two rather than risk having none.
So, we'll see what I get this week. I'd be shocked if I picked exactly the same things both times for every meal. That's not the way the human mind works. Given choices where there are no obviously correct answers, most people would probably make one choice one time and another choice another time. If I did that, what I get to eat might depend on which of my menus somebody picks up.
Food here is not bad at all, but I do miss my favorite foods, and favorite meals. I look forward to having home cooking again at some point.
So, we'll see what I get this week. I'd be shocked if I picked exactly the same things both times for every meal. That's not the way the human mind works. Given choices where there are no obviously correct answers, most people would probably make one choice one time and another choice another time. If I did that, what I get to eat might depend on which of my menus somebody picks up.
Food here is not bad at all, but I do miss my favorite foods, and favorite meals. I look forward to having home cooking again at some point.
Friday, March 23, 2012
Night Adventures
Last night, about 2, I had to use the bathroom. I pushed the call button as usual, an aide came and got the urinal-- and I couldn't go. For whatever reason, that happens sometimes. The problem was that I was still hurting. Since my bout with bladder cancer, I've hurt when I have to urinate, and I keep hurting until I can relieve myself. The pain is not as bad now as it once was, but it still focuses my mind.
Anyway, by about 3:30, I decided I had to try to go again, so I pushed the call button again. That time, nothing happened. The light didn't come on. I kept pushing, but it didn't work. So, I yelled for help for about a half-hour, but nobody came. Finally, I got out of bed, crawled to my doorway, and yelled down the hall. Pain can be a motivator. Fortunately, the first person who came along was the aide who usually helps me at night. She got me into the bathroom, and all was well.
This morning, I showed my aide the call button wasn't working, and she fixed it quickly. I think it was just a fluke the thing stopped working; maybe I hit something I shouldn't have while trying to get the button.
It was an interesting night.
Anyway, by about 3:30, I decided I had to try to go again, so I pushed the call button again. That time, nothing happened. The light didn't come on. I kept pushing, but it didn't work. So, I yelled for help for about a half-hour, but nobody came. Finally, I got out of bed, crawled to my doorway, and yelled down the hall. Pain can be a motivator. Fortunately, the first person who came along was the aide who usually helps me at night. She got me into the bathroom, and all was well.
This morning, I showed my aide the call button wasn't working, and she fixed it quickly. I think it was just a fluke the thing stopped working; maybe I hit something I shouldn't have while trying to get the button.
It was an interesting night.
Thursday, March 22, 2012
My Incredible Disappearing Pants
The nursing home does my laundry. About every day a young lady brings my clean clothes back to my room, and we exchange pleasantries. An odd thing happens fairly regularly, however. I run out of clean pants. I have an adequate supply of pairs of pants, but some of them, somehow, get held up somewhere. There are times when I have no clean pants in my closet.
This is no big deal. I haven't mentioned it to management. My pants always come back. Actually, I have one pair much too big for me that I wouldn't care if they did lose. The interesting point in this for me is why it keeps happening with my pants. I assume it's just one of those quirky things that happen inside the bureaucracy of a large institution.
This is no big deal. I haven't mentioned it to management. My pants always come back. Actually, I have one pair much too big for me that I wouldn't care if they did lose. The interesting point in this for me is why it keeps happening with my pants. I assume it's just one of those quirky things that happen inside the bureaucracy of a large institution.
Wednesday, March 21, 2012
The Meeting
This morning featured a meeting with representatives from the Bureau of Developmental Disabilities about getting the process that might allow me to move out of the nursing home in gear, which we did. The BDDS lady shared stories of people who have successfully moved out, and some of them had even less physical ability than I have. That they made this work encouraged me. She also said the whole process might take years-- which didn't encourage me-- or months. A representative from ARC was also present, and she provided a different perspective. Her experience and guidance will be extremely useful moving forward.
And move forward we will. The next step in the process is currently mid-stride. The challenge will be to create momentum going ahead, and then to maintain that momentum so we can reach a conclusion in a reasonable period of time.
And move forward we will. The next step in the process is currently mid-stride. The challenge will be to create momentum going ahead, and then to maintain that momentum so we can reach a conclusion in a reasonable period of time.
Tuesday, March 20, 2012
Pursuing Privacy
I understand staff members in institutions like this need constant, easy access to residents, in case something goes wrong. I also understand family members of residents are probably comforted by knowing aides and nurses and maintenance people are regularly in and out of rooms. Having people in and out, however, can be difficult.
I often have someone come into my rooms, look around, and leave. This can happen any time through the day and on into the night. Sometimes they knock on my open door as they come in, but often they don't. It can be somebody I know, but it can also be a stranger. Most of them are in some sort of uniform, but sometimes they're not. I only assume those belong here. Once, in fact, a woman in uniform came in here, opened my closet, looked through my clothes, and left without ever saying a word to me. There's nothing in there anybody would want, so I guess it wasn't a big deal, but it was bizarre. I'm not criticizing the staff here-- most of them are very nice, and I understand they're only doing their job-- but living with that kind of uncertainty is different.
Never knowing when somebody might come in here, or who it might be, is odd. I like my privacy, and I get a lot of it here, but knowing somebody might come in at any time takes something away from that feeling of privacy. It emphasizes that this is not a home in the usual sense. In my own home, only people I knew would be in my house. No stranger would come in and go through my closet.
I often have someone come into my rooms, look around, and leave. This can happen any time through the day and on into the night. Sometimes they knock on my open door as they come in, but often they don't. It can be somebody I know, but it can also be a stranger. Most of them are in some sort of uniform, but sometimes they're not. I only assume those belong here. Once, in fact, a woman in uniform came in here, opened my closet, looked through my clothes, and left without ever saying a word to me. There's nothing in there anybody would want, so I guess it wasn't a big deal, but it was bizarre. I'm not criticizing the staff here-- most of them are very nice, and I understand they're only doing their job-- but living with that kind of uncertainty is different.
Never knowing when somebody might come in here, or who it might be, is odd. I like my privacy, and I get a lot of it here, but knowing somebody might come in at any time takes something away from that feeling of privacy. It emphasizes that this is not a home in the usual sense. In my own home, only people I knew would be in my house. No stranger would come in and go through my closet.
Monday, March 19, 2012
Timimg The Call
Here, when I need an aide, I press the call button. I only do it when I have to go to the bathroom, which makes timing the call tricky. First, I have to be sure I really have to go; there's no point in getting an aide to come if I can't make the visit productive. Second, I have to take their arrival time into account. Sometimes it's ten minutes, sometimes twenty, and sometimes longer-- sometimes they even come, ask me to wait while they help somebody else, and take off again. In that case, I can have a tough few minutes if I waited too long to push the call button in the first place. Yes, I could try to get them to help me first, but I don't know the situation of the other person, so I don't. So, I don't want to push the button too early, but I can't wait too long, either. It adds stress to the physical activity involved.
In my own small home, with one aide around at any given time, I wouldn't need to worry about timing the call. I wouldn't need a call button. I could simply call.
In my own small home, with one aide around at any given time, I wouldn't need to worry about timing the call. I wouldn't need a call button. I could simply call.
Friday, March 16, 2012
Chain Of Command
When I have a specific issue here, I email the unit manager, who is over my part of this complex. She is very good about it, and assures me she will take care of my problem. Execution of her directions, however, can be spotty. We've made progress, but consistency is a problem. I assume that has to do with the parade of aides through my rooms lately. Each aide has their own approach, and at least one thing they do well, but there seems to be no real unified approach to providing the help I require. There seems to be relatively little effort to inform new aides about what I need except by word of mouth, which leaves the aide and I to work it out between us, even though we've never met. Lately, they've been sending new aides with aides who know me to learn some of what to do. That might help.
Lots of this is my own problem. I admit that. I am naturally a private person, and I don't like constantly dealing with new people. I also dislike being unable to plan ahead. I never know which aide I'll have next. Sometimes one aide will take me to the bathroom, and another will get me off the toilet. It keeps me on edge.
In my own home, there would be no chain of command. My aides and I would work things out between us because we would get to know each other-- and because I would have only a limited number of people to get to know.
Lots of this is my own problem. I admit that. I am naturally a private person, and I don't like constantly dealing with new people. I also dislike being unable to plan ahead. I never know which aide I'll have next. Sometimes one aide will take me to the bathroom, and another will get me off the toilet. It keeps me on edge.
In my own home, there would be no chain of command. My aides and I would work things out between us because we would get to know each other-- and because I would have only a limited number of people to get to know.
Thursday, March 15, 2012
Disaboomjobs
The website www.disaboomjobs.com posts job openings with major corporations that are aimed specifically at the disabled. The goal of such efforts, from the corporate viewpoint, is to increase diversity in the workforce, in accordance with public policy objectives. I keep an eye on the website, hoping to find a job I could do on my PC from home.
Having a steady job would allow me to either buy or rent my own home, meaning the state would only have to pay for aides. I'm assuming that would make getting such help more likely. Ideally, of course, I could make enough money-- perhaps by selling my novels-- to fund my own needs, leaving the state completely out of it. Maybe someday.
So far, the jobs offered on the website haven't meshed, necessarily, with what I bring to the table. Maybe that will change, or maybe I can find another avenue to independence.
Having a steady job would allow me to either buy or rent my own home, meaning the state would only have to pay for aides. I'm assuming that would make getting such help more likely. Ideally, of course, I could make enough money-- perhaps by selling my novels-- to fund my own needs, leaving the state completely out of it. Maybe someday.
So far, the jobs offered on the website haven't meshed, necessarily, with what I bring to the table. Maybe that will change, or maybe I can find another avenue to independence.
Wednesday, March 14, 2012
Aides
A few aides here have told me I'm the nicest person here. Of course, if most people here are elderly, maybe lonely, maybe ill, maybe in pain, maybe even dying, being the "nicest" may not be saying much. Some people here probably have good excuses for not being especially nice. For my part, I try to be pleasant enough, but I suspect the aides like me because I keep my demands on them to a minimum. I go along with them when they're working with me, even if another approach would be simpler for me, and I only use the call button when I need to go to the bathroom.
I would approach the aides in my own home in much the same way. Maximizing personal independence, for me, involves lots of private time, when I can do as I choose. In fact, most days I'd only need an aide at specific times-- in the morning helping me get up, at mealtimes, later in the evening, and usually once during the night. How an agency would schedule my aides, I'm not sure, but the people would have plenty of free time of their own.
I would approach the aides in my own home in much the same way. Maximizing personal independence, for me, involves lots of private time, when I can do as I choose. In fact, most days I'd only need an aide at specific times-- in the morning helping me get up, at mealtimes, later in the evening, and usually once during the night. How an agency would schedule my aides, I'm not sure, but the people would have plenty of free time of their own.
Tuesday, March 13, 2012
Lunch
First, an update. I was weighed again yesterday, and I'm down to 90 pounds. Hopefully, we'll be able to reverse the downward trend.
That reversal didn't begin at lunch today. For starters, I didn't get lunch until 1. When she did bring it, the aide, whom I don't know, spent a lot of her time on her cell phone. I've had aides use their cells when they were with me before, but they always asked me if they could first. This one didn't ask. She gave me little to eat, even less to drink, and asked me if I were through. She was obviously ready to leave, so I went along with it. I was ready for her to leave, too. I should say, for her side, that I don't know how much people here eat. Maybe she gave me as much to eat as she gives other residents. Anyway, I didn't even go to the bathroom after eating, preferring to try to be sure she helped me get on the computer.
The sort of thing outlined above happens sometimes in big institutions, where some people are more interested in doing a good job than others. I understand that. Aides here regularly ask me to wait while they deal with somebody else, too. Maybe they ask everybody that, I don't know. It all goes to a basic case, however. If I had my own home, with aides, there'd be no one else there an aide would need to aid. If I only had a few aides, we'd develop friendships, and friends are treated better than just another nursing home resident.
That reversal didn't begin at lunch today. For starters, I didn't get lunch until 1. When she did bring it, the aide, whom I don't know, spent a lot of her time on her cell phone. I've had aides use their cells when they were with me before, but they always asked me if they could first. This one didn't ask. She gave me little to eat, even less to drink, and asked me if I were through. She was obviously ready to leave, so I went along with it. I was ready for her to leave, too. I should say, for her side, that I don't know how much people here eat. Maybe she gave me as much to eat as she gives other residents. Anyway, I didn't even go to the bathroom after eating, preferring to try to be sure she helped me get on the computer.
The sort of thing outlined above happens sometimes in big institutions, where some people are more interested in doing a good job than others. I understand that. Aides here regularly ask me to wait while they deal with somebody else, too. Maybe they ask everybody that, I don't know. It all goes to a basic case, however. If I had my own home, with aides, there'd be no one else there an aide would need to aid. If I only had a few aides, we'd develop friendships, and friends are treated better than just another nursing home resident.
Monday, March 12, 2012
Housing
I'm assuming that if the government helps me get a place of my own, it will be subsidized, low income housing. That would be fine with me. My Aunt Mila used to live in such housing, and her sister Becky said it was a nice, clean place. Trust me, if my Aunt Becky says a place is clean, it's clean.
There may be a bigger opportunity here, however. Because of the recent collapse of the residential housing markets, banks now own huge numbers of properties they would love to get off their books. If the government wanted to expand its effort helping people move out of nursing homes to include the elderly generally, more housing would be required. The outlines of a deal to get banks out from under bad debt while acquiring housing necessary to provide maximum personal independence for the maximum number of Americans seem to be apparent. Because most people helped by such a program probably could never buy a home on their own, the approach wouldn't seem to hamper housing's recovery as the people involved wouldn't be part of the market and the properties involved would not re-enter the market.
Will this happen? Probably not. Smarter people than I am are trying hard to bring housing back, and if they haven't pursued the above approach, it's probably because there's a flaw in the idea I don't see. Still, if we want to move away from institutionalizing people in a major way, we will have to get creative about some things, including residential housing.
There may be a bigger opportunity here, however. Because of the recent collapse of the residential housing markets, banks now own huge numbers of properties they would love to get off their books. If the government wanted to expand its effort helping people move out of nursing homes to include the elderly generally, more housing would be required. The outlines of a deal to get banks out from under bad debt while acquiring housing necessary to provide maximum personal independence for the maximum number of Americans seem to be apparent. Because most people helped by such a program probably could never buy a home on their own, the approach wouldn't seem to hamper housing's recovery as the people involved wouldn't be part of the market and the properties involved would not re-enter the market.
Will this happen? Probably not. Smarter people than I am are trying hard to bring housing back, and if they haven't pursued the above approach, it's probably because there's a flaw in the idea I don't see. Still, if we want to move away from institutionalizing people in a major way, we will have to get creative about some things, including residential housing.
Friday, March 9, 2012
Weighty Matters II
The nurse who gave me my medicine this morning told me from now on I will get protein shakes three times a day. She said that would help build up my muscle mass and strength. I guess maybe the doctor here decided my weight loss should be addressed.
It's good news. Trying to maintain my weight can't hurt, plus I like the stuff. Also, it will help my daily liquid intake. A tech at my urologist's office told me I should have at least 36 ounces of liquid daily for the health of my bladder. I'm not entirely sure whether she meant all the time or just while I'm going through treatments, but since it should be such a simple thing to do, I see no point in taking chances. When I have my best aides all day, I get that and more. I keep rough track. (Okay, maybe I'm a bit obsessive about it.) When I have other aides, however, I often fall short. So, maybe this new approach will help on two fronts.
Not to pound away on the point, but if I had the same aides consistently, essentially day in and day out, we could work out my liquid intake and my diet easily.
It's good news. Trying to maintain my weight can't hurt, plus I like the stuff. Also, it will help my daily liquid intake. A tech at my urologist's office told me I should have at least 36 ounces of liquid daily for the health of my bladder. I'm not entirely sure whether she meant all the time or just while I'm going through treatments, but since it should be such a simple thing to do, I see no point in taking chances. When I have my best aides all day, I get that and more. I keep rough track. (Okay, maybe I'm a bit obsessive about it.) When I have other aides, however, I often fall short. So, maybe this new approach will help on two fronts.
Not to pound away on the point, but if I had the same aides consistently, essentially day in and day out, we could work out my liquid intake and my diet easily.
Thursday, March 8, 2012
Weighty Matters
They weigh residents here regularly. The first time they weighed me, I weighed all of 95 pounds. The most recent time, I was down to 90. It's puzzling. I have a better, more varied diet here, and I generally eat most or all of what I'm given.
One factor might be that I'm not always given much. Elderly, sedentary people presumably don't eat much, and I presumably get the same portions they do. Asking for seconds is a possibility, but I'd need to pick my spots. Most of the aides who feed me now-- including several high school kids-- are good about it, but some clearly just want to get it over with, and I'm sure all of us, myself included, feel a certain time limit holds because the aides have other people who need their help.
This is not a complaint. I'm perfectly fine with getting meals over with as quickly as possible. The fact is, though, that my eating is influenced by this institutional setting. In my own home, the aide wouldn't be especially concerned with anybody else, and I could have seconds if I wanted-- and have home cooking again.
One factor might be that I'm not always given much. Elderly, sedentary people presumably don't eat much, and I presumably get the same portions they do. Asking for seconds is a possibility, but I'd need to pick my spots. Most of the aides who feed me now-- including several high school kids-- are good about it, but some clearly just want to get it over with, and I'm sure all of us, myself included, feel a certain time limit holds because the aides have other people who need their help.
This is not a complaint. I'm perfectly fine with getting meals over with as quickly as possible. The fact is, though, that my eating is influenced by this institutional setting. In my own home, the aide wouldn't be especially concerned with anybody else, and I could have seconds if I wanted-- and have home cooking again.
Wednesday, March 7, 2012
Group Vs. Private
Governments at the state level, encouraged by federal funding grants, are trying to develop programs to allow people in nursing homes to move out if they choose. Obviously, there are criteria to be met by those wanting to move, but the overall thrust to help people regain as much personal independence as possible, is positive.
Leaving is only half the process, however. The other half involves where the person goes. Perhaps the most common destination is a group home, a place in which a few-- two, three, four-- residents live, supported by a few aides. Group homes can be largely run by the residents themselves, and are therefore often less structured, with more relaxed atmospheres than nursing homes. Group homes can be good options.
That said, however, if the driving force for getting out of a nursing home is maximizing personal independence, a group home may be only a step forward. I would no longer have to deal with the administrative quirks and staffing shifts of a large nursing home, but I would have to deal with my housemates about how we would live together. We would all have to make comprises.
After all these years, I would like a few years in which my compromises were kept to a minimum-- in which I would live largely on my own, in my own, private home. Governments no doubt see group homes as more cost-effective. Finding a way to acquire my own home with my own money would change the situation, but failing that, if I can pursue this project, I'll have to make decisions as we move through the process, a step at a time.
Leaving is only half the process, however. The other half involves where the person goes. Perhaps the most common destination is a group home, a place in which a few-- two, three, four-- residents live, supported by a few aides. Group homes can be largely run by the residents themselves, and are therefore often less structured, with more relaxed atmospheres than nursing homes. Group homes can be good options.
That said, however, if the driving force for getting out of a nursing home is maximizing personal independence, a group home may be only a step forward. I would no longer have to deal with the administrative quirks and staffing shifts of a large nursing home, but I would have to deal with my housemates about how we would live together. We would all have to make comprises.
After all these years, I would like a few years in which my compromises were kept to a minimum-- in which I would live largely on my own, in my own, private home. Governments no doubt see group homes as more cost-effective. Finding a way to acquire my own home with my own money would change the situation, but failing that, if I can pursue this project, I'll have to make decisions as we move through the process, a step at a time.
Tuesday, March 6, 2012
Possibilities
Last year, I wrote an article for a non-paying website which laid out a rationale for human spaceflight. That article brought me two interesting invitations, neither of which I could accept. The first was an opportunity to go on a national radio show to discuss the ideas in the article. The second was a chance to attend a space policy conference in Hawaii. It seems the State of Hawaii is supporting an effort to build an industrial park on the Moon as part of its economic development strategy.
As things turned out, the week of the conference in Hawaii was the first week I spent in the nursing home. Not that I could've gone out there, anyway, but the difference between where I was-- physically and otherwise-- and where I could possibly have been was stark.
I plan to contact the fellow in Hawaii again in hopes of getting a freelance writing assignment or two. Or three. If I could finally-- quickly-- get my writing career in gear, maybe I could buy my own home, or establish a fund to allow me to pay rent. If the state, then, would only need pay for my aide help, maybe the chances of me getting out on my own would increase.
As things turned out, the week of the conference in Hawaii was the first week I spent in the nursing home. Not that I could've gone out there, anyway, but the difference between where I was-- physically and otherwise-- and where I could possibly have been was stark.
I plan to contact the fellow in Hawaii again in hopes of getting a freelance writing assignment or two. Or three. If I could finally-- quickly-- get my writing career in gear, maybe I could buy my own home, or establish a fund to allow me to pay rent. If the state, then, would only need pay for my aide help, maybe the chances of me getting out on my own would increase.
Monday, March 5, 2012
Expanding The Pool
Programs giving the disabled the option to leave large, structured nursing homes in favor of living in their own homes, with aides provided, or in settings such as group homes, may well be the early ripples of a wave of the future. It's probably safe to assume most people would prefer to stay out of nursing homes if at all possible. If so, the realities of budgets and demographics may play out to the advantage of most of us.
Governments at every level in the United States are facing severe budget problems that extend for years into the future. However the political class eventually deals with those problems, reform of Medicare, Medicaid, and the larger healthcare system will be part of the approach. Ways to economize while still providing people with the basic help they need will be developed. Demographics will push that trend, as well. The American population is aging, and will demand care suited, as much as possible, to the lifestyle those people have established for themselves.
Without doing any real calculations, it's likely that a person staying in the home they own with aides provided by government program is less costly to the government than paying to support that person in a traditional nursing home, because that involves paying for the overhead of the facility, the enforcement of regulations, a large staff, etc. Providing housing for individuals may also actually save government money, though that is a closer call, dependent on various factors.
The emergence of telemedicine will strengthen the trend allowing people to live on their own terms. Doctors will be able to monitor the health of their patients over the Internet, allowing more people to continue living in their own homes. To the extent that working to maximize the independence of the disabled creates programs and approaches that can serve as models for helping the elderly a few years hence, the philosophy developed now can lead to a less centralized future, one focused on the dignity of each individual.
Governments at every level in the United States are facing severe budget problems that extend for years into the future. However the political class eventually deals with those problems, reform of Medicare, Medicaid, and the larger healthcare system will be part of the approach. Ways to economize while still providing people with the basic help they need will be developed. Demographics will push that trend, as well. The American population is aging, and will demand care suited, as much as possible, to the lifestyle those people have established for themselves.
Without doing any real calculations, it's likely that a person staying in the home they own with aides provided by government program is less costly to the government than paying to support that person in a traditional nursing home, because that involves paying for the overhead of the facility, the enforcement of regulations, a large staff, etc. Providing housing for individuals may also actually save government money, though that is a closer call, dependent on various factors.
The emergence of telemedicine will strengthen the trend allowing people to live on their own terms. Doctors will be able to monitor the health of their patients over the Internet, allowing more people to continue living in their own homes. To the extent that working to maximize the independence of the disabled creates programs and approaches that can serve as models for helping the elderly a few years hence, the philosophy developed now can lead to a less centralized future, one focused on the dignity of each individual.
Friday, March 2, 2012
Moving Forward
I had a good meeting yesterday morning with people who can help me navigate the state government bureaucracy to get a home of my own. Dealing with bureaucrats is not the favorite thing of most people, especially if the bureaucrat has to be asked to push a limit or two. That's not always the fault of the person in the government job, however.
Legislatures create government agencies and programs and task them to do certain things. Then, people in the agencies write rules and regulations designed to help employees of that agency to meet the goals set for it by the legislature. Then, staffers do their jobs based upon those regulations. English, though, is an elastic language. It gives people inclined to stand strictly on their reading of the regulation the strength to do so, but the same language, looked at from another perspective, can often give somebody so inclined lattitude to respond to individual situations. It's an intriguing process the media and the public too often see in black-and-white terms. In our eagerness to proclaim ours a government of laws, we tend to downplay the role individuals can play in applying those laws.
It's not clear yet whether my case will fit firmly within the definition laid out by the main program that could help me, but I'm comfortable I will get a fair chance from the people I met yesterday.
Legislatures create government agencies and programs and task them to do certain things. Then, people in the agencies write rules and regulations designed to help employees of that agency to meet the goals set for it by the legislature. Then, staffers do their jobs based upon those regulations. English, though, is an elastic language. It gives people inclined to stand strictly on their reading of the regulation the strength to do so, but the same language, looked at from another perspective, can often give somebody so inclined lattitude to respond to individual situations. It's an intriguing process the media and the public too often see in black-and-white terms. In our eagerness to proclaim ours a government of laws, we tend to downplay the role individuals can play in applying those laws.
It's not clear yet whether my case will fit firmly within the definition laid out by the main program that could help me, but I'm comfortable I will get a fair chance from the people I met yesterday.
Thursday, March 1, 2012
Staffing
I'm basically a private person, so staffing is a big issue for me. I'm told one of the aides who has helped me here at the nursing home has been let go. I gather one factor was that some residents didn't like her attitude. Tasha does have a natural severe expression to her face, and a brusque approach, but she also has a nice smile and a playful, engaging side. I will miss her.
This is a big place, and I understand there will be staffing challenges, but dealing regularly with new aides, each of whom has their own way of doing things, is difficult. I never know who is coming into my room next. In my own home, with contracted aides, I could hopefully deal with only three or four main aides (yes, I understand there will be substitutes) with whom I can establish relationships, even friendships. That would make my life much simpler, and much richer.
This is a big place, and I understand there will be staffing challenges, but dealing regularly with new aides, each of whom has their own way of doing things, is difficult. I never know who is coming into my room next. In my own home, with contracted aides, I could hopefully deal with only three or four main aides (yes, I understand there will be substitutes) with whom I can establish relationships, even friendships. That would make my life much simpler, and much richer.
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