Monday, July 16, 2007

Nursing homes

I"m going to preface this blog with the following disclaimer: "Yes, I realize that I am going to sound like an asshole for what I'm about to say, and NO, there's nothing I care to do about it.

I don't think nursing homes should exist. I think they're a complete drain on the health care system and a complete drain on money. I can personally guarantee that at least 75 percent of the people in nursing homes are not there on there own dime, or even the dime of their families. Their "care" is being paid for by you and I, through social security and medicaid/medicare Personally I can't see how the government can justify spending billions each year to barely keep people alive.

I'm not saying that I should be the judge of when quality of life becomes more important than life itself. But what I can say is; what's the point of keeping a 97 year old women alive on a machine or what's the point of drawing labs and analyzing every possible bodily fluid just to make sure parts of her haven't stopped working, i.e. renal failure. It just doesn't make sense to me.

Normally I'm a big fan of capitalism and competition, even in health care. The competition drives us to develop new technologies to help with the diagnosis and care of patients. This isn't the case with nursing homes. Nursing homes are strictly a business. Most hospitals are non-profit organizations.

We have a contract with a company who has contracts with nursing homes, they'll go out to a nursing home and draw blood or take urine samples. Next, they send these samples to my lab for analysis. We charge this company for our services and they in turn charge nursing homes any fee they feel like charging them for a service that they don't need. The reason companies like these have popped up is because nursing homes continue to employ under qualified people. Why pay a nurse 20 bucks an hour when you can pay an aid 8 bucks an hour. It's all about the bottom line for these people.

Not only do the pocketbooks of whomever pays for these services suffer, but general health care of everyone in the community can suffer. I've been told that company's like the one I just described to you (let's call them B&B) are the reason I have a job, they keep us in the black. So guess what. We basically have to suck their collective dick and process everyone of those specimen stat. The get pushed ahead of patients that have just had heart attacks, they get pushed ahead of the patients in the I.C.U's, and they even get pushed ahead of the patients in the E.R. Simply to make a buck.

I've stated this before, but why do I give a fuck if some 97 year old grandma who can't bathe herself, is completely devoid of use to our society, and who uses the money I'm putting into social security and medicaid live? The answer is I don't. at 97 you've lived a full life, why are you trying to prolong death. I think it's time we start investing money into people who are productive members or at least have the potential to be productive members of society. (Think scholarships for the best and brightest).

I'll give a couple groups a break though. I think if you're a veteran and have war related injuries then the government should take care of you until you decide you're ready to die. Secondly, If you've been smart enough to invest you're money well, and save enough so that you're still paying you're own ticket, by all means stay alive as long as you'd like. I don't care if you prolong death till the year 2050 waiting for the fountain of youth, as long as you're waiting on your dime. I'm all about giving things to people who have earned them. If you've worked hard to provide for yourself into your golden years then you should be allowed to do whatever you want. Even people with old money, If one of your ancestors had the foresight to work hard and make a fortune so that his descendants could live well, then good for him.

The only thing I'm trying to say here is that we're pumping money into a useless system. It's not an investment in any way. AT least the war in Iraq has the potential for some positive impact. I know many of you are not supporters of the war, but in 100 years history is going to look back and see a democracy being established in the middle east as one of the most significant events of the last 200 years. That, or it really is the beginning of Apocalypse.

12 comments:

Anonymous said...

I have to disagree. Not all elderly people in the nursing home are on machines just waiting to die. In my own experience people go to the nursing home to recoop after going to the hospital because they dont have family at home that can help them out. I know that without nursing homes many grandparents would die at home alone because their familys dont love theme enough to take them into their own homes. I do agree that there are a lot of people that are just waiting to die but shouldn't the blame go to science for trying so hard to keep these poor people alive and miserable? I do believe that nursing homes are essential but I dont believe that people should live till they are 101 just so science can say they are doing good when the helpless old person just wants to die because life just isn't worth living that long.

rob rob the party slob said...

this is where being a poor writer gets me into trouble.... while I don't think we should blame science.. because the ultimate decision belongs to the patient.... I do think I was more trying to make a point that nursing homes, too often are places that prolong death, and not preserve life... I hope that makes a little more sense

Lauren said...

I waitressed in an assistant living home for a while, but I didn't really see this situation a lot because the home employed registered nurses to take care of the residents. Of course, a lot of the people living there were mostly capable of taking care of themselves, and lived there because the rooms were nice and they didn't have to do any of the cooking and cleaning, which is kind of ridiculous considering how much it costs to live there.

My mom is an executive at the local veterans' hospital and has definitely made me feel like they need more funding, not less. =]

Anonymous said...

Go work at one and come back and tell me what you think then.

Anonymous said...

I happened upon this old blog and felt the overwhelming need to shed some light on a topic being looked at from the outside. A prespective but not the inside looking out.

I have worked in the nursing home industry for many years.

Nurses and aides are both needed in nursing homes. There are no doctors working in the nursing home like in the hospital. Both are needed for quality care of patients at all ages.

Not all people in nursing homes are old. Insurance companies at all levels are looking to nursing homes as a more cost effective and more effective rehab setting for people age 18 and up. Currently, there are people ages 22 to 102 where I work.

The lab tests you speak of are far more cost effective then sending someone to the ER or a doctor's appointment - even to you or I in the private sector. Those tests can tell us a ton in a population that can be hard to diagnosis.

Many or our 97 year olds are much healthier then you might think - there is a reason they have made it that long! Most of our elderly have been very hard working members of the world. Even doctors themselves who never expected to out live their money. Also, people that never expected to see medical care become so expensive.

Many of our family members would like nothing more then to be able to take care of thier loved ones at home BUT they have to work later and later in life. To safely take care of a 97 year old at home is not an easy task nor a part time task. Often, these people's children are elderly themselves. It would break your heart to see a 97 year old grieve the death of thier 70 year old 'baby'. Love is ageless - I have learned so very much about life from our elderly. Thank goodness something like a urine test can keep them comfortable and off any nasty machine.

You can also that the regulatory agencies for the STAT lab orders. Nursing homes are so heavily regulated that if they waited a night to get a lab done they would be fined and given a big no-no from they state and federal government. The microscope they are under is huge and unforgiving.

No one is on machines waiting to die that I know of unless they are in a special vent facility.

Actually, I think doctors have got much better about end of life care and when to educate people on terminal issues. I do not see the drama you are thinking goes on.

Some of our patients still go out, date, get married, drink, have sex, order pizza....etc.

The quality of ones life does change as we age but so does what we view as valuable or important.

For many - they would like to die, but know 'nature will take its course' and then there are those that are afraid to die. Reality - it will happen to all of us at sometime, its just not always up to us.

Everyone has a set of issues young or old. If our 97 year olds that helped make our cities, towns, and country what they are today need us to help them out --- should we really decide their value? Not to mention - they probably thought the same way you do at your age.

Anonymous said...

Okay you self righteous prick, when you get old, we'll just bury you up to your neck in your backyard and leave you there to die. How about that? What in the hell is wrong with you? These are people who are mothers and fathers, war veterans, inventors, creators of our very way of life. Without them none of us would exist, and you don't think they deserve to be well cared for in their old age? You think they should just be left to rot at home with no one to care for them or about them? Would you feel the same about your own mother or father or yourself? I have worked in long term care for years. Many of my residents still live active lives, but simply cannot do it alone at home anymore. They deserve adequate, compassionate care. THEY WORKED for the Medicare benefits which they are now receiving. WE ARE NOT PAYING FOR IT, THEY ARE! Do you work for a living? Look at your paystub, do you see where money is taken out and put into social security? If you don't work, you can't get medicare. It's not a free ride, it is for people who earned it. You are a nefarious ass and don't deserve to have someone take care of you when you are old and decrepit.

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