https://www.ncronline.org/opinion/guest-voices/beyond-saying-no-church-s-answer-assisted-suicide
Will the anti-abortion fight pattern of spinning the wheels while spending millions on lobbying be any more effective in fighting assisted dying?
There won’t be enough babies to save the system. There are many theories about the decline in birth rates. I suspect that all play a part. It would be a good idea for the PTB to face reality and begin serious planning for a steady decline in the birth rate. They should stop wasting time pondering what appears to be looking for "soft" ways to coerce women to have more children to save social security and Medicare. They need to look at options that include increasing taxes on corporations, multi-millionaires, and the growing numbers of billionaires, and removing the income cap for deducting social security so that these deductions continue for all income, at the same rate as lower income Americans. Perhaps there should be a means test at some point. Trump earns way over the cap just with his salary as President, and also gets SS. But since our politicians are now owned by billionaires, tax increases are not likely anytime soon. Meanwhile the baby boomers keep getting old.
There are no realistic policy solutions being proposed in the US as far as I know. Pushing for more couples to have big families isn’t going to do it.
Most elderly Americans, including those with Alzheimer's, are cared for by family, simply because hiring in home care or moving an elderly family member to assisted living is VERY expensive. But there is no financial help from government for this at all. Instead, it proposes trillions more for the depleted weapons stockpile and a new class of unneeded battleships. Even when there is money (or Medicaid) to cover the cost of basic assisted living, many resist it. Many people in assisted living really don't want to be there (read the comments to the frequent articles on the subject) It’s depressing to be living where everyone is smiling through their pain while waiting to die.
Family caregiver burn-out is widespread. The looming eldercare crisis will be exacerbated by trump's deportation policies. Most caregivers, in homes and in facilities, are immigrants of color. In the last almost three years I haven't seen a single non-immigrant caregiver in either assisted living facility that my husband lived in (with me in the first, alone for a month in the second) nor in the home caregivers we have had. The work is very hard and is poorly paid, even in “luxury“ assisted living places with fees that run well into six figures annually. I have no idea how many caregivers are legal, or are using false SS cards, but our country desperately needs them. Americans should be thankful they are here and willing to undertake these very difficult jobs. The Haitians will be gone soon unless somebody files another lawsuit to delay. The Latinos live in fear, even if they are legal. So some no longer go to work, and all face a danger of arrest without a warrant, just based on the color of their skin and the language they use. The law of supply and demand hasn't been repealed, and a smaller caregiving workforce will result in even higher care costs soon.
So, what will be done to relieve the pressure—assisted dying? Some families follow advice to run through all their savings, or give their assets away, to qualify for Medicaid coverage for basic assisted living (not “ luxury” assisted living). They should be aware of the look-back provisions. When they apply after giving away or spending all their funds, Medicaid will look back at their finances for the previous five years and they will be ineligible for assistance if they followed the advice to deplete their assets during the five years before applying for assistance. Voluntary self-impoverishment v. voluntary assisted dying shouldn’t be the only options..
In the comments to articles about the looming elderecare crisis, many of the elderly, or nearly old, say that they plan to request assisted dying once life holds no pleasure, no joy, only pain. They also don't want to be a huge burden for their adult children or adult grandchildren. I struggle with the moral issue of assisted dying, but I don't condemn those who seek it.
Americans, and especially Catholic christians, need to think hard about this as states continue to legalize assisted dying and the bishops fight it. The Catholic church has failed to persuade most Americans that abortion should be a crime after spending 50 years and millions and millions of dollars to end legal abortion. Abortion continues, as it always has, including before Roe v Wade. It will continue even if there is a national ban--history, including US history, has many, many examples of this reality.
Will the church also waste milions fighting the right to assisted dying legislation? If it does, what will it offer as an alternative? It has failed miserably in providing meaningful help to poor women who seek abortion, both at the local (parish) level and at the political level. Will it do any better with this new issue?
This has been going on for at least two generations now. I was trying to raise my kid, work, and help care for my parents. Now I'm the ailing elderly.
ReplyDeleteThe situation is similar in Europe. Possibly there are tips that could guide US elder policy, if not at the fed level, maybe the state.
The Boy lives in Oregon, which has legal assisted dying. I see no indication on the Oregon Right to Life site that it is interested in that issue, just abortion and birth issues.
RTL Oregon does have a statement against "euthanasia," but efforts are still focused on abortion law. Possibly the thinking is that people who want to die are making decisions for themselves; abortion is making that decision for another human life.
DeleteI'm guess that, just looking at numbers, the thinking is that abortion is more common than legal euthanasia. In 9 years, about 2,800 people have died via assisted suicide.
https://deathwithdignity.org/news/2024/03/annual-oregon-dwd-report-data/
Not many so far. But it’s being legalized in many states. I see lots of comments following news articles about the crisis with so many getting old snd frail without good choices for care. A surprising (to me ) number of those comments are written by people still in good shape - maybe in their 60s or 70 s, who say that they would seek assisted dying if they become helpless, in great, non- stop pain, or are on their way to advanced Alzheimer’s. So the church is fighting the legislation. But it is not offering any meaningful help for families facing these situations, just as they never offer meaningful help to women seeking abortion. Jack had some ideas about how parishes could help the elderly, but couldn’t get anyone in his parish or diocese interested. Just as mostly unused parish halls could be used to provide free childcare to women who need it in order to give birth, there might be a way for parishes to facilitate caring for the elderly in their parish at home to give the family caregivers a break. The church has spent huge amounts of money fighting for laws to ban abortions. What if those $ millions had been spent on programs like this one instead?
Deletehttps://www.stanns.org/about
According to the report I linked to above, half the people who obtain the meds for assisted suicide don't take them. So, yes, Americans have a "take me out and shoot me when I'm useless" bravado when they see age and infirmity looming, but that seems to give way to a more measured acceptance of limitation and illness as it happens.
DeleteIt may also be that palliative care is improving, though I do not see evidence of that in my cancer group. American medicine is not much focused on quality of life issues. If it were, there would be less clamor for the Black Capsule.
St Ann's is a wonderful program.
I have been grousing that the huge church hall at the local parish has not been used for a cooling and air quality center on heat warning and dangerous smoke from wildfire days.
But the RCC does not exist to act as a social services outlet, but to get people to Heaven. And the Church Ladies don't want to mess with it bc of cleaning and energy expenses. They have a point.
If one doesn't have physician-assisted suicide legally available, there's always Drs. Smith and Wesson and other DIY alternatives. It's my Catholic outlook that will stop me from doing it, not legislation. Actually, given the present drift in this country and the surfeit of unaddressed noble causes, one could always stand up for one of them and end up in the ICE hoosegow. The care would probably be at about the same level as a nursing home. I guess I sound as if I'm being a wise guy but I do actually think about these things.
ReplyDeleteAnne, you're right about nursing homes. my mother worked in a nursing home / assisted living facility in the Philadelphia Main Line, for the rich. No picnic for them, either.
A solution to this problem might be if medical science can prevent dementia. I wonder if my mother and aunt might have avoided their couple years of dementia at the end if they had had CPAP machines like mine. I have two motivations to use the machine. Improved daily energy and, I hope, reduced probability of dementia. Brains like oxygen.
Do you have a plan if your efforts to stay healthy and fit (including the CPAP) machine don’t do the job? A plan for care if you can no longer care for yourself? I am thinking about this a lot recently. It’s a challenging possibility to have to think about— losing your independence and also your autonomy — your freedom to make your own choices.
DeleteAnne, I haven’t figured that one out. I’m not sure there is a solution I like. I kind of like what cats do when they know it’s time. I imagine a cabin in the woods but that’s just a thought right now. However, reality has a way of pulling the rug from under you. “All the plans of mice and men”.
DeleteClimate change driven extreme heat waves and civilizational collapse may make the problem moot. Older people will be the first to go. But catastrophic failures are hard to predict. Dementia never occurred in my family until members lasted into their 90’s. I don’t think the 2040’s will be coddling me. I see heat waves from hell and intermittent electric power. I guess one has to weigh the chances, make provisions, and hope for the best. Who knows? We’re in the middle of a fascist takeover.
DeleteTo tell the truth, Anne, half of my attention is directed toward the present crisis. I feel like Shrodinger’s cat before someone opened the box. On one hand, I plan for a civilization-based future with its problems. On the other hand, I see imminent catastrophe wrt the current political association. I am more worried about the young than myself. If there’s something I can still do to help them, I will. A lot depends on what happens in November. Even if the election takes place and the Democrats win, we’ll still be in deep trouble. Hakeem Jeffries is an Israeli asset and AOC (originally my great hope) has become a totally politics-as-usual creature. Anyway, I’m biding my time. Please, Lord, let my strength endure a little longer.
DeleteI don’t think I will survive long enough to be killed by climate change, so my husband and I really have to agree on a plan, make sure the money lasts with the very high costs of care, and inform our kids. Because they will be stuck if we don’t. Somehow I just vaguely assumed that we would fade into the sunset together, holding hands. My husband’s parents moved into a life are community when they were still a new idea and fairly scarce. Mostly independent living units with a meal plan they could choose ( dinner only). They sold their house for the entry fee, which was 90% refunded to the estate after they passed away ( 5 weeks apart). They used the nursing care wing briefly, but were in and out of the hospital the last couple of months. . There was no memory care then. Those entry fees have skyrocketed in the last 35 years, along with the apartment rents. Back then they didn’t have assisted living units in the complex either. If you didn’t need only short- term skilled nursing residents could hire aides to come out of pocket— not included in the monthly fee. Now most have all three options - independent living apartments, assisted living ( usually a studio for one person) and memory care. For skilled nursing, residents have to move out to a nursing home.
DeleteNo dementia in either of our families, but nobody lived to late 80s or 90 s either. Most died suddenly from a heart attack or short end stage chronic illness in their early 80s.
"Too few babies and too many old folks" For the USA more and better immigration is the easiest solution.
ReplyDeleteImmigration may not be a solution for other advanced economies, such as Europe, China and Japan. This imbalance really threatens their economic productivity. They might have to look at some rather inhuman alternatives such as combinations of AI and robots to take care of the elderly unless, of course they want to promote assisted suicide. If voluntary assisted suicide doesn't work, it will probably become involuntary.
The US has the resources to continue to economically lead the world IF we continue and improve immigration as our solution to the imbalance.
The Democratic Party should make MORE and IMPROVED IMMIGRATION the center plank of its Make America Great Again program. Immigration worked in the past and it will work again.
The NEW religious political coalition should be Catholic Democrats rather than Evangelical Republicans. Catholics with full support of the bishops and clergy should promote immigration not only as a humane solution to world economic problems but also in our own economic self- interests.
Catholic Democrats should promote the talents of the elderly to fashion our parishes into retirement communities for the elderly and welcoming places for immigrants (especially Catholic immigrants) as well as educational communities for raising children.
This Catholic Democrat prolife vision should emphasize voluntarism, tax credits for citizens that raise children and support the elderly, and government support for institutions that raise children and support the elderly by taxing the wealthy (unless they give away substantial amounts of their wealth as well as their earnings for support of the young and the elderly).
I don't think attacking the bishops for wanting to make laws against abortion and assisted suicide serves much use purpose. As Greenleaf said, Catholicism's ability to create a positive human vision is great, unfortunately it spends too much time telling the world what it is against rather than what it is for.
Jack -“ The NEW religious political coalition should be Catholic Democrats rather than Evangelical Republicans. Catholics with full support of the bishops and clergy should promote immigration not only as a humane solution to world economic problems but also in our own economic self- interests.”
DeleteYet more than 60% of white Catholics supported Trump and, based on comments and media reports, abortion wasn’t the only reason — they wanted the immigrants deported. The most well- known Catholic politicians like Vance, DeSantis, Abbot etc are all virulently anti- immigrant.
Jack —“Catholicism's ability to create a positive human vision is great, unfortunately it spends too much time telling the world what it is against rather than what it is for.”
DeleteAll too true. Rather than lead, rather than be the shining light on the hill, the RCC focuses on “thou salt not”s.
Cathleen Kaveny discusses this in the current Commonwealth online
ReplyDeletehttps://www.commonwealmagazine.org/importance-being-burden-kaveny-physician-assisted-suicide?utm_source=Main+Reader+List&utm_campaign=99caf050fc-EMAIL_CAMPAIGN_2017_03_16_COPY_01&utm_medium=email&utm_term=0_407bf353a2-99caf050fc-544529510
Thanks for the link. I think she is correct that elder care is a community challenge.
DeleteMy discomfort with most pro-life teaching us that it isn't very nuanced. It demands that all life is good and reflects the image of God. It ignores the fact that all life dies, sometimes with mental and physical suffering beyond medicine's ability to alleviate it with legal palliative. And sometimes that suffering lasts years.
There was a push to legalize heroin, superior to morphine as a palliative, for terminal patients about 50 ago. The pharmacists at the hospital where I worked as a college student were involved in trying to change the law.
Unless pro-lifers educate themselves about and push for better palliative care, more states will cave to legalizing assisted suicide.
A good deal of how you live out your last few years depends on where you live.
ReplyDeleteMy mother's community had several free or low-cost assistance programs that allowed her to stay at home. She got meals, shopping, and cleaning.
Dad died on home hospice, which Medicare pays for, and he received tremendous compassionate care. But others say a lot depends on which lead nurse you get. Plus hospice is available only to someone in the last six months of life, and many final illnesses drag on for much longer.
A friend who had a debilitating stroke also lives in a community with these programs. Plus she is in a college town with a speech therapy program. The faculty and students have helped her set up a book club and free speech coaching for stroke victims. She seems to have a tremendous social network.
My widowed brother-in-law lives in a massive, subsidized, low-income apt complex. It is overheated, cramped, loud, and dingy. Some of the neighbors are beset with cognitive problems and knock on his door for help at all hours. But he loves it. He likes helping folks, can rent a community room for family reunions, and there is a coffee shop on the first floor with a nearly 24/7/365 euchre game. The local grocery store takes online orders and delivers twice a week.
How well-equipped a community is to help people age and die comfortably isn't always apparent. Takes some digging and initiative that elders don't always have. In my parents' case, the initiative fell to me. Now that I'm ailing myself, I understand that sense of inertia better.
I'm late to the conversation. Both the NCR article and the one in Commonweal by Cathleen Kaveny are good.
ReplyDeleteMost of what is on my mind is the end-of-life stuff. But just a few comments on beginning of life issues: I read a statistic that 40% of the births in the US are covered by Medicaid. Most of these families would also be relying on SNAP or WICS for at least part of their food budget. All of these programs are on the chopping block for MAGA, constantly and continuously. You cannot be credibly pro-life if you are willing to pull medical care and food support out from under mothers and children.
Now for the end of life issues. We are in the process of updating our medical directives. And I am wondering when it is appropriate to put a "do not resuscitate " directive in writing. Hopefully we've both got some good years left, and we aren't at the point where we don't want any interventions in the case of a health crisis. But resucitating an older person from cardiac arrest often does not end well. And if they had to do chest compressions it would crack ribs and make breathing painful. Part of me thinks, if my heart stops just let me go. But I'm not on board with foregoing interventions that have a good chance of success.
ReplyDeleteThe other thing we have to do is make a will. Dirty little irresponsible secret, we don't have one. I know there are online templates, but everyone says at least have a lawyer look it over.
We do have long term care insurance (which probably wouldn't cover the full bill for extended care, which continues to skyrocket, but at least it would help.) Our older son is designated as financial power of attorney if we were incapacitated.
DeleteKatherine, the DNR issue is complicated. The how long in a coma with no detectable brain activity issue is also - when should life support be stopped? If you have any non- retirement financial assets and own your home, you should look into setting up a trust to avoid probate delays ( often a year or more). If you own assets jointly the surviving spouse inherits automatically usually. Bank accounts can be set up to transfer on death to non- spouse family to avoid probate and IRA accounts can transfer immediately to designated beneficiaries. But whoever is in charge after both are gone will need access quickly to funds to pay final bills, including funeral expenses. My mom pre- paid her funeral expenses. If there are assets left at the time of death of the second spouse, a trust is often better than just a will.
DeleteYou may need to figure out who should have medical power of attorney ( my husband has mine and I have his, but after one of us is gone the survivor will have to choose another). Also who should have financial power of attorney if you can no longer manage your financial accounts or sign paperwork to sell a house while you are still alive. One of my closest friends had a form of Lou Gehrig disease and once she couldn’t write a check or manage her computer with her hands she gave a son in law financial power of attorney to manage her IRA accounts, bank accounts and credit card accounts. Her mind was fine, but her body wasn’t working. He was honest, fortunately. She died a few months after my husband fell. She was only 73 and had part- time home health care, with her daughter next door managing everything in between flights ( she was an AF pilot, then commercial after retirement from the military) and finally hospice. You need to figure out a trustee probably for possible cognitive incapacity, and an executor. You can get forms for all of this off the internet but you should have a lawyer look them over. It can be very complicated for survivors and heirs. The will is often limited to distributing inheritance money to non family or personal property like jewelry. The lawyers who do this are usually called elder law attorneys or estate planning attorneys. Elder law attorneys do both, and also have expertise on what Medicare and Medicaid cover and the requirements for qualifying for Medicaid. Some are pro bono through a community elder care resource.
We have to change some of our plans because of the son in Spain and the son moving to a France in two years because of the laws in those countries about managing a trust outside the country and taxing inheritances. In the US estates aren’t taxed by the feds until they exceed $11 million/person , and most states and the feds don’t have inheritance taxes ( some states do) but Spain does tax inheritances. Maybe France too, so our estate planning just got a lot more complicated. We are now looking for a lawyer that handles estates for multi- national families. People in their 70s - even without known health issues- should do some planning ant least to figure out what forms they need from the internet! Most of them need to be notarized also.
I talked to my MD about a DNR after my mother's arrest and resuscitation, and that was helpful. If you decide you do want to be resuscitated, it's a good idea to review the decision every few years as age and health situation change.
DeleteKatherine, my husbands older sister died last summer 3 days before her 86th birthday. She was single with no kids. She had all the paperwork done, signed and notarized. Her younger sister (14 years younger); had all the powers of attorney, but she lives in Maryland and elder sister lived in NY. She had financial power of attorney but the bank in NY wouldn’t give her access to her sisters funds unless she came into the bank with the papers with younger sister in person to the bank. By that time elder sister was in assisted living. Younger sister kept having arguments with the+bank because she didn’t want tomato to NY, get elder sis out of assisted living and go to the bank together. The clock ran out while she was still fighting the bank. So younger sister had no access to funds to pay the bills. My husband’s brother gave younger sister a pile of money to handle bills to be repaid after big sister died and little sister could get money from the estate. But, the bank closed the accounts immediately until after the estate was settled in probate. That was more than a year ago. It’s still not through probate. Something you might want to check on. The signed, notarized financial power of attorney didn’t work when needed. You might have to check with your bank about their rules for honoring the paperwork and go with your son to the bank.
DeleteBeen talking to my sister. They got her mother in law admitted to a nursing home. She keeps falling and can't get up. She has a heart condition and some degree of dementia. The Medicaid paperwork went through. My sister says it's a nice place. But her mil is an anxious restless person and is convinced that she needs to go home. Her husband is frail himself and can't get her up when she falls. Their house has multiple stairs. Home is just not a good option.
ReplyDeleteShe won't be anxious and miss home after they shoot her up with enough dope to keep her quiet.
Deletehttps://www.hrw.org/report/2018/02/05/they-want-docile/how-nursing-homes-in-the-united-states-overmedicate-people-with
Pretty sure her family wants to avoid the dope. Right now they're doing the "Let's just give it more time" talk. I hope it works.
DeleteAssisted living can be a better choice for mild dementia with fall risks. Unfortunately, Medicaid won't pay for that. We ran into these issues with my MIL and uncle. Raber's brother moved his dad in with them because of the experience with their mom. That created tremendous stress on his marriage. The lack of choice and expense will only get worse as we keep deporting immigrants. Families are sitting on emotional and financial powder kegs, and there is no coherent policy to deal with it.
DeleteWhich is why more aging people are saying they might choose assisted dying. The bishops are fighting these laws, but don’t offer church- based alternatives. Jack has ideas but nobody with authority listens.
DeleteThe dividing line between what is assisted living and what is nursing home.seems blurry. If someone is a fall risk, needs medication management, and needs help getting to the bathroom, it seems that it crosses the line into nursing care.it
DeleteYes, it is blurry, and it likely varies by state and from facility to facility.
DeleteIn Michigan, asst living provides you with meals, a safe environment, and someone keeping an eye on you.
A friend has her sister with mild dementia and history of falls in asst living about a mile away. It's a good one as these things go. Has a doc on staff, whose function primarily seems to be to evaluate residents and move them on to nursing homes if they start needing too much care.
Friend coordinates and shuttles her sister to all medical appts, does her laundry, takes her shopping, and keeps track of her meds. I think the facility keeps meds at the desk and reminds residents to get them. Friend brings her sister home on weekends and for extended holiday stays. Facility calls friend if sister needs emergency or urgent care, day or night. Friend okays ambulance or comes to get her.
If/when the money runs out, sister will have to move in with friend or go to Medicaid facility. Friend already cares for her schizophrenic son and is widowed. She has rheumatoid arthritis.
Jack's idea of elders taking care of elders sounds great in theory, but retirees in good shape mostly want to go go go or are busy taking care of grandchildren like my neighbor across the street.
I'd volunteer as a reading book lady at the nursing home cuz I can still run my mouth, no problem. But I am immune compromised. Raber does ukulele programs for toddlers at the library. He comes home with a three-day cold from those little Typhoid Marys. Then I get bronchitis for 6 weeks.
And nobody is getting vaxxed cuz RFK is making us healthy!
After experience with two assisted living facilities since 2023 (I was three months in one with my husband. He was in a second for one month) this is how I see the difference.—Assisted living provides the help I mentioned above - food, shelter, laundry, housekeeping, recréation activities like bingo, virtual bowling, puzzles etc, social (happy hour once/week), entertainment (usually a musician or music student who plays the piano or violin) a couple of times/month, scheduled transportation weekly to shopping, a monthly excursion to a museum or concert or whatever, (bus fills up fast so sign up early), transportation to doctors within a certain distance (first come first served for available slots during specific times and dates. Medication management by staff called “med techs” who distribute meds to residents on schedule and make sure they are taken. Everyone is given a lanyard with an electronic monitor that shows someone in the office the location on the premises of every resident, who monitors residents for falls, and calls the caregivers to go to residents who use the lanyard’s call button to summon assistance when needed. There was a doctor on staff whose job, as Jean notes, was to evaluate residents who might need to go to a hospital or move to a nursing home. The aides are mostly minimum wage, unskilled who are trained in basics like bed baths, changing diapers, and helping residents dress and transfer into and out of wheelchairs. They are not even CNAs. In emergencies, the EMTs are called ( almost daily at the two places I’m familiar with). Nursing homes have licensed nurses. They are qualified to do more advanced care like administer IV meds or fluids. The residents usually very old, very frail, and have advanced chronic illnesses— they are not there just because they are fall risks or need help remembering when to take their meds or help taking a shower or assistance getting to the bathroom— that’s all done in assisted living. Some residents had mild dementia and the lanyard monitor would alert staff if they left the building and started wandering. A staff member would chase after them and bring them back before reaching the street. Those with advanced dementia were in a locked wing with their own dining and recreation and a higher staff to resident ratio.
DeleteThose facilities would be *very* ritzy by Michigan standards outside the Detroit area.
DeleteBecause of Raber's cognitive problems, I will need to go to a facility for some weeks for rehab after cardiac surgery, though "letting nature take its course" sounds better as time goes on. If it's not cancer, it's liver, or heart, the constant battle with dental problems, fatigue, and my shitty attitude generally. I'd like to outlive Trump, but c'est la guerre.
Yes, they are referred to as “ luxury “ although I wouldn’t go that far. They were nice, clean, and attractive. My husband commented that they spent too much on interior design and not enough on quality ( v quantity) food. One is in a fairly big city in the heart of expensive Silicon Valley - San Jose- and one in a high end suburb of Washington DC. Both very expensive which is why I worked hard to get us home. We were living with a son and a daytime caregiver in San Jose (who was expensive) Then Son and wife decided to go to Europe for 6 weeks in the summer and my husband hadn’t finished rehab or gotten his custom Medicare covered wheelchair yet so we had to stay in San Jose. They found a nice place ( as assisted living goes) and moved us there. By the time they got back from Europe I had made all the arrangements, flights, one month respite for my husband at a Maryland assisted living not too far away and we came home. Our monthly part- time care is 1/3 of the assisted living care because we aren’t paying apartment rent and food costs that are triple at least what I spend at home.
DeleteFood is always a complaint. Most places here contract food service. Seems like a little thing, but food is one of the few pleasures left to people in care. Last hospital stay, I just ate soup, OJ, and toast, and had Raber bring me coffee and a falafel sandwich from the deli.
DeleteI was told by a few residents when I first came here that if there was something many residents had complaints about, it was the food. It was true. This place is part of a big chain, and the overall corporation supplies much of the food, while each location has a certain amount of autonomy. That way, if you have complaints, you're told it's the corporation's fault, and were it not for those constraints, your locality would deserve three Michelin stars.
DeleteWe had a Tex-Mex lunch yesterday (Santa Fe Salad) accompanied by salsa and "tortilla chips." The tortilla chips were identical to the "homemade chips" served with other meals, which in reality are simply rippled potato chips. (The first time we had them, I asked for the recipe for homemade chips.) Rolls that are clearly straight from the package are "fresh baked rolls." A great deal of the time vegetables come in overcooked "medleys" with way too much squash and zucchini. Sometimes the serving sizes are ridiculously small. (I have had as little as two smallish Brussels sprouts or two thin stalks of asparagus.) Here is the recipe I wrote for asparagus:
• Use the thinnest asparagus available, allowing four stalks per serving.
• Bring a pot of water to a rolling boil.
• Plunge the asparagus into the water and boil for 30 minutes or until asparagus starts to dissolve.
• Drain, allow to cool to room temperature, and serve.
I would estimate that "hot" food is served barely warm or at room temperature at least 75% of the time. You can always ask for things to be rewarmed, but why bother? You can theoretically ask for seconds, but people rarely do.
I am probably making it sound worse than it is, and mostly I don't really care. It is usually edible, and it is adequate. It's better than having to shop, cook, and clean up myself. But there is certainly room for improvement. And it's great to have housekeeping and laundry all taken care of.
When my mother in law was in assisted living (she passed away in 2009) we ate lunch with her sometimes at the home. What I noticed was that the food was pretty bland. They had a lot of people who were on salt restriction. A lot of people had dentures or missing teeth, so everything was cut up and cooked pretty thoroughly.
DeleteGeez, David. Write me via email if you want me to send you a care package of supplemental treats--those dinky Snickers bars, Brach's soft peppermints, dried dates, a bottle of maple syrup, Lowry's seasoning salt, real tortilla chips. I get groceries Tuesdays and Fridays. Make a list!
DeleteHah! David that sounds like the assisted living place in Maryland where my husband spent a month. Totally unappetizing mush. I picked him up every morning and brought him home ( we were waiting on delivery of his hospital bed and Hoyer lift) so usually he had dinner here. But occasionally not and it was pretty unappealing stuff. The food in our “ luxury “ assisted living was ok- not terrible… Edible. They had a couple of decent dishes . But they frequently ran out of food, including staples like orange juice for breakfast and bread for toast. I would order an egg over easy on toast and it would be an egg with hard cooked yoke on a slice of untoasted bread - once it was raisin bread because they were out of wheat, they only got restocked once/month. I didn’t like the laundry service. I lost clothes and gained some that belonged to someone else. Probably have to sew on name tags like kids going to camp. Housekeeping in a small 2 bed, one bath apartment would seem easy for me after living in a two story colonial with 4 bedrooms and 3 bathrooms.plus there were just us, no sons, no sons’ friends, and no golden retriever.
DeleteIt was a decent place, not really luxury. I felt a bit like I was living in a white collar prison. It’s hard to get used to the regimentation, and the loss of autonomy and privacy. I’m sorry your illness has progressed, David. You seem to have a better attitude towards your place than I had to ours. It was so depressing for me to spend all our time with people in their 90s, basically waiting to die. They were very nice, but it was depressing for me anyway, especially with the daily visits of the ambulance. I hope to never have to go to one again, but probably will have no choice at some point.
Well of course I don't want to end up in a nursing home. No one does. But neither do I want to be where I can't take care of my basic needs and something bad happens. What I have noticed with relatives who were in assisted care is that attitude mattered a lot. Eventually they made friends and adjusted. It's not the same as home. Some similarities to a college dorm. I hated sharing a room back then, that was the worst. I notice nowadays college dorms are all single rooms, maybe around a "suite". More privacy in care homes would make all the difference. I hope the trend is to single rooms for everyone. We have to put up with our own frailty. We shouldn't have to put up with random strangers in our private space as well. Private space makes a lot of things bearable.
DeleteAmen, Katherine! Private rooms would also cut down on the infectious diseases that run through these places.
DeleteMy MIL was bedridden but with all her marbles. She was in with a woman so far gone with dementia that she could only squawk, which she did several times a night, loudly. When we visited, she would ramp up squawking. The only thing that kept her quiet was if we took turns sitting by her and held her hand.
We rode the nurses and admin to move MIL, but they said they "had to" group all bedridden patients together because of staff constraints. Plus MIL was Medicaid, so no $$ to leverage her into a private room.
Best they could do was pull curtains between the beds.
We tried to get FIL to look for a different facility, but he said he preferred the current one because it was close to his house.
Just a heartbreaking horrorshow.
The facility where my mother in law was had two wings, one was assisted living and the other was skilled nursing. She spent most of her time there in assisted living, in a little studio apartment. She liked that okay. But a couple of times she was hospitalized for her CHF symptoms and was discharged into the nursing care side. (When the residents spoke of someone "going to the other side" it was the nursing care side, not the Big other side!) Anyway it was shared rooms on that side. One time she had a roommate who must have been depressed, she insisted on drawing the drapes and keeping the room darkened. The other time it was a roommate who would. not. stop. talking. I don't know which was worse. I think that one would have been. It was actually a blessing when mil had a yeast infection and they were required to give her a private room. Of course the whole time she was also paying for the room on the assisted living side to keep it in case she would be able to go back. Which she did, twice.
DeleteAlso: Yes, attitude matters, but you cannot expect much attitude adjustment from patients with dementia. They constantly forget why they are not at home and often fixate on this.
DeleteWith luck they fall into a happier past life or fantasy. My Aunt Joan thought she was in Virginia where long-dead Uncle Hank was stationed in the Navy. Aunt Grace used to run a Kleenex over the rails along the walls of her facility and complain that staff didn't dust "my hotel" properly. My friend Kathy thinks she is on medical leave from her job in the music department. A friend's mom kept telling everybody about her excellent bowling league scores.
We all know that the problem is that we keep people alive beyond the endurance of their mental and physical faculties, and until we start emphasizing quality of life over quantity, these sad situations will proliferate.
It seems like the trend in hospitals now is for no shared rooms. My mom had to share a room when all us kids were born. One of the times the roommate was a smoker and they let you smoke in the hospital back then, even when the babies were in the room! But I had a private room for my surgery, and my daughter in law had a private room when their kids were born. My husband takes Communion to the hospital sometimes and he says it is all private rooms now. They're figuring out that people do better that way, and like Jean said, it cuts down on contagious illnesses.
DeleteJean,
DeleteThanks for the offer of care packages, but I have left out the fact that my assisted living home is in an affluent part of the borough of Queens, and there are numerous stores (including a Target, a Trader Joe's, and a Walgreens) nearby. We also have the services of a car and driver to go (for free) anywhere in a 7-mile radius plus periodic shopping trips and other excursions on our bus. While it does feel a bit like being in prison, it's a prison where you can come and go as you please.
Anne's comment about the place she described running out of staples made me laugh. We have two options for lunch and dinner, and we have a pretty decent breakfast menu that also includes a number of options if you don't want the day's offerings for lunch and dinner. The two lunch offerings for today didn't appeal to me, so I asked for a hot dog, onion rings, and slaw. The waiter went to the kitchen and returned to say they were out of hot dogs. So I asked for chicken salad, and they were out of that, too. I settled for a Turkey and Swiss sandwich. I asked for ginger ale, and they were out of that, so I got apple juice. Theoretically, you can choose white bread, whole wheat, or rye, but it is not rare for them to be out of one (or two) of the three.
I told somebody yesterday that we had an old family saying: "If we had ham, we could have ham and eggs, if we had eggs." (I just looked it up, and it is attributed to Groucho Marx.)
The apartments are equipped with kitchenettes—refrigerator, microwave, sink, but no stove of any kind—and coffeemakers are the only appliances permitted. Eating in the dining room is strongly encouraged, although meals are delivered if necessary.
In the overall scheme of things, all of this is pretty trivial. But not to us inmates.
I will cross your need for treats off my list if worries, David. Sounds like a good set-up.
DeleteOut here in the Michigan cornfield, the old folks' homes are nowhere near shopping, usually on the outskirts of town near a car dealership or industrial park. No transpo anywhere except where yr fam wants to take you.
David, the place we were in includes one glass of wine per resident at both lunch and dinner (probably from what we used to call Two Buck Chuck winery). We didn’t drink it. But the shortage that caused the most widespread angst among the residents was when they ran out of white wine. Don’t blame them. The red was awful. I tried one glass. Never tried the white because I never like white anyway, but it was popular with our fellow inmates. One man brought his own bottle to lunch and dinner. Obviously not a fan of the house wines. My husband and I drank water at lunch and dinner but did like OJ for breakfast — when they had it.
DeleteSorry to be so late to the "party" here.
ReplyDeleteI love both the original article from NCR, and Cathleen Kaveny's in Commonweal. Something Cathleen wrote along the lines of, If we don't feel we can turn to our children in our time of need, that may be a sign that we don't feel we can turn to Jesus, either, went straight to the heart for me.
I can understand frustration being directed toward the institutional church for the millions (probably tens of millions) spent to overturn Roe v Wade. I can only say that it wasn't the institution's wish that a virtually unfettered Constitutional right to abortion be made the law of the land; and when unjust laws are enacted and promulgated, they should be resisted, and that can be expensive.
One of the strengths of the the original post's NCR article is its recognition that much can and should be done apart from legislation to bring about better treatment of the elderly and ill in our midst. I found his article a bracing call to action. I think of it this way: our parish, and most/all parishes around here, already make hospital visits, nursing home visits and memory care facility visits. Fr. Del Bracco's call for compassionate accompaniment of the elderly, ill and dying could be treated as an extension of that existing foundational hospital/nursing home ministry. Something to pray about, and discuss with our pastor and the other deacon and his wife, who run those ministries in our parish.
FWIW, my parents are both still living. My mom is in her eighth decade (nearly through it), my dad is in his ninth. They are living in a large home with multiple bedrooms and a finished basement where the washer and dryer are located. It is way more house than they need, but it is their home, they are independent in it, they don't want to leave and, so far, no reason why they should. They don't live too nearby (I am an hour+ away from them) but I am the closest family member to them, so I see them whenever I'm able, and try to keep an eye on them. My dad's hearing is declining so I think quite a bit of life passes him by, simply because he can't hear what people are saying. (Drives my mom crazy that he won't try hearing aids, but I guess he sees them as a sign of weakness or something. He's the kind of guy who will absolutely ignore health issues because he doesn't want to deal with them - possibly hasn't reconciled himself to mortality.) My mom's faculties are sharper, but she can be a bad patient in different ways - gets irritable about what the doctors want her to do.
I've been pondering for some months now, What will I do when I retire (which could happen any day now.) I guess the simple answer is: care for my parents.
If your folks are doing okay where they are, I can certainly understand their wish not to move.
DeleteLately several of our friends have decided to sell their houses and move into some new condos which are being built. They are actually duplexes with no stairs, two bathrooms and three bedrooms. And yard upkeep provided by the HA. Sounds pretty nice, except I'm pretty sure our 1950s era tract home wouldn't sell for enough to get us into one of the spiffy new condos. Just as well, we don't want to move anyway. Probably if we do move in the future it would be to Omaha to be near our kids.
One of my sisters on the west coast, recently divorced, not employed and more or less at loose ends in her life, had been making noises about moving in with my folks and becoming their live-in caretaker as that becomes increasingly necessary. That would be a godsend for everyone involved. But now she's backtracking on that thought. I don't want to say, "reneging" because as far as I know she never actually committed to it. But I admit to being chagrined about it. Well, to be frank, I thought of that passage in one of the opening chapters of Sense and Sensibility in which John Dashwood has the best of intentions to share a generous inheritance with Elinor and Marianne's mother, but then he allows Fanny to talk him out of it.
DeleteYour sister may simply know her limits and is avoiding family tensions that might make things worse down the road. The "wayward kid" is rarely the best person to move in with ailing parents. Think more about Janice from the Sopranos than Fanny Dashwood?
DeleteJanice - now there's a scary thought! I don't think my sister would be tapping the basement walls looking for buried loot, but who knows?
DeleteOn the waywardness scale for our family, she's about average. Kind of a wild child, went her own way as a young adult, lots of things haven't worked out for her. Those things run in our family.
Being an only child, no confusion as to where the buck ended. When there are multiple offspring, I guess that adds a layer of “who does what” to the deliberations. I think I could have used a sister in taking care of my mother but who knows what kind of siblings I would have had if I had had any.
DeleteIt might not have been a sister!. If you read the advice columns (that’s all I read in the WaPo these days) you will read about a whole lot of resentment from the daughters who were assumed to be willing to drop everything and be the caregiver even when there is also a son available! If the worst happens, Stanley, have you made any plans for your own care? Assisted living or a family member? I’m still figuring that out for myself if I live longer than my husband. He’s 7 years older and the demographic averages indicate that I am more likely to survive him than he is to survive me. I hated assisted living, but I would clench my teeth and go so that none of our three sons would have to bear all the burden of caring for me.
Delete"I hated assisted living, but I would clench my teeth and go so that none of our three sons would have to bear all the burden of caring for me."
DeleteI would guess all of us who are parents can identify with this.
Anne, this is one of the things that Cathleen Kaveny wrote about in her Commonweal article referenced above. If you don't mind my asking, did her article ring any bells for you?
Jim. The visits to hospitals and nursing home are fine, but do absolutely nothing to help the family members who are the caregivers of the frail elderly, including those with dementia, who are cared for at home- which is about 98% of the very old. . For obvious reasons, I probably notice and read more of these articles than a healthy young 65 year old. The burnout rate for family members caring for elderly parents who are not well is in the millions. Depression is a major problem for them. Exhaustion too, which leads to illness. Ask Jean, she knows all about these demands because she lived the stresses involved caring for her parents. We’ve been lucky enough to be able to afford a good, part- time caregiver but millions of families can’t afford it and aren’t poor enough for Medicaid coverage. This administration (the GOP in congress too) plans to cut the few existing programs that were designed to keep the frail elderly at home - that support families who care for them. Now those programs are going away.
ReplyDeleteAgree that there is nothing in the Constitution that mandates a woman’s right to choose whether or not to carry a pregnancy to term. But there is stuff in the Constitution and Bill of Rights about religious freedom and separation of church and state. The church wants the government to impose its own theological views on all, including the 81% of Americans who aren’t Catholic and don’t believe that a one celled zygote, or a blastocyst , or an embryo, or a even a fetus in the early stages of development, is a “person”—.only a potential person. Just as an acorn is a potential oak tree but isn’t an oak tree. So most Americans believe that abortion should be legal at least through the first trimester. Because the biological systems needed for personhood aren’t all in place until 12 weeks. Fighting for a limit is fine (and agreed upon by most Americans) but a national ban is not. I have studied the data in far more depth than most because of my gig with the abstinence program, and I also know that absolute abortion bans don’t work. Women will find a way, Today in the US they use mail order or travel to another state. In Ireland, before a referendum to legalize abortion passed by an overwhelming majority, the women went to the UK. It’s illegal in Poland these days so they go to Germany. In the US before Roe legalized abortion, there were about as many abortions before legalization as after, but there were fewer deaths of women because no demand for back street abortions. Abortions have occurred throughout the world, throughout all of history. Bans just drive it to the unsafe backstreet abortionists. Since banning abortion in the US is a violation of the separation of church and state anyway, the bishops would have better spent the time, effort and millions on helping women who did not believe they could afford another child be able to give birth and care for the baby and other children ( as I’ve noted here multiple times, most most women who seek abortions are poor and already have children).
Your parents are in our age group. My husband will be 86 in November and I will be 80 next summer. Your father should go to Costco for hearing aids. They are the same as expensive audiologists but half the price. Full refund if they don’t work out and they allow a very long trial period or at least they did. I think it was 90 days. Your father may not care, but you should know ( and tell him) that people with hearing impairment who refuse hearing aids are at higher risk for dementia. Unfortunately Medicare doesn’t cover hearing aids. Untreated hearing loss is also associated with higher rates of depression. As you said, a lot of life is passing him by. I agree that they should stay in their own home as long as it’s safe. Perhaps you and your six sibs could hire someone to do the laundry because a fall down basement stairs could be disastrous.
Some older people have a plumbing contractor move their washer and dryer to an upstairs location. Sounds like there would be enough room to do that.
DeleteMy dad had a severe hearing loss for probably the last two decades of his life. He had some of the newer hearing aids but they didn't seem to help that much. I think he sort of learned to lip read. I learned to be directly in front of him when I was talking with him, and we made it work. Talking on the phone wasn't easy,, though.
Katherine, I got my first hearing aids 18 years ago. They were fine for a long time but then I experienced a dramatic decline. No explanation for it. I had to start going to a real audiologist because my hearing loss got very complicated. Even with the very latest, very very expensive hearing aids, my hearing is awful. I just spent $1600 on a microphone that my husband clips on his shirt and which can be set in a table if we are with others. I was able to test that a week ago when we had dinner with his sister and her husband at a restaurant, it was early and the restaurant was quiet. I don’t know how it would work if there was a lot of background noise but it did pick up the voices of all three (husband and sister and brother in law) at our table and I could follow most of the conversation. . I constantly have to remind my husband to face me when he talks to me. Phone calls are a nightmare and I have to make a whole lot of them for dr appointments. Very often the person answering has an accent which is another big hurdle with severe hearing loss.
DeleteMoving the washer and dryer upstairs would be an ideal solution. My mother’s fit in a wide closet in her condo, and I’ve also seen stacked washers and dryers in a narrow closet.. They don’t have to take up too much space but do need some plumbing and electrical work.
"Jim. The visits to hospitals and nursing home are fine, but do absolutely nothing to help the family members who are the caregivers of the frail elderly, including those with dementia, who are cared for at home- which is about 98% of the very old."
DeleteRight - I understand. My thought here is: we could build out a new ministry on the foundation of the existing ministry. Because we bring communion to people who are homebound, we should know who the candidates are who are being cared for at home by a spouse, child or another loved one.
I don't know exactly what a new ministry woudl entail. We'd probably start modestly and try to build from there. Maybe, "We'll give you, caregiver, an afternoon off."
I would disagree just a little on visits: It helps adult children caregivers tremendously to know someone is visiting your folks at a regular day and time, someone who will tip you off if they seem distressed or aren't answering the door.
DeleteSo a "ministry" might be as simple as saying you'll show up for home Communion between 2 and 5 Sunday afternoon, and have the name of contact in case of something feels "off."
Dad refused pastoral visits, but a volunteer who happened to have been one of his cronies, visited every Wednesday afternoon for an hour or so. I could always breathe a bit easier on Wednesdays knowing somebody had been in.
Once again, the point isn’t getting through. Communion visits at home might let someone see if something is off, but it doesn’t help with the burnout of the family member who is the designated (or default) caregiver because nobody else is willing to wipe Dad’s bottom and give him a bed bath.
DeleteIf a parish had a group of volunteers who would even give the primary caregiver a 4 hour afternoon off each week by staying with Dad, even if they are unwilling to change the diaper or clean up the mess from a leaking colostomy bag, but Just sit with Dad that would be a break from the 24/7 exhaustion. If we couldn’t afford a part- time caregiver who does most of the backbreaking labor of caring for a paraplegic, I would probably be dead of exhaustion, by now, literally. Pastoral visits are nice, but the primary family caregiver who had to quit her job and all of her own activities (90% of the time the caregiver is female - wife or daughter) needs support, needs a break now and then. I think that understanding this is the key to understanding why so many older adults want access to legal assisted dying. They know that a caregiver might break if doing it without help. They’ve probably witnessed that happening in their own family or friend’s families. They say they want to spare their loved ones from this backbreaking responsibility. They aren’t seeking assisted dying because nobody came to the house every week to give them communion. They seek it to spare their loved ones the burden of care, often a heartbreaking, backbreaking burden. Jean didn’t live this 24/7 under the same roof and I was still really hard. But millions do, and it can break them. I’ve known of cases where the family caregiver ends up in the hospital and then the rest of the family really has to step up. The church could help prevent this. Caregivers need practical support for themselves, not just spiritual support for the patient.
Off topic: I will be out for the foreseeable due to cardiac surgery. It is scheduled for St Hildegard of Bingen's Day, which is a happy coincidence. There are a ton of pre-op instructions that will start Sept 2.
ReplyDeleteLeft to my own devices, I would forego the surgery. However, without the surgery my mitral valve is likely to fail causing arrest or stroke, and Raber doesn't need that. Plus Raber needs my SS income, and I need to be alive for that.
So here we go.
Please know that, despite my increasing irascibility and faithlessness to the Church, I appreciate the time, heart, and thought you all put into your comments here, and especially this topic. Please pray for Dave if you think of it, as he does not deal well with change.
And, yes, I will be completing my mail-in ballot in case I cannot make it to the polls.
Jean, you are in my prayers. Hopefully the surgery goes well and you have a successful recovery. Will pray for Dave too.
DeleteJean, I'll also continue to pray for you, and I'll add Raber to the list.
DeleteJean, unless you object, you will be in my prayers also. I may be a doubting Christian but if there is a God, a God of love hears all prayers I think, even from the unworthy. Prayers ascending.🛐
ReplyDeleteI've had my 70 years and then some. I have had a faithful husband, a wonderful son who texts me several times a week, and all the cats I ever wished for when I was yearning over barn kittens at five-years-old.
ReplyDeleteI have good lifelong friends, my home is paid for, and I had work I loved. I've read thousands of wonderful books, and I saw Maggie Smith on stage. I got to go to the British Museum and see the wonders of the world.
I have lived longer than either of my grandfathers, who had similar heart/blood problems but smoked and drank their heads off. I had two grandmothers who made up for a lot that my parents couldn't provide.
So if you want to pray, please pray for those who have not had these joys or who will die because they cannot afford this type of surgery. Cost was almost a deal-breaker for me until the hospital system offered a payment plan for the pre-op test co-pays. Those alone run thousands.
I’ll pray anyway. I pray for those who have nothing every day - no family, no real home, no joy in life ever.
DeleteBut I’m a bit confused - if I’m not mistaken, you are 70 ish now. Doesn’t Medicare cover all tests etc? But the co- pays are still in the thousands? Unbelievable. I am grateful looking back that we did decide to get the supplement. We debated a while but my late older sister, the elder law attorney, advised us to get it. Deductible and co- pays alone sound like they are almost unsustainable for anything serious like heart surgery..
I have a Medicare Advantage plan that replaces Medicare with more traditional insurance coverage. Better than straight Medicare, less than top-line Medicare with supplemental (which I cannot afford). Straight Medicare and Medicare Advantage both leave you with co-pays and out-of-pockets for many care costs.
DeleteAll this has been covered in previous discussions on here over the years.
In my experience, "welp, I'm prayin' for ya" is what you say when people run on too long with a tale of woe and you want to get offa the phone. Three people here have told me they're praying for me, and I'm taking the hint.
The Medicare advantage plans cover hearing aids (average price $5000-7000) pair, and vision and dentistry to some degree. We were interested in that but because we traveled a lot and would be out of network a lot we followed my sister’s advice. The first year home after California we paid more than $10,000 for dentistry out of pocket for the two of us and about $7000 for hearing aids and accessories for me out of pocket, plus almost $1000 for an eye exam, new contacts and glasses for me. And I need new glasses again. I now have a clip- on microphone that streams to my hearing aids for my husband to wear to try to improve my comprehension of what he says when speaking to me. I also have a tv streamer but still rely on the captions. Even with the high priced technology I’m legally deaf while using the hearing aids. I was legally blind without correction before cataract surgery ( I’ve worn glasses since 1st grade and contact lenses since I was 12) But now that I’ve had cataract surgery, covered by Medicare I can drive legally without glasses. I would have been legally blind without them - 20/400.Thats the highest they count. Beyond that they don’t assign a number like 20/20 or 20/50 because 20/400 uncorrected is well beyond legally blind so they stop it there. No 20/500 or 20/1000 etc. that was before the cataract surgery but even after the surgery I .still need glasses.
DeleteMedicare Advantage does cover a lot that Medicare and the supply do. It. A trade off I suppose. Now that we are housebound we probably should look at the Advantage plans. Our Medicare premiums have gone up a lot and the supplement cost has skyrocketed— much higher than the Medicare premiums.
I’m just surprised at the thousands in co- pays for your surgery. We might stick with what we have and hope that our teeth don’t totally rot. I broke a crown several months ago and still haven’t gotten it fixed.
Advantage plans are all different, and they vary from state to state. My first one was great, offered by our regional hospital. Unfortunately, the University of Michigan health system bought our regional hospital and discontinued the advantage plan.
DeleteOn the new plan, we supposedly have the same dental coverage, but no dentist accepts it. Our vision coverage is about the same, but does not cover my prismatic lenses.
RX coverage is slightly more generous as long as you have generic meds. For others there is a Byzantine tiered system.
Lab work is covered, but there is a co-pay for scans, the specialists who read them, any anesthesia you needed, and for all specialist docs besides yr primary. This adds up fast.
Catastrophic coverage caps costs at $5K per calendar year. So I was happy I could get the surgery scheduled and will be thru the three-month rehab period before Dec 31.
I expect, however that the catastrophic coverage cap has some caveats. For example, I doubt that my plan will pay for post-op cardiac rehab or the visiting nurse that the surgeon is trying to arrange, but the surgeon's office is checking that. And I expect that co-pays will still rack up.
Medicare.gov has a page that allows people to compare advantage plans in their states, but measuring one plan's co-pays against another one's out-of-pockets can leave you pretty confused.
I don't know why you are surprised that my pre-op costs are in the thousands. The Kaiser Family Foundation issued a report in 2024 that 25 percent of elderly Americans have trouble paying health care costs.
KFF report: https://www.kff.org/medicare/what-are-the-consequences-of-health-care-debt-among-older-adults/
DeleteInstead of praying for me, I'd suggest sending a copy to your elected reps and asking them to shift the nation's priorities toward elder care and away from concentration camps for immigrants, bombing Iran and and tax breaks for Billionaire Bros.