Nursing Home Story of 107 Year Old Man

tripleB said: Then the State of Virginia tells him he can't use Medicaid money, which he contributed into his entire lifeMediCare/Social Security is contributed into for your entire life

tripleB said: This Washington Post Article describes the story of a 107 year old man who has outlived his money "twice". Its interesting from a financial perspective but I found it interesting from a socio-political perspective:

"He lived alone in a Fredericksburg apartment until he was 102. Locals knew him as the older fellow often seen cycling around town. But in 2004, he fell off his bike and was taken to a hospital. Social workers determined that he could not safely return to his apartment. They found a place for him at Greenfield, a private-pay facility."

"Virginia is one of eight states that do not allow Medicaid -- a program to help low-income people obtain health care -- to be used for assisted living services, according to the Assisted Living Federation of America."

To summarize, the State of Virgina Social Workers, whose salary were paid by his tax dollars, told him he was not allowed to live alone in his home and required him to sell it and move into a private-care facility. Then the State of Virginia tells him he can't use Medicaid money, which he contributed into his entire life, to pay for the facility and he has to move into a crap nursing home.
How exactly can a state prevent someone from living in his own home?

BradMajors said:
How exactly can a state prevent someone from living in his own home?

Not a lot of people volunteer to go into a nursing home, sometimes family will make this decision for them, sometimes the state will.

BradMajors said:
How exactly can a state prevent someone from living in his own home?

Welcome to the era of Big Government. Social workers and bureaucrats are gaining increasing control over the lives of adults, supposedly for "their own good."

As more and more people become dependent on government programs (Medicare/Medicaid, Social Security, UHC, etc.), the administrators of those government programs will use their authority to dictate lifestyles.

If this man is on a fixed income sourced completely from the government, and relies on the government for medical care, they can tell him exactly where to live if he is to continue to qualify for benefits.

minorthreat1 said:
How do you propose we provide 24 hour individual care for every bed-ridden, or mentally incapacitated person who refuses to leave their home?
I typically agree with you, but this seems far-fetched.

We dont. He has the right to die alone in his house. Then his estate gets the house and pays taxes on the estate. Everybody wins.

minorthreat1 said:
How do you propose we provide 24 hour individual care for every bed-ridden, or mentally incapacitated person who refuses to leave their home?
I typically agree with you, but this seems far-fetched.
The real problem is in who wields the power to declare a person mentally incapacitated or incapable of living on their own, and how they will exercise that power.

There are people who are truly mentally incapacitated, with limited ability to understand the world, and without the capacity to feed themselves or perform basic hygienic functions. I cannot believe that these people make up the majority of seniors forced from their homes into old age care, as many of these people were already in assisted living prior to aging. Alzheimer's victims are the one notable exception.

The problem with these definitions is how overbroad they are, and how they may be applied in a loose fashion by a government bureaucrat.

What is to be considered a mental health issue? Obviously, people who cannot feed themselves need care. However, what are you going to do with people who may be old and frail, and suffer from serious chronic conditions, but remain committed to their own independence and are able to make a rational choice between a higher standard of care and losses of personal freedom and dignity?

Do we assume that a person who refuses assisted living, when that program would better meet their needs and improve the quality of care they receive, must be mentally incompetent for not wanting to receive the "best" care for their circumstances? Do we assume that anyone who rejects care which, in the opinion of social workers or medical professionals, would allow them to live a better life must automatically be suffering from a mental defect?

This is the exact problem seniors are currently facing in the UK and other wealthy nations with extensive government social service programs. Seniors who choose independence over assisted living are deemed incompetent if the social workers feel that a person with their conditions would automatically want government care.

There is no question that assisted living helps seniors suffering from mobility problems or chronic conditions, but just because that confers a benefit, doesn't mean rejecting that benefit is proof of insanity. Rather, rational seniors frequently see a greater benefit in independence and dignity, and choose that lifestyle over one which might provide assistance with their physical needs, while ignoring their emotional well-being.

The test for mental capacity must be based upon that person's ability to understand and evaluate their situation, not based upon the fallacious idea that turning down the benefits of assisted living is prima facie proof of mental incapacity.

This isn't a widespread problem here in the US, yet. The danger lies in trends which are taking the US down that Orwellian path.

staci86 said:

. . .

This isn't a widespread problem here in the US, yet. The danger lies in trends which are taking the US down that Orwellian path.

With all due respect, I suggest you visit an assisted living home, I've volunteered and visited at many. If you see any who look normal and as if they are able to care for themselves sit down and talk to them for five minutes and see what you find out. Often times the family will choose that it is time for their relative to go into a home,it's a very hard decision to make. There is not a Ministry of Young that bangs on doors at a given age to whisk away the elderly, there's no Orwellian path here. The person has demonstrated at some point that they no longer can care for themselves and require 24 hour care. It would be wonderful if it were possible to provide 24 hour care for them in their own homes, but hiring 4 full time nurses per person and having thousands of dollars in equipment at each home just isn't feasible.

And you can be sure the Washington Post will then put up an article about how you died sitting in your own filth and starved to death when you were an obviously at risk individual who should have had 24 hour care. And your nephew, of course outraged, will take those responsible to court. Respecting the wishes of a 98 year old man with dementia? Where was the State!? Completely incompetent, all of them!

BrlDsguise said: hejustlaughs said: Moral of story: Don't live in Virginia.

Ironically my mother lived in Virginia for a short time and then moved to NJ where she has been catered to with assistance. She just moved into an assisted living facility which is paid for with medicaid + her social security. While I can understand a state not forcing assisted living facilities to accept medicaid why wouldn't they allow it?

Because the state has to pay for some of the medicaid money while the rest of it is free federal money (sic).

This thread should be preserved as "Exhibit A" of the absurdity of the anti-government absolutism espoused by several posters here. I wonder if these people think that mandatory education for minors is "Orwellian" and that six year-olds should be allowed to live on their own if they so desire. Or perhaps they hold the equally ridiculous belief that self-sufficiency has an "always upward" trajectory and that as centenarians they will be able to take care of themselves just like when they were twenty five.

OLEOLEOLEO said: This thread should be preserved as "Exhibit A" of the absurdity of the anti-government absolutism espoused by several posters here. I wonder if these people think that mandatory education for minors is "Orwellian" and that six year-olds should be allowed to live on their own if they so desire. Or perhaps they hold the equally ridiculous belief that self-sufficiency has an "always upward" trajectory and that as centenarians they will be able to take care of themselves just like when they were twenty five.
If a centenarian has the mental capacity to make an informed decision about his own situation, then what do you care if he prefers his dignity?

Not all of these people are completely disconnected from the world. Do you honestly believe that a person with the normal mental capacity, and the legal capacity to commit crimes, enter into contracts, and sign informed consent papers for medical procedures, should be denied the right to choose the manner in which he or she lives?

.

minorthreat1 said: BradMajors said:
How exactly can a state prevent someone from living in his own home?

Not a lot of people volunteer to go into a nursing home, sometimes family will make this decision for them, sometimes the state will.

Actually, a judge has to make the call on this one.

BrlDsguise said: hejustlaughs said: Moral of story: Don't live in Virginia.

Ironically my mother lived in Virginia for a short time and then moved to NJ where she has been catered to with assistance. She just moved into an assisted living facility which is paid for with medicaid + her social security. While I can understand a state not forcing assisted living facilities to accept medicaid why wouldn't they allow it?

Federal requirements. The Medicaid program default coverage only applies to nursing home care. States my apply for demonstration waivers to provide broader services, though they must demonstrate that the new services won't result in overall increases in cost (the States have ways of finessing numbers so that doesn't necessarily have to be true). But as my previous post states, if you want to let this dude live in assisted living, you have to let everyone do the same. Or you can allocate "slots" in the waiver, but the elderly advocates always lobby for first preference be giving to people already in nursing homes... which I can cynically attribute to their desire to antagonize the nursing home industry (who they equate with Hitler), rather than their desire to provide needed services to those they claim to speak for.

staci86 said: BradMajors said:
How exactly can a state prevent someone from living in his own home?

Welcome to the era of Big Government. Social workers and bureaucrats are gaining increasing control over the lives of adults, supposedly for "their own good."

As more and more people become dependent on government programs (Medicare/Medicaid, Social Security, UHC, etc.), the administrators of those government programs will use their authority to dictate lifestyles.

If this man is on a fixed income sourced completely from the government, and relies on the government for medical care, they can tell him exactly where to live if he is to continue to qualify for benefits.

Hmmm, interesting, yet he is in this situation because of the "small" state government, but big government is being blamed?

How about medicaid pays for all the people over 100 that want assisted living, in any facility of their choice. That might raise overall Medicaid expenditures by 0.0000000000000001% even though they choose the places that serve steak and lobster puree for dinner.

OLEOLEOLEO said:
What evidence do you have that this man meets any of these criteria??? The article says that those who know him think he would be better off staying in the assisted living facility rather than moving to a nursing home. Unfortunately, Virginia does not provide public assistance for assisted living. That is the issue. No one in this article is suggesting he would be just fine living alone. Whoever donated $60,000+ to keep him in assisted living probably doesn't think so either.

The article does not say what kind of medical treatment was necessary after this man fell off his bike. At that age even a minor injury and the stress of the ensuing treatment can easily incapacitate a formerly active individual both mentally and physically. Why hasn't anyone mentioned that? Instead a picture is painted of menacing totalitarian social workers forcibly institutionalizing a perfectly capable adult.
Head back to page one of this thread, and you will see that this discussion has eclipsed the specific man referenced in the article.

He fell off a bike, received treatment, and was brought by social workers to assisted living. That is all we know, and hence, why we are no longer talking about the man in the article.

OLEOLEOLEO said:
This will immediately be recognized as absurd by anyone who has experience working with old people. Please, continue to harp on this issue. I and most other reasonable, humane individuals, shudder at the thought of what would happen to penniless old folk with no family in a "libertarian utopia" without Social Security, social workers, or Medicare and Medicaid.
That isn't what is being discussed here. Nobody is making value judgments, one way or the other, regarding funding for those who do end up in assisted living. We are also not discussing those individuals so mentally disabled that they cannot perform basic functions, such as feeding themselves.

The sole point of discussion is whether an aged individual capable of making informed judgments about her own situation should be allowed to do so, even if those judgments favor intangible benefits such as independence and dignity over tangible benefits such as residency in an assisted living facility.

So, once again, should a person with mental capacity to understand and judge their own situation be able to be forced into assisted living if a government bureaucrat determines that it is in their best interests? Is rejection of state-sponsored "better care" grounds for assuming that a person is incapable of self-care, on the theory that no rational person would turn down assisted living when it delivers tangible medical benefits?

fasttimes said: minorthreat1 said: BradMajors said:
How exactly can a state prevent someone from living in his own home?

Not a lot of people volunteer to go into a nursing home, sometimes family will make this decision for them, sometimes the state will.

Actually, a judge has to make the call on this one.

We made the decision for my old dad, no judge involved.

tripleB said: Perhaps less "old folk" would be penniless if they werent paying 70%+ of their income into taxes to pay for previous penniless old folks care.

Ah yes, the old "When all else fails, complain that we are overtaxed." What an original idea.

tripleB said: Dont think its 70%?

No, as a matter of fact, I don't think it's 70%. In fact, it couldn't possibly be 70%, because somehow, in the recent past, I was able to save nearly 30% of my gross (in tax-deferred, inflation-adjusted i-bonds, no less!) and I still had money to put food on the table. Mirabile dictu!

Tax revenue in the United States as a percentage of GDP is 28%. If you're paying 70%, find a better accountant.

staci86 said: Head back to page one of this thread, and you will see that this discussion has eclipsed the specific man referenced in the article.

You're right, looking at it, this thread has become just another untethered FWF daydream about the wonders of a completely hypothetical tax-free government-free society where no one is poor (because there are no taxes, of course!), no one gets sick, no one gets old...etc etc etc. In that case I'll just bow out now.