The White House Says Nursing Home Regulations Are Too Tough

kadefol

Just heart-warming.


The Trump administration wants to reduce the "burden" on nursing home operators by relaxing rules governing the facilities. Critics see troubling implications for the care of millions of residents.


........ they've been chipping away at Obama-era rules for a while. Here's just one example. They've changed the way that fines are assessed for substandard care. The result is that the average nursing home fine has dropped by about a third. And there's another regulation proposed in this package that could result in a further reduction of fines.

https://www.npr.org/2019/11/30/783819886/the-white-house-says-nursing-home-regulations-are-too-tough

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JodiK

Just marvelous... a license to treat our elderly even worse with less repercussions.

Oh, where oh where has compassion gone?

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elvis

Abuse in nursing homes has been a problem forever. Sadly, many patients are dumped there by relatives who don't pay enough attention to recognize problems. Shaking my head.

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chipotle

Some of you are extremely lucky to never have had a loved one placed in a nursing home.

You may not be as lucky.

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catspa_zone9sunset14

My mother, who passed away last year, developed violent dementia so severe that a nursing home was the only safe option for her or her caretakers -- it proved impossible to care for her at home (right-wing relatives gave sister and I a lot of grief about that decision until they tried caring for her themselves and lasted less than a week...after that, they shut up). We placed her in Oregon, near my sister's home, because it's less expensive up there than in California. The only leverage my sister had for insuring that the homes took decent care of my mother were the regulations and potential of fines, in which she became well-versed. So, yes, this is a bad and thoughtless idea.

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elvis

chipotle

Some of you are extremely lucky to never have had a loved one placed in a nursing home.

We promised our parents we would care for them in their own homes. We did, and don't regret one minute of that. The last of them, Mom, passed away on 4 November at the age of 97 1/2.

On her couch, in her living room, peaceful and comfortable, as she wished.

And you are right, chippy, we may not be as "lucky", but will try to plan ahead as best we can.

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Carro

Wow, elvis, 97 1/2, and at home. I'm really sorry for your loss and...your mom was really blessed ;-)

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Wants to Grow

Hi Elvis, my condolences for the loss of your Mom. What a blessing, her long life must have meant for your family.

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roxsol

My condolences, elvis.

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elvis

JaneAnn

We promised our parents we would care for them in their own homes.

I'd never expect my children make such a promise to me.

Or hold them to such a promise

None of them asked. Surely their lives would have been more convenient if they didn't have us to care for when we needed them. Life is a circle.

_____________

Thanks to Carro, WTG, and Roxsol. Mom had a good life and a good death. Her passing to the next part of her life was a blessing, she was very tired.

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roxsol

elvis, it is said that a good death is its own reward.

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mudhouse

Well stated, Elvis, and my heart goes out to you and to your family.

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Zalco/bring back Sophie!

Elvis, please accept my most sincere condolences on your mother's death.


As for nursing home care, there are two different scenarios in my mind. Nursing home care because an elder is old and needs assistance- that I do not understand, unless the older person has no family. And nursing care because the care required is serious, of a medical nature, like memory issues. And in those cases, I would hope the family would be on top of the care facility, watching out for their relative. And, no, I don't think we should relax standards for nursing homes.

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elvis

I agree with you Zal, as long as the memory issues are of such a severe nature that the patient doesn't know/care where they are or they are truly a serious danger to themselves or others.

The smaller memory issues are not really any more of a big deal than they are with a young child. That circle thing again!

And my thanks to you and to Mud.


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ohiomom

I have friends that are home health care aides, they take care of the elderly in their homes. The majority of these people have family, but the children/family don't want to be bothered bathing mom/dad and wiping their butts let alone fixing them a meal. In fact they oppose nursing homes because then mom/dad's wealth would go to the home instead of them. So they hire minimum wage workers to do what they won't do and so there will be more for them when the old folk die. Do you have any idea how many of these elderly people only get a few hours a day of care and the rest of the time they are alone? My friends have told me of arriving at the homes to find the seniors lying on the floor from the evening/night before because the loving children could not be bothered to check on their parent/s. Give me a break about the supposed caring for mom and dad in the twilight of their lives. And remember your own children learn from you (generic you) in how to treat their elders.

I imagine this is more common than some would think or admit.

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queenmargo

Sorry to read about your mother Elvis, my condolences.

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Stan Areted

Elvis, I am so sorry for your loss.

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how2girl

Meanwhile in Australia The Royal Commission into Aged Care Quality and Safety was established on 8 October 2018, to inquire into:-

(a) the quality of aged care services provided to Australians, the extent to which those services meet the needs of the people accessing them, the extent of substandard care being provided, including mistreatment and all forms of abuse, the causes of any systemic failures, and any actions that should be taken in response

(b) how best to deliver aged care services to

i. people with disabilities residing in aged care facilities, including younger people; and

ii. the increasing number of Australians living with dementia, having regard to the importance of dementia care for the future of aged care services

(c) the future challenges and opportunities for delivering accessible, affordable and high quality aged care services in Australia, including:

i. in the context of changing demographics and preferences, in particular people's desire to remain living at home as they age; and

ii. in remote, rural and regional Australia

(d) what the Australian Government, aged care industry, Australian families and the wider community can do to strengthen the system of aged care services to ensure that the services provided are of high quality and safe

(e) how to ensure that aged care services are person‑centred, including through allowing people to exercise greater choice, control and independence in relation to their care, and improving engagement with families and carers on care‑related matters

(f) how best to deliver aged care services in a sustainable way, including through innovative models of care, increased use of technology, and investment in the aged care workforce and capital infrastructure

(g) any matter reasonably incidental to a matter referred to in paragraphs (a) to (f) or that [the Commissioners] believe is reasonably relevant to the inquiry.

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blfenton

Well My siblings and I know that we don't have the experience or the capabilities to care for my mother, and yes I have done the showering and the bum wiping for my mother as well and I knew I didn't have the temperament. to continue doing that. So yes, my mother is in care.

Better to admit my own weaknesses than to make my mother suffer for them.

So for all of those who say it's better to keep them at home and you take care of them, have at it.

Elvis - I;m sorry about your mom. It's something we'll be facing soon and it'll be tough. There are a lot of us in this position making these same decisions for our parents.

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Nana H

My sympathies Elvis but she passed where she wanted to be and that is comforting I am sure,

There are so many situations that control what is the best to do for our loved ones in their later years not the least of which is finances. There are also many complicating health factors, physical and mental.

If a person wants to stay in their home and is safely able to do that with family and outside support they are truly blessed. My MIL had a type of dementia that caused her to act out in very harmful ways, harmful to her health and safety. She could not be on her own. There were no other options other than nursing home care. I felt heartsick about it but it was what it was.

However, what I did do was visit her multiple times weekly and never with a pattern so the staff never knew when to expect me. I was a tireless advocate for her , it was the best I could do. We all have different situations but one thing I know to be true we all have a moral obligation to ensure our elderly parents are well cared for no matter the situation.,

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Stan Areted

blfenton--I agree, the thing we have to remember is the situation is not like children growing up--it gets worse, not better. No mobility, dementia issues, constant falls, dialysis, repeated UTIs, allergies to medications--are difficult issues to grapple with when trying to care for an ageing loved one at home. There is no one easy answer, but a lot of us need to come up with some scenarios for ourselves and take good care of ourselves. Small measures can sometimes make the difference between needing help at home or a nursing home.

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queenmargo

Better to admit my own weaknesses than to make my mother suffer for them.

I agree with this. Not every one is cut out for all things. Not everyone is meant to own a dog, a cat, a child, etc. We are all different. As long as we do the best we can with what we've got to give.

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Kathy

Enforcement is something the bills lack that Trump wants to pass. It is the same with USMCA. There is lack of enforcement. They sound good but have no teeth. It is the same with this bill.

They also say that the proposed new rule will save nursing homes more than $600 million a year and that this will free up funds to improve patient care, though there's no requirement that the nursing homes spend the savings that way.

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blfenton

Stan - It sounds like you've been through it.

Nana - I agree and that;s what I can and do for my mom. The care facility knows that I visit often at different times and I have and will be her advocate and that I can do.

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Stan Areted

blfenton, yes I have, many have at this juncture we have to do the best we can, not second guess ourselves and go with what life gives us. Peace to anyone and everyone caring for a parent, disabled child, or spouse, or has.

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Stan Areted

Great reminder, Elvis, but there are more productive ways available to vent if one is struggling, I would certainly hope.

Thank you for your contributions to the subject, and peace to you and your family.

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HU-26819714

One of my best friends and my SIL are RNs that were home health care workers at one point in navigating the CNA/ LVN alphabet soup of nursing education. There are many stories about loving families that hire help because the older person doesn’t want their children doing the work of showering and as mentioned here, butt wiping. They find it demoralizing and having a qualified professional step in helps them retain their dignity.


They are paid minimum wage in some places because society doesn’t value their roll, not because they don’t deserve more.

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elvis

There are many stories about loving families that hire help because the older person doesn’t want their children doing the work of showering and as mentioned here, butt wiping. They find it demoralizing and having a qualified professional step in helps them retain their dignity.

I'm sure you're right. And then there are the parents who realize that turnabout is fair play.

Hospice care was very helpful, but they're on more or less a schedule where someone comes in to bathe the loved one say, every other day, an RN comes once a week, maybe a masseuse once a week, chaplain on demand, etc. The bulk of daily routine care is still for the family unless they hire someone. A couple of weeks ago I had the opportunity to visit with a niece who is a doctor in London. She's relocating to Australia, where she says the pay is better. Anyway, she was very impressed with the hospice care she witnessed while MIL was dying here at my house. She said Great Britain doesn't have anything close to comparable. She was equally amazed that Medicare pays for it.

Just some nuggets that surprised me.

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JodiK

Never gonna happen, Chipolte... not on our watch! Not if the wishes of our loved ones include no hospitals or other venues for the ill or aging as their time approaches.

We've nursed all of our parents through illnesses, at home, as they aged and passed, and we've been there for other family members, as well. When passing at home is their wish, we do everything within our power to ensure they are home... where everything is familiar, where they are more comfortable, happy, and with plenty of family to help care for them.

Our wishes are also cemented in legality, and trusted family is well aware of what to do.

No... no nursing homes. And the one closest to us is pretty nice, too... but still, no, thank you.

~~~

The nurses and aides who do the work deserve a heck of a bigger paycheck than they get. It's often difficult work, and sad... so sad... and for a variety of reasons.

~~~

So, just how much is this current administration going to take away from the citizens, and to what purpose? And how much is the current citizenry going to let them take? Is it too much to bear that someone who is poor, or someone who is ill or aging actually finds a ray of sunshine in life for a moment or two? Are they that jealous and mean?



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Stan Areted

Jodik:

Never gonna happen, Chipolte... not on our watch! Not if the wishes of our loved ones include no hospitals or other venues for the ill or aging as their time approaches.

Seems I've heard don't count on things are "never gonna happen" because we can all get hurt, die, be involved in an accident, have a fire and lose everything--in the blink of an eye.

Fact is, we never know.

Another fact is, some people have jobs and have to work, some people have physical and other limitations, their homes are not safe for the elderly or too far from medical care, some have no siblings, no spouse, no aunts and uncles, no cousins around to help.

People with choices more than some are fortunate indeed.

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carolb_w_fl_coastal_9b(zone 9/10)

Skipped down to remark on what seems like a severe failure of the imagination, combined with ignorant assumptions. Apologies if someone else has pointed this out already:

What about people who are unable to care for elderly parents due to their own health/physical issues?

What about people who cannot afford to care for their elderly parents?

What about people who have to work - and care for their children?

And of course not all elderly folks are parents - or have living children. And not all people in nursing homes/assisted living are elderly either.

And why is it some folks appear to judge what seems like the entire world based only on their own personal life experiences? Do they believe that nobody else needs nursing homes/ senior care facilities?

Or do they simply not care?

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Stan Areted

Carol we were on the same wavelength here.

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patriciae_gw(07)

When family are themselves old and unable to do the lifting and shifting, or younger but have to work so there is a home for the aged/disabled person to live in or any of many other limitations that makes it impossible for family to give the care themselves you go with a professional system. There is a tendency for people to assume a home will not care for your loved one unless you hang over them (and that helps) I certainly saw the staff of the Nursing home where my MIL was give exemplary care for the many patients you never saw anyone visit. They loved to see family visit by the way. I have seen people try to care for a family member and do a piss poor job of it because elder care is not something you are born knowing how to do and dying can be fraught-unanticipated things can happen that would have been better dealt with in a Nursing facility. So lets cut everyone some slack.

Elvis, I am sorry you had these loses but am glad you can feel the satisfaction of a job well done. We all have to die and a good death is what we hope for.

We do not need fewer rules for Nursing homes.

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elvis

Thanks, Patriciae. Everybody's situation is unique to them. I do think that this is an important topic for most here. This had been a good one.

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Stan Areted

It has been a good topic.

Compassion and common sense, knowing when to persevere and when to call in reinforcements--are all what we learn on a day by day basis in these situations.

It's never easy, no matter he road(s) we choose.

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chisue

How very Trump. Elder care in general is an enormously profitable business that will only grow as Boomers hit the health skids. (YOU may already be 'elderly'; are you over 65?) Nursing homes have no 'balance of power'; people in them are captives. Management has no incentive to improve their lives -- that's an empty bed with no Medicare payment coming in. Who checks? (I once 'found' a man in a nursing home after he'd been dead for three years; no notification to Soc. Sec.; the home was still cashing his checks.)

Licensing is already a joke in many instances. Enforcing *existing* regulations is another joke. Take a look at the budget for your local public health department, the people responsible for inspecting these places. Spread *thin*...do you think? Notice the 'scheduled inspections' and the *years* between checks.

'Skilled nursing' facilities are only one part of this story. There are countless places that are billed as 'care homes' that are only 'room and board', with regulations no more stringent than hotel licensing. (Need medical help...they'll dial 911 for you.) There's such a tempting market out there! These franchises are traded on the stock market. Someone buys into residing at X facility, then Y buys it and makes cuts to achieve better returns. But, no...we don't need no stinkin' regulations.

These regulations affect not only the elderly, but also the old, and the old old -- and people in all stages of life who are in nursing facilities. Standards? Standards have to be ENFORCED.

DH and I are 'elderly'. We don't want our adult children or grandchildren to care for our physical health needs, but we DO expect them to MONITOR our care in any facility -- as we have done for our own parents. I don't want a child to throw away years of his or her life trying to provide 24/7 care, killing himself and compromising his own family. This 'stage' can take decades, especially draining where the elder is *medically* alive, but mentally dead.

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dandyfopp

Hm. Pro-life something something.

As usual with Donnie, follow the money.



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chipotle

No... no nursing homes. And the one closest to us is pretty nice, too... but still, no, thank you.


We didn't have a choice when my mom suffered a massive stroke at 91. Not only did we not live nearby, but her physical limitations would have prevented home care.

Dh & I have no offspring, so the care option is greatly reduced. IMO, suicide would be an option should it ever come down to nursing home care.

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Michele

My condolences on your mother’s passing. It’s great she was able to go the way she wanted You should take comfort that you were able to help her with that wish

I am my mom’s caregiver. She moved to her one bedroom apartment 24 years years ago when she sold the house. She’s 90 and legally blind. That’s where she wants to stay. At this point it amounts to bringing her to appointments, setting up her meds, cleaning, doing laundry.... I get no help from my brother. He’ll go for weeks without even calling her. My sister lives 5 hours away.

When the day comes and she needs constant care...what will I do? Leave my family and live with her? Ask my sister to take her? She can’t. She has her for a week a couple of times a year and brings her back with swollen ankles and difficulty breathing because she won’t watch the sodium.

I pray (yes, pray) that when her time comes, it will be an easy passing. Not after years of deteriorating health. I’d be considered a bad daughter if I needed some help at some point I suppose? I don’t pass judgement on anyone about these things. It’s too complicated to make these decisions.

Nursing homes? If we value the elderly then we need to do what’s right by them. Sometimes it’s the only way. We need to be sure they are safe and clean and “accessible.” If you get my drift.

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JodiK

As I recall mentioning, and not that long ago (see above), there is a rather nice place right in town near us. Should we be forced to by elements beyond our control, we'd feel okay placing someone there.

But it is not a choice we'd want to have to make, and we'll do just about anything to ensure that the wishes of our loved ones are followed... to the letter.

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Kathy

This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.


I’m curious if this has anything to do with hospitalization or Medicare covering Hospice or elder care.

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elvis

Nursing homes have no 'balance of power'; people in them are captives. Management has no incentive to improve their lives -- that's an empty bed with no Medicare payment coming in.

Medicare does not cover long-term nursing home care, chisue.

...Medicare does not, however, pay any nursing home costs for long-term care or custodial care. If you need unskilled care for activities of daily living, care for an extended period of time, or care that is not reasonably expected to improve your condition within a limited timeframe, Medicare will not cover it...

https://medicare.com/coverage/does-medicare-cover-nursing-home-care/

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patriciae_gw(07)

People go through their savings and end up on Medicaid. Nursing homes typically have a limited number of beds for that. You go on a list to get into the better facilities. If you are lucky. It is a crap shoot but always has been.

I used to read Russian literature. I remember this famous tale. An old man is dying. His son puts him out in the barn to die and he does. The son with his own son in tow digs out an ancient worn out blanket to wrap the body for burial but the grandson carefully tears it in half. His father askes him why and the boy says I am keeping this half for you.

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JodiK

While there are a select few rather nice nursing homes within our general area, most are not places I would condemn anyone to.

Aside from lack of cleanliness, poor food, lack of adequate staff, and a single doctor who looks in on patients from time to time... they still charge an abnormal amount for the little they give.

"For profit" never means the inmates are getting the best in care. It means the entity operate strictly to earn money, and are concerned with their own interests.


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haydayhayday

"For profit"

It's what makes the world go around. Take that out and you're left with Bedlam.

Hay

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patriciae_gw(07)

But "for profit" has nothing to do with giving good care to people who cant complain.

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haydayhayday


Everybody can complain.

https://www.gardenweb.com/discussions/5833372/a-corrupt-country-ruled-by-an-autocrat-and-billionaire-oligarchs#n=9

Here's a whole thread just for that purpose.

Go complain. You'll feel so much better.


Hay



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haydayhayday

"But "for profit" has nothing to do with giving good care to people who cant complain."

You're so right.

"You get what you pay for. "


Sorta funny. A long time ago, we were passing around an article that showed up in the news one day about a wealthy old lady who figured out that it was as cheap, and a much better life, just to always keep going on cruises.

Hay

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patriciae_gw(07)

Hay, people who are care givers " give" care. It isn't an indication that it is free. It is another meaning for the word "give". Where have you been that you don't know that.

I suppose you might consider a life on a Cruise Ship a better life. Poke a stick in my eye.

It would be cheaper to put all those "illegals" on the border in Resort hotels. A case of not getting what we pay for in the present instance. They could afford soap and toothpaste at a fraction of the cost since resorts routinely give you 'complementary' personal hygiene products.

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Michele


"For profit"

It's what makes the world go around. Take that out and you're left with Bedlam.


Do you have a conscience? Have you ever stepped foot into a nursing home? I’ve visited good and bad. Cruelty is a word that comes to mind when I think of the bad. You feel it’s ok as long as someone is making $$$$$. ??

Horrible way to look at it.

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chisue

elvis -- My typo. I mean to say Medicaid. Makes no difference. The bottom line is the only line for these vultures enriching themselves warehousing human beings of all ages.

How callous to bring up retirement to consecutive cruises. How telling. (And no, you do not 'get what you pay for'. That's a large part of the point here.)

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margaritadina

I seriously don't understand liberals. When Obama took a chunk of elderly people Medicare - ''give your mother a pill'' (instead of a hip replacement) - and gave it to the poor he was and still is an idol of right doing. Why are you suddenly up on arms about nursing homes/elderly? You don't care about them.

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elvis

chisue

elvis -- My typo. I mean to say Medicaid. Makes no difference. The bottom line is the only line for these vultures enriching themselves warehousing human beings of all ages.

How callous to bring up retirement to consecutive cruises. How telling. (And no, you do not 'get what you pay for'. That's a large part of the point here.)

Cruises? I didn't post anything about cruises, callously or otherwise. What the heck are you on about, chisue?

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haydayhayday

Michele:

"Do you have a conscience? Have you ever stepped foot into a nursing home? I’ve visited good and bad. Cruelty is a word that comes to mind when I think of the bad. You feel it’s ok as long as someone is making $$$$$. ??

Horrible way to look at it."

I agree. You've created a terrible Straw Man. Shame on him. Shame, shame, shame!

Hay

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haydayhayday

Patriciae:

"Hay, people who are care givers " give" care. It isn't an indication that it is free. It is another meaning for the word "give". Where have you been that you don't know that."

Give? People with a lot of money don't get the kind of treatment you're all talking about:

Michele:

Cruelty is a word that comes to mind when I think of the bad

Someone with a lot of money puts up with that when they could go on cruises instead?

Chisue:

How callous to bring up retirement to consecutive cruises. How telling. (And no, you do not 'get what you pay for'. That's a large part of the point here.)

Of course you get what you pay for!. Try getting the kind of service you'd get on a cruise with what you'd get from a Medicaid subsidized home!

Just the facts, Ma'am.

Don't shoot the messenger.

Hay


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chisue

Elvis -- Not every word here is directed to you. Hay made the callous remark about cruising as a substitute for nursing care. (It is of course nonsense. Who would want a cruise ship's medical staff to provide ongoing care?)

Now, I need to correct my correction about "Medicare" and "Medicaid". I don't *know* if the man I 'found' for relatives had received Medicaid. I only knew that his Soc. Sec. benefits were mailed to the facility, and they were still being cashed within the facility three years after his death. (I was reminded by today's Chicago Tribune headline about a cop who continued to cash his late mother's benefit checks for 23 years.)

Hay -- I think you are unaware that you can spend tons of money and get rotten care in a nursing home, retirement community, etc. You are entrusting your favorite people, capitalists, and you don't want any government 'meddling' about how they operate. If they can save a buck on your care, they will do it, undetected by overburdened public health departments. I hope you have family to protect you -- and to remove you if necessary. Don't expect any agreed-upon refunds to you or your estate when you leave. (Read the fine print, twice.)

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patriciae_gw(07)

Hay you are not understanding give. It is in its sense of perform, carryout, do that the word is used in this context. You seem to be resisting that meaning of the word.

And as Chisue said Nursing homes where rich people go can be as callous and uncaring and ungiving as any cheesy place.

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White Kitchens Houzz Tour: White Is Right for Nurses in Ottawa
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Immaculately sleek and comfortingly bright, this modern Canadian home is a soothing retreat for hardworking healers
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Small Homes Houzz Tour: Coastal Maine Home Celebrates White, Wood and Windows
Efficiency, resiliency and waterfront views drive the design of this New England vacation house
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Houzz Tours Houzz Tour: Glamorous Home Strikes a Bold Note in Black and White
A new house in suburban Minneapolis looks to Hollywood and Italy for interior inspiration
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