(C) Daily Kos This story was originally published by Daily Kos and is unaltered. . . . . . . . . . . Kitchen Table Kibitzing 5/4: When you've fallen and get can't get up [1] ['This Content Is Not Subject To Review Daily Kos Staff Prior To Publication.'] Date: 2024-05-04 NN 2024 is scheduled for Baltimore this year, July 11-13. Haven’t been to one of these in a while, but since it’s close I’ll probably drive down. I’m curious whether it’s going to serve as a protest venue, but I expect that the magnitude of the protests may have cooled down by midsummer since most college students will be home, abroad, or at work. I admit the idea of hearing chants of “Genocide Joe has got to go” outside an NN convention in downtown Baltimore certainly sounds like a uniquely strange opportunity; anyway, it should be interesting. As usual, I’ll be at the bar. One thing that I suspect is certainly not at the very top of all these mostly young protester’s minds — whatever side they happen to come down on — is their possible future, far away into their octogenarian years, at an assisted living, long-term care facility. I am a bit distant from those years as well— although they begin to loom, vague and indistinct over the horizon — but I became acutely aware of them during the past year when I gently nudged my mom into one after my father’s passing. There wasn’t much of a choice involved. Full-time home care, which can run anywhere from $15,000 — 20,000 per month, assuming you can find it, is not covered by Medicare so it wasn’t a viable option unless I was prepared to gamble on my mother’s own passing well before the incredible longevity on her side of of the family. And neither I or my family were prepared, emotionally or physically to attend to the multiple constellation of medical issues that elderly people face when they succumb to the inevitable falls that tend to debilitate them beyond any hope of self-sufficiency. So mom, who was already well past that point, was not coming to live with us. But fortunately (for me) both my parents grew up with a vestigial Great Depression-era mentality and had socked away enough to care for themselves. Still, even the best assisted living practices among trained medical technicians and nurses cannot protect against the inevitable falls (my mother’s had five fall-related hospitalizations since going into a facility last year, with medical bills that would have totaled about half a million dollars had Medicare not paid for them). The facility’s policy is generally to call an ambulance and have the elderly person medically checked out in an ER every time they experience a serious fall. That’s because AL facilities are not hospitals or nursing homes, and though staffed with (some ) nurses they simply don’t have the staff, equipment, or necessary medication to do medical assessments and treatment. Many falls involve blows to the head and those, obviously, can result in the most serious consequences. The problem is that it’s hard to tell whether a fall is serious or not, and whether and how they can be assisted — even in getting them up — can be very tricky, depending on the person’s pre-existing physical condition. But as the population ages, the assisted living industry is now expanding right along with it, as more and more people absolutely require that kind of care. Naturally, the number of incidents of old people falling in such establishments has proliferated as well. As Todd Frankel, writing for the Washington Post reports, many facilities are now routinely calling for local EMS help when falls occur, because they are unwilling or fearful of picking people up (quite literally) off of the floor. These “lift assist” calls are now becoming a significant strain on local ambulance companies, who find themselves acting as caregivers at assisted living facilities instead of responding to fires, gun violence or auto accidents. Lift-assist 911 calls from assisted living and other senior homes have spiked by 30 percent nationwide in recent years to nearly 42,000 calls a year, an analysis of fire department emergency call data by The Washington Post has found. That’s nearly three times faster than the increase in overall 911 call volume during the same 2019-2022 period, the data shows. The growth has infuriated first responders who say these kinds of calls — which involve someone who has fallen and is not injured but can’t get up — unfairly burden taxpayers and occupy firefighters with nonemergencies that should be handled by staff at facilities that charge residents as much as $7,000 a month. Veteran firefighters and EMS techs are naturally annoyed when they are called in to simply assist picking someone who is otherwise uninjured off of the floor. But the main reason they are called, of course, is liability concerns. As Frankel explains, “[C]ompanies want to avoid the risk and expense associated with picking someone up off the floor.” Some assisted living facilities even have “no lift” policies in place to avoid the risk of liability (or even back injury) to their workers, liability which runs to their owners. As Frankel notes, the experience of having to call in a volunteer firefighter to be lifted after a fall can be embarrassing and demeaning for the elderly person as well, but that is apparently of the least concern to some of these places. Some cash-strapped local EMS services (that includes most of them) have started charging additional fees of up to $800 for such calls. The charges are held against the facility itself, but as Frankel notes there is nothing stopping the facility from passing that fee right along to the patient. The American Seniors Housing Association, a group representing assisted living facilities nationwide, has strenuously objected to municipalities imposing such “fee for service” arrangements and in some cases has supported laws banning their adoption. This sets up an inherent and often heated conflict between communities which need adequate EMS service and long-term care facilities, as the latter seek to exploit the relatively capabilities of local ambulance companies. Frankel notes that the assisted living industry is relatively unregulated (unlike nursing homes, which are more heavily staffed), and that the bulk of these types of “lift assist” calls come from these types of facilities. What he does not mention, but probably should, is that most of the long-term care facilities in the U.S. are run by private equity corporations whose concern is almost entirely satisfying their bottom line. That is what is preventing them from investing in the personnel and equipment necessary to address this epidemic of people falling, and not being able to get up. Caught up in this debate, of course, are the 1.2 million patients and residents at these types of facilities. Until you’ve understood and experienced the prevalence and consequences of falls to older people it’s easy to dismiss or even parody those late-night commercials for Life Alert (which is too expensive, by the way; the best one is Bay Alarm which is far cheaper, as I found out). But for the elderly, falling is no joke. It’s deadly serious and it happens a lot. This is yet another example of how our for-profit medical system is facing serious problems as the nation’s elderly population explodes. I’ll be out earlier tonight, but will catch up when I get back. [END] --- [1] Url: https://www.dailykos.com/stories/2024/5/4/2238875/-Kitchen-Table-Kibitzing-5-4-When-you-ve-fallen-and-get-can-t-get-up?pm_campaign=front_page&pm_source=more_community&pm_medium=web Published and (C) by Daily Kos Content appears here under this condition or license: Site content may be used for any purpose without permission unless otherwise specified. via Magical.Fish Gopher News Feeds: gopher://magical.fish/1/feeds/news/dailykos/