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Caregiver’s Toolbox Ep. 47 “4 Common Reasons Seniors Need Private Care”

Announcer:

Welcome to The Caregiver’s Toolbox, tools for everyday caregiving. We provide education and information on senior care topics. Here’s your host, Ryan McEniff.

Ryan McEniff:

Hello, everybody. My name is Ryan McEniff, and I’m here with Janet, and welcome to The Caregiver’s Toolbox, tools for everyday caregiving. Today, we’re getting into it with four common reasons seniors need private home care. I mean, Janet, there are maybe 5 million different reasons why seniors need private home care, but these are kind of the four that we find come through the door more often than not, maybe.

Janet:

Yeah, I think that’s a fair statement.

Ryan McEniff:

We could add a fifth on there. We’ll add one fifth one, a bonus one, at the end of it.

Janet:

Okay.

Ryan McEniff:

The first one we wanted to talk about was fall prevention. And Janet, you have plenty of experience with dealing with fall prevention and seniors. What are your thoughts on that?

Janet:

Well, with fall prevention, people get unsteady for a variety of reasons. Can and be a certain health condition, medications, they’ve had an injury, losing balance, whatever, and they still want to stay in their home, and they can’t be watched 24/7 by family, so they oftentimes need a caregiver in there to help them safely do their personal care, help them with their meals, take them out on errands, things like that.

Ryan McEniff:

Yeah. I mean, fall prevention is such a huge one. I mean, we were just dealing with it with a client that’s still using us right now, where… Falls happen all the time. I would say the most likely time that is is nighttime, where somebody’s just a little disoriented getting up, they fall.

Ryan McEniff:

But falls happen, and we just got a call today where somebody had a fall where they… They were not receiving care from us, but they had a fall one way or another. And they happen anytime. And where I feel for families, and I’m sure you empathize with them as well, is that private home care, as we’ve talked about, gets expensive. When falls can happen any time of the day, any time of the night, 24 hours a day, how do you weigh the amount of money you can spend, or you can budget for spending towards this, to dealing with making sure the most at-risk hours are covered. And I think that’s a problem a lot of families deal with in America, of “I don’t have the money to pay 24/7 care.”

Janet:

Yeah. And I think people will look into things where… Just like for anybody, you and I, the most dangerous place usually is a bathroom, and that’s either getting up at night, and if there’s someone at home or someone has a monitor or an alarm on the bed, they deal with that. If you have mom living or dad living with you, or something like that. But a lot of times it’s that getting up in the morning, it’s the personal care. The majority wear glasses, and you don’t usually wear your glasses in bed, so you haven’t put them on yet-

Ryan McEniff:

Yep.

Janet:

… and getting started for the day. And a lot of times, if people are trying to manage their finances and figure out how to ease into some of this, some people do very well if a caregiver’s in there in the morning for a period of time, and maybe the client goes to daycare, elder daycare, for the day.

Ryan McEniff:

Sure.

Janet:

Or a certain type of program or-

Ryan McEniff:

A pooled care where at least eyes are on them, where-

Janet:

Exactly.

Ryan McEniff:

… it doesn’t guarantee that somebody won’t fall, but if they happen to, maybe it’s a slow fall where they can be there and pick them up, or catch them, or they’re not on the ground for six hours waiting for somebody to realize that they’ve fallen because they haven’t answered the phone for a while.

Janet:

Yeah. And some people that are unsteady, but they’re cognitive, and their thought process is clear, will often, if they live alone, they will try and stay in bed until the caregiver comes. So, it’s that first thing in the morning that probably is the time when most people feel the need for someone to be there.

Ryan McEniff:

And that’s more the reason why seniors need to know about how to use smartphones. Because I can tell you, on a Saturday morning, I can waste a good hour laying in bed viewing my smartphone, whether it’s Netflix or YouTube or social media. Before I know it, I’ve spent an hour, and I’ve already been up, and haven’t even gotten out of bed. So, that’s what we need to do is make sure the seniors know how to waste their time on the smartphone for when the caregiver’s gone.

Janet:

Well, there you go. That’s what you need to do. Or you could be like in my house, where you use the cell phone, you take it off the handle, and you try and change the TV channel on it. So, technology’s a challenge.

Ryan McEniff:

Our home lives are a little different. I grant you that.

Janet:

Yeah.

Ryan McEniff:

So, the next one up, and granted, there’s a bit of a particular order for this, for fall prevention, I think, being number one. But dementia, it can be 1B, or fall prevention could be 1B and dementia’s 1A. I mean, they’re tied. They’re thoroughbreds racing down to the wire on the Belmont. So, dementia’s obviously a huge one where there are obviously multiple different kinds of dementia, but Alzheimer’s is number one.

Ryan McEniff:

And in that, it’s just kind of even just general forgetfulness, where they become a safety risk for themselves. And almost, dementia can be a one-two punch with you have dementia, and you’re wandering, and your brain’s telling you to just keep walking, keep walking, and you’re also a fall risk at the same time.

Janet:

That’s right.

Ryan McEniff:

And way to put the perfect ingredients for a catastrophe to occur. Hey, I just decided to start walking down the road, and I’m going to keep going until my legs give out.

Ryan McEniff:

And all the cracks and crevices and traffic. So, dementia is obviously a big reason why people call private home care agencies. And kind of, what are your feelings on that?

Janet:

Well, and with dementia, a lot of people think that dementia and Alzheimer’s are the same thing. And Alzheimer’s is a form of dementia, but there’s so many dementias that are undiagnosed, especially early stages, and there are also dementias that are reversible.

Janet:

One that people are getting more comfortable with, because usually you think, “Dementia? Oh my gosh. We’re going off the cliff.” But you can have dementia because you had anesthesia at the hospital. So, someone could break a hip or break something, have a surgery, and now they’re saying they’ve got symptoms of dementia. It doesn’t mean it’s forever, but they need to have some observation. They need to have some assistance to make sure that they’re not a safety risk to themselves, because their reasoning is just not what it ought to be.

Ryan McEniff:

Absolutely.

Janet:

So, depending upon what the nature is, and some people, they’re determined to live alone, and it’s not safe to do so. Some people, they live with family, but family needs a break, and they need someone to be there for them. So, there’s such a variety, and there’s so many different ways to deal with the dementia, that that oftentimes is the first call that we get. “I’m not sure where we’re at with mom, but we’re starting down that road. What do we do?”

Ryan McEniff:

Yeah. And so often when we get those calls, one of the questions we always ask is, “How’s mom’s or dad’s memory?” And inevitably, I would say, well, maybe seven out of 10 times, maybe six out of 10 times, there’s always an issue with memory impairment of some level. It might be at a one, it might be at a 10, somewhere in the middle, but there’s always some forgetfulness in there.

Ryan McEniff:

Like, “Oh, well there’s this one time they left the gas stove on, the gas burners on for three hours, and realized three hours later that it was going.” So, we could spend all day talking about all the different scenarios and intricacies of different dementia cases that we’ve dealt with over the years.

Ryan McEniff:

But it definitely is always… If it’s not the primary reason people are calling us up, it’s definitely a secondary or a “third-ary” reason, if I can use that made-up word. It’s always lurking in the shadows at some point in time. It’s just how big that monster is under the bed. So, it is part of the aging process and part of being in private home care.

Ryan McEniff:

The next one that we thought was a good one, number three was just kind of maybe more of a vague title, but general wellness and kind of personal care. We get this lot where family members just want somebody to come in, a caregiver to be more clear, to come in three or four times a week for anywhere from three to six hours a day, just to make sure that the house is being kept up with, making sure that mom’s okay, that there are some eyes and ears. Maybe there’s a neighbor that doesn’t mind stopping in every once in a while, or every day. Maybe there’s an event that happens on the weekends, or maybe the family gets there on the weekends, but they need some eyes and ears for most of the day on the weekdays. Whatever that is, it’s just making sure that there’s a general wellness there.

Janet:

Yeah. It’s like a wellness check. I can remember when my grandmother was alive, and she was living alone, and the neighbors knew that my grandmother was one of these people that ran a timetable like a train station would. And they always looked to see that the kitchen window shade was up. So, if they didn’t see it, you’d get a call. That kind of thing.

Janet:

But for a lot of people… And we get more and more of these calls. That people want mom or dad to maybe get used to care, because they don’t think they need it, or they’re reluctant. We always hear, “Well, they’re reluctant. They’re not sure they need this.” So, they want someone to come in to kind of get them to realize it’s not the bogey man under the bed. Or, very, very common is, their personal care, to your point, is such that they’ll do the little… We call them bird baths, a little surface cleaning here and there. And nobody I know of died from not getting a bath. But the chances are, needing an honest-to-goodness shower or a real good cleaning, you probably need that a couple times a week.

Janet:

And the last thing most men want to do is drop by to give their mother a bath.

Ryan McEniff:

Gosh, sure [crosstalk 00:10:31].

Janet:

So, often check on things like that. So, a lot of times things will work that way. Or maybe it’s some personal care in the morning, and take them shopping once a week, because it gets them out, and they still have a purpose or whatever. But we have taken mom’s keys, fortunately, and now she’s not on the road trying to do this herself.

Ryan McEniff:

Yeah. And the reason why it’s kind of vague is because there’s no one task. It’s just a variety. Making sure that the linens get changed every week. Making sure the laundry gets folded and put away. It’s just the beginning stages of maybe being unsteady on their feet, or the beginning stages of dementia, where they haven’t lost complete independence, but they just need a helping hand X amount of hours per week.

Ryan McEniff:

And one of those helping hands that you didn’t mention, and I’m sure you’ll agree with, is meal preparation.

Janet:

Absolutely.

Ryan McEniff:

It doesn’t matter… Generally, I think when you think of Hungry Man or Stouffer’s, you think of a guy that’s just gotten back from work and just wants something quick, and certainly that’s a demographic they cater to.

Ryan McEniff:

But seniors use a lot of pre-made meals where it’s microwave ready, and those aren’t bad every once in a while. I’m guilty, just as anybody who’s eaten them before. But when they become your primary source of food every single night, or maybe even lunch and dinner, we get a lot of calls about that where they’re worried about their parent’s nutrition, their nutrients that they’re getting on a daily basis. And those foods have just mega sodium. And I know we’ve even talked about this before in the past, but it is a cause of concern, and that’s why I kind of list it under that just general wellness, making sure everything’s okay.

Janet:

Yeah. And even in terms of, we’ve talked about people’s vision, or their sense of smell or whatever, can be off. It can be hard to read the instructions on some of these things, so you may have to help them. And as we’ve talked about, too, with sense of smell, to have part of that wellness check for a caregiver to kind of do a little quickie check of the refrigerator, because a lot of people can’t determine when something’s expired. And especially dairy, and I mean, we all know what bad chicken smells like, especially in the summertime. Elderly people can’t always sense that smell, and they can be at risk for that. And that’s something that doesn’t eat every day.

Ryan McEniff:

Did we talk about that recently? I can’t remember. Was that something-

Janet:

Exactly. What is that smell in the fridge?

Ryan McEniff:

Yeah. And so, if you think about it, if you have a mom or a dad, they don’t say these things, but we hear it all the time where they’re a little unsteady on their feet. Maybe they’ve had a minor fall, and they say, “Listen, I’m not reaching up high to grab things out of the cabinets. I’m not reaching down low to get a bunch of pots and pans. Then I got to clean it all up.” My dad is able bodied, and I was a single guy. I didn’t want to have to clean up five pans just to make myself one meal, when I could order from Domino’s and just have it delivered and throw it out.

Ryan McEniff:

So, there’s the convenience part of it as well, but it’s good where… Just to summarize, what happens is an aide will come in, will make a nutritious meal, and make a large portion of it so that they can have it for lunch and dinner for the next two days. And then when the home health aide comes in two days later, they do the same thing. So, they’re still getting the microwave meal, it’s ready, it’s in the Tupperware, but at least it’s nutritious and it’s not 5 million calories and 5 million grams or milligrams of sodium that’s in there. And it’s more balanced nutrition, rather than the same thing over and over again.

Janet:

Yeah. And because the caregivers do this type of thing day-in and day-out, and someone wants to be pretty independent, to be the sous chef, to be the helper, the caregivers are very good at seeing that Mrs. Smith has to reach way over here for this and way over there for that, and never uses this or that.

Janet:

And, as a project, they will over time move some things around in the kitchen, just like I did for my own mom, because she has back issues. And it was like, “Why are people bending down to get this, or reaching up to get that, when this space is not being used?”

Ryan McEniff:

Sure.

Janet:

So, we do it because we always did. That’s where it always was.

Ryan McEniff:

Absolutely.

Janet:

And that’s something we’re more tuned into because it’s our world. It’s what we live with.

Ryan McEniff:

Yeah. And so another one that we thought was an important one was rehab and hospital discharges. One of the things that occurs is when… And I thought this before I got into the space as well, that when you go into a hospital, you go in injured, they make you feel better, and you walk out of there, and you do a couple jumping jacks, and you skip down the road, and everything’s okay. And that’s about as far away as the experiences that we’ve had with seniors that go into a hospital or a rehab.

Ryan McEniff:

Now, granted, maybe if it’s stitches on your finger that you got, you’ll do that. But usually, when a senior leaves the hospital, the hospital has done a good job treating the acute issue, but hospitals are notorious. And I don’t think it’s a hospital’s fault. I think it’s just the nature of the beast, of they’re confused, disoriented, they’re weak, they’re tired, they’re grumpy, you’ve just gone and completely shaken the Christmas snowball, and the blizzard is going on.

Janet:

That’s a good example. Yeah.

Ryan McEniff:

Versus when it was quiet and nice. And you see that all the time, too, Janet, right?

Janet:

Yeah. It’s one of those things that you… And especially if it’s someone that lives alone, that maybe they came home from rehab for a knee or a hip or whatever, and their mind is sharp as a tack, but they’re home, and they have this walker. And how are they supposed to open the oven, or get at the fridge? Or, like you say, the hospitals are curing and working on the reason that you came to the hospital. Not how you’re going to get around the house.

Janet:

And a wheelchair and a standard walker don’t fit through my bathroom door at home. And these are the kinds of things that people don’t realize. And in some cases, if the condition is such that getting through a doorway, or doing something, is only temporary, you’re not going to go modify the whole house. And you don’t even necessarily need the home care for a long period of time, but you need it for that in-between while the person’s trying to adjust.

Janet:

I mean, I remember when I had shoulder surgery. And, of course, it’s always your dominant hand or leg that you get hurt. And I’m trying to beat an egg in a bowl, and I felt like an idiot because I’m chasing the yolk around trying to beat it with the other hand. And you take someone who was an older person, and maybe they were a little frail to begin with. They can be overwhelmed by, how do they adjust? So, to help them ease back into their own environment, a lot of people will ask for an aide to help them with that transition.

Ryan McEniff:

Absolutely. And this actually kind of segues into our bonus one or fifth one is assisted living, and discharging to an assisted living. We can kind of do 4B or 4A or whatever, where we have a client now, we had a client in the past, where they go to the hospital. They have a fall in assisted living.

Ryan McEniff:

And they come back home, and this gentleman, the difference between him when I saw him and when he moved back into the assisted living, and literally 48 hours later, was totally different.

Janet:

Yep.

Ryan McEniff:

He was back up on his feet. He felt good. He was cognitively okay, for the most part. You would’ve thought it was just getting back home and getting a solid night or two of sleep, and he was feeling great from a nasty fall that he had had a week earlier, or whatever, a few days earlier. And that’s where we get a lot of calls as well with assisted living facilities. Oh, you take it from there.

Janet:

Well, sometimes, to that exact point, people will come home from a hospital or a rehab, and they have been filled with proper nutrition and they’ve had enough fluids, and all of that. And they get back home, and in a few days they look like they’re doing great, but you can also often get a lull that next week, because they don’t have someone that is caring for them the same way they did when they were in the hospital bed.

Ryan McEniff:

Basically, catering to whatever need they have.

Janet:

Exactly. And to one of the cases I think you’re referring to, this person came back, was doing well, kind of backslid a bit. The family was getting a little worried, and he needed some adjustment. He needed to kind of accept where he was at, and that he had had a fall. And after about a week, or two weeks, he’s participating in activities. And the family’s like, “Oh, I’m so relieved. I thought we were going down, down, down.”

Ryan McEniff:

Yep.

Janet:

And it’s one of those things, that it works like the Stock Market or the rolling hills of somewhere, you have your ups and downs. We do.

Ryan McEniff:

Yeah. It’s not a linear movement. It can go up, it can go down. But the idea is over the course of a few days, a few weeks, maybe even a few months, that we’re trending in the right direction to get him back to his baseline, whatever that might be.

Janet:

Yeah. And we’ve had people that are moving to an assisted living, and just the nature of assisted living, we’ve had many families call us because for 48 hours, or through a weekend, they want one-on-one, just so the person can adjust. Because if they’ve lived in a certain home, or out of state, and now they’re in this new place, they got to figure out where their apartment is. The bathroom’s not in the same place. Where’s my toothbrush? And they need that little help for a period of time to help them get settled in.

Ryan McEniff:

And in our recommendation, whether you’re in our service area where we can care for you, wink-wink, nod-nod, or if you’re out in California where we can’t, if your loved one is coming back from a rehab stay or a hospital discharge that isn’t anything more than a mild issue, get 24 hours or 48 hours of care.

Ryan McEniff:

Make sure that that person, that loved one you have, if you can afford it, doesn’t go back into the hospital immediately after being discharged because they’re weak, they’re confused, they’re exhausted, they’re just not in the right frame of mind to make smart safety choice decisions. When you hire a private agency, it doesn’t mean you need to use 24 hours for the rest of your life. And if they say to you, “Well, if you sign on the dotted line, you have to give us three weeks to do 24 hours. And then, if you don’t sign on the dotted line, there’s somebody out there that will do this.”

Ryan McEniff:

So, get that 24 hours for a day or two, or three days, or whatever it might… Even if it’s a week, the amount of stress and pressure and angst that you’ll save the whole family is worth it. And you can lower the amount of hours you get as you don’t need it.

Ryan McEniff:

The gentleman that we’re caring for started out with 24 hours a day. Then he’s down to 16 hours a day, and then they’re going to move down to 12 hours a day. Now, granted, this has been going over for what, two months now?

Janet:

Yeah.

Ryan McEniff:

And so, that is a lot of money. It is costly. There’s no doubt about that. But we’re preventing him from going back into the hospital, which I can all but guarantee would’ve had happened if we weren’t in there providing care for him.

Ryan McEniff:

And so, if you have the ability to do that, and even it just allows… When an assisted living is taking back one of their residents, or if you’re taking in your mom again, it allows you to determine where they’re at after two or three days. And it is a bit of an investment, but I can promise you, it pays its dividends. But you never know that, because the idea is they won’t be going back to the hospital. So, it’s just some food for thought with that.

Ryan McEniff:

But, that’s what ends up happening, where we’d speak with people. They’re getting discharged at the last minute, or they’re getting discharged home, and they’re like, “What should we do?” Use us for 72 hours for home care or 48 hours for 24-hour care. And then let’s reassess on the second or third day. And if you don’t need us at all, then by all means, just cancel services.

Ryan McEniff:

So, it’s just something to think about when you’re listening to this, and you’re like, “Well, if mom ever does go in the hospital, what do we do?” That’s our recommendation.

Janet:

Or, we even do it as just plain respite. You got mom living with you, everything’s working out fine. You want to go to an out of state wedding with the family, and you need someone to come in for a period of time. Or you’re going on a vacation. They’re in a familiar setting and it’s a short term thing. And everybody ends up being a little bit safer, I think.

Ryan McEniff:

Absolutely. Well, excellent. Well, thank you, Janet, very much for the time. And thank you very much to all the listeners for listening, and we hope you have a great day, and we will catch you on the next one. Thank you.

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Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

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Caregiver’s Toolbox Ep. 46 “Different Types of Home Care Services”

Speaker 1:

Welcome to The Caregiver’s ToolBox, tools for everyday caregiving. We provide education and information on senior care topics. Here’s your host, Ryan McEniff.

Ryan McEniff:

Good day, everybody. Ladies and gentlemen, thank you for joining us. My name is Ryan McEniff. I am here with Janet. Janet, how are you?

Janet:

I am well, Ryan.

Ryan McEniff:

Thank you. Glad everything’s going well.

Janet:

Everything’s going good.

Ryan McEniff:

I like your shirt by the way.

Janet:

Yes, I’m going the nautical theme today.

Ryan McEniff:

Janet is wearing a buttoned down navy blue with small little anchors all over it.

Janet:

Yeah. Anchors away, it’s Friday.

Ryan McEniff:

Anchors away, absolutely. Let’s anchor. Let’s pull up anchor away from this place-

Janet:

Pull up anchor, there you go.

Ryan McEniff:

…and get the back out of here.

Janet:

Yep.

Ryan McEniff:

Anyways, you are listening to The Caregiver’s ToolBox, tools for everyday caregiving, where we discuss senior caregiving issues and topics. And today, we’re talking about four common reasons. Oh, no, we’re not talking about that. Excuse me. That was the last podcast. Today, we’re talking about breaking news. If there’s breaking news sound waves you can think of when you hear it on the radio. This is breaking news. Yeah, exactly. That if you didn’t know this already, Medicare is going to be insolvent in 2026 and social security is going to be insolvent in 2034. 2034 still is ways away, but 2026 is close. We’re talking in less than a decade, Medicare, where tens of millions of people get their healthcare in this country and hundreds of millions more are expecting to get their healthcare from in this country, is going to be basically bust, completely bankrupt. There is no money in the piggy bank to pay for anything.

             And I don’t know if this podcast will come out before or after, but we just did a couple, a podcast on the four different types of home care. And two of those types of home care were about VNAs and certified home care and hospice. And that sure as heck falls under Medicare. So, Janet, what are your thoughts on this? What are your concerns and feelings?

Janet:

Well, with Medicare, it is how a vast majority of the population is going to get their healthcare benefits. It helps them with their medications. It helps them with their doctor visits and all of those things. And the whole industry is based on getting paid by that bank account. And if there’s no money in the till and they can’t pay the services that are needed, there are services that are going to fade away. There’s just no way that everything could continue to be maintained. In over the past, I don’t know how many years, I can remember when even a VNA, you could get reimbursed for more home health aid hours than they tend to give now, because there’s less money to go or around. It will probably affect the Medicaid side, as well in terms of MassHealth and there are a lot of people that get their insurance through that.

Ryan McEniff:

Subsidized insurance, all of that.

Janet:

Subsidized insurance, your very pills. And the nature of at least our society is we’ve got at people with diabetes, hypertension, high blood pressure. This doesn’t even deal with people that are developing dementia as they age. And there are doctors that aren’t taking certain insurances because they’re not getting reimbursed enough now. You can’t help but wonder, where is this going to go? Who’s going to buy all the pharmaceutical stuff that’s being invented. The whole thing is kind of a creepy thought, I think.

Ryan McEniff:

Oh, I think it’s very disturbing. And one of the things I’m reading in this article, and I’m sure based off of what news outlets you read are present in the United States who by no means is polarizing in any way, shape or form. But I’m sure it just says here, “President Trump has ruled out changes to social security retirement, although he’s called for reforms to the disability program as part of his budgets and things like that.” But I highlighted that because it’s another case. And I don’t think while President Trump isn’t winning popularity, contests in every place of this country, this isn’t anything new with the way that he’s reacting to it. It is clearly kick the can down the road. And whether you are a democrat or republican or somewhere in between, we can point to past, what, seven presidents, six presidents, that we’ve known that this train is coming.

             This catastrophe is coming for decades now and nobody’s wanted to do anything about it. And it’s looking like, what, maybe the next, maybe not even, what, it would be maybe the next president or the president after that, who’s administration is going to have this happening. I mean, you’re talking less than 10 years. So, if Trump doesn’t get elected, let’s say he doesn’t get elected in two years. And let’s say, whoever does get elected goes for eight years, there you go, you’re right in 2026 and you’re dealing with this head on. So, if Trump does get reelected, either way, it’s going to be the next president of the United States that deals with this issue.

Janet:

Yeah. I actually think, even, you’re starting to see changes now. So, even past midterms and even into the next election, the things, the changes that have been implemented to alter Obamacare have had a huge impact on a lot of things. And at the same time, we are living in an age where, as technology moves faster and faster, there are devices that are being invented that help fix things, cure things, pharmaceuticals, but there’s a huge cost to those. And when people know that there’s a medication out there that’s going to save their family member, they want that. They want more things, but they’re costing even more and more.

Ryan McEniff:

Yeah, absolutely.

Janet:

So, things we didn’t even have cures for in the past, now we’re looking for reimbursement for.

Ryan McEniff:

Yeah. And I’m sure a lot of these pharmaceutical companies and being in the Boston area, that’s one of our pillars of economy here. I’m sure a huge part of their profits and their revenue every year come from reimbursement from the federal government. I mean, it’s got to be, just because the federal government is basically an insurance program with a military attached to it.

Janet:

And a lot of drugs are invented, tested and fail, and they still have to pay the employee that worked their butt off trying to make that work.

Ryan McEniff:

Well, that’s the point I was making was that, what’s going to happen when they realize there’s no money in the bank account to replenish the money they’re giving out to all the seniors and giving out to people? And then the money that they’re using to, like you just said, do R&D on things, research and development, then all of a sudden your medical industry doesn’t continue inventing and researching new cures for things. You’re absolutely right, Janet.

Janet:

And you look at one thing that came along, was pain medications to cure a lot of things. And what the healthcare system that was looking to take care of us did was it created opioid addictions. Well, now they want to expand these drug abuse programs and mental health programs, that’s to spend money beyond what we’re spending now.

Ryan McEniff:

Absolutely.

Janet:

it’s crazy.

Ryan McEniff:

It’s going to be an interesting few years, because obviously, our president cut taxes, which everybody loves getting their taxes cut. I mean, let’s be honest here. Everybody loves having to pay less and keep more. But at the end of the day, I’m sure part of the reason this came out was because that tax cut is probably going to bring this faster than it would otherwise would’ve come. That we were inevitably going to be dealing with this day was whether it’s going to be 2026, or is it going to be 2036 or 24? It was going to happen. But those tax cuts probably aren’t helping the cause. But I don’t know what the answer is going to be because there’s going to have to be a big one because it’s a huge, huge…

             I mean, for those maybe listening, without getting into it too much, you’re talking, I believe 61% of the federal budget comprises of Medicare and social security and Medicaid. I mean, you’re talking nearly two thirds of the federal government is based on just providing entitlements to people. So, you’re talking about the two biggest entitlements that are going to go bankrupt in the next 20 years. So, the only way to fix that is the either to get more money to come in. And the only way you get more money to come in is either tax people more, or you take out more loans from other countries to pay off what you owe people. So, I don’t know what the solution’s going to be. That’s way over my head.

Janet:

And for every cut, somebody’s going to like a cut, somebody’s going to hate a cut. Somebody wins, somebody loses. And I mean, we hear and we know clients that are dealing with VA benefits and the VA hospitals. And that’s a huge sum of money. That’s I think one of the largest budgets in the country as well, and yet listen to all the issues there are for safe and reasonable care under that budget. Is that a harbinger of things to come? I don’t know.

Ryan McEniff:

No, it feels like you’re between not only just a rock and a hard place, but five rocks and five hard places.

Janet:

Don’t get sick, don’t get old, and get rich and then it’ll be okay.

Ryan McEniff:

Everybody follow Janet’s rules to life and you’ll be just fine. But I mean, it will be interesting too, because I don’t know how it will effect this would have on the private industry, our industry. I mean, we’re granted, we’re not reimbursed by anybody other than generally private paid. A little bit of, I mean, a small, small amount of veteran that’s aid in attendance we’ve gotten over the years, but we’re predominantly just private pay. So, I don’t know how much of a affect it would have on us per se, but it’s still just… Changes are common people.

Janet:

They are.

Ryan McEniff:

One way or another, we’re going to have some big changes coming away. So, we thought it was appropriate just to speak about this, since this is going to affect our industry, it’s going to affect everybody who’s listening to this, this channel. It’s going to affect anybody that was just born three minutes ago, because at the end of the day, people are counting on this, whether you’re three minutes old or you’re 30 years old, or you’re 79 years old, it doesn’t matter. You are looking forward to this type of stuff.

Janet:

Yep. So, to use your nautical theme or setting sail in choppy waters.

Ryan McEniff:

We’re going to end on that one. We’re going to end it on that one. So, thank you very much for listening. Then my name is Ryan McEniff and if I’m here with Janet and you’ve been listening to The Caregivers ToolBox. Have a great day.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

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Caregiver’s Toolbox Ep. 45 “Medicare and Social Security Will Become Insolvent”

Speaker 1:

Welcome to The Caregiver’s ToolBox, tools for everyday caregiving. We provide education and information on senior care topics. Here’s your host, Ryan McEniff.

Ryan McEniff:

Good day, everybody. Ladies and gentlemen, thank you for joining us. My name is Ryan McEniff. I am here with Janet. Janet, how are you?

Janet:

I am well, Ryan.

Ryan McEniff:

Thank you. Glad everything’s going well.

Janet:

Everything’s going good.

Ryan McEniff:

I like your shirt by the way.

Janet:

Yes, I’m going the nautical theme today.

Ryan McEniff:

Janet is wearing a buttoned down navy blue with small little anchors all over it.

Janet:

Yeah. Anchors away, it’s Friday.

Ryan McEniff:

Anchors away, absolutely. Let’s anchor. Let’s pull up anchor away from this place-

Janet:

Pull up anchor, there you go.

Ryan McEniff:

…and get the back out of here.

Janet:

Yep.

Ryan McEniff:

Anyways, you are listening to The Caregiver’s ToolBox, tools for everyday caregiving, where we discuss senior caregiving issues and topics. And today, we’re talking about four common reasons. Oh, no, we’re not talking about that. Excuse me. That was the last podcast. Today, we’re talking about breaking news. If there’s breaking news sound waves you can think of when you hear it on the radio. This is breaking news. Yeah, exactly. That if you didn’t know this already, Medicare is going to be insolvent in 2026 and social security is going to be insolvent in 2034. 2034 still is ways away, but 2026 is close. We’re talking in less than a decade, Medicare, where tens of millions of people get their healthcare in this country and hundreds of millions more are expecting to get their healthcare from in this country, is going to be basically bust, completely bankrupt. There is no money in the piggy bank to pay for anything.

             And I don’t know if this podcast will come out before or after, but we just did a couple, a podcast on the four different types of home care. And two of those types of home care were about VNAs and certified home care and hospice. And that sure as heck falls under Medicare. So, Janet, what are your thoughts on this? What are your concerns and feelings?

Janet:

Well, with Medicare, it is how a vast majority of the population is going to get their healthcare benefits. It helps them with their medications. It helps them with their doctor visits and all of those things. And the whole industry is based on getting paid by that bank account. And if there’s no money in the till and they can’t pay the services that are needed, there are services that are going to fade away. There’s just no way that everything could continue to be maintained. In over the past, I don’t know how many years, I can remember when even a VNA, you could get reimbursed for more home health aid hours than they tend to give now, because there’s less money to go or around. It will probably affect the Medicaid side, as well in terms of MassHealth and there are a lot of people that get their insurance through that.

Ryan McEniff:

Subsidized insurance, all of that.

Janet:

Subsidized insurance, your very pills. And the nature of at least our society is we’ve got at people with diabetes, hypertension, high blood pressure. This doesn’t even deal with people that are developing dementia as they age. And there are doctors that aren’t taking certain insurances because they’re not getting reimbursed enough now. You can’t help but wonder, where is this going to go? Who’s going to buy all the pharmaceutical stuff that’s being invented. The whole thing is kind of a creepy thought, I think.

Ryan McEniff:

Oh, I think it’s very disturbing. And one of the things I’m reading in this article, and I’m sure based off of what news outlets you read are present in the United States who by no means is polarizing in any way, shape or form. But I’m sure it just says here, “President Trump has ruled out changes to social security retirement, although he’s called for reforms to the disability program as part of his budgets and things like that.” But I highlighted that because it’s another case. And I don’t think while President Trump isn’t winning popularity, contests in every place of this country, this isn’t anything new with the way that he’s reacting to it. It is clearly kick the can down the road. And whether you are a democrat or republican or somewhere in between, we can point to past, what, seven presidents, six presidents, that we’ve known that this train is coming.

             This catastrophe is coming for decades now and nobody’s wanted to do anything about it. And it’s looking like, what, maybe the next, maybe not even, what, it would be maybe the next president or the president after that, who’s administration is going to have this happening. I mean, you’re talking less than 10 years. So, if Trump doesn’t get elected, let’s say he doesn’t get elected in two years. And let’s say, whoever does get elected goes for eight years, there you go, you’re right in 2026 and you’re dealing with this head on. So, if Trump does get reelected, either way, it’s going to be the next president of the United States that deals with this issue.

Janet:

Yeah. I actually think, even, you’re starting to see changes now. So, even past midterms and even into the next election, the things, the changes that have been implemented to alter Obamacare have had a huge impact on a lot of things. And at the same time, we are living in an age where, as technology moves faster and faster, there are devices that are being invented that help fix things, cure things, pharmaceuticals, but there’s a huge cost to those. And when people know that there’s a medication out there that’s going to save their family member, they want that. They want more things, but they’re costing even more and more.

Ryan McEniff:

Yeah, absolutely.

Janet:

So, things we didn’t even have cures for in the past, now we’re looking for reimbursement for.

Ryan McEniff:

Yeah. And I’m sure a lot of these pharmaceutical companies and being in the Boston area, that’s one of our pillars of economy here. I’m sure a huge part of their profits and their revenue every year come from reimbursement from the federal government. I mean, it’s got to be, just because the federal government is basically an insurance program with a military attached to it.

Janet:

And a lot of drugs are invented, tested and fail, and they still have to pay the employee that worked their butt off trying to make that work.

Ryan McEniff:

Well, that’s the point I was making was that, what’s going to happen when they realize there’s no money in the bank account to replenish the money they’re giving out to all the seniors and giving out to people? And then the money that they’re using to, like you just said, do R&D on things, research and development, then all of a sudden your medical industry doesn’t continue inventing and researching new cures for things. You’re absolutely right, Janet.

Janet:

And you look at one thing that came along, was pain medications to cure a lot of things. And what the healthcare system that was looking to take care of us did was it created opioid addictions. Well, now they want to expand these drug abuse programs and mental health programs, that’s to spend money beyond what we’re spending now.

Ryan McEniff:

Absolutely.

Janet:

it’s crazy.

Ryan McEniff:

It’s going to be an interesting few years, because obviously, our president cut taxes, which everybody loves getting their taxes cut. I mean, let’s be honest here. Everybody loves having to pay less and keep more. But at the end of the day, I’m sure part of the reason this came out was because that tax cut is probably going to bring this faster than it would otherwise would’ve come. That we were inevitably going to be dealing with this day was whether it’s going to be 2026, or is it going to be 2036 or 24? It was going to happen. But those tax cuts probably aren’t helping the cause. But I don’t know what the answer is going to be because there’s going to have to be a big one because it’s a huge, huge…

             I mean, for those maybe listening, without getting into it too much, you’re talking, I believe 61% of the federal budget comprises of Medicare and social security and Medicaid. I mean, you’re talking nearly two thirds of the federal government is based on just providing entitlements to people. So, you’re talking about the two biggest entitlements that are going to go bankrupt in the next 20 years. So, the only way to fix that is the either to get more money to come in. And the only way you get more money to come in is either tax people more, or you take out more loans from other countries to pay off what you owe people. So, I don’t know what the solution’s going to be. That’s way over my head.

Janet:

And for every cut, somebody’s going to like a cut, somebody’s going to hate a cut. Somebody wins, somebody loses. And I mean, we hear and we know clients that are dealing with VA benefits and the VA hospitals. And that’s a huge sum of money. That’s I think one of the largest budgets in the country as well, and yet listen to all the issues there are for safe and reasonable care under that budget. Is that a harbinger of things to come? I don’t know.

Ryan McEniff:

No, it feels like you’re between not only just a rock and a hard place, but five rocks and five hard places.

Janet:

Don’t get sick, don’t get old, and get rich and then it’ll be okay.

Ryan McEniff:

Everybody follow Janet’s rules to life and you’ll be just fine. But I mean, it will be interesting too, because I don’t know how it will effect this would have on the private industry, our industry. I mean, we’re granted, we’re not reimbursed by anybody other than generally private paid. A little bit of, I mean, a small, small amount of veteran that’s aid in attendance we’ve gotten over the years, but we’re predominantly just private pay. So, I don’t know how much of a affect it would have on us per se, but it’s still just… Changes are common people.

Janet:

They are.

Ryan McEniff:

One way or another, we’re going to have some big changes coming away. So, we thought it was appropriate just to speak about this, since this is going to affect our industry, it’s going to affect everybody who’s listening to this, this channel. It’s going to affect anybody that was just born three minutes ago, because at the end of the day, people are counting on this, whether you’re three minutes old or you’re 30 years old, or you’re 79 years old, it doesn’t matter. You are looking forward to this type of stuff.

Janet:

Yep. So, to use your nautical theme or setting sail in choppy waters.

Ryan McEniff:

We’re going to end on that one. We’re going to end it on that one. So, thank you very much for listening. Then my name is Ryan McEniff and if I’m here with Janet and you’ve been listening to The Caregivers ToolBox. Have a great day.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

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Subscribe to The Caregiver’s Toolbox Podcast

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Caregiver’s Toolbox Ep. 42 “Understanding Sepsis”

Speaker 1:

Welcome to The Caregiver’s Toolbox, Tools for Everyday Caregiving. We provide education and information on senior care topics. Here’s your host, Ryan McEniff.

Ryan McEniff:

Hello everybody and welcome to another overdue episode of the Caregiver’s Toolbox. My name is Ryan McEniff, I’m here with Janet. We are back together doing another episode, it has been way too long. Today we’re talking about something very timely. We are talking about sepsis, which has been brought up in the news because of our past President, George H.W. Bush, got it and was hospitalized with it after his untimely death of his wife, and so we thought this would be a goo time to talk about it because it’s not something that everybody knows about. People don’t talk about it much but it causes a lot of chaos and a lot of people can pass away from it. Janet, you’re my clinical person, you’re amazing at all this stuff. We’ve always been you’re clinical, I am the business side of things. What is sepsis?

Janet:

Well, sepsis, it’s also called septicemia. Some people generally refer to it as a form of blood poisoning. It’s one of those things that it affects a large population and yet only a third of Americans have ever even heard of it or know what it is. It’s due to an infection that usually when you get an infection your body fights it off. You get a fever and that’s your body fighting it off. What sepsis is, is when your body goes into hyper-drive to try and kill an infection and it ends up turning on your body and it ends up damaging healthy stuff and oftentimes it can be fatal.

Ryan McEniff:

Obviously, it was close… He was in critical condition at one point in time with this so it certainly is an example of how quickly it seems to come on and the damage that it can do.

Janet:

Yeah, and it’s one of those things that even for doctors can sometimes be a little bit difficult to pick up because the initial symptoms mimic a lot of other symptoms so it can be a little tough. The elderly are really susceptible to it because they probably already have some underlying medical conditions so their immune system isn’t that great to begin with. People that are diabetics, they tend to have wounds that don’t heal in a timely way and especially people that have to use catheters, IVs, feeding tubes, anything that allows …

Ryan McEniff:

Is foreign, yeah.

Janet:

… Germs to come internal to the body. You think of former President Bush, he covers all categories. The man has Parkinson’s. The man is elderly. The man’s immune system was very low, just as part of the mourning process of having lost his wife. What happens is your body just all of a sudden turns on itself to try and get rid of this germs and it can cause organ failure, organ damage, cognitive disabilities, and in some cases it can move very quickly once you get it. It’s one of those things where about 50% of people that contract it do poorly or fail or, at the very least, end up re-hospitalized within three months.

Ryan McEniff:

Yeah, and I was going to mention just because you get over the initial diagnosis and you recuperate, that doesn’t mean that there aren’t lasting effects and ongoing complications that can come with this.

Janet:

Yes, and cognitive abilities are one of the things that can come up. I was looking at some statistics and I was even looking for the papers to see what people had to say about sepsis as a result of President Bush and 40% of sepsis patients are re-hospitalized within three months and these initial hospitalizations, that costs our healthcare system $5.5 billion, and that’s only the first time in the hospital.

Ryan McEniff:

Yeah.

Janet:

That doesn’t count re-hospitalizations, nursing homes, BNAs coming, private home care or families that cut back on their jobs to support caregivers, and some of this damage can be permanent, lasting, people needing organ transplants, forms of dementia. One study that I was just reading up the other day said there’s, on average, 20,000 new dementia cases in the elderly annually because of sepsis. A lot of people when they hear dementia they think Alzheimer’s but this is something that has nothing to do with Alzheimer’s, this is an infection and it results in permanent dementia.

Ryan McEniff:

Yeah, and obviously 5.6 billion a year isn’t pocket change. Like you said, that doesn’t even include whatever re-hospitalizations come with it because people leave the hospital just because they might not for the same exact ailment, if they’re so weak that they fall or they’re so weak that they come back for another disease that because their immune system is so low and they’re fighting, it just becomes a vicious cycle of going in and out of the hospital and, as we’ve said in other podcasts, in general, one of the worst places to take elderly people is the emergency room in the hospital because there’s a bunch of sick people there. Everybody’s sick in there and it can be easy to come out just as sick, if not sicker, than when you went in. That’s not a knock on the hospital system, they’re doing a great job, but it’s just the nature of the beast.

             So many times we’ve seen patients, we’ve seen clients, and we’ve heard about where people go into the hospital and people have an idea that mom will get better, everything will be okay and they’ll come home feeling great. They come home weighing less, less body mass or muscle mass, they’re dehydrated, just because being in a different facility than being home causes stresses as well as being sick and trying to cope and get over with what they’re doing. There are plenty of different things that can occur once somebody’s in the home that maybe you weren’t expecting that is going to be that collateral damage from this disease and from this infection … Excuse me, not disease, this infection.

Janet:

Yep, and bacteria we know, it’s like we joke around and talk about daycares being little Petri dishes …

Ryan McEniff:

Yeah.

Janet:

… And every kid shares it. The same thing can happen to adult daycare centers, any place that there is a congregation of germy people.

Ryan McEniff:

Absolutely.

Janet:

As a result, the last thing you want to do is have to take mom and dad to the hospital or even doctor’s appointments during flu season or things of that nature and it’s really, really important to watch. Oftentimes, this can come around as a result of pneumonia, which is very, very common in the elderly so you have to watch that. That’s why … To your point, the hydration and making sure they’re getting enough fluids, which is probably the number one problem with elderly people because they’re concerned about getting to the bathroom so they don’t drink, and we’ve talked about UTIs. UTIs can become …

Ryan McEniff:

A nightmare real quick.

Janet:

Septic very, very easily and people just don’t have the health and the energy to fight it off. I mean, you think President Bush had the best of care around the clock with his Parkinson’s and yet this is the situation he found himself in.

Ryan McEniff:

Absolutely, so it’s not … Just because you have the means to be able to pay for it doesn’t mean that it’s not going to happen for you.

Janet:

Yeah.

Ryan McEniff:

Well, something I was looking at here. I mean, there’s a nice little acronym for sepsis and The Sepsis Alliance offers the following acronym to help the public easily remember the telltale signs of sepsis. S is shivering due to a fever over 101, E is extreme pain or general discomfort. That’s a little vague but we’ll work with it. P is pale or discolored skin, that should be easy to see. The next S in sepsis is for sleepiness, confusion or changes in consciousness, and then the I is I feel like I might die or similar remarks from a patient. That kind of goes back to the extreme pain or general discomfort. Then the final S is shortness of breath.

             Kind of going back to what you said as I’m sure that I don’t know The Sepsis Alliance that well, I’m sure they’re all good people over there trying to do their part, but there’s a lot vague descriptions or symptoms in that acronym, right? You’re dealing with extreme pain, general discomfort, shivering due to a fever, so maybe you think somebody just has the cold or the flu. It just proves your point where you’re talking about that it’s not exactly the easiest to pinpoint and say, “Oh, this is that right there, I know exactly what this is,” because it’s a lot of vague, general symptoms that accumulates at one time.

Janet:

Right, and in some cases, depending upon what the other underlying medical conditions are, if someone suffers from shortness of breath …

Ryan McEniff:

Yeah …

Janet:

That’s their baseline so I think what they’re trying to get to with acronyms like this is, if these things are not part of the norm or, as the clinical people call it, the baseline for that person. At the same time, if an elderly person has underlying medical conditions and they develop a fever or have a cold you got to watch them that much closer because you and I can maybe be out a day if it’s a really bad cold and we bounce back. This can quickly go downhill for an elderly person so it’s really what is their norm and of these things, as far as shivering, the aging process thins your skin and you go to an assisted living, you go to a nursing home and people have got their ski jackets on in July and you go into their room and you could grow orchids in there because they keep the heat so high.

Ryan McEniff:

Absolutely.

Janet:

There’s what is normal but then there’s this is more so.

Ryan McEniff:

Absolutely.

Janet:

That’s when you have to watch it most.

Ryan McEniff:

Because everybody’s baseline is different and so you’re going to have to, just like you said, take that into consideration. If somebody’s always wanting it to be warm, that doesn’t necessarily mean that they have a disease, that might just be what their baseline is. That’s interesting. It’s so …

Janet:

And stress low is your immune system.

Ryan McEniff:

Yeah.

Janet:

I mean, George Bush, who knew his wife since he was 17 or something, that was a tremendous loss to him. Other family members, when they lose a spouse, their immune system is very vulnerable. Or certain holiday seasons, especially if someone has some kind of dementia because there’s memories, and it wears you down. You know how you’re tired after a major event. Well, if you got a low immune system you’re a little more fragile,

Ryan McEniff:

It completely makes sense and I’m sure there are plenty of people out there that just thought he was sick or just saw … They chop it up to just, “Oh, his was immune system, a bug got in, a bug.” Well, this bug is a serious issue and it causes a lot of damage throughout the country on a yearly basis when it comes to hospitalizations, re-hospitalizations, and obviously people’s health.

Janet:

Yep.

Ryan McEniff:

Then people like us get calls where it’s like, “Hey, we need private home care,” because somebody needs to be there around the clock to make sure they get better for the three or four days, the week, the two weeks, whatever it is until they get back on the mend.

Janet:

When they come home doesn’t mean they’re better.

Ryan McEniff:

Unfortunately, that’s the case. Well, excellent. Well, thank you, Janet, and thank you all for listening to The Caregiver’s Toolbox, Tools for Everyday Caregiving. We will see you on the next go round. Thank you.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

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Subscribe to The Caregiver’s Toolbox Podcast

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Caregiver’s Toolbox Ep. 42 “Understanding Sepsis”

Speaker 1:

Welcome to The Caregiver’s Toolbox, Tools for Everyday Caregiving. We provide education and information on senior care topics. Here’s your host, Ryan McEniff.

Ryan McEniff:

Hello everybody and welcome to another overdue episode of the Caregiver’s Toolbox. My name is Ryan McEniff, I’m here with Janet. We are back together doing another episode, it has been way too long. Today we’re talking about something very timely. We are talking about sepsis, which has been brought up in the news because of our past President, George H.W. Bush, got it and was hospitalized with it after his untimely death of his wife, and so we thought this would be a goo time to talk about it because it’s not something that everybody knows about. People don’t talk about it much but it causes a lot of chaos and a lot of people can pass away from it. Janet, you’re my clinical person, you’re amazing at all this stuff. We’ve always been you’re clinical, I am the business side of things. What is sepsis?

Janet:

Well, sepsis, it’s also called septicemia. Some people generally refer to it as a form of blood poisoning. It’s one of those things that it affects a large population and yet only a third of Americans have ever even heard of it or know what it is. It’s due to an infection that usually when you get an infection your body fights it off. You get a fever and that’s your body fighting it off. What sepsis is, is when your body goes into hyper-drive to try and kill an infection and it ends up turning on your body and it ends up damaging healthy stuff and oftentimes it can be fatal.

Ryan McEniff:

Obviously, it was close… He was in critical condition at one point in time with this so it certainly is an example of how quickly it seems to come on and the damage that it can do.

Janet:

Yeah, and it’s one of those things that even for doctors can sometimes be a little bit difficult to pick up because the initial symptoms mimic a lot of other symptoms so it can be a little tough. The elderly are really susceptible to it because they probably already have some underlying medical conditions so their immune system isn’t that great to begin with. People that are diabetics, they tend to have wounds that don’t heal in a timely way and especially people that have to use catheters, IVs, feeding tubes, anything that allows …

Ryan McEniff:

Is foreign, yeah.

Janet:

… Germs to come internal to the body. You think of former President Bush, he covers all categories. The man has Parkinson’s. The man is elderly. The man’s immune system was very low, just as part of the mourning process of having lost his wife. What happens is your body just all of a sudden turns on itself to try and get rid of this germs and it can cause organ failure, organ damage, cognitive disabilities, and in some cases it can move very quickly once you get it. It’s one of those things where about 50% of people that contract it do poorly or fail or, at the very least, end up re-hospitalized within three months.

Ryan McEniff:

Yeah, and I was going to mention just because you get over the initial diagnosis and you recuperate, that doesn’t mean that there aren’t lasting effects and ongoing complications that can come with this.

Janet:

Yes, and cognitive abilities are one of the things that can come up. I was looking at some statistics and I was even looking for the papers to see what people had to say about sepsis as a result of President Bush and 40% of sepsis patients are re-hospitalized within three months and these initial hospitalizations, that costs our healthcare system $5.5 billion, and that’s only the first time in the hospital.

Ryan McEniff:

Yeah.

Janet:

That doesn’t count re-hospitalizations, nursing homes, BNAs coming, private home care or families that cut back on their jobs to support caregivers, and some of this damage can be permanent, lasting, people needing organ transplants, forms of dementia. One study that I was just reading up the other day said there’s, on average, 20,000 new dementia cases in the elderly annually because of sepsis. A lot of people when they hear dementia they think Alzheimer’s but this is something that has nothing to do with Alzheimer’s, this is an infection and it results in permanent dementia.

Ryan McEniff:

Yeah, and obviously 5.6 billion a year isn’t pocket change. Like you said, that doesn’t even include whatever re-hospitalizations come with it because people leave the hospital just because they might not for the same exact ailment, if they’re so weak that they fall or they’re so weak that they come back for another disease that because their immune system is so low and they’re fighting, it just becomes a vicious cycle of going in and out of the hospital and, as we’ve said in other podcasts, in general, one of the worst places to take elderly people is the emergency room in the hospital because there’s a bunch of sick people there. Everybody’s sick in there and it can be easy to come out just as sick, if not sicker, than when you went in. That’s not a knock on the hospital system, they’re doing a great job, but it’s just the nature of the beast.

             So many times we’ve seen patients, we’ve seen clients, and we’ve heard about where people go into the hospital and people have an idea that mom will get better, everything will be okay and they’ll come home feeling great. They come home weighing less, less body mass or muscle mass, they’re dehydrated, just because being in a different facility than being home causes stresses as well as being sick and trying to cope and get over with what they’re doing. There are plenty of different things that can occur once somebody’s in the home that maybe you weren’t expecting that is going to be that collateral damage from this disease and from this infection … Excuse me, not disease, this infection.

Janet:

Yep, and bacteria we know, it’s like we joke around and talk about daycares being little Petri dishes …

Ryan McEniff:

Yeah.

Janet:

… And every kid shares it. The same thing can happen to adult daycare centers, any place that there is a congregation of germy people.

Ryan McEniff:

Absolutely.

Janet:

As a result, the last thing you want to do is have to take mom and dad to the hospital or even doctor’s appointments during flu season or things of that nature and it’s really, really important to watch. Oftentimes, this can come around as a result of pneumonia, which is very, very common in the elderly so you have to watch that. That’s why … To your point, the hydration and making sure they’re getting enough fluids, which is probably the number one problem with elderly people because they’re concerned about getting to the bathroom so they don’t drink, and we’ve talked about UTIs. UTIs can become …

Ryan McEniff:

A nightmare real quick.

Janet:

Septic very, very easily and people just don’t have the health and the energy to fight it off. I mean, you think President Bush had the best of care around the clock with his Parkinson’s and yet this is the situation he found himself in.

Ryan McEniff:

Absolutely, so it’s not … Just because you have the means to be able to pay for it doesn’t mean that it’s not going to happen for you.

Janet:

Yeah.

Ryan McEniff:

Well, something I was looking at here. I mean, there’s a nice little acronym for sepsis and The Sepsis Alliance offers the following acronym to help the public easily remember the telltale signs of sepsis. S is shivering due to a fever over 101, E is extreme pain or general discomfort. That’s a little vague but we’ll work with it. P is pale or discolored skin, that should be easy to see. The next S in sepsis is for sleepiness, confusion or changes in consciousness, and then the I is I feel like I might die or similar remarks from a patient. That kind of goes back to the extreme pain or general discomfort. Then the final S is shortness of breath.

             Kind of going back to what you said as I’m sure that I don’t know The Sepsis Alliance that well, I’m sure they’re all good people over there trying to do their part, but there’s a lot vague descriptions or symptoms in that acronym, right? You’re dealing with extreme pain, general discomfort, shivering due to a fever, so maybe you think somebody just has the cold or the flu. It just proves your point where you’re talking about that it’s not exactly the easiest to pinpoint and say, “Oh, this is that right there, I know exactly what this is,” because it’s a lot of vague, general symptoms that accumulates at one time.

Janet:

Right, and in some cases, depending upon what the other underlying medical conditions are, if someone suffers from shortness of breath …

Ryan McEniff:

Yeah …

Janet:

That’s their baseline so I think what they’re trying to get to with acronyms like this is, if these things are not part of the norm or, as the clinical people call it, the baseline for that person. At the same time, if an elderly person has underlying medical conditions and they develop a fever or have a cold you got to watch them that much closer because you and I can maybe be out a day if it’s a really bad cold and we bounce back. This can quickly go downhill for an elderly person so it’s really what is their norm and of these things, as far as shivering, the aging process thins your skin and you go to an assisted living, you go to a nursing home and people have got their ski jackets on in July and you go into their room and you could grow orchids in there because they keep the heat so high.

Ryan McEniff:

Absolutely.

Janet:

There’s what is normal but then there’s this is more so.

Ryan McEniff:

Absolutely.

Janet:

That’s when you have to watch it most.

Ryan McEniff:

Because everybody’s baseline is different and so you’re going to have to, just like you said, take that into consideration. If somebody’s always wanting it to be warm, that doesn’t necessarily mean that they have a disease, that might just be what their baseline is. That’s interesting. It’s so …

Janet:

And stress low is your immune system.

Ryan McEniff:

Yeah.

Janet:

I mean, George Bush, who knew his wife since he was 17 or something, that was a tremendous loss to him. Other family members, when they lose a spouse, their immune system is very vulnerable. Or certain holiday seasons, especially if someone has some kind of dementia because there’s memories, and it wears you down. You know how you’re tired after a major event. Well, if you got a low immune system you’re a little more fragile,

Ryan McEniff:

It completely makes sense and I’m sure there are plenty of people out there that just thought he was sick or just saw … They chop it up to just, “Oh, his was immune system, a bug got in, a bug.” Well, this bug is a serious issue and it causes a lot of damage throughout the country on a yearly basis when it comes to hospitalizations, re-hospitalizations, and obviously people’s health.

Janet:

Yep.

Ryan McEniff:

Then people like us get calls where it’s like, “Hey, we need private home care,” because somebody needs to be there around the clock to make sure they get better for the three or four days, the week, the two weeks, whatever it is until they get back on the mend.

Janet:

When they come home doesn’t mean they’re better.

Ryan McEniff:

Unfortunately, that’s the case. Well, excellent. Well, thank you, Janet, and thank you all for listening to The Caregiver’s Toolbox, Tools for Everyday Caregiving. We will see you on the next go round. Thank you.

About Us

Minute Women Home Care is a premium, non-medical, live-in care, and in-home care service provider that enables our clients to live at home with dignity and respect by assisting with their activities of daily living. We support families in senior home care within their mission to allow their parents to age in place rather than transition to a nursing facility.

Minute Women Home Care | Home Care Services Since 1969

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