Re: Adult Day Care

1

There is a range of care these places provide. Some are just kind of a senior center with free coffee and chatting, others are a little like day camp, with singing and crafts. I think they're great for seniors who can't be home alone, but their caregivers can't quit their jobs. (Although in some places, Medicare will now pay caregivers for in-home services. Sometimes it's enough to compensate for loss of income.)

My mother was terribly shy and would have hated the very idea of a place like this, but when the time came, it was useful for a while. She could do a craft and be supervised, and Dad got some peace and quiet, eg to make phone calls (she got angry that she wasn't the center of his attention and was really disruptive when we was on the phone).

Lots of caregivers with snobby (or less demented) parents tell them they are going to "volunteer" to help senior citizens. The staff will often give them jobs like passing out yarn so they feel useful, and they also can give extra attention to lower-functioning seniors.


Posted by: ydnew | Link to this comment | 01-11-18 7:54 AM
horizontal rule
2

These are rare where my parents live. I have no idea how other people with less cushion manage it. My mother got sick at 58. She retired shortly after symptons became noticeable, and my father retored when she needed full-time supervision and took care of her for the next four years, then couldn't manage further decline. Adult day cares generally require that seniors be capable of following instructions, mostly continent, and non-aggressive, which can be a big ask.


Posted by: ydnew | Link to this comment | 01-11-18 7:57 AM
horizontal rule
3

I, personally, can overuse the phrase I, personally.


Posted by: heebie-geebie | Link to this comment | 01-11-18 8:25 AM
horizontal rule
4

I, personally, thought I should look into adult day care things and then events moved way too quick for it to be a solution to anything.


Posted by: Moby Hick | Link to this comment | 01-11-18 8:33 AM
horizontal rule
5

This would have been useful to give a rest to my Mom, when she was taking care of my Dad and they still lived in their old house. It was a shit-ton of work for her and she could have used a regular break.


Posted by: Spike | Link to this comment | 01-11-18 8:41 AM
horizontal rule
6

The Unpleasantness at the Bellona Adult Day Care.


Posted by: ajay | Link to this comment | 01-11-18 8:45 AM
horizontal rule
7

I wonder how various Medicare rules complicate this. You can get in-home services paid for only if you are home bound. This was really a handy thing to get. But if you have somebody going out every day to adult care, do they still count?


Posted by: Moby Hick | Link to this comment | 01-11-18 8:50 AM
horizontal rule
8

I'm a tiny bit worried about this. My parents and Cassandane's both live in rural areas. It might be hard to find something around them like this. In addition, my dad's dad had Alzheimer's. Between us we've got four aunts or uncles in some sense for which we're the oldest or only likely caretaker of our generation.

One bit of good news is, my parents live just a mile away from my dad's brother and wife half the year. My uncle is a year or two older than my dad but in better shape in most respects. Hopefully the four of them would be able to take care of each other until things get really bad.

I can't imagine planning this far ahead for myself or Cassandane. In 15 years I'll revisit the question after I know whether we're in cyberpunk penury, a nuclear wasteland, or what.


Posted by: Cyrus | Link to this comment | 01-11-18 9:07 AM
horizontal rule
9

This is something Medicaid can pay for sometimes in California and at least some other states (we call the benefit Community-Based Adult Services, pronounced "sea bass"), but there are a lot of hoops to jump through based on health conditions (complex PDF).


Posted by: Minivet | Link to this comment | 01-11-18 9:14 AM
horizontal rule
10

7: I found a form (CA) saying that you are "categorically eligible" for CBAS if you have already qualified for In-Home Supportive Services for over 195 hours/month. Hopefully they recognize the complementarity of the programs in general.


Posted by: Minivet | Link to this comment | 01-11-18 9:20 AM
horizontal rule
11

9: It would be better if they pronounced it "Patagonian toothfish".


Posted by: Moby Hick | Link to this comment | 01-11-18 9:23 AM
horizontal rule
12

Lindos Momentos, which roughly translates to Precious Moments, is one of 223 such centers in the Valley, many with similarly uplifting names like Mi Casa (My House), Nuestra Familia (Our Family) and Fuente de Juventud (Fountain of Youth).

I have thoughts about the names of elder-care facilities, but I never expanded my knowledge into how these things happen in Spanish. It seemed to me that the more folksy the name, the more intractable and severe the problems people at the facility had. That is, if you are at something that sounds like a hospital, you have an acute issue they might fix. If it sounds like a suburban subdivision full of white people worried about "the schools", you have a long term issue they can't fix but that hasn't gotten very bad yet. If it sounds like something you would see on a plaque you can buy at a Cracker Barrel and the walls are covered with wooden ducks, you can't care for yourself and you aren't expected to ever be better.


Posted by: Moby Hick | Link to this comment | 01-11-18 10:02 AM
horizontal rule
13

Anyway, I now associate wooden ducks with death.


Posted by: Moby Hick | Link to this comment | 01-11-18 10:05 AM
horizontal rule
14

Which, honestly, is an improvement over my prior association.


Posted by: Moby Hick | Link to this comment | 01-11-18 10:07 AM
horizontal rule
15

12 is amazing and I suspect entirely accurate.


Posted by: Thorn | Link to this comment | 01-11-18 10:25 AM
horizontal rule
16

How do you say, "Going out to the countryside to live on a farm" in Spanish?


Posted by: SP | Link to this comment | 01-11-18 10:27 AM
horizontal rule
17

Muerta.


Posted by: Moby Hick | Link to this comment | 01-11-18 10:28 AM
horizontal rule
18

16 Casa de los Buenos Perros


Posted by: Barry Freed | Link to this comment | 01-11-18 10:30 AM
horizontal rule
19

Therefore, send not to know. For whom the wooden duck was hung. It hangs for thee.


Posted by: Moby Hick | Link to this comment | 01-11-18 10:49 AM
horizontal rule
20

Mom's is called Autumn Leaves, which I find kinda horrifying and not even a little euphemistic.


Posted by: ydnew | Link to this comment | 01-11-18 10:52 AM
horizontal rule
21

My grandmother's is called Aegis. Not sure how to categorize that according to 12.


Posted by: ydnew | Link to this comment | 01-11-18 10:53 AM
horizontal rule
22

21: Are you sure your grandmother is not secretly a superhero? That sounds like their HQ.


Posted by: Minivet | Link to this comment | 01-11-18 10:54 AM
horizontal rule
23

22: Maybe a superannuated superhero.


Posted by: ydnew | Link to this comment | 01-11-18 10:59 AM
horizontal rule
24

My grandmother is in Fox Run, which has occasioned many jokes on several fronts from her children.


Posted by: Thorn | Link to this comment | 01-11-18 11:09 AM
horizontal rule
25

For a brief while:

1) a relative was in an assisted living facility with the same name as (the short version of) my law firm;

2) a friend was in a drug/alcohol rehab facility with the same name as my daughter's school.


Posted by: Robert Halford | Link to this comment | 01-11-18 11:15 AM
horizontal rule
26

It actually only now occurred to me that I have never seen any of these outside of the Valley. When I was a kid we would sometimes go on school outings to volunteer at these places. We may have done a band concert once, too. It's easy and tempting to say that the prevalence of these places is caused by stronger community values on the border, but if that were the case I would expect to hear about these places in San Diego and El Paso, too. I'll have to ask my step-parents about them.


Posted by: Trivers | Link to this comment | 01-11-18 11:18 AM
horizontal rule
27

And the oddest part of all is that all four are called "SexyHut."


Posted by: Robert Halford | Link to this comment | 01-11-18 11:18 AM
horizontal rule
28

"The Grotto"


Posted by: Barry Freed | Link to this comment | 01-11-18 11:21 AM
horizontal rule
29

25.2 is a big problem here except community college and rehab/halfway house. Foster care caseworkers really need to learn to specify but hadn't while I was still in the game.


Posted by: Thorn | Link to this comment | 01-11-18 11:33 AM
horizontal rule
30

Autumn Leaves

Autumn is a teaching assistant at some kind of school where the kids have a disease that makes them more sympathetic and more photogenic than regular kids. She stops for coffee and dies after choking on a biscotti. The EMTs fail to save her, but she is revived when a businessman with swept-back hair drops his briefcase on her stomach as he fights with the EMTs about why he can't just slip in for a cup of coffee before his very important meeting. His big important meeting goes well and he gets the Big Contract, so now he wants a trophy wife and he remembers the hot girl on the ground at the coffee shop. She feels she owes a Wookie life debt to the man who saved her and they become engaged. But she leaves him at the altar for a poor guy with a 2,500 square foot apartment and messy hair who works at the same school but not in a position where it is sexual harassment to pursue her.

Coming Fall 2019


Posted by: Moby Hick | Link to this comment | 01-11-18 11:38 AM
horizontal rule
31

Would not watch.


Posted by: Barry Freed | Link to this comment | 01-11-18 11:42 AM
horizontal rule
32

You're not a female aged 24 through 40. It's all about market segmentation.


Posted by: Moby Hick | Link to this comment | 01-11-18 11:43 AM
horizontal rule
33

30 is great btw


Posted by: Barry Freed | Link to this comment | 01-11-18 12:04 PM
horizontal rule
34

Yeah, Moby's on fire in this thread.


Posted by: teofilo | Link to this comment | 01-11-18 1:58 PM
horizontal rule
35

Casa en fuego.


Posted by: SP | Link to this comment | 01-11-18 2:08 PM
horizontal rule
36

Yeah, Moby's on fire in this thread.

Yeah, I love the description of, "a poor guy with a 2,500 square foot apartment and messy hair ."


Posted by: NickS | Link to this comment | 01-11-18 2:18 PM
horizontal rule
37

Using the SUV scheme of adding "Anal" tot he front of the name not really working that well in this case. Maybe something else works.


Posted by: JP Stormcrow | Link to this comment | 01-11-18 2:31 PM
horizontal rule
38

Anal Casa en Fuego works. They even make a little donut you sit on if it happens.


Posted by: Moby Hick | Link to this comment | 01-11-18 2:34 PM
horizontal rule
39

20, 21, 24, 25: My great-aunt's was called Vi, which I used to privately translate from Latin as "by means of force."


Posted by: Stranded in Lubbock | Link to this comment | 01-11-18 11:03 PM
horizontal rule
40

This thread is close to the literal embodiment of Moby's Law of elder care facility names.

We have just changed companies, and need to name our day service. The people we have in our service are adults in wheelchairs, who have both physical and intellectual disabilities. We need a nice, bright, and catchy name. Please, any suggestions will be gratefully received :O)

Posted by: JP Stormcrow | Link to this comment | 01-12-18 6:26 AM
horizontal rule
41

In grade school, I once got two free movie passes for naming the local senior center.


Posted by: Moby Hick | Link to this comment | 01-12-18 6:32 AM
horizontal rule
42

You mean you knew what it was called or you won a prize for suggesting "The Moby Hick Academy of the Fourth Age"?


Posted by: chris y | Link to this comment | 01-12-18 7:25 AM
horizontal rule
43

Suggesting "Sexyhut". Actually, my suggestion was "SexyHutt", but they were afraid of being sued by George Lucas.


Posted by: Moby Hick | Link to this comment | 01-12-18 7:27 AM
horizontal rule
44

39 I think of it as a Unix editor. But I'm probably just showing my age.


Posted by: chris y | Link to this comment | 01-12-18 7:30 AM
horizontal rule
45

43 Excellent suggestion.


Posted by: chris y | Link to this comment | 01-12-18 7:31 AM
horizontal rule
46

Forgive me to be a little cynical, but the spin in the cited article about adult care centers being "cost effective" and a "cultural phenomenon" seems very naive. More likely, someone figured out how to make a lot of money by running such centers in an area that offers limited economic opportunities. The trick is to attract relatively healthy seniors with freebies and then bill medicare.

Another place with a lot of such facilities is NYC, in particular the Chinese and Russian areas. There was an article in the NYT about this a while ago -- see http://www.nytimes.com/2013/04/23/nyregion/day-centers-lure-fit-elders-and-bill-medicaid.html. (This is not to say such centers are a bad idea in general, but there seems to be some potential for abuse.)


Posted by: tsts | Link to this comment | 01-12-18 9:45 AM
horizontal rule
47

Definitely room for abuse, which isn't sugarcoated in the original article, IMO. But is the potential for abuse particularly different than with in-home help or nursing homes? It's a very vulnerable population, and all three settings tend to be severely underfunded.


Posted by: heebie-geebie | Link to this comment | 01-12-18 10:06 AM
horizontal rule
48

The potential for abuse is certainly there in other settings. But where the abuse actually happens depends very much on where oversight focuses on at a given point in time. In NYC, the explosion in these facilities happened because the authorities were not focusing on it. Once they clamp down on it, the operators will find other schemes, maybe involving home care, or patient transport schemes that bill Medicaid, etc. (But note that this scheme does not require victimizing a vulnerable population - it is mainly about providing a cheap but desirable service and then massively overbilling the government for something else.)

I do think the article goes a little easy on the possibility of abuse, and mainly presents the whole thing as an interesting cultural curio. I don't believe that economics explains everything, but when you have an area where a certain service is used by an order of magnitude more than in the country as a whole, I would want to first follow the money.

Back to the actual service being offered: yes, having community centers where older folks go to chat and play cards is a great idea. We have playgrounds for kids in our neighborhoods, maintained by communities -- maybe we need more facilities for older folks as well. But this is exactly the service best directly provided by government.


Posted by: tsts | Link to this comment | 01-12-18 3:48 PM
horizontal rule
49

Government provided senior centers do exist lots of places, certainly in NY. But they serve a different need than a population that can't function independently enough to manage on their own during the work day, and the latter population is significant.


Posted by: LizardBreath | Link to this comment | 01-12-18 3:57 PM
horizontal rule
50

Yeah, there are a lot of fly-by-nights that max out on fraud wherever the opportunity pops up, and vulnerable people get caught in the middle. Medicare is the cash cow, but Medicaid can sometimes let more slip through by dinkiness. Drug rehab, ambulance transport, wheelchairs...


Posted by: Minivet | Link to this comment | 01-12-18 4:03 PM
horizontal rule
51

49: Chinatown in San Francisco is the site of the original PACE program (Program of all-inclusive Care for the elderly). Basically you need to be eligible for a nursing home. Most beneficiaries have Medicaid too, but you can pay for the long term care part. They have teams with an MD,NP, visiting nurses, OT, physical therapy and social work. People live at home with their families and go to the day Center (transportation ofte provided) and they try to provide services that keep people out of nursing homes, though they will continue to follow you if you wind up in one.


Posted by: Bostoniangirl | Link to this comment | 01-12-18 4:47 PM
horizontal rule
52

44: I did not know that! I do suspect, however, that you are far more Unix-literate than my great-aunt and the vast bulk of her 90+-year-old fellow travelers.


Posted by: Stranded in Lubbock | Link to this comment | 01-13-18 10:59 PM
horizontal rule