Wednesday, March 14, 2007

120 news: plaque detection & how to make money not caring about the elderly

I recently wrote a "guest essay" for the Unforgettable Blog, as the owner, Patty, is away taking care of her brother who is ill. If you're reading this in the future, it was posted on March 13, 2007.

Some news in the world of AD Medicine:
A new technique can detect plaque. This will help with diagnosis and also with the progress of plaque-fighting medicines, like the kind my dad just beta-tested. (In the Yale study.)
Scientists have confirmed that an imaging agent known as Pittsburgh Compound B binds to abnormal protein growth in the brain that are a signature of Alzheimer's disease.

An insulting multi-part Forbes Magazine article about how to make money running a nursing home, posted on March 1, 2007 Mona has already blogged this far better than I ever could. (Her blog is so classy, compared to my earthiness. But there's room and need for both styles.)
The article asks, Would you put your own mother in any old assisted living home? Clearly not--which means entrepreneurs running these facilities have to be on their games right out of the gate. That includes knowing how to get the right permits, having a handle on start-up costs, keeping an eye on the most meaningful performance metrics and even choosing the right role model for your business. In other words, you need to know the fundamentals.
Like how to CARE for sick, demented and sad people? How to hire quality staff who know what they are doing?
Protecting yourself from liability seems to be more important to Forbes than keeping patients happy, healthy and alive.
They consider the wants and needs of the aging to be "external threats", complaining that: The most creative assisted-living facilities are offering fatter menus, cocktail lounges and, yes, even sex-education classes. Others are adding services to encourage more family involvement--say, painting or acting classes for children--to make that weekly trip to visit Grandpa not quite so boring. Oh, how awful, to have to provide good food and painting classes. What a way to cut into profit margins.
Sunrise is touted as a role model. If you're read Mona's post, you know about the problems Forbes didn't mention. On the surface, it does sound good: When it comes to keeping residents happy, Paul speaks not in terms of offering both fish and chicken on the menu, but of higher-order pursuits like "preserving dignity, nurturing the spirit, celebrating individuality, encouraging independence and involving family and friends."
The Technology section touts automated care: living management "solutions" to automate patient care. That is so repulsive I can't even put it into words. I can't imagine what it means and I don't want to know. The rest of the section focuses on things like sales leads and accounting software and how much it all costs. You'd think this would be about medical technology, heart monitors, "I've fallen and I can't get up" devices (which even my grandmother's ancient senior housing has--in the form of strings attached to alarms hanging from every wall in every room), more comfortable hospital beds and wheelchairs.
The Metrics section focuses on cash flow, occupancy rate and staff turnover. Not how healthy the patients are, how many get opportunistic infections or are injured or made sicker by staff errors and misjudgments.
Expenses bemoans every penny, like caregiving staffers and food and an activities director to keep your residents busy, while touting the nice 30% profit margin.
Permits whines that: After you break ground, expect regular inspections from the fire department, health department and other city agencies. When construction is complete, depending on the state's requirements, you or the executive director of the facility may have to take up to a week's worth of training in operating a facility. A whole WEEK of training? A WEEK!? To take care of sick and demented people? And how dare the fire and health inspectors come around and waste your time when you could be making money serving cheap food and using automated patient care rather than compassionate humans.
The final section, about supplies, deals with the logistics of buying cheap food and medicine. Enough said about that. Cheap medicine I can see (I used to work in procurement) but to go for the lowest bidder on food? For people who aren't well to begin with?
This entire article is basically how to make money off old sick people with the minimum amount of effort and care on your part. If that's what kind of person you are, go for it. But know that someday you'll be old and need care...and maybe someone will stick you in your own facility. Poetic justice.

Monday, March 12, 2007

119 "you dropped it"

I haven't written much lately. I've been busy working on several books.
My dad's been peeing in the hallway at night on a regular basis. My mom tries to wake up when he does so she can steer him into the bathroom but she doesn't always wake up in time. She tried a nightlight but he just turns it off. ("You left the light on.")
Friday we went to eat. A passing waitress dropped a scrap of paper on the floor by our table. My dad flipped out. He's yelling, trying to get her attention. My mother and I kept saying "Don't worry about it." But he sat there and stared at that scrap of paper, almost trembling, like a dog who sees a rabbit and is on a tight leash. Finally he told our waitress about it (over our protests) and she scooped it up. This is what he's like. Tiny things he has to make a big deal of, and major things...well you just don't want to witness them. There's probably one going on right now as I write this, because today he starts the real drug for the Alzheimer's study. A full day in the hospital.
A couple of weeks ago I was over there and he couldn't find something. He couldn't articulate what it was that he lost either. ("You write on it.") He was in the living room, swearing and slamming things around, then he started punching the doorway and yelling at us. My mom and I were just sitting there saying "we don't know what you're looking for, how can we help?" He got really violent. I didn't like it at all. We told him to calm down but he wouldn't. Finally he found what he was looking for (stickers) and some of them were missing from the package and he went on another rampage even as my mom explained that HE had used the missing stickers to label something.
They are supposed to be upping his dosage of the anti-depressant/anti-anxiety drug to help with this.
My mom's friend from the support group lost her husband. He had been in a home since last summer and recently started having seizures. I had suggested to my mother a few months ago that he wasn't going to live long and she didn't believe me, because he's only had AD about 6 years (he started early--like my dad. I think this man was around 70 when he died). But my mom said some of the people from the support group called and told her he had died. Not sure what happened. I know he had some problems eating too.
My dad's farting is worse than ever. When my parents went to get their taxes done he was blowing big loud farts in the accountant's office. My mom was mortified. He doesn't even try to hold them in and pretends he didn't do anything even though he often leans over to let them out. It's really disgusting and I'm embarrassed when he does it at restaurants (always when he gets out of the booth) or when we have people over for holidays. They stink too. Being in the car with him can be like a punishment. It's 20 degrees out and you've got the window open so you can breathe fresh air.