[john_yaya]

Senior homes and assisted living centers are a national disgrace. They are entirely about profit maximization (what business isn’t?), and as such hire people at the exact minimum and have well over 100% yearly turnover. The staff commonly steal from residents, and the management do not care. They’d rather retain a larcenous pig who barely executes her duties than have to go back and scrape the barrel for a replacement.

The residents are often lonely, in awful health, overlooked by their families, and spend all day watching television. Many of them are verbally abusive towards the staff.

Elderly people should live with their families. The ones with no families to care for them should be in nonprofit, closely regulated facilities with well-paid staff. And it’s time to stop spending $500K on medical care just so an 88 year old can make it to 89. Whoever spread that “death panels” meme should be forced to write America a check for five hundred billion dollars.

[pmorici]

"Elderly people should live with their families."

Spoken with the confidence of someone who has never had to care for an elderly relative who was in both mental and physical decline. In any case it is a deeply personal decision without a definitive right or wrong answer. After seeing my Aunt try to care for my grandmother for years only for it to negatively effect their relationship because of her dementia I wouldn't blame anyone for choosing a care facility.

I know people who were so effected by their experience of caring for an elderly relative that they checked themselves into a senior living community in their 50's so their kids would never have to feel like they needed to do the same for them.

[roenxi]

Without disagreeing - if that is what happened to her relationship with someone close to her, what would have happened in a care facility of people who don't have any personal connection at all? These care facilities don't sound like fun either.

Fact is that getting old can be a truly horrible process. Which is why the pro-euthanasia people keep standing up.

[batch12]

Damn-- in their 50s. I don't have much time left. I'd rather walk the planet than check myself into a center.

[falcolas]

> Elderly people should live with their families.

No. It’s an unreasonable burden to expect families, which are barely holding themselves together in this wonderful world of mandatory-two-income-households we’ve built, to take on not only their adult children who can’t afford to rent or buy their own homes, but also the extensive and expensive care of their elders.

[stirlo]

I don't support the GPs view that the elderly should live with their families.

I do however take issue with you suggesting this would be bad for financial reasons. Realistically assigning some of the wealth older people have built up to their families caring for them rather than for profit corporations would be a financial benefit.

The issue is expecting younger family members in the prime of their lives to put their life on hold to care for the elderly when this care can be required for decades (unlike infants).

[nyokodo]

> the extensive and expensive care of their elders.

Granted cognitive decline and other conditions are extremely difficult to manage, however it’s remarkable how easy and cheap a disturbingly large chunk of elder care is. Just someone there to make sure elders take their meds on time, monitor their blood pressure, making sure they’re eating or go to the doctor if anything bothers them etc; all these tasks could be done in-home with family, or minimally trained healthcare workers. We could even pay families and healthcare workers handsomely and we’d still save massive amounts on the outrageous expense in elder quality-of-life and healthcare expenditure we pay because those simple interventions aren’t made.

[wombatpm]

The best thing about the pandemic was working from home. It allowed me to move in and care for my father-in-law for the last 6 months of his life. If I had been commuting, the stress of everything would have probably killed my wife

[disabled]

> Whoever spread that “death panels” meme should be forced to write America a check for five hundred billion dollars.

Alaska governor and 2008 Republican Vice President candidate Sarah Palin started the “death panels” farse.

See: https://en.m.wikipedia.org/wiki/Death_panel

It’s quite disgusting as she is a mother with a disabled child.

[code_duck]

What I found odd about that discussion or claim is that we have essentially the same system already, but it's operated by for-profit corporations rather than the government. As you probably know, insurance companies will fight you literally to your death to avoid paying for treatments that doctors say are necessary.

[gruez]

>It’s quite disgusting as she is a mother with a disabled child.

how is that disgusting? that seems entirely consistent with her beliefs, as disabled child means high costs which potentially could mean getting denied care on the basis of cost. it's not any different than say, "congresswoman with cancer pushes for cancer treatment funding bill".

[tomrod]

So the solution is to spend less money but pay people more, and shoulder the rest on taxpayers?

This probably won't work very long since the population isn't as triangular as it used to be (to my understanding this is what happened to Japan).

I get the justified call to fix things for people that require these services. The US can barely afford to school its children, purchase its homes, or enact reasonable public health measures without bankrupting people.

As a society the US is unwilling to consider euthanasia, decriminalization of most nonviolent drugs, effective gun control, and funding infrastructure. The plight of the elderly is on par with the plight of the transient. Policy is actively hostile for them.

[dragonwriter]

> The US can barely afford to school its children, purchase its homes, or enact reasonable public health measures without bankrupting people.

No, it can easily afford all that. It chooses not to because the US (that is, the majority of political power in the country) prefers to impose the pain of the imminent risk and frequent reality of bankruptcy on the working class.

[soperj]

>The US can barely afford to school its children

You're the richest nation on earth. You can afford it, the people who control the purse strings choose to use it on other shit that benefits themselves.

[FunnyLookinHat]

> The US can barely afford to school its children

Ironically, I was just listening to this today: "Why Does the Richest Country in the World Have So Many Poor Kids? (Ep. 475) " [1]

There really isn't any excuse - it's all a product of our politics and culture, or vice versa... I'm not sure.

1) https://freakonomics.com/podcast/child-poverty/

[xyzzyz]

> The US can barely afford to school its children

FWIW, US has one of the highest spend on education in the world. Among OECD countries, it is only behind Luxembourg, Norway, and Austria, and only barely so. If the educational outcomes in US are below expectations, it’s not because we spend too little, but rather because we’re not getting our money’s worth.

[titanomachy]

> US is unwilling to support euthanasia

I don’t know about the rest of the US, but Washington and Oregon have allowed physician-assisted suicide for the terminally ill for years.

[tehwebguy]

We print money for bombs & bailouts because there is a valuable enough carrot for our policy makers.

Maybe we can think of a carrot (or better yet a stick) that would stop those things and start printing money for things like education, healthcare, end of life care.

[kshacker]

You discussed everything except the profit motive of the owners to bleed every bit of penny from their "earnings"

[gruez]

>The ones with no families to care for them should be in nonprofit, closely regulated facilities with well-paid staff.

how's that working for higher education? state schools aside, AFAIK most private schools are non-profit. rather than money flowing to shareholders, it'll be money flowing to bloated administrations.

[bpodgursky]

The worst part is the payment structure and how it doesn't allow real choice. If you told the 88 year old:

"We can (a) pay $500,000 on treatments that will likely extend your life 1 year, or (b) put $250,000 in a tax-advantaged account to put your great-grandchildren through college", I bet that 99% of those 88 year olds would take option B and take hospice care instead. They would all prioritize their children, grandchildren, etc!

But that's not the option... it's them, vs some nebulous national slush fund of cash where they and nobody they know gets no benefit out of being selfless. We should fix that.

[neither_color]

And in the rest of the non-nihilistic world those grandchildren would rather have one more year of grandma than any amount of money 15 years later. This whole discussion of letting seniors die to optimize economic potential is gross.

[swman]

Or we could just you know, invest into this since all of us will be old some day and some of us may, even after a life time of contribution, could face unlucky circumstances that leave us alone in the end?

What's wrong with dignity for other people, I feel like trying to maximize for monetary profit is going to be our downfall.

[TrispusAttucks]

Unfortunately, the people with the power to "invest in this" will not ever be in the situation that the rest of us will be. Most "real" people are more worried about how their children will live with not enough time left over to deal with how their parents will die.

This is just one of many issues. We are coming apart at the seams in our society in so many ways that by solving one issue we must ignore another. There is so much poor investment across the board. It's tragic but I fear we are so far off the rails now that perhaps none of it can't be saved.

[ErikVandeWater]

The other end of this is depending on the government to ensure the wellbeing of the most vulnerable; the government is the one giving billions to these facilities that do not provide adequate service.

Facilities where the family pays aren't going to get away with mistreatment, because the family will choose a different facility.

[Factorium]

The necessary innovation is ethical/political. People over age 80 should be able to request to medically cease their life for any reason.

[reb]

Right, there are no ethical downsides to putting the elderly in hellish group homes as long as we give them death when they ask for it.

[vbezhenar]

You can buy gun. Why do you have to request anything?

[eru]

> They are entirely about profit maximization (what business isn’t?), [...]

And yet, most businesses are rather pleasant to deal with. Perhaps it's something other than the desire for profit that makes them so awful?

(Btw, there are also not-for-profit senior home and assisted living centres around the world. They aren't necessarily better.)

[Aloha]

You can take care of my mother then, I didn't sign up for that burden.

[ARandomerDude]

This is a poor criterion for responsibility. If you don't sign up to obey the law should you be immune from prosection for murder or robbery (supposing you were to commit those crimes)? Some responsibilities are innate.

[rrrrrrrrrrrryan]

> And it’s time to stop spending $500K on medical care just so an 88 year old can make it to 89.

Does U.S. Medicare not use QALYs? (Quality Adjusted Life-Years)

The WHO recommends using 3x GDP/capita for each QALY, which would set America's threshold somewhere around $150k, not the $500k in your example.

[nradov]

Medicare doesn't use QALY thresholds to decide which treatments to cover. From a pure economic efficiency standpoint it probably should, but the politics around care rationing are so toxic that it can't be done.

[wombatpm]

My mother-in-law had kidney failure. The statements showed the cost as 70k per month. Obviously Medicare paid a lower amount, but she had 4 years of dialysis before death. And that’s not counting her hospitalizations for falls and UTIs. I can easily believe 500k

[stult]

> Whoever spread that “death panels” meme should be forced to write America a check for five hundred billion dollars.

Something tells me Sarah Palin doesn't have that much money

[antiSingularity]

And these are precisely the people we just shut down the global economy (and culture, and inter-personal connection) to apparently "protect".

[batch12]

Sad thing is that this is nothing new. I caught this same thing in the first episode of a show from 1984. If I get in a situation where I have been committed to one of these facilities, I hope, for their sake, I have forgotten all the adversarial pentesting skills I've acquired over the years.

[ricardobayes]

Let me get that straight, are you advocating that old people should just die and not be treated/cured because of financial reasons?

[marsdepinski]

They are given psychotropic drugs to make them easier to manage and less likely to be able to complain.