Aging Alcohol Abuse Archives ⋆ Cathy Cress

The 2 Deadliest US Sites of COVID-19 Nursing Homes & Prisons

May 2, 2020

PRISON INMATES AND NURSING HOME PATIENTS NOT 6FT APART – 6 FEET UNDER

70% of inmates in federal prisons have COVID-19. In Kansas, the Lansing Correctional Facility had a riot of inmates over COVID-19 lack of care or protection It took the rebellion to get the coronavirus testing PPE and care. The Bureau of Prisons in Kansas confirmed finally that 79 staff have coronavirus and 88 prisons and prisoners dead.

Older residents in nursing homes cannot rebel like prisoners. Many can’t even walk. The Atlantic Magazine just published an article, We are Killing Elders Now. The writer states “In at least six states, these fatalities account for half of all COVID-19 deaths, and according to the World Health Organization, half of all coronavirus fatalities in Europe have been traced to nursing homes too. Some of this mortality is linked to long-term-care facilities that are shoddily run or that violate health standards. But most of them are doing the best they can with what they have. And they don’t have much”.

KAISER FOUNDATION NURSING HOME STAFFING AND USE OF PPE NOT REQUIRED IN MOST STATES

Kaiser reports -Staff Screening. It is more common for states to recommend rather than require daily screening of staff for illness in NFs (24 states recommend, 16 states + DC require)

Use of PPE. More states recommend (23 states) than require (7 states + DC) staff to use PPE

Two States that require testing for coronavirus of ALL residents of nursing homes are Maryland where 556 have died as of the Washington Post article. and Tennessee

THE FEDS HAVE NO CMS FEDERAL GUIDELINES OR REPORTING

We have no federal guidelines for safety testing according to an article by the Kaiser Foundation

It is now estimated that 16,000 deaths have occurred in nursing homes and that is without the federal government revealing any numbers and not making available any testing. But the numbers are probably huge- if we could just do testing.

CMS announced it would have a meeting of a “panel” of experts “ sometime at the end of May”. After probably 20,000 older people died and the feds did nothing this shows their sense of urgency about this pandemic’s national “elder cleansing”.

WHAT CONNECTS PRISONS AND NURSING HOMES – CONCENTRATION CAMPS

So, what is the connection between the viral spread of COVID-19 in nursing homes and prisons- 6 feet ? Prisoners and residents, in nursing homes, and prisons cannot social distance. Jails and prisons have human beings crammed together with no choice. Nursing homes have 2 beds or if you are on Medicaid three to a room. Neither group has a choice to social distance. They are ” concentrated” as in concentration camps or death camps.

Do SOMETHING – HELP NURSING HOMES PREVENT MORE CARNAGE

So, as someone who has spent her career in aging, I am calling out to everyone, especially professional in aging – do something. Since the feds appear to be doing little- call your congressman, write a letter to the editor.

BE KIND LIKE RACHEL MADDOW REPORTS LA JEWISH HOME LA WAS

Rachel Maddow suggests calling your local nursing homes and see what they need. Be kind like the LA Jewish Home was to a smaller nursing home LA Brier Oaks. They wanted to test their residents and had no tests and the larger LA Jewish Home had tests and shared them with the smaller as a good neighbor. What they found was ravaging but it also showed caring and generosity. Care and be generous and show the helpless elders in nursing homes in your town you are opposed to -nursing home being prisons or concentration camps.

Best Tool for Dysfunctional Family on Holidays- Hope

December 8, 2019

Hope is the Best Tool on the Holidays

During Christmas and Hannaka family caregivers, especially in the dysfunctional family can be drinking or numbing themselves from the pain of caregiving. They will ruin the holiday celebration one way or another. Maybe they are drugging themselves with the telly or abusing prescription drugs. Depression and anxiety ( rife among caregivers) are predictors of increased alcohol use. Social isolation, which is experienced by some caregivers, is also predictive of increased alcohol use.

How do you as a geriatric care manager change the script for these aging dysfunctional families – family caregivers and older members who are supposed to care for but can’t. How does a professional GCM make the characters transform?

It’s actually simple –but loaded with skill- give them hope. You need to and use yourself to give them hope that things will change. It’s the best tool a geriatric care manager toolbox- especially on and after the dreaded holidays.

Use of Self

The use of Self is perhaps the most powerful tool for geriatric care managers. The use of Self provides families with guarded optimism. GCM’s have to offer a vision of the future that is based not only on a desire for hopeful outcomes. This has come from our own clinical knowledge and belief that change to their nasty crippled, family system is indeed possible.

By being direct, empathetic, and nonjudgmental, we become a holding bay for stressed caregivers, creating a place of safety, confidentiality, consistency, and support. Finally, GCM’s offer our clients a model of perseverance. By not giving up on the possibility of positive change and by exploring all options, the GCM enables families to feel that, regardless of the outcome, they have done all that they can to support the older adult.

Be like Judy Garland on the holiday offering hope

Have yourself a merry little Christmas.
Let your heart be light
From now on
our troubles will be out of sight

Give the” Merry Christmas – next year

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When Cut Off in The Family is a ” Phantom Limb” at Thanksgiving

October 24, 2019

The Dysfunctional Family’s Worst Time of The Year

Thanksgiving can be the gateway to the dysfunctional family’s worst time of year- the holidays. You face family across the table you despise or just both love and hate. Or there is that empty seat- the uninvited guest- the brother-sister, aunt, son, daughter who you never invite- the cut off-family member.

Families Phantom Limb

But since this leaves the family with that “phantom limb”- like the awful sensation that an amputated or missing limb is still attached and where it was is pulsating in pain- families reach out for someone to fix it.

The ordinary aging processes are made far tougher when a family has a history of dysfunction. Aging professionals, like geriatric care managers, have their greatest challenges in working with these “difficult” families around this time of year.

Dysfunctional Families Fail Eldercare

Dysfunctional families are not able to organize themselves effectively in the face of eldercare challenges and crises. These families are under more stress as they move from long-established roles into uncharted territory.

Family” Cut” off faces Phantom Limb at Thanksgiving

What if they “ cut off” their Dad years ago and now he had a severe stroke-what do they do?? Someone has to take over Mom or Dad’s care and these dysfunctional midlife adult kids are heavy ambivalent or just don’t want to do it. Now that the holidays are arriving – they have the same attitude about attending the family Thanksgiving dinner.

My favorite aging dysfunctional family ” cut off ” Thanksgiving film is Pieces of April Made as a comedy in 2003, it touches death and dying, sibling rivalry, mother-daughter estrangement, interracial love- and Alzheimer’s all fueled by deep family fault lines and how to cook a turkey on a broken stove. The film manages to make the old theme of fraught family Thanksgiving, crisp, funny and ultra worth watching.

Shot in 3 weeks for a measly $350 K, it received a Sundance Film award and accolades for its pedigree cast including 21 year old Katie Holmes as the grunge Goth daughter who her family has ” Cut Off”,Patricia Clarkson as the dying Mom who distains then forgives her rebellious eldest child and Alice Drummond as the demented grandmother who comes along and plays the most rational person in the film in her obliviousness to the family holiday freak-out.

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Is Senior Alcohol Abuse At A Crisis Level?

February 15, 2019

AARP says alcohol abuse among seniors in a national crisis

According to Paula’s Span ‘s New York Times blog New Old Age, about assisted living 70% of all older people in assisted living drink alcohol.

Does that surprise you? Increasingly geriatric care managers, need to and do worry about alcohol.

Substance abuse or dependence, including alcohol use, drug misuse, and nicotine use, can have severe negative physical, cognitive, and psychological consequences for the older adult. Geriatric Care manager screening for this is essential, not only to detect the problem, but to identify potentially harmful interactions with other physical and mental conditions that could lead to high blood pressure, falls, or memory loss. Improper substance use can increase comorbidities and interfere in the treatment process, and therefore increase medical complexity.

Having a clear definition of what constitutes problem drinking in the elderly is difficult.

With younger adults, clear criteria are defined in the Diagnostic and Statistical Manual of Mental Disorders, including disruption of role function, financial instability, and decreasing social networks. But these criteria can be present in the older adult population at large without a substance abuse problem. Additionally, substance abuse problems are masked by other problems associated with aging, including falls, injury, confusion, self-neglect, depression, emotional liability, memory loss, sleep disturbance, and adverse drug interactions. Furthermore, an elder’s tendency to use alcohol frequently or heavily is dismissed as “the only vice she has left” or “something to help him sleep.

Are there solutions? AARP recommended this book

The National Council on Aging has a good list of solutions at the end of this article.Recommendations are made in this article but there is not one answer and this topic is obviously one that needs much more exploring by Geriatric Care Managers, who encounter this problem frequently with their aging clients.

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