WEBVTT - A History of Nursing Homes 0:00:01.120 --> 0:00:03.400 Welcome to Stuff you should know, a production of My 0:00:03.600 --> 0:00:12.480 Heart Radios How Stuff Works. Hey, and welcome to the podcast. 0:00:12.520 --> 0:00:15.520 I'm Josh Clark, and there's Charles w Chuck Bryant and 0:00:15.680 --> 0:00:18.919 Jerry's out there wandering around in the ether and that 0:00:19.000 --> 0:00:23.560 makes this stuff. You should know. She's been wandering around 0:00:23.560 --> 0:00:27.920 the ether for weeks at least, I dare say months 0:00:27.960 --> 0:00:32.479 by not Chuck. Yeah, she's uh, actually just chatted with 0:00:32.560 --> 0:00:35.839 Jerry from ten feet away. Oh that's nice, man, that 0:00:35.920 --> 0:00:40.360 must have felt really special. Did in her hair is long? O? Man? 0:00:40.600 --> 0:00:43.280 My hair is really long too. Yeah. I feel like 0:00:43.320 --> 0:00:45.080 I saw Jerry a couple of months ago and her 0:00:45.120 --> 0:00:47.560 hair was long, So she must have like a full 0:00:47.600 --> 0:00:52.600 on like do now? Uh? Yeah, you know she looks 0:00:52.600 --> 0:00:59.200 like a proper lady. I'm not touching that one, all right, So, Chuck, 0:00:59.320 --> 0:01:01.960 this one was of yours. It was a nursing homes 0:01:02.000 --> 0:01:04.399 is the idea? Right? Yeah? So I have a question 0:01:04.440 --> 0:01:07.920 for you. What what made you decide that you want 0:01:07.920 --> 0:01:11.480 to do on nursing homes? You know, I mean, I'm 0:01:11.520 --> 0:01:15.360 almost fifty, My parents are in their mid seventies. Emily's 0:01:15.400 --> 0:01:20.480 grandmother is edging towards one so you know, this is 0:01:20.480 --> 0:01:22.479 the kind of stuff that just you gotta start thinking 0:01:22.480 --> 0:01:24.960 about at some point. And Emily and I are old 0:01:25.000 --> 0:01:28.720 parents and have an only child that we don't want 0:01:28.720 --> 0:01:31.120 her to have to like have to take care of 0:01:31.160 --> 0:01:34.080 us or anything. So like we're just starting to have 0:01:34.160 --> 0:01:35.800 all these thoughts. And I was like, yeah, you know what, 0:01:36.120 --> 0:01:39.679 I'm not so sure America does it right here. Um, 0:01:39.760 --> 0:01:44.600 And after studying this stuff, it's we do it, okay. 0:01:44.640 --> 0:01:47.280 But it's also like, hey, work your whole life and 0:01:47.319 --> 0:01:50.240 then go broke at the end. Yeah, that's that's a 0:01:50.320 --> 0:01:52.880 real bomber about the whole thing is just you're just 0:01:52.960 --> 0:01:55.800 kind of like expected to spend whatever money you have 0:01:55.920 --> 0:01:58.280 on care at the end of your life. And it 0:01:58.360 --> 0:02:00.520 just seems a little wrong to me too. Yeah, and 0:02:00.560 --> 0:02:02.880 we need to shout out first of all, our buddy 0:02:02.960 --> 0:02:05.760 Dave Ruse helped us put this together, and he actually 0:02:05.800 --> 0:02:10.680 did a real deal interview with Dr Muriel Gillick, who 0:02:10.720 --> 0:02:13.800 was an author of Old and Sick in America colon 0:02:14.520 --> 0:02:17.600 the Journey through the health Care system and was quite 0:02:17.600 --> 0:02:20.160 a resource, and that the history of this stuff in 0:02:20.160 --> 0:02:22.680 this country I think was pretty fascinating. Yeah, it is. 0:02:22.680 --> 0:02:25.200 It's super fascinating. Um, and the whole thing kind of 0:02:25.280 --> 0:02:28.440 started out. Um, you know, when we're talking about nursing 0:02:28.480 --> 0:02:31.160 homes in particular, but there's just no way we can't 0:02:31.200 --> 0:02:34.720 talk about other kinds of homes in particular, because nursing 0:02:34.760 --> 0:02:38.239 homes grew out of this kind of system that developed 0:02:38.600 --> 0:02:41.200 that seemed to really kind of take shape and take 0:02:41.280 --> 0:02:45.640 hold around the Second Industrial Revolution, the one that happened 0:02:45.639 --> 0:02:49.680 here in the States, and because of that, because people 0:02:49.720 --> 0:02:51.920 were like, you know, I don't feel like swinging the 0:02:52.000 --> 0:02:54.360 scythe any longer. I'm gonna go into town and see 0:02:54.360 --> 0:02:56.880 what they have in the way of jobs. So long 0:02:57.000 --> 0:02:59.040 mom and dad. All of a sudden, Mom and dad 0:02:59.080 --> 0:03:01.920 were like gulp, because they were on their own, not 0:03:02.120 --> 0:03:05.000 just you know, one set of parents in particular, but 0:03:05.040 --> 0:03:08.680 as like a general intergenerational trend where kids were moving 0:03:08.720 --> 0:03:10.240 away from the farm, and all of a sudden, there 0:03:10.240 --> 0:03:13.360 weren't multi generational homes like there were before. Because when 0:03:13.400 --> 0:03:16.480 you have a multigenerational home, you don't have to worry 0:03:16.520 --> 0:03:19.040 about what's going to happen to you when you get older. 0:03:19.040 --> 0:03:20.760 Where you're gonna live. You're gonna live in the same 0:03:20.800 --> 0:03:23.800 house you raised your your Brady, little kid in to 0:03:23.919 --> 0:03:26.400 take care of you until you die. And that's just 0:03:26.560 --> 0:03:28.720 the way it was for years and years and years 0:03:28.720 --> 0:03:32.360 in America. Yeah, there's a stat here. Uh In nineteen hundred, 0:03:33.160 --> 0:03:37.080 fifty seven percent of adults over sixty five lived in 0:03:37.120 --> 0:03:41.440 a multigenerational household, and by nineteen eighty eight years later, 0:03:41.520 --> 0:03:45.760 that went down to seventeen percent. And big reasons for that, 0:03:45.800 --> 0:03:47.680 Like you were talking about, you know, moving away from 0:03:47.720 --> 0:03:52.000 the farm. But just nowadays people just move away. I mean, 0:03:52.040 --> 0:03:56.600 sixty percent of American adults have moved to a completely 0:03:56.600 --> 0:04:01.000 new community at least once. And as uh Dr Gillick 0:04:01.080 --> 0:04:04.440 points out, she says, not only are people not living 0:04:04.440 --> 0:04:07.480 with their adult children, they're not even living near them 0:04:07.520 --> 0:04:11.360 many times now, Yeah, because they finally wised up and 0:04:11.360 --> 0:04:13.320 we're like, gosh, I can get away from my kids 0:04:13.360 --> 0:04:15.600 once and for all now that they're adults. Well, I 0:04:15.600 --> 0:04:17.240 think it's more like the kids are like, hey, gee, 0:04:17.240 --> 0:04:19.560 I want to go live in wherever the heck I 0:04:19.640 --> 0:04:23.599 want to and we'll just think of a plan for 0:04:24.240 --> 0:04:27.839 my parents at home. My generation doesn't have any hangups 0:04:27.880 --> 0:04:31.920 about guilt or morality, you know. But the thing is, 0:04:32.040 --> 0:04:34.400 it's not just the kids moving away. Like my grandmother 0:04:34.480 --> 0:04:37.040 moved far away. She moved to Florida, she moved to Arizona. 0:04:37.839 --> 0:04:41.480 She moved. She was like, so long, everybody, I got 0:04:41.520 --> 0:04:44.320 this UM. But she was very fortunate that she had. 0:04:44.720 --> 0:04:47.719 One of the things that UM nursing homes exist for 0:04:47.880 --> 0:04:49.680 is to take care of people who don't got it, 0:04:49.920 --> 0:04:52.159 who either don't have family, who don't have the money 0:04:52.160 --> 0:04:54.320 to hire people to take care of them, who don't 0:04:54.360 --> 0:04:56.279 have the money to go live in and you know, 0:04:56.480 --> 0:04:59.920 say like assisted living or something. UM. That's what nursing 0:05:00.040 --> 0:05:02.279 homes have kind of evolved to take care of. And 0:05:02.320 --> 0:05:06.120 in that sense, they're actually directly related to what came 0:05:06.279 --> 0:05:10.479 what were originally called alms houses or county houses or 0:05:10.880 --> 0:05:13.840 poor houses, which if you were old and you didn't 0:05:13.839 --> 0:05:15.400 have anyone to take care of you, in like the 0:05:15.520 --> 0:05:19.760 late eighteenth early nineteenth century in America, you could go 0:05:19.920 --> 0:05:23.640 to like a farm that the county maintained and there 0:05:23.640 --> 0:05:26.719 would be a bed there for you, and um, you 0:05:26.760 --> 0:05:29.120 would be housed with a bunch of different people with 0:05:29.160 --> 0:05:31.520 a bunch of different conditions, and the one thing that 0:05:31.560 --> 0:05:34.119 you all had in common was that society didn't quite 0:05:34.120 --> 0:05:37.160 know what to do with you. Yeah. So I mean 0:05:37.200 --> 0:05:40.520 it could range from people who had no living family 0:05:41.040 --> 0:05:44.440 two and just you know, needed care that had nothing 0:05:44.680 --> 0:05:46.720 else wrong with them except just being old and needing 0:05:46.760 --> 0:05:49.680 care and having no one around, uh, to people that 0:05:49.720 --> 0:05:53.760 were mentally ill, maybe people who were suffering from dementia, 0:05:54.000 --> 0:05:57.960 or people who were alcoholics or drug addicts, and like 0:05:58.000 --> 0:06:00.760 you said, they you could get a bed, but there 0:06:00.760 --> 0:06:03.600 were no doctors, there were no nurses, you couldn't get 0:06:03.720 --> 0:06:07.320 medical care. Uh. And that was sort of the the 0:06:07.360 --> 0:06:10.360 beginnings of of the shame almost if you want to 0:06:10.360 --> 0:06:12.359 look at it that way. Yeah, kind of. But it 0:06:12.440 --> 0:06:16.760 does say something that society did say, we have a 0:06:16.839 --> 0:06:19.640 responsibility of people. We can't just be like, well, there's 0:06:19.640 --> 0:06:21.479 a corn field for you to go lay in until 0:06:21.520 --> 0:06:24.279 you die of exposure, good luck, you know, Like there 0:06:24.320 --> 0:06:28.080 was a bed that was provided. As meager and horrific 0:06:28.120 --> 0:06:30.120 as that whole thing was, it was at at least 0:06:30.120 --> 0:06:34.160 an experiment or an attempt to do something. Yeah. And 0:06:34.320 --> 0:06:37.480 you know, the next big change happened, um, sort of 0:06:37.520 --> 0:06:41.600 midway through the nineteenth century when uh, sort of around 0:06:41.600 --> 0:06:43.560 the time in the Civil War, we started getting our 0:06:43.560 --> 0:06:48.200 first big hospitals like medical hospitals, public medical hospitals and 0:06:48.680 --> 0:06:52.320 the big cities around the country, and they, you know, 0:06:52.360 --> 0:06:55.640 they were sort of the the beginnings of modern um 0:06:55.920 --> 0:06:59.880 large scale public healthcare. And here's the thing, though, is 0:07:00.160 --> 0:07:03.720 they were back then they focused on acute care. So 0:07:03.839 --> 0:07:08.840 if you again were a senior and you uh they 0:07:08.880 --> 0:07:11.080 called them old chronics, like you had maybe a chronic 0:07:11.080 --> 0:07:14.160 condition and no one to take care of you, then 0:07:14.840 --> 0:07:19.400 you uh, basically you were too too dependent to go 0:07:19.480 --> 0:07:21.440 to one of these places because it was a hospital, 0:07:21.440 --> 0:07:24.360 and they're like, you can't stay here, right because even 0:07:24.360 --> 0:07:26.520 though you know you're called an old chronic, you might 0:07:26.520 --> 0:07:29.600 not have anything wrong with you aside from being really old, 0:07:29.680 --> 0:07:31.680 and maybe you can't make it to the bathroom very 0:07:31.680 --> 0:07:34.760 easily something like that, but not necessarily anything that a 0:07:34.840 --> 0:07:37.800 hospital could treat you for. It was just they had 0:07:37.840 --> 0:07:41.040 a bed about hospitals. Very quickly, we're like, we can't, 0:07:41.080 --> 0:07:44.520 like this isn't working. You're gonna stay here indefinitely and 0:07:44.560 --> 0:07:46.360 there's really nothing wrong with you. We gotta find a 0:07:46.360 --> 0:07:49.720 place for you. And so about that time, some charities, 0:07:50.120 --> 0:07:54.080 especially either ethnic or religious based charities like the um 0:07:54.280 --> 0:07:59.680 Baptists or the German Aid Society was was a big 0:07:59.680 --> 0:08:03.080 one in Boston. I think, um, the German Ladies Aid 0:08:03.160 --> 0:08:05.600 Society of Boston. I'm sorry. Um, they kind of said, 0:08:05.600 --> 0:08:08.680 you know what, we we have members who are uh 0:08:08.920 --> 0:08:11.440 they're members of our church or you know, they're German, 0:08:11.480 --> 0:08:13.760 they're part of our community and they don't have anybody, 0:08:14.040 --> 0:08:16.280 so we we need to make sure that they're taken 0:08:16.280 --> 0:08:19.840 care of. And they actually started founding what we're called 0:08:19.880 --> 0:08:22.160 old age homes, which is basically they would get like 0:08:22.160 --> 0:08:25.520 a large home and um kind of outfit it with 0:08:25.560 --> 0:08:27.520 different Each room was like a different room for a 0:08:27.560 --> 0:08:30.720 different tenant, and they would take care of like old 0:08:30.760 --> 0:08:34.040 widows basically who didn't have the money or the children 0:08:34.080 --> 0:08:37.199 to take care of them. Yeah. But specifically, what they 0:08:37.240 --> 0:08:41.120 deemed as worthy poor uh, And here's what differentiated them 0:08:41.120 --> 0:08:45.400 from the almshouses was, uh, if you were worthy poor 0:08:45.640 --> 0:08:48.800 and you know that's in air quotes, that meant that 0:08:48.880 --> 0:08:53.280 you were the wife of of a man who who 0:08:53.320 --> 0:08:55.959 worked hard all his life but never made a lot 0:08:55.960 --> 0:08:58.959 of money, maybe worked at a shipyard or just had 0:08:59.000 --> 0:09:02.880 sort of a very low paying, blue collar but respectable job, 0:09:03.240 --> 0:09:05.840 but certainly not the kind of dough to pay for 0:09:05.920 --> 0:09:09.640 like private nursing homes or anything like that, but not 0:09:09.760 --> 0:09:13.079 alcoholic or drug addict or you know, there was no UM. 0:09:13.240 --> 0:09:16.480 They didn't like force a shame attachment to it. So 0:09:16.600 --> 0:09:19.439 these widows who were you know, in their sixties or seventies, 0:09:19.760 --> 0:09:22.240 depending on you know, how their husband lived their lives, 0:09:22.400 --> 0:09:25.400 They're like, I've been morphine free since seventy three, so 0:09:25.520 --> 0:09:28.559 let me in. Uh. They didn't have these big pensions 0:09:28.640 --> 0:09:31.400 or anything because of the jobs their husbands had. So 0:09:31.559 --> 0:09:33.319 they were taken into one of these homes like a 0:09:33.360 --> 0:09:35.679 Baptist m or something, and they were given to bed 0:09:35.720 --> 0:09:37.760 and they were given again, not medical care, but they 0:09:37.760 --> 0:09:42.040 were at least given meals in a bed. Right. Um. 0:09:42.080 --> 0:09:44.160 A lot of times they were expected to kind of 0:09:44.240 --> 0:09:47.920 pay for their their room and board. Um. It was 0:09:48.000 --> 0:09:51.640 kind of like a needs based sliding scale. I got 0:09:51.640 --> 0:09:55.240 the impression some of them, UM just straight up said hey, 0:09:55.720 --> 0:09:58.679 give us five hundred dollars. At the time, I think 0:09:58.679 --> 0:10:02.079 around nine or uh, late nineteenth century, I don't remember 0:10:02.080 --> 0:10:05.520 exactly when it was, um, the Winchester Home for Aged 0:10:05.559 --> 0:10:09.280 Women in Massachusetts, the Winchester Mystery House. I looked it up. 0:10:09.320 --> 0:10:11.000 I was like, is that the same one? But it was. 0:10:11.120 --> 0:10:14.000 It was bequeathed by a Lucy Winchester, who I couldn't 0:10:14.000 --> 0:10:16.440 find anything about. But it's not the same person. A 0:10:16.440 --> 0:10:19.720 lot of people in the house, you would, um, although 0:10:19.760 --> 0:10:22.400 you gain a lot more ghosts, it's true. But um, 0:10:22.440 --> 0:10:24.480 they said, you pay us five hundred dollars. So this 0:10:24.520 --> 0:10:26.240 is in nineteen o four. You pay us five hundred 0:10:26.240 --> 0:10:28.040 dollars and you can stay here for the rest of 0:10:28.080 --> 0:10:30.040 your life. And five hundred dollars back then was worth 0:10:30.080 --> 0:10:34.640 about fifteen thousand today, And exactly I was thinking about that. 0:10:34.720 --> 0:10:36.720 It's a bit of a gamble on both sides. But 0:10:36.800 --> 0:10:39.400 it's a bit like insurance. It's like some sort of 0:10:39.800 --> 0:10:44.240 long term care um insurance where you're like, okay, let's 0:10:44.240 --> 0:10:46.360 stretch my five dollars as far as I can go, 0:10:46.600 --> 0:10:49.240 or you know, you could die two days after they 0:10:49.240 --> 0:10:52.080 still kept your five hundred dollars. But then hopefully it 0:10:52.160 --> 0:10:54.440 was used to make life better for the other people 0:10:54.480 --> 0:10:57.280 who's who had used up their five hundred dollars long ago. 0:10:58.320 --> 0:11:00.960 You know. So there was this kind of idea that 0:11:01.280 --> 0:11:04.440 if you could pay for it, you should pay for it. 0:11:04.640 --> 0:11:06.960 And then as time went on, it was like, oh, 0:11:07.080 --> 0:11:09.520 you just you know, you sold your house. We need 0:11:09.559 --> 0:11:12.240 that money if you're gonna stay here, And people would 0:11:12.240 --> 0:11:15.440 take in more and more money from that person's estate 0:11:15.760 --> 0:11:18.440 um as they were alive to take care of them. 0:11:18.679 --> 0:11:21.040 And this was starting in like the beginning of the 0:11:21.040 --> 0:11:23.640 twentieth century into the nineteenth century. So that's a very 0:11:23.679 --> 0:11:27.800 long tradition of extracting everything from old people as they're 0:11:27.880 --> 0:11:31.600 dying to to pay for their care. And I'm got you, 0:11:31.960 --> 0:11:35.599 I'm bothered by that. Yeah, I mean the question became U, 0:11:35.800 --> 0:11:38.479 not how how much is it for your care facility, 0:11:38.600 --> 0:11:40.960 and it's more like how much you got how much 0:11:41.000 --> 0:11:43.319 you got here? Graham by the ankles and turn them 0:11:43.360 --> 0:11:46.840 upside down, or if they you know, if they weren't charging. 0:11:46.880 --> 0:11:50.160 There was the expectation that they didn't need so much 0:11:50.200 --> 0:11:52.400 care that they couldn't also contribute, like here, we got 0:11:52.480 --> 0:11:54.760 a room for you. We'll feed you, but you gotta 0:11:54.800 --> 0:11:56.320 make your bed, and you gotta clean your room and 0:11:56.360 --> 0:11:59.520 maybe help keep the property up. So I got the 0:11:59.559 --> 0:12:02.600 idea that these were people who, like I said, you know, 0:12:03.840 --> 0:12:07.400 a senior widow who just didn't have anywhere else to 0:12:07.440 --> 0:12:11.280 go and otherwise was doing okay, yeah, but forced to 0:12:11.360 --> 0:12:15.920 make knockoff Gucci wallets during craft arts and craft. Should 0:12:15.920 --> 0:12:18.600 we take a break? All right, I got a Gucci 0:12:18.600 --> 0:12:53.199 wallet to work on myself. Okay, So we've got alms 0:12:53.200 --> 0:12:56.400 houses are still around. They have they stayed around until 0:12:56.400 --> 0:12:58.439 like the nineteen forties. From what I could see, these 0:12:58.480 --> 0:13:01.760 county houses poor houses, um, and then alongside of those 0:13:01.800 --> 0:13:05.760 you've got old age homes. But then, um, the government 0:13:05.800 --> 0:13:07.560 was kind of like, we can do we can do 0:13:07.600 --> 0:13:10.840 better than this. New York itself, I think, became the 0:13:10.840 --> 0:13:14.200 first state in the United States to say, um, it's 0:13:14.240 --> 0:13:17.400 a ten ninety it's modern era, we need to do 0:13:17.480 --> 0:13:20.760 more to take care of like our our elderly and 0:13:20.800 --> 0:13:25.160 in particular are mentally infirm. Um. They and they that 0:13:25.240 --> 0:13:28.160 state made a commitment to take care for the state, 0:13:28.200 --> 0:13:32.920 to take responsibility for its mentally ill and that included 0:13:33.600 --> 0:13:36.840 people with dementia of all sorts, which they would have 0:13:36.880 --> 0:13:40.800 called senility back then. Um. And so that was kind 0:13:40.840 --> 0:13:44.040 of like the first entree of the state into caring 0:13:44.120 --> 0:13:47.640 for elderly people. And that actually kind of opened a 0:13:47.640 --> 0:13:50.360 bit of a floodgate. I think, um. Other states started 0:13:50.360 --> 0:13:52.720 to kind of follow suit, but it was like a 0:13:53.960 --> 0:13:57.040 it was a step in a really dark direction, because 0:13:57.080 --> 0:14:01.400 by World War One, if you were elderly, especially if 0:14:01.440 --> 0:14:04.800 you had some sort of um declined, some sort of 0:14:04.840 --> 0:14:09.000 cognitive decline from age, there was a really good chance 0:14:09.080 --> 0:14:13.280 that you were in a mental asylum um with everybody else. 0:14:13.679 --> 0:14:15.719 And in a lot of cases, I think even if 0:14:15.720 --> 0:14:17.760 you were just elderly, you would find yourself in a 0:14:17.760 --> 0:14:20.640 mental asylum in that right, Yeah, I mean absolutely. So 0:14:20.800 --> 0:14:24.880 you've got a situation where the states start to say, hey, 0:14:24.880 --> 0:14:26.760 we need to take care of our mentally ill, but 0:14:27.720 --> 0:14:30.800 seniors just started getting kind of lumped in if they 0:14:30.840 --> 0:14:33.600 didn't have anywhere else to go. So you might have 0:14:34.200 --> 0:14:37.040 you know, someone's someone's grandmother who just didn't have family 0:14:37.560 --> 0:14:41.560 and who was really doing okay upstairs and and was 0:14:41.600 --> 0:14:46.160 in pretty good health, might find themselves in, like you said, 0:14:46.200 --> 0:14:50.240 a mental hospital with people with severe mental illness. Uh. 0:14:50.280 --> 0:14:52.720 And I think there's a couple of stats here that 0:14:52.800 --> 0:14:56.600 Dave dug up by there were more elderly Americans and 0:14:56.640 --> 0:15:00.120 mental hospitals than in those almhouses and the price that 0:15:00.600 --> 0:15:04.720 old age homes combined. And he mentioned one in particular, 0:15:04.840 --> 0:15:08.160 Chicago State Hospital, which was a mental hospital in the 0:15:08.240 --> 0:15:12.600 nineteen thirties, of the patients there were quote aged or 0:15:12.680 --> 0:15:17.880 infirm that had no other underlying psychosis or mental health condition. Right. 0:15:18.120 --> 0:15:20.320 So that's a really dangerous place for old people to 0:15:20.360 --> 0:15:22.160 be because if you act up, they can put you 0:15:22.160 --> 0:15:26.600 on medications, they can give you, um, the hydrotherapy treatment, 0:15:26.600 --> 0:15:28.160 they can do all sorts of stuff to you because 0:15:28.200 --> 0:15:30.520 you're in a mental hospital. And I think it's kind 0:15:30.560 --> 0:15:32.960 of like one of those things where, um, if you're 0:15:33.080 --> 0:15:35.560 a hammer, everything looks like a nail. Well, if you're 0:15:35.600 --> 0:15:39.680 a nineteen thirties old timing psychiatrist, everything looks like a um, 0:15:40.040 --> 0:15:43.320 a mental condition, a mental condition, right, you know, um, 0:15:43.360 --> 0:15:45.520 and you're gonna treat all of the people the same way. 0:15:45.560 --> 0:15:50.200 And so luckily Francis Perkins arrived on the scene around 0:15:50.240 --> 0:15:53.200 this time. So World War One is when old people 0:15:53.240 --> 0:15:57.240 really started to get shuffled off to mental hospitals by 0:15:57.400 --> 0:16:00.800 the government. Swoop James like, whoa, whoa, this is way wrong, 0:16:00.920 --> 0:16:03.880 Like we need just because these people are old doesn't 0:16:03.920 --> 0:16:07.720 mean that they're um, they're mentally ill. So let's extract 0:16:07.720 --> 0:16:09.840 them from that environment and figure out if we can 0:16:09.880 --> 0:16:13.560 do something else. And thanks to Social Security that that 0:16:13.680 --> 0:16:16.560 really began to change. Fairly quickly. Yeah, so this is 0:16:16.680 --> 0:16:19.960 nineteen thirty five. Again, you mentioned the great Francis Perkins. 0:16:19.960 --> 0:16:22.520 If you didn't listen to that episode, go listen to it. 0:16:22.520 --> 0:16:28.760 It's fantastic out the Social Security Act. Um. Basically like 0:16:28.760 --> 0:16:31.760 when we think of Social Security now, we think of 0:16:31.880 --> 0:16:35.920 the program where you pay in your whole life from 0:16:35.920 --> 0:16:37.960 your paycheck and then when you retired you get a 0:16:37.960 --> 0:16:41.680 monthly income and if you work longer than your checks 0:16:41.680 --> 0:16:44.360 are gonna be bigger. Um. I started working when I 0:16:44.360 --> 0:16:46.600 was thirteen, so imagine I'm gonna be rolling in dough. 0:16:47.120 --> 0:16:50.680 You're always boasting about that of hearing about that about 0:16:50.720 --> 0:16:53.880 my thirteen year old bus boy job. Yes, it's a 0:16:53.920 --> 0:16:58.160 title Max. Now, by the way, yeah dry Max, got 0:16:58.280 --> 0:17:02.760 your money, your mind, real money. Oh man, that's some 0:17:02.840 --> 0:17:06.120 good free advertising. Yeah. I drove. I drive by there 0:17:06.119 --> 0:17:09.720 on the way to my mom's and Emily's parents house sometimes, 0:17:09.800 --> 0:17:12.720 and I always pointed out to my daughter and say, hey, 0:17:12.760 --> 0:17:15.200 that's the barbecue restaurant I worked at. It's now a 0:17:15.280 --> 0:17:17.800 title Max. Is that the one where the guy put 0:17:17.800 --> 0:17:22.400 his foot in the Brunswick sto? Yeah? God, I wonder 0:17:22.400 --> 0:17:25.560 where that guy is now. Randy, he's in he's in 0:17:25.680 --> 0:17:27.760 I don't know. I'm not even going to guess the 0:17:27.800 --> 0:17:30.920 feeling Randy's in prison, do you think so? I mean, 0:17:31.560 --> 0:17:33.280 he saw him do a lot worse than put his 0:17:33.280 --> 0:17:34.680 foot in the Brunswicks, do you know what I mean? 0:17:35.400 --> 0:17:38.520 Oh jeez, I don't put My mind is rased at 0:17:38.960 --> 0:17:42.000 life behind bars and I'm not laughing at that. It's 0:17:42.080 --> 0:17:44.960 it's very sad. But Randy, you know, he made his 0:17:44.960 --> 0:17:49.479 own decisions. That reminds remember Randy the hippie from MTV 0:17:49.720 --> 0:17:53.320 and like the late eighties, early nineties, No, he ran 0:17:53.400 --> 0:17:56.480 for president. He was like just this total weirdo burnout 0:17:57.240 --> 0:18:00.879 who was yeah, who looked today like he could have 0:18:00.880 --> 0:18:05.480 been in l m f A. Oh okay, Like really 0:18:05.480 --> 0:18:07.359 he dressed like that, but this is like decades before. 0:18:07.440 --> 0:18:10.399 But anyway, I remember like he he like ran for 0:18:10.440 --> 0:18:13.320 president and I think he lost and he's like, I've 0:18:13.359 --> 0:18:15.920 made my bed now I must lie in it. I'll 0:18:15.920 --> 0:18:18.679 never forget that. For some reason, I thought it was hilarious. 0:18:18.720 --> 0:18:20.840 But yeah, that was Randy. Well, I mean maybe it 0:18:20.880 --> 0:18:25.480 was d Randy Brunswich, it was the Rands. What I'm saying, um, so, yeah, 0:18:25.640 --> 0:18:28.360 that that was old age insurance is what they called 0:18:28.400 --> 0:18:32.320 it originally. But then there was also Old Age Assistance 0:18:32.440 --> 0:18:36.600 oh a A, which was you're gonna get payments when 0:18:36.640 --> 0:18:39.800 you're older, even if you didn't work, which was a 0:18:39.800 --> 0:18:42.680 big deal because so many women were not allowed to 0:18:42.720 --> 0:18:45.199 work and have jobs, so like what were they going 0:18:45.240 --> 0:18:47.520 to do? They're like, say, hey, you didn't pay anything 0:18:47.560 --> 0:18:51.240 in sorry, you just raised your kids and grandkids. That's 0:18:51.280 --> 0:18:54.040 a great that's a great point. I think we still 0:18:54.080 --> 0:18:57.000 do that today though, unfortunately, but at least women can 0:18:57.040 --> 0:19:00.400 actually work in the workforce if they want to. But yeah, 0:19:00.400 --> 0:19:02.640 if they if they stay home and raise kids, then 0:19:02.680 --> 0:19:04.960 they're still treated the same way, which is pretty shameful. 0:19:05.240 --> 0:19:07.000 But I get your point. And the point is is 0:19:07.040 --> 0:19:10.160 that we needed to be able to UM take care 0:19:10.160 --> 0:19:14.080 of people who hadn't necessarily worked in the workforce and 0:19:14.119 --> 0:19:17.399 paid into Social Security, and then also we had to 0:19:17.520 --> 0:19:22.880 offset that first basically generation that we're like, Okay, we're 0:19:22.880 --> 0:19:25.959 the first ones nobody's been paying in, but why do 0:19:26.040 --> 0:19:27.479 we Why are we the ones who have to pay 0:19:27.560 --> 0:19:29.680 him but we get nothing from it? So the Old 0:19:29.680 --> 0:19:32.439 Age Assistance the o a A really helped with that 0:19:33.040 --> 0:19:35.240 UM and I guess that's kind of gone the way 0:19:35.280 --> 0:19:37.879 of disco because the only thing I know about is 0:19:37.920 --> 0:19:40.520 the Old Age insurance that's still around, and I know 0:19:40.560 --> 0:19:43.080 they don't call it that any longer, but that Old 0:19:43.119 --> 0:19:47.560 Age assistance where it's like, I guess that would be Medicaid, right, yeah, 0:19:47.680 --> 0:19:51.000 I think so okay, So so we'll and we'll talk 0:19:51.000 --> 0:19:53.399 a lot more about Medicaid and medicare. Just put a 0:19:53.400 --> 0:19:56.399 button in that all of you bureaucrat walks. You're gonna 0:19:56.440 --> 0:19:59.080 love it. Yeah, but uh, you know, FDR, this is 0:19:59.080 --> 0:20:02.160 when things really changed. And the reason we're talking about 0:20:02.200 --> 0:20:04.840 social security and stuff like this is because it really 0:20:05.600 --> 0:20:07.600 it's sort of laid out the roadmap for what was 0:20:07.600 --> 0:20:11.400 going to happen and how we cared for our grandparents 0:20:11.640 --> 0:20:14.200 and what kind of places they were going to be. 0:20:14.280 --> 0:20:16.360 So because he went in there with a new deal 0:20:16.400 --> 0:20:19.679 and he was like these all houses are terrible. He's like, 0:20:19.720 --> 0:20:21.760 we need to get rid of these. And he said 0:20:21.800 --> 0:20:25.159 in these state mental hospitals, they're overburdened. And that's not 0:20:25.280 --> 0:20:27.760 right either. So here's what I'll do. Part of the 0:20:27.760 --> 0:20:30.960 o A A the Old Age Assistants. A big provision 0:20:31.040 --> 0:20:34.000 here is that you can't um you can't get any 0:20:34.040 --> 0:20:36.440 of that money if you're living in a public institution 0:20:36.840 --> 0:20:39.560 like an alms house or like a state mental hospital, 0:20:39.720 --> 0:20:42.560 No money come in your way. No. So suddenly the 0:20:42.640 --> 0:20:46.080 people who were stuck in state mental hospitals or alms 0:20:46.119 --> 0:20:49.480 houses not only were like, oh, well I could get 0:20:49.480 --> 0:20:52.120 out of here. Now I have the funds to get 0:20:52.119 --> 0:20:54.520 out of here and go somewhere better. And this led 0:20:54.560 --> 0:20:57.560 to a huge boom in the growth of private um 0:20:58.119 --> 0:21:01.760 uh living facilities for the elderly. Yeah. I think that 0:21:01.880 --> 0:21:04.720 was the big change. I mean, surely people were like, great, 0:21:04.760 --> 0:21:07.080 I can get out of here, but I think people 0:21:07.119 --> 0:21:11.000 saw dollar signs said wait a minute, I can get 0:21:11.000 --> 0:21:13.199 paid by the government to take in these people and 0:21:13.240 --> 0:21:15.959 take care of them, right, sometimes directly get paid by 0:21:15.960 --> 0:21:18.680 the government. Yeah. That was kind of like an amendment 0:21:18.720 --> 0:21:21.480 that they made later on where it was like, um yeah, 0:21:21.600 --> 0:21:24.120 that that incentivized it even more. It's like, well, we'll 0:21:24.160 --> 0:21:27.040 pay you directly. There's not even this person as gonna 0:21:27.040 --> 0:21:29.439 have to be involved. Just take care of them, you know, 0:21:29.520 --> 0:21:32.800 follow these guidelines and we'll send you this check every month. 0:21:32.840 --> 0:21:35.479 And the people is there any money left over for me? 0:21:35.560 --> 0:21:38.080 You know? And no, no, no, no, this just don't 0:21:38.080 --> 0:21:39.800 ask any questions. It's as a matter of fact, now 0:21:39.840 --> 0:21:41.359 that you bring it up, do you have any money, 0:21:41.400 --> 0:21:43.320 you're gonna give it to them first before we give you. 0:21:43.520 --> 0:21:46.760 There's a balance on your account, sir. So. Um, this 0:21:46.840 --> 0:21:49.040 is kind of how it went for like the first 0:21:49.200 --> 0:21:52.440 you know, fifteen twenty years after so Security Act was 0:21:52.440 --> 0:21:56.399 introduced in nineteen thirty five, where um it fueled this 0:21:56.520 --> 0:22:00.200 boom of retirement homes. Basically the retirement home into Tree 0:22:00.280 --> 0:22:03.640 found its its birth there. And then about fifteen years 0:22:03.640 --> 0:22:05.440 after the government was like, you know what, we've been 0:22:05.840 --> 0:22:08.160 sinking a lot of money into this, maybe we should 0:22:08.200 --> 0:22:10.240 look around and see if any of these places are 0:22:10.240 --> 0:22:12.400 any good. And they found that no, in a lot 0:22:12.400 --> 0:22:15.560 of cases they weren't really good. There was, um, you know, 0:22:15.600 --> 0:22:19.600 if you if you converted an old Victorian mansion into 0:22:19.640 --> 0:22:23.080 an old age home with a dozen rooms, you probably 0:22:23.359 --> 0:22:26.720 didn't add a fire exit onto every room and fire 0:22:26.840 --> 0:22:30.240 stairs on the second and third floor. Um, there's probably 0:22:30.280 --> 0:22:33.800 not sprinkler system because they weren't very prevalent by that time, 0:22:34.160 --> 0:22:37.000 and so if there was a fire, all of these uh, 0:22:37.119 --> 0:22:40.320 the dozen ages and infirm people who lived there were 0:22:40.359 --> 0:22:42.720 going to die in a fire. Um that was the 0:22:42.760 --> 0:22:44.880 one big one that they turned up that came out 0:22:44.880 --> 0:22:47.639 of these early investigations into into what came to be 0:22:47.680 --> 0:22:50.439 called nursing homes. Yeah, so this is when Congress steps 0:22:50.440 --> 0:22:53.240 in again, like you said, about fifteen to twenty years 0:22:53.320 --> 0:22:56.080 later in the nineteen fifties, and said, all right, here's 0:22:56.119 --> 0:22:59.679 the deal. If you're getting this dough from us, we 0:23:00.080 --> 0:23:02.960 need to regulate, um, what's going on there, and they 0:23:02.960 --> 0:23:05.520 need to be safe. And a lot of these mom 0:23:05.520 --> 0:23:07.760 and pops that, like you said, converted an old house, 0:23:08.200 --> 0:23:11.240 they couldn't make those upgrades. You can't just slap on 0:23:11.280 --> 0:23:13.240 a fire escaped to an old Victorian. I guess you could, 0:23:13.280 --> 0:23:15.720 but it wouldn't look that great or probably work that well. 0:23:16.760 --> 0:23:20.080 And so a lot of these smaller ones floundered and 0:23:20.119 --> 0:23:22.200 all of a sudden, and this is things where things 0:23:22.200 --> 0:23:26.240 really start to change. There's a big market for just 0:23:26.840 --> 0:23:28.800 basically I don't even know if I would call it 0:23:28.840 --> 0:23:32.520 the corporatization yet, but maybe to a certain degree, these 0:23:32.560 --> 0:23:36.600 bigger facilities for residents that had this money that could 0:23:36.640 --> 0:23:40.159 go straight to them. And uh so these sort of 0:23:40.320 --> 0:23:44.920 larger places that weren't individual houses started popping up. Yeah, well, 0:23:44.920 --> 0:23:47.040 that's like an ongoing and recurring theme in a big 0:23:47.040 --> 0:23:51.040 criticism among conservatives of big government or government regulation is 0:23:51.080 --> 0:23:55.359 that it homogenizes things because usually the mom and pop operations, 0:23:55.400 --> 0:23:59.359 even if they are well meaning and not nefarious, like 0:23:59.400 --> 0:24:01.879 they don't have money to add those fire exits on. 0:24:02.040 --> 0:24:05.000 But say like a corporation that's going to own several 0:24:05.000 --> 0:24:07.400 of these things, they can build new ones with all 0:24:07.440 --> 0:24:10.880 the modern fire exits and fire sprinklers. And so those 0:24:10.920 --> 0:24:14.080 bigger corporations start owning more and more and more, and 0:24:14.119 --> 0:24:16.200 by building more and more and more, they're not gonna 0:24:16.440 --> 0:24:19.800 make each one like really unique and and embedded in 0:24:19.840 --> 0:24:22.359 the community. They're going to plunk down the same one 0:24:22.600 --> 0:24:25.000 in every place they build one. And so there's this 0:24:25.040 --> 0:24:27.920 homogenization that occurs as a result of that. And that's 0:24:27.960 --> 0:24:30.680 exactly what happened with what came to be called nursing homes, 0:24:30.720 --> 0:24:33.520 which really started to find their advent in the nineteen 0:24:33.560 --> 0:24:36.399 fifties from these reforms where the government was like, you 0:24:36.400 --> 0:24:38.920 guys need to be able to do this, this, and this, um, 0:24:38.960 --> 0:24:42.320 we're gonna assign the Public Health Service to to lay 0:24:42.320 --> 0:24:46.200 out guidelines. The Public Health Service knows about regulating hospitals, 0:24:46.440 --> 0:24:51.240 so they really added onto that homogenization, this this underlying 0:24:51.680 --> 0:24:56.679 medicalization of caring for older people, which makes sense. You know, 0:24:56.800 --> 0:25:01.040 you think of older people, olderally people, senior adult you think, gosh, 0:25:01.080 --> 0:25:03.200 the you know, the body is starting to wear down. 0:25:03.280 --> 0:25:05.320 There have they have all these conditions or whatever, So 0:25:05.440 --> 0:25:09.280 it makes sense that you a couple hospitalization or medicalization 0:25:09.359 --> 0:25:12.080 with that. But that's not always the case. And the 0:25:12.119 --> 0:25:14.240 problem is, as it became the case, whether you needed 0:25:14.280 --> 0:25:16.439 it or not, that was the kind of place you 0:25:16.520 --> 0:25:23.480 lived was basically a bland institutional extension of a hospital. Yeah, 0:25:23.640 --> 0:25:27.160 I mean it's not like in Uh. I kept thinking 0:25:27.160 --> 0:25:32.200 of the movie Say Anything when I was researching this 0:25:32.359 --> 0:25:36.240 because that was a prominent storyline in that movie. I 0:25:36.280 --> 0:25:39.880 never saw it. You never saw Say Anything. I didn't 0:25:40.280 --> 0:25:42.199 do you wonder what happens every time a guy in 0:25:42.200 --> 0:25:44.760 a trench coat holds up a boom box over his head. So, 0:25:44.800 --> 0:25:47.240 I mean, I know you need the cultural reference. Yeah, 0:25:47.280 --> 0:25:49.199 of course, I just wondered up all this time. You're like, 0:25:49.240 --> 0:25:52.280 what is the deal with this boom box? Yeah, it's 0:25:52.320 --> 0:25:55.320 like a reference to Kevin Smith and Clark. Okay, sure, 0:25:55.840 --> 0:26:00.880 exactly now Ione Sky's father, the late great John Mahoney. 0:26:00.960 --> 0:26:05.560 Was he ran a mom and pop nursing home. Yes, 0:26:05.640 --> 0:26:08.119 and was in spoiler coming if you haven't seen a 0:26:08.280 --> 0:26:11.480 thirty something year old movie. Uh, he was found to 0:26:11.480 --> 0:26:13.840 be ripping them off and that was a big sort 0:26:13.880 --> 0:26:17.240 of subplot in that movie. All I heard was that 0:26:17.320 --> 0:26:21.680 was a big subplot in that movie. Very good, but uh, 0:26:21.920 --> 0:26:25.480 say anything aside. They um, like you said, became more 0:26:25.600 --> 0:26:29.199 hospitalized for lack of a better word, And if you 0:26:29.240 --> 0:26:31.560 went to one of them back then, there was very 0:26:31.560 --> 0:26:34.679 little to differentiate it from a hospital, from the central 0:26:34.760 --> 0:26:38.800 nurses station to the cafeteria food. I remember going to 0:26:38.880 --> 0:26:42.160 visit my my grandmother on my my paternal grandmother, who 0:26:42.160 --> 0:26:45.600 lived to be a hundred and one before my dad 0:26:45.920 --> 0:26:48.719 and his wife took her in. She was in one 0:26:48.760 --> 0:26:51.399 of these places and uh, or actually maybe it was 0:26:51.400 --> 0:26:54.280 the other way around. She went afterward. But it was 0:26:54.640 --> 0:26:57.800 it was terrible, you know, it was awful and very 0:26:57.880 --> 0:27:00.800 very sad. And if I was not a young man 0:27:00.920 --> 0:27:03.040 with nothing, you know, nothing going on in my life, 0:27:03.400 --> 0:27:05.359 I might have done something about it, but you know, 0:27:05.400 --> 0:27:07.320 I didn't know what to do back then. You would 0:27:07.320 --> 0:27:09.359 have opened all the doors and been like, go free, 0:27:09.440 --> 0:27:11.359 go free. I would have ripped her out of there 0:27:11.359 --> 0:27:13.439 at least and said come home with me. Yeah, I 0:27:13.440 --> 0:27:15.800 mean they were pretty bad, especially by the time I'm 0:27:15.800 --> 0:27:18.200 guessing you were there in the eighties or nineties. Maybe 0:27:18.320 --> 0:27:20.560 this was in would have been the nineties. Yeah, So 0:27:20.600 --> 0:27:23.520 in the fifties, in the mid fifties, even these things 0:27:23.560 --> 0:27:25.600 made a little more sense at the very least they 0:27:25.600 --> 0:27:28.359 were newer. By the seventies and eighties, they were so 0:27:28.400 --> 0:27:33.000 bad that we had a reform Act that kicked in seven, 0:27:33.480 --> 0:27:37.600 which is basically like this place is wrong, and like 0:27:37.760 --> 0:27:40.600 maybe we don't know what to do or replace him with, 0:27:40.680 --> 0:27:43.480 but here are some things that that you have to 0:27:43.600 --> 0:27:46.480 treat these people with, like dignity. They have to be 0:27:46.520 --> 0:27:49.240 able to have a say in what they wear or 0:27:49.280 --> 0:27:51.720 what they um, what they eat, or what they do 0:27:51.840 --> 0:27:54.520 during the day. And it really kind of got off 0:27:54.560 --> 0:27:57.200 the rails within a couple of decades after their advent. 0:27:57.640 --> 0:28:00.199 The thing is is like I was saying, nobody knows 0:28:00.680 --> 0:28:02.720 what to do about nursing homes, and we'll talk a 0:28:02.760 --> 0:28:04.960 little more about that later, but just just kind of 0:28:04.960 --> 0:28:07.760 put a pin in that nursing homes were not not great, 0:28:07.800 --> 0:28:10.280 and they're still not great. Yeah, should we take a 0:28:10.320 --> 0:28:12.520 break and then come back and talk about medicaid and 0:28:12.560 --> 0:28:15.200 medicare and how that figures in. Yeah, all right, Well 0:28:15.240 --> 0:28:18.040 we'll be right back with those two tiny little things 0:28:18.119 --> 0:28:52.080 right after this. Alright, So we promised talk of Medicare 0:28:52.120 --> 0:28:55.280 and medicaid, and I think Dave kind of put it 0:28:55.800 --> 0:28:58.080 really on the nose here he said no to government 0:28:58.080 --> 0:29:01.280 programs have shaped a nursing home care model over the 0:29:01.320 --> 0:29:05.200 last fifty years more than than those two programs. UH. 0:29:05.560 --> 0:29:10.840 Created in nineteen Lyndon Johnson amended the Social Security Act. 0:29:11.480 --> 0:29:14.640 And UH, if you still get confused, if you're like 0:29:14.680 --> 0:29:18.240 a young hip and heppen and millennial and you don't 0:29:18.240 --> 0:29:20.600 know what those two words mean and you get them 0:29:20.600 --> 0:29:26.440 mixed up. Medicare is health insurance universal, one might dare 0:29:26.480 --> 0:29:32.160 say socialized medicine. That's a red herring for Americans over 0:29:32.240 --> 0:29:37.640 sixty five. Medicaid is long term care for Americans lower 0:29:37.680 --> 0:29:42.040 income status. That's right, Yeah, and it can. You don't 0:29:42.040 --> 0:29:46.760 necessarily have to be elderly for um Medicaid. I believe. Yeah, Medicare, 0:29:46.840 --> 0:29:49.440 you do Medicaid. You could be lower income and have 0:29:49.520 --> 0:29:53.880 a lifelong disability and you'd be eligible for Medicaid too. Yeah, 0:29:53.880 --> 0:29:56.560 so Medicare again, this is if you're over sixty five, 0:29:57.200 --> 0:29:59.520 it's gonna pay for acute medical care when you're in 0:29:59.520 --> 0:30:03.720 a hospital. But if you need something long term UM 0:30:03.800 --> 0:30:05.520 kind of like what we're talking about at the beginning, 0:30:06.240 --> 0:30:09.480 then uh, it won't pay for that. Like you can't 0:30:09.480 --> 0:30:10.960 just say all right, I'm gonna go to a nursing 0:30:10.960 --> 0:30:13.000 home now and it's gonna just pay for that in full, 0:30:13.360 --> 0:30:16.520 but Medicaid would. And for a while everybody's like, okay, well, 0:30:16.520 --> 0:30:20.640 we'll just take Medicaid. This is UM after Lyndon Johnson's 0:30:20.640 --> 0:30:24.960 Great Society in UM. So they were like, this is fine. 0:30:25.160 --> 0:30:29.720 And then somebody realized that Medicare pays way more than 0:30:29.840 --> 0:30:34.160 Medicaid does, and so all of the bottom line people said, 0:30:34.200 --> 0:30:35.760 how can we can we do this? What are we 0:30:35.760 --> 0:30:38.720 gonna do? So they read the the act um and 0:30:38.760 --> 0:30:42.360 they found that, uh, there was language in there that 0:30:42.440 --> 0:30:47.560 says Medicare will pay for uh stay up to a 0:30:47.600 --> 0:30:53.040 hundred days in a skilled nursing facility UM after three 0:30:53.120 --> 0:30:56.560 days or more of treatment in the hospital. And so 0:30:56.680 --> 0:30:58.480 all of those nursing homes were like, well, we have 0:30:58.800 --> 0:31:02.120 we have nurses, we have doctors. Well, let's just rebrand 0:31:02.160 --> 0:31:05.400 ourselves as skilled nursing facilities. And so there was a huge, 0:31:05.760 --> 0:31:10.680 massive transition from nursing homes where you would go live 0:31:10.840 --> 0:31:12.720 potentially the rest of your life and there were not 0:31:12.920 --> 0:31:15.360 nurses and doctors and all of that. Um, and this 0:31:15.440 --> 0:31:18.800 was your new home until you died. To you guys 0:31:18.800 --> 0:31:21.400 got to go because we're now a skilled nursing facility, 0:31:21.480 --> 0:31:23.760 which means the most you could stay as a hundred days, 0:31:23.920 --> 0:31:27.160 but we're gonna make way more off of flipping people 0:31:27.200 --> 0:31:30.520 every hundred days than we would because Medicare is gonna 0:31:30.560 --> 0:31:32.800 pay then we would letting you stay here as a 0:31:32.880 --> 0:31:36.720 nursing home because Medicaids paying for that. That, like I said, 0:31:36.760 --> 0:31:40.880 just caused a huge change in the industry. Yeah, and Americans, 0:31:41.200 --> 0:31:44.880 uh in the eighties and nineties, UM, generally we're like, 0:31:44.920 --> 0:31:47.840 you know what, we need better um facilities and more 0:31:47.920 --> 0:31:51.960 comfortable facilities that feel more like uh, feel less like 0:31:51.960 --> 0:31:54.800 a hospital and more like an apartment, let's say. And 0:31:54.880 --> 0:31:56.760 that was sort of the birth of what's known now 0:31:56.800 --> 0:32:01.040 as assisted living facilities, where they're different levels of care 0:32:01.320 --> 0:32:05.440 that you can pay for um. And the idea is 0:32:05.520 --> 0:32:07.120 that if you go to one of those, you have 0:32:07.120 --> 0:32:10.440 a little bit more independence. Um, you have a little 0:32:10.480 --> 0:32:14.160 bit more uh say, and like how your day goes, 0:32:15.040 --> 0:32:17.160 um like and that's just at a just like a 0:32:17.240 --> 0:32:20.800 daily schedule level. Um. And you know that it's like 0:32:20.800 --> 0:32:23.240 a little more social like it it's it's sort of 0:32:23.240 --> 0:32:25.680 like you what you I mean. The best ones are 0:32:25.720 --> 0:32:27.440 like what you would hope they would be, which is 0:32:27.760 --> 0:32:29.800 a place for your grandparents to go hang out and 0:32:30.280 --> 0:32:33.800 hang out with other seniors who and and you know, 0:32:33.920 --> 0:32:36.479 have a social life and tell stories and be with 0:32:36.520 --> 0:32:38.160 one another and not just sort of be in a 0:32:38.240 --> 0:32:42.160 hospital room. Right, So, like if you can't just stay 0:32:42.560 --> 0:32:45.720 in your house or something as you're getting older, this 0:32:45.800 --> 0:32:49.520 is a real alternative for you. Um. And because there's 0:32:49.560 --> 0:32:52.959 different levels of care, you can age in place there, 0:32:53.000 --> 0:32:54.760 like you can just keep getting older and older and 0:32:54.760 --> 0:32:57.479 then they'll start, you know, adding greater and greater layers 0:32:57.520 --> 0:33:00.800 of care. The thing is is assisted living is expensive 0:33:01.360 --> 0:33:04.160 and it's outside of the federal purview. Like the Feds 0:33:04.200 --> 0:33:07.120 went all in on nursing homes. They regulate nursing homes, 0:33:07.240 --> 0:33:11.880 they don't regulate assisted care. Um. They they will pay 0:33:11.920 --> 0:33:15.400 for nursing homes, they won't pay for assisted care. Um, 0:33:15.440 --> 0:33:18.280 there's a lot of differences, and they're almost they're they're 0:33:18.400 --> 0:33:22.720 very much intertwined nursing homes and assisted living, but um, 0:33:22.760 --> 0:33:25.440 they're very they're very separate as far as the US 0:33:25.520 --> 0:33:28.400 government is considered. There are two different things, and the 0:33:28.440 --> 0:33:31.520 government recognizes nursing homes. Um. The thing is, it's like 0:33:31.560 --> 0:33:33.640 you were saying, in the eighties and nineties, people were like, 0:33:34.240 --> 0:33:36.560 we we don't want to live in nursing homes anymore, 0:33:36.560 --> 0:33:38.360 we want to move over here. And all the nursing 0:33:38.360 --> 0:33:42.320 homes were like, fine, we're skilled nursing facilities now, and 0:33:42.440 --> 0:33:45.440 we can get some of that sweet sweet medicare money. 0:33:45.760 --> 0:33:50.480 So if you did you see that stat Yeah, sixty 0:33:50.560 --> 0:33:52.920 three there were five hundred and seventy thousand skilled nursing 0:33:52.960 --> 0:33:56.920 beds into there were one point two millions. So they 0:33:56.960 --> 0:33:59.600 definitely were like, oh, that that money needs to become 0:33:59.640 --> 0:34:02.760 in our way exactly so, and that's exactly what they did. 0:34:02.760 --> 0:34:05.880 They said, you know, we're we're skilled nursing facilities now, 0:34:05.920 --> 0:34:08.440 and you know they probably are owned by the hospitals 0:34:08.440 --> 0:34:10.000 where you do three days in there and then get 0:34:10.080 --> 0:34:12.839 moved to the skilled nursing facility and then maybe if 0:34:12.840 --> 0:34:15.800 it's a large enough group, they might own an assisted 0:34:15.840 --> 0:34:19.040 living facility to that you can say move into after 0:34:19.160 --> 0:34:23.120 that hundred days or something. Um. The thing is is 0:34:24.480 --> 0:34:28.520 the assisted living is great. Um. It can be really 0:34:28.520 --> 0:34:30.640 really good, and nursing homes can be good too. There's 0:34:30.680 --> 0:34:33.319 not like all nursing homes aren't bad, and they all 0:34:33.400 --> 0:34:35.880 of them have like their their upsides. Like you were saying, 0:34:36.080 --> 0:34:38.880 assisted living is very social. There's probably you know, a 0:34:38.880 --> 0:34:41.480 lot more going on, a lot more activity, just because 0:34:41.880 --> 0:34:44.240 a lot of the people who live there these days 0:34:44.719 --> 0:34:48.720 are going to be more active still, whereas in nursing homes. 0:34:49.400 --> 0:34:51.879 It's now the people who live in nursing homes tend 0:34:51.920 --> 0:34:55.399 to be much sicker, more infirm. Um, But there's still 0:34:55.480 --> 0:34:59.160 socialization where there's not necessarily if you just you know, 0:34:59.280 --> 0:35:01.759 live alone your house and somebody comes by a couple 0:35:01.800 --> 0:35:04.200 of times a week. So there are definitely good things 0:35:04.239 --> 0:35:07.879 to nursing homes. The problem is is se of them 0:35:07.880 --> 0:35:11.160 are for profit. Some of them are owned by um 0:35:11.360 --> 0:35:15.400 private equity firms. We shouldn't let private private equity firms 0:35:15.440 --> 0:35:20.680 anywhere near the aged population. Ever in any country. That's 0:35:20.719 --> 0:35:24.400 just a terrible combination. And apparently, in fact, their studies 0:35:24.440 --> 0:35:28.200 that show when private equity firms take over nursing homes 0:35:28.560 --> 0:35:31.880 there is a measurable decline in health outcomes for the 0:35:32.120 --> 0:35:35.279 residents because their whole thing is there they you know, 0:35:35.320 --> 0:35:39.440 they're dedicated to making you know, corporate profits, and so 0:35:39.560 --> 0:35:41.759 you've cut costs and you cut services, and you just 0:35:41.800 --> 0:35:44.799 approach things differently than you should. And that's kind of 0:35:44.800 --> 0:35:48.919 like this evolution that's going on now, is we we've 0:35:48.960 --> 0:35:53.000 been providing services to elderly people as they age, as 0:35:53.040 --> 0:35:56.880 if their customers where instead we should be providing care. 0:35:57.320 --> 0:36:00.239 And those are two different things. Even though from you know, 0:36:00.280 --> 0:36:03.239 a few paces back they might look similar, they're not. 0:36:03.400 --> 0:36:05.680 They're different. And that's kind of the push that we're 0:36:05.680 --> 0:36:08.760 going toward now. Yeah, So where we find ourselves today 0:36:08.880 --> 0:36:13.520 statistically is uh. And I was kind of surprised about this. 0:36:13.760 --> 0:36:18.080 I had a feeling that more Americans were in these 0:36:18.120 --> 0:36:21.959 facilities than I thought. Um, I guess it's a little 0:36:21.960 --> 0:36:24.840 bit heartening to hear the numbers. Um, there are about 0:36:24.840 --> 0:36:28.400 one point four million Americans in residential nursing homes and 0:36:28.440 --> 0:36:32.560 then another one point seven million cycling through those skilled 0:36:32.600 --> 0:36:36.000 nursing nursing facilities if they have like a surgery or 0:36:36.040 --> 0:36:39.080 an illness or something they're recovering from or rehabbing from, 0:36:39.800 --> 0:36:42.000 which is only about four point five percent of all 0:36:42.000 --> 0:36:47.439 Americans over sixty five and ten of all Americans over 0:36:47.480 --> 0:36:52.000 eighty five. I thought it would be higher than that. Um, 0:36:52.080 --> 0:36:54.000 you know, if you want to look at the downside, though, 0:36:54.080 --> 0:36:58.200 is one big reason why. Maybe the cost um It 0:36:58.320 --> 0:37:00.879 depends on where you are, of course, but if you 0:37:01.239 --> 0:37:04.319 um are in a private room at a nursing home, 0:37:05.080 --> 0:37:08.720 and I guess was this in Georgia, Yeah, two hundred 0:37:08.760 --> 0:37:11.359 and thirty five dollars a night in New York, that's 0:37:11.360 --> 0:37:14.920 about four hundred dollars a night and change on average 0:37:14.960 --> 0:37:19.239 a night like at that point, just move them into 0:37:19.239 --> 0:37:23.080 the w Hotel, right, pretty pretty much. Yeah. The only 0:37:23.120 --> 0:37:25.080 thing is that they don't have nurses at the the 0:37:25.560 --> 0:37:29.040 W Hunt. But that's a lot of money, man, And 0:37:29.080 --> 0:37:31.640 you can just get bled dry at the end of 0:37:31.680 --> 0:37:33.799 your life. Well you do. And as a matter of fact, 0:37:33.880 --> 0:37:38.000 to pay four a place like that a nursing home, 0:37:38.360 --> 0:37:42.560 Medicaid says you have to have paid in which basically says, 0:37:43.080 --> 0:37:45.399 you need to have if you if you don't own 0:37:45.440 --> 0:37:48.400 your house anymore, you have to um give the proceeds 0:37:48.400 --> 0:37:52.239 from your house. Um. Yeah, you have to liquidate your 0:37:52.320 --> 0:37:55.200 your your inheritance, you have to you have to pay 0:37:55.239 --> 0:37:57.600 down to usually something like I saw like maybe seven 0:37:57.680 --> 0:38:01.160 hundred dollars a month income is the cut off. Anything 0:38:01.200 --> 0:38:04.200 over that, and you have to be contributing. Um. Anything 0:38:04.280 --> 0:38:06.440 under that, the Medicaid will kick in and pay the 0:38:06.760 --> 0:38:09.960 place directly for letting you stay there. Um. But the 0:38:09.960 --> 0:38:13.840 thing is, it's like, of course, the the better alternative 0:38:13.880 --> 0:38:20.000 is assisted living. Some state Medicaid programs will pay or 0:38:20.080 --> 0:38:22.359 help pay for assisted living. But for the most part, 0:38:22.719 --> 0:38:25.160 if you're if you are paying for if you're living 0:38:25.160 --> 0:38:27.480 in an assisted living facility, you might have a reverse 0:38:27.520 --> 0:38:30.960 mortgage on your house. You are probably you've liquidated all 0:38:31.000 --> 0:38:35.880 of your um, your investments. Um, you're you're you're paying 0:38:35.960 --> 0:38:38.160 for it out of pocket. In the United States for 0:38:38.239 --> 0:38:43.000 the good kind of retirement home. Yeah, and you know 0:38:43.040 --> 0:38:44.880 there are people out there that are trying to further 0:38:45.120 --> 0:38:49.360 reform uh what these places look like. Uh. There's a 0:38:49.360 --> 0:38:54.399 gentleman named Dr Bill Thomas, who is a geriatrician who 0:38:54.440 --> 0:38:57.919 has something called the Eden Alternative. Um. That is he's 0:38:57.960 --> 0:39:03.680 trying to basically reframe these nursing home uh residents in 0:39:04.360 --> 0:39:07.480 caregivers as care partners. And you know it sounds kind 0:39:07.520 --> 0:39:11.360 of hippie dippy, but um, he wants people to be 0:39:11.400 --> 0:39:14.560 able to still grow in life and to still flourish 0:39:14.640 --> 0:39:18.080 and to still learn. Um, just because you're a senior 0:39:18.120 --> 0:39:20.440 doesn't mean you just have to to sit in a 0:39:20.560 --> 0:39:25.560 room and watch Judge Judy or push checkers around a checkerboard. Uh. 0:39:25.600 --> 0:39:28.200 And you know that they're depending on where you are, 0:39:28.280 --> 0:39:31.560 they might be adopting these methodologies of the Eden Alternative 0:39:32.280 --> 0:39:35.120 or UM the greenhouse movement. Another thing he helps spawn, 0:39:35.920 --> 0:39:38.440 which is you're in an in an individualized home. It's 0:39:38.440 --> 0:39:40.600 not a big facility. You got a private room, you've 0:39:40.600 --> 0:39:44.160 got a bathroom, and there's outdoor space for you to 0:39:44.280 --> 0:39:46.760 go and garden and to walk around and to again 0:39:47.160 --> 0:39:49.759 try and flourish in your in your last years on 0:39:49.800 --> 0:39:54.279 this planet. Right. Um. And that's a that's there's also 0:39:54.400 --> 0:39:57.719 a push for um for aging in place at home. 0:39:58.080 --> 0:40:00.680 Yeah sure, which can be really been official, but again 0:40:00.920 --> 0:40:03.719 it can also be isolating, depending on you know what 0:40:03.840 --> 0:40:05.680 kind of friends or family maybe if you live in 0:40:05.719 --> 0:40:07.239 a condo it would be a little more. But if 0:40:07.239 --> 0:40:09.080 you're living in the house that you spent your entire 0:40:09.160 --> 0:40:11.600 life in and all the neighbors have moved away and 0:40:11.680 --> 0:40:14.520 you don't know anybody anymore, that can be isolating. So 0:40:14.600 --> 0:40:17.160 in that sense, assisted living or even a nursing home 0:40:17.160 --> 0:40:19.759 could be a better alternative. But a lot of people say, no, 0:40:19.920 --> 0:40:22.319 this is my house, I want to stay here at home. 0:40:22.840 --> 0:40:25.440 The problem is is um I've seen I've seen it 0:40:25.520 --> 0:40:29.200 put that medicaid has an institutional bias, which means that 0:40:29.280 --> 0:40:31.800 like they'll pay for you to go to a institution 0:40:32.440 --> 0:40:34.919 like the definition of the word institution, they don't really 0:40:34.960 --> 0:40:36.839 pay for you to be able to stay at home. 0:40:37.239 --> 0:40:39.839 Some programs do, but a lot of them don't, even 0:40:39.880 --> 0:40:41.680 if you do want to stay at home, which is 0:40:41.760 --> 0:40:44.440 kind of heartbreaking to me. Yeah, I mean, you know 0:40:44.480 --> 0:40:48.040 Emily's grandmother Mary, who was very popular with the stuff. 0:40:48.040 --> 0:40:51.239 You should know Army as the eldest general. She you know, 0:40:51.280 --> 0:40:53.560 we had to move her out of her house that 0:40:53.640 --> 0:40:55.480 she was in, you know, not our whole life, but 0:40:55.640 --> 0:40:58.759 for a large portion of of her life. But you know, 0:40:58.800 --> 0:41:00.440 it was one of those deals where it's out in 0:41:00.440 --> 0:41:03.000 the middle of the country in Ohio. Uh, there was 0:41:03.040 --> 0:41:06.200 no family close by, there was no hospital close by, 0:41:06.400 --> 0:41:08.840 and it's just it's hard to say it's okay to 0:41:08.880 --> 0:41:11.839 stay there, you know. Um. And it was sad when 0:41:11.840 --> 0:41:14.919 she left, but she was also like, no, this is great, 0:41:14.920 --> 0:41:18.040 I'll move in with you guys. Like she didn't kick 0:41:18.040 --> 0:41:20.440 and scream, you know, she was she was willing and 0:41:20.520 --> 0:41:23.319 understood it was the best thing. And uh, you know, 0:41:23.360 --> 0:41:26.120 it's probably one reason why she's pushing one right now. 0:41:26.200 --> 0:41:28.600 I think for sure where she live, she lives with 0:41:28.640 --> 0:41:33.960 Emily's parents and here in Georgia. Now that's great. Yeah, um, well, 0:41:33.960 --> 0:41:36.040 I'm yeah, I'm I'm very glad that that worked out 0:41:36.080 --> 0:41:38.719 for um. But I was also looking at like the 0:41:38.760 --> 0:41:42.080 antithesis of that, like what happens in the United States 0:41:42.080 --> 0:41:46.120 to people who who don't have any family, who don't 0:41:46.160 --> 0:41:48.640 have any children, and who don't have any money, like 0:41:48.680 --> 0:41:55.319 what happens to them, And they seemed to be they 0:41:55.360 --> 0:41:57.239 seem to be kind of left on their own, Like 0:41:57.280 --> 0:42:00.120 if they have a house, they're they're probably just to 0:42:00.200 --> 0:42:02.240 be left in their house and maybe meals on wheels 0:42:02.239 --> 0:42:05.239 will come by. Um. The County Social Services might be 0:42:05.320 --> 0:42:07.640 able to help them. But this is if they reach 0:42:07.680 --> 0:42:10.239 out for help, if they need assistance, they might not 0:42:10.360 --> 0:42:12.359 get it at home because again, there's a lot of 0:42:12.719 --> 0:42:14.839 UM services that aren't paid for. And if you don't 0:42:14.840 --> 0:42:17.279 I mean money, you're s o l. You could go 0:42:17.360 --> 0:42:20.960 to a UM uh nursing home. But if you don't 0:42:21.000 --> 0:42:25.759 have any ability to pay UM, they can kick you out. Uh, 0:42:25.800 --> 0:42:27.880 they can kick you out for a bunch of different reasons. 0:42:27.960 --> 0:42:31.120 They're The most oppressing thing that I've looked up in 0:42:31.120 --> 0:42:35.440 a while was nursing home evictions, and they there are 0:42:35.520 --> 0:42:37.800 there's a there was a loophole that was recently closed 0:42:37.800 --> 0:42:41.920 in two thousand sixteen that said UM, if you if 0:42:41.920 --> 0:42:45.440 the nursing home is not able to UM to offer 0:42:45.920 --> 0:42:50.880 care for the person, then they can be discharged. And 0:42:51.440 --> 0:42:53.960 they use that as like a huge loophole. They'd be like, 0:42:54.080 --> 0:42:56.160 we're sorry, we can't offer you the care you need 0:42:56.200 --> 0:42:58.920 any longer. You have to leave. And you know, if 0:42:58.920 --> 0:43:01.520 you don't have anybody to advocate for you, you're you're 0:43:01.920 --> 0:43:04.440 you know, where are you going to go? And I 0:43:04.480 --> 0:43:06.920 couldn't get a really good answer, but I get the 0:43:06.960 --> 0:43:10.720 impression that it's there are it's not huge and rampant, 0:43:10.960 --> 0:43:13.439 but there are a lot of people who are still 0:43:13.480 --> 0:43:17.279 falling through the crack society as they age because we 0:43:17.400 --> 0:43:23.959 don't have a robust, nationalized UM plan to care for 0:43:24.040 --> 0:43:27.440 the elderly no matter what. And I thought, well, of 0:43:27.480 --> 0:43:29.920 course the United States is super behind in that respect, 0:43:29.920 --> 0:43:33.520 but apparently we're in line with other countries like Canada. 0:43:33.760 --> 0:43:36.240 You think Canada would have like a place for every 0:43:36.239 --> 0:43:38.120 senior and they're all happy and taking care of and 0:43:38.120 --> 0:43:41.040 everybody gets a pet beaver or something like that. Now 0:43:41.440 --> 0:43:43.799 you're on your own, kind of like your state might 0:43:43.840 --> 0:43:45.960 help you out a little bit, the local city might, 0:43:46.320 --> 0:43:49.000 but that's about it. Same with the UK too, which 0:43:49.040 --> 0:43:53.520 I was really surprised because both of them have nationalized medicine. Yeah. 0:43:53.560 --> 0:43:57.320 I will say that this is where UM. Social media 0:43:57.400 --> 0:44:01.680 has been beneficial UM as far as neighborhood and neighbors 0:44:01.800 --> 0:44:05.440 go UM. I mean all the time on our neighborhood pages, 0:44:05.520 --> 0:44:09.479 we see people stepping up, and especially in a place 0:44:09.520 --> 0:44:13.279 like Atlanta, Atlanta, where gentrification has happened, UM, you do 0:44:13.400 --> 0:44:16.439 see a lot of neighbors stepping up to help take 0:44:16.480 --> 0:44:21.520 care of UM, the senior African American community that is um, 0:44:21.600 --> 0:44:24.560 still living in their houses and they haven't been bought 0:44:24.600 --> 0:44:28.560 out for a shamefully low price by a greedy contractor 0:44:28.600 --> 0:44:31.440 to to flip it into a little McMansion. But you 0:44:31.480 --> 0:44:32.880 see it all the time that we work with a 0:44:32.880 --> 0:44:35.040 group called Neighbor in Need that really does great things. 0:44:35.160 --> 0:44:39.560 And aside from just the the official organizations. All the 0:44:39.600 --> 0:44:43.439 time you'll see someone that lives next door to someone 0:44:43.480 --> 0:44:45.839 like that. They'll be like, hey, she's having a hard 0:44:45.880 --> 0:44:49.239 time paying her power bill this winter, and you know, 0:44:49.440 --> 0:44:52.080 in an hour it is funded for for the rest 0:44:52.160 --> 0:44:55.040 of the year. Uh, the neighbors step up and and 0:44:55.080 --> 0:44:57.399 pay for her power bill. And it's just it's little 0:44:57.440 --> 0:45:00.640 things like that. But um, these are in unities where 0:45:00.680 --> 0:45:03.279 the houses are close together and people are you know, 0:45:03.400 --> 0:45:06.080 each other's business, like um, Emily's grandmother out there in 0:45:06.080 --> 0:45:08.440 the middle of the country, and a lot of rural 0:45:08.840 --> 0:45:11.680 America like that might not be the case. You might 0:45:11.719 --> 0:45:15.400 not have someone checking up on you, and people you 0:45:15.440 --> 0:45:18.080 know bleeding hearts like you, and I feel that they 0:45:18.080 --> 0:45:20.799 should be taking care of no matter what. You know. Yeah, 0:45:20.840 --> 0:45:23.600 but I mean, isn't that something everybody can get behind? 0:45:23.719 --> 0:45:26.279 You would think so, But that's just not true. I'll 0:45:26.320 --> 0:45:29.600 remind you of our episode on homelessness many years ago. Yeah, 0:45:29.680 --> 0:45:31.560 that one's tough for me to swallow. Those are the 0:45:31.560 --> 0:45:35.319 people who believed in the unworthy poor. Huh, and we're 0:45:35.360 --> 0:45:39.000 to send him to alms houses back in the day. Yeah. Um. 0:45:39.080 --> 0:45:41.479 The good news is if you're looking for a home 0:45:42.160 --> 0:45:45.040 for a family member these days, Medicare dot gov has 0:45:45.080 --> 0:45:47.759 a lot of resources. Oh, I'll tell you another place 0:45:47.800 --> 0:45:50.160 to u S News and World Report is really hot 0:45:50.200 --> 0:45:54.040 and heavy on um an assisted living in nursing home ratings. Yeah, 0:45:54.120 --> 0:45:57.200 nursing home compares another website. And you know there are 0:45:57.200 --> 0:45:59.959 places where you can go to really dig in see 0:46:00.040 --> 0:46:02.560 which ones you feel are a good fit. Uh. They're 0:46:02.640 --> 0:46:06.080 rated on you know, how the people are really doing. 0:46:06.080 --> 0:46:08.440 They're not just like how pretty it is. And if 0:46:08.480 --> 0:46:09.960 you go and visit one, they said to be aware 0:46:10.000 --> 0:46:13.200 of the chandelier effect. Like in fact, if you walk 0:46:13.239 --> 0:46:15.080 in and you see a grand piano and a lobby, 0:46:15.200 --> 0:46:17.920 just turn around and leave. Well yeah, that's I mean, 0:46:17.960 --> 0:46:19.560 that's one of the ways that they get you. You 0:46:19.560 --> 0:46:21.799 want to do a little more digging than just that, 0:46:21.920 --> 0:46:24.239 and you want to talk to residents, You want to 0:46:24.239 --> 0:46:28.760 read like actual like, uh, inspections and reports on those places. 0:46:28.800 --> 0:46:31.640 You want to look at stats like how many patients 0:46:31.719 --> 0:46:33.920 had to get were taken to the e er or 0:46:33.960 --> 0:46:37.480 were readmitted in the hospital, how many have bed sores? 0:46:37.920 --> 0:46:41.960 Um any allegations of abuse. Apparently abuse has doubled between 0:46:41.960 --> 0:46:45.320 two thousand thirteen and two thousand seventeen. Still low. I 0:46:45.360 --> 0:46:47.319 think it was like eight hundred and forty five, which 0:46:47.360 --> 0:46:51.800 is too many, but it's still doubled since two thousand thirteen. 0:46:52.080 --> 0:46:53.799 So you want to like really look for that kind 0:46:53.800 --> 0:46:58.200 of thing. Are they over prescribing medications like for psychosis 0:46:58.280 --> 0:47:02.200 to to people who are um who are problematic when 0:47:02.239 --> 0:47:04.520 you don't really think they're problematic. There's a lot of 0:47:04.520 --> 0:47:06.120 stuff you want to look for that you can look for. 0:47:06.200 --> 0:47:09.440 It's out there. Just do some digging because this is 0:47:09.480 --> 0:47:12.160 somebody you care about, don't forget. Yeah, and we really 0:47:12.160 --> 0:47:15.040 want to point out that, uh, it's easy to zero 0:47:15.080 --> 0:47:21.080 in on things like abuse cases and unnecessary medication. But UM, 0:47:21.200 --> 0:47:25.240 we really salute you if you are the lion share 0:47:25.320 --> 0:47:27.960 of these people, UM that are in nurses that are 0:47:27.960 --> 0:47:31.120 taking care of our seniors and doing a great, great 0:47:31.239 --> 0:47:33.680 job and a very very tough job. Yeah, and one 0:47:33.760 --> 0:47:35.479 of the things actually I saw I'm glad you said 0:47:35.480 --> 0:47:40.120 that was that, um, it's it's a really a thankless 0:47:40.239 --> 0:47:45.200 kind of job because traditionally people who work in elder care, 0:47:45.960 --> 0:47:49.880 like the actual workers are treated like garbage by management. 0:47:49.920 --> 0:47:52.799 It's just like an industry wide problem. And that was 0:47:52.800 --> 0:47:55.600 actually one of those things from the the Eden alternative 0:47:55.760 --> 0:47:59.000 was that workers are treated with the respect that you 0:47:59.040 --> 0:48:02.000 want the workers to treat the patients with like everyone 0:48:02.080 --> 0:48:05.320 is treated with respecting dignity, not just ideally the patients, 0:48:05.360 --> 0:48:07.640 the workers too, because they deserve it for the work 0:48:07.640 --> 0:48:11.239 they're doing. It's amazing. Ah, you got anything else about 0:48:11.320 --> 0:48:14.000 nursing homes, I've got nothing else. We can do. Better 0:48:14.360 --> 0:48:16.600 start thinking about stuff, you know. I mean, you're never 0:48:16.640 --> 0:48:19.080 too young to get a plan in places. That's all 0:48:19.120 --> 0:48:23.399 I'm saying. Great point, um, And since I say great point, 0:48:23.480 --> 0:48:28.319 it's time for a listener, man. I mean, maybe if 0:48:28.320 --> 0:48:30.000 you're like twenty five, you don't need to be thinking 0:48:30.000 --> 0:48:34.960 about your nursing home options. Okay, but you know what 0:48:35.000 --> 0:48:38.799 I mean, well, not necessarily, I'm your parents. I saw 0:48:38.880 --> 0:48:42.520 that of nursing home residents were under sixty five, so 0:48:42.600 --> 0:48:45.480 there are some younger residents in there that I think 0:48:45.520 --> 0:48:48.640 get overlooked a lot, like by us. You know what 0:48:48.680 --> 0:48:54.359 you call those people? What the party crowd? That's right, Oh, 0:48:54.800 --> 0:48:58.640 that's gonna be me. Man. What the party crowd at 0:48:58.680 --> 0:49:01.040 the at the nursing home. I'm be mixing it up 0:49:01.080 --> 0:49:03.960 like scat Man Cruthers in the Twilight Zone movie. I 0:49:04.000 --> 0:49:05.960 could see that. Let's go play kick the can. Everyone. 0:49:05.960 --> 0:49:08.239 It's midnight. It's time. It's time to take off that 0:49:08.280 --> 0:49:13.680 gown and live. Good things happen. You're ready, I'm ready, Well, 0:49:13.760 --> 0:49:19.400 bread away. I'm gonna call this one. Uh goots follow up? Okay, 0:49:19.640 --> 0:49:23.480 this is a good one about the great, great Steve Guttenberg. 0:49:24.239 --> 0:49:27.000 I'm hoping someone throws the stuff his way, by the 0:49:27.040 --> 0:49:31.359 way he needs he needs to know. I can feel 0:49:31.400 --> 0:49:33.680 him right now listening to all right this from Dave. Hey, guys, 0:49:33.719 --> 0:49:35.719 on a recent episode, you discuss the episode of Party 0:49:35.760 --> 0:49:39.279 Down which the wonderful Steve Guttenberg allows the caters to 0:49:39.280 --> 0:49:41.719 throw a party at his house. You knew this had 0:49:41.760 --> 0:49:44.120 come up before and wondered in what episode in what context. 0:49:44.600 --> 0:49:47.000 By chance, the next day, I was scrolling randomly through 0:49:47.000 --> 0:49:54.080 older episodes and selected Barefoot running uh boy, remember that one. 0:49:54.480 --> 0:49:56.920 When in this episode you started talking about Steve Guttenberg, 0:49:57.000 --> 0:50:00.160 I had an intensely existential experience. I was listen thing 0:50:00.160 --> 0:50:02.840 in the present to you talk about Steve Gutenberg in 0:50:02.880 --> 0:50:05.719 the past, having listened in the more recent past to 0:50:05.760 --> 0:50:08.680 you also for more from a more recent past talk 0:50:08.680 --> 0:50:12.080 about Steve Gutenberg, unable to remember the more distant past, 0:50:12.600 --> 0:50:14.840 and which you were talking about Steve Gutenberg, which I 0:50:14.920 --> 0:50:17.400 was now listening to in the present, which knowledge of 0:50:17.400 --> 0:50:20.080 the future, in which you would again discussed Steve Gutenberg. 0:50:20.960 --> 0:50:23.640 Steve Gutenberg the center of our cosmos, the nexus around 0:50:23.920 --> 0:50:26.520 which space and time and God swirl until they've become one. 0:50:27.080 --> 0:50:30.080 The answer to this question for which our souls cry out, 0:50:30.800 --> 0:50:33.759 I can only speculate yes. Anyway, I wanted to let 0:50:33.800 --> 0:50:37.799 you guys know in which previous episode he featured Steve Gutenberg. 0:50:38.640 --> 0:50:41.480 As to the context, there was none. You you started 0:50:41.480 --> 0:50:44.920 talking about Steve Gutenberg for no discernible reason. It sounds 0:50:44.960 --> 0:50:47.759 like me, which is as it should be, and that 0:50:47.880 --> 0:50:51.239 is from Dave. And Dave was very excited that this 0:50:51.280 --> 0:50:53.840 was getting read, and he said, to be honest, I 0:50:53.880 --> 0:50:55.400 had a little bit to drink when I wrote that, 0:50:55.440 --> 0:50:59.959 and I didn't fully remember the whole experience, so good 0:51:00.080 --> 0:51:04.200 job there go. This would be proud. Yeah, I think 0:51:04.280 --> 0:51:06.040 Dave's going to be part of the mixing it up 0:51:06.040 --> 0:51:10.440 crowd at the nursing home to kicking that can you know, Well, 0:51:10.440 --> 0:51:13.040 thanks a lot, Dave. That was pretty great. Um. And 0:51:13.160 --> 0:51:16.480 if you have something great to tell us, especially if 0:51:16.520 --> 0:51:18.880 it's in reference to something we said about something we 0:51:18.960 --> 0:51:22.080 said in the past, we'd love to hear from you. 0:51:22.080 --> 0:51:25.239 You can send us an email to Stuff podcast at 0:51:25.239 --> 0:51:30.680 iHeart radio dot com. Stuff you Should Know is a 0:51:30.680 --> 0:51:33.800 production of iHeart Radios How Stuff Works. For more podcasts. 0:51:33.800 --> 0:51:36.719 For my heart Radio, visit the iHeart Radio app, Apple Podcasts, 0:51:36.760 --> 0:51:38.440 or wherever you listen to your favorite shows.