Geriatric Unit Dispositions

[Sushirolls]

As I watch the news these days. It dawned on me, if we are culturally accepting of our elected leaders having dementia, perhaps we should expand our geriatric unit dispositions. Expedite this pipeline.

Arrange family meetings, at time of admission, for families that have a little bit more resources, to consult with political campaign managers, for their viability to run for office. Just check the box "Campaign Manager Consultation" it will be right under Social Work order, Dietary, and PT/OT consult options, too.

Essentially the equivalent of adult day care with staffers around to supervise and perform the majority of work. Salaried. Health insurance that isn't Medicare (so any readmissions are reimbursed better for the Big Box shop hospital!). Routine grooming is required for the job, so no fears of degrading in squalor with poor hygiene. Frequently will have gift baskets and luncheon meetings, so no fears of malnutrition. Steady source of stimulus, social engagement, or comfortable chairs to sleep in during debates or voting on the floor. Large buildings, or even private jets with steps to go up/down for exercise. Babies to lift for exercise [just don't make comments about the children's tongues...].

Since nursing homes are full. Memory care unit placement is very difficult. Adult day care are filled, in home nursing care is impossible to find. Truly, all options should be considered.

Any of the inpatient folks considering this as a discharge/disposition?

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[allantois]

GOP already has a bunch of walking zombie voters

 

[PsyDr]

 

[birchswing]

The most representative aspect of the Senate is that they reflect our collective morbidity and despair.

They are the chosen of us, though, who are taken care of in their suffering and transitioning to death.

They make such an issue of Feinstein, and I am the *last* to protect the elite, but does no one remember Ted Kennedy not being present for the last year or so of his tenure? He was the whole reason they had to pass ObamaCare "as is" rather than being able to amend it before passing it.

Same with McCain who died in office.

They keep saying gears are grinding to a halt, but as we discussed in a previous thread, both of Pennsylvania's senators were recently incapacitated at the same time.

I am usually the very last person to see signs of sexism where others do, but it does seem different.

And I don't like Diane Feinstein. She was adamant pro death penalty supporter, and who can forget her hectoring those poor schoolchildren who came to see her about climate change.

I just don't know why they are suddenly clamoring to get the infirmed out of the Senate when it was like a papal-like tradition for Kennedy and McCain to take the seat to their graves.

I don't think it's right, but it is inconsistent that they're now all up in arms. Maybe people were calling on Kennedy and McCain to resign, but I don't recall it now.

Edit: Since this whole thing is OT to psychiatry, I'll indulge myself: They are no more owed the Senate as their fiefdom than Biden is a trip to Ireland to go down memory lane. I don't follow Biden on Twitter, but his posts are suggested to me, and then were with such frequency I was getting 5 minute interval updates on his trip there like he worked for the tourism board and had won some trip to help promote the country, and it absolutely disgusted me. I finally had to block him. Marianne Williamson—his competitor who his press secretary smugly dismissed with religious bigotry—is out there talking policy every day. And at a time millions are being shoved off of Medicaid, Biden is talking about the f'ng bonds between Ireland and the US and all this bombast that means nothing. The bond between the US and Ireland is that Ireland is a tax haven for American corporations like Apple that are skirting paying billions in taxes they owe. Meanwhile Biden's tweets are full of poetry and meaningless drivel about our shared bonds and how he's at the site his great-great-great-great-grandfather might have stood. He is going down the Hillary 2016 path of aloofness and going to alienate all the blue collar workers. Why do they give a vacuum for Donald Trump to fill? Hillary treated 2016 like a coronation rather than a campaign, and he's been doing the same thing—completely out of touch. I feel like you need to be a citizen of Ireland or Ukraine to be on his radar. The media didn't even pick up that he said US foreign aid will be going to Ukrainians *pensions*. Why does he not speak to Americans going bankrupt as they die? He's pulling a 2016 Clinton.

 

[birchswing]

not my best by far, i write these for my own amusement late at night and have nowhere to post my satire because i think they're too dark for people' sensibilities, but you all handled the dancing psychiatrist for years (my writing for her has continued in parallel to the forum in response to your threads but i don't publish it anywhere):


Ice floe readied for Diane Feinstein off coast of California

California Governor Newsom said that he is tired of the rancor surrounding questions of Senator Diane Feinstein’s health and capacity to serve the state of California.

“These rumblings have gone on for too long and are growing too loud,” Newsom said on Meet the Press. “The woman deserves some dignity. That’s why as part of my recent tour of the backwater states, my aides brought down an ice floe from Alaska, right now safely floating off Catalina Island. But summer’s approaching and it’s time for me to act make the most humane decision: to set Senator Feinstein free at sea.”

Meanwhile, several House Democrats have demanded Diane Feinstein crawl into a grave.

“She’s just impeding progress at this point being among the living,” Said Congresswoman Ro Khanna. “She could do more good for us in the ground fertilizing a redwood—or even General Sherman—than doddering around the Senate when she even manages to show up.”

Representative Alexandria Ocasio-Cortez has brought a casket outside Feinstein’s office and says she plans to ask Feinstein to step in for a final slumber when she next catches her in the hallowed halls of Congress.

“I plan to be very respectful about it,” Ocasio-Cortez said. “While we don’t often agree politically, she is a pioneer and a lion of the Senate and deserves to be put down humanely. And honestly she probably won’t even know what’s going on. I got the casket at Costco. Do you like it?”

Senator Bernie Sanders agrees with the plans, but points out that that it is due to Feinstein’s senility and not her age. “Let me be very clear: I am a very clear person,” Sanders said. “No sharks are going to circle me, and if they do, well, they’ve got another thing coming. But yeah Feinstein, I think she’s gotta go.”

When President Biden was asked about the plans to bury Feinstein alive, he responded, “Where is Diane? Come up here Diane. God love her.”

Diane Feinstein’s office responded that she is considering the request to crawl into a grave or coffin but refuses to retire and would serve the remainder of her term from the tomb.

 

[Sushirolls]

And Babylon Bee generates a skit on this topic...

 

[PsyDr]

A pharmacist says he has filled Alzheimer's prescriptions for members of Congress

"They’re making the highest laws of the land and they might not even remember what happened yesterday."

www.vox.com

 

[whopper]

Being non-political, IMHO anyone showing significant cognitive decline that is measurable shouldn't be in office. Doesn't matter their political party. Also the voters have should be told of the politician's health, that could affect the ability to do their jobs (prior stuff not important should be kept private), in a transparent manner.

What's recently gone on with Feinstein and McConnell shouldn't have been allowed to go on as far as it did. McConnell even now won't tell the public his health status other than he's allegedly "fine." Feinstein was showing mental decline problems for literally years with several first-hand witnesses saying even years ago she was having serious problems.

Adding to the problem are the current laws do not have fitness for duty requirements, other than ones that are not up to the current medical science, several cognitive disorders have gradual onset, and there is a fine line between what is medical information the public has a right to know vs the individual person's privacy.

 

[Merovinge]

Being non-political, IMHO anyone showing significant cognitive decline that is measurable shouldn't be in office. Doesn't matter their political party. Also the voters have should be told of the politician's health, that could affect the ability to do their jobs (prior stuff not important should be kept private), in a transparent manner.

What's recently gone on with Feinstein and McConnell shouldn't have been allowed to go on as far as it did. McConnell even now won't tell the public his health status other than he's allegedly "fine." Feinstein was showing mental decline problems for literally years with several first-hand witnesses saying even years ago she was having serious problems.

Adding to the problem are the current laws do not have fitness for duty requirements, other than ones that are not up to the current medical science, several cognitive disorders have gradual onset, and there is a fine line between what is medical information the public has a right to know vs the individual person's privacy.

There is a giant freaking line when it comes to someone serving at the highest level of public service. I think your right to privacy is nearly nil if you want to serve in congress when it comes to health information.

 

[whopper]

I remember when Bill Clinton ran for president he refused to release his medical records, and his then-opponent Bob Dole tried to use this against him but the public didn't seem to care. The economy was going well, and you had an elderly man pointing the finger over health against a younger man that showed tremendous charisma and apparent good physical health.

Only my speculation, but I suspect Bill Clinton didn't want his records release cause he had some type of venereal disease that was treated. (REMEMBER SPECULATION).

 

[mistafab]

There is a giant freaking line when it comes to someone serving at the highest level of public service. I think your right to privacy is nearly nil if you want to serve in congress when it comes to health information.

I think the issue is that if you enforce specific definitions, there would be incentive from political opponents to orchestrate (i.e. bribe) providers to bar them from office.

If they allow you to use your own physician, then you can seek a rubber stamper anyway. All this would amount to is an elaborate IQ test to circumvent the requirements.

Perhaps a universal age cutoff (i.e. 75) where the expected rate of cognitive impairment is fairly high could be fairly applied across the board for the greater good.

 

[Merovinge]

I think the issue is that if you enforce specific definitions, there would be incentive from political opponents to orchestrate (i.e. bribe) providers to bar them from office.

If they allow you to use your own physician, then you can seek a rubber stamper anyway. All this would amount to is an elaborate IQ test to circumvent the requirements.

Perhaps a universal age cutoff (i.e. 75) where the expected rate of cognitive impairment is fairly high could be fairly applied across the board for the greater good.

That's fair, I am not sure how it would be determined. Age cut off makes a lot of sense as a good starting point that is concrete and incorruptible.

 

[Sushirolls]

72yo or whatever the Required Mandatory Distribution age is for retirement accounts. Government says you are so old that you have to withdraw from your retirement account, than that should be the same age we say, get out of office.

Pair those 2 items together.

 

[whopper]

Age itself doesn't mean cognitive problems. Several people over have 65 have brilliant minds. Further the MOCA is too simplistic to be considered a good test for fitness of duty for office. It's designed to people including those of below average intelligence to catch a cognitive disorder that's far more extensive than a standard for trusting someone to have access to the nuclear arsenal. IMHO neuropsychological testing on the order of a TRAILS A&B, and other psychological testing should be once a year for anyone in Congress, the White House, and pretty much anyone in higher office.

 

[Stagg737]

I think the issue is that if you enforce specific definitions, there would be incentive from political opponents to orchestrate (i.e. bribe) providers to bar them from office.

If they allow you to use your own physician, then you can seek a rubber stamper anyway. All this would amount to is an elaborate IQ test to circumvent the requirements.

Perhaps a universal age cutoff (i.e. 75) where the expected rate of cognitive impairment is fairly high could be fairly applied across the board for the greater good.

But then you run into people screaming about ageism. I don't disagree with you, but considering the average age of congress as well as the largest voting contingency I'd say good luck with that.

There is a giant freaking line when it comes to someone serving at the highest level of public service. I think your right to privacy is nearly nil if you want to serve in congress when it comes to health information.

But does the public (or anyone) really care? Look at Fetterman. He had a stroke and refused to participate in debates because he couldn't coherently string a sentence together and not only did his party not feel the need to replace him, he won. Then he developed severe depression and went to Walter Reed's psych unit for 7 weeks for depression treatment (likely contributed to by being in a post-stroke state). And none of this was new, he was diagnosed with A fib in 2017 and has had episodes of syncope/near syncope between then and his stroke and never saw a doctor during that time. Not a commentary on his politics at all, but I was flabbergasted that he was actually elected with his medical history.

Our country seems to have no problems with incoherent people being elected and staying in high powered positions (in both parties) so long as they can show up, wave, and be generally literate with a teleprompter or some notes. I think it's partially because people have no idea what "cognitively impaired" actually means and partially because Americans today (in general) value someone who tells them what they want to hear far more than a competent leader.