Finally…an update…gerontology continues.

Caption: I just got a drastic new haircut and I’m struggling with the swoopy bangs!

I’m sorry I haven’t updated much lately. I normally go overboard and post TOO much and now I’m going underboard. Which probably means I’m drowning. Hmm.

Anyway…here are a few tidbits of things I’ve learned or thought about lately.

When you see someone sign their name Bob Smith, OTR/L….the R is referring to the fact they are certified through the national body, NBCOT….while the L stands for your state licensure, which not all states require.

I was recently at a Mexican restaurant w/ a bunch of OT girls and when I went into the bathroom, I noticed it was not very ADA-complaint… somewhat unaccessible. The handicap sign was on a normal stall instead of the handicap stall, and the angles were so sharp that it would be very difficult to get in to the stalls. That’s the kind of thing I never would have thought about before OT school. It’s all about universal access!

This is our geriatric semester, so we’ve had several lectures pertaining to the topic. One of our lecturers explained that in old age, we continue to be who we always were, only more so…” I took that to mean our personality characteristics become a little more exaggerated. We also did a chart of stereotypes of older people, looking at both positive and negative stereotypes. Typically, OTs are going to see the elderly person at their worst, since it is usually at a time of crisis/stress. We need to remember that we are just seeing one side of their personality at that time! I’ve talked about this before, but it’s so important to do some decorating of an elderly patient’s hospital room. Flowers, cards, PICTURES – things that remind the staff this person is loved and a real person, regardless of how low level he/she currently is.

We also learned about the difference between dementia and delirium – to condense a lecture into a sentence, dementia is more chronic and delirium is more acute.

We learned that white males over the age of 65 are most likely to commit suicide after a loss, and it is usually via violent means. As OTs we have to be aware of this statistic and look for warning signs! This is kinda scary to me.

Finally, we learned a little bit about Medicare/Medicaid. Honestly, this is still very confusing to me!!!!!!!!!!!!!

Part A – Medicare covers 80% of approved charges
Part B – out patient services
Part C – private Advantage programs like fitness?
Part D – prescriptions

*Typical student disclaimer: This is all my own understanding and I could be totally wrong. Don’t trust me as a source!

UPDATE: My friend Suzanne sent me an e-mail with her more in-depth understanding of Medicare, which I am copy/pasting here.

Part A – This is the coverage for INPATIENT expenses only — it pays 100% of approved amounts after a deductible, and is good for the first 60 days of hospitalization that are NOT broken up by a period of 60 days out of the hospital. If the patient is re-admitted within 60 days of their last hospitalization, they don’t pay another deductible. However, if they then are hospitalized for days that add up to over 60 without a break ( i.e. days 61-90), the patient is in what’s called their “Co-pay” days. For each of these days, the patient is assessed a “co-pay”, I don’t know the amount any more, but I think it’s about 20-25% of the deductible. If the patient remains hospitalized beyond 90 days, they go into what are called “Lifetime Reserve” days, which are finite. If you use Lifetime Reserve days, you never get those back, and you are charged 1/2 of the inpatient deductible for every day in the hospital. You could use some of your Lifetime Reserve days, stay out of the hospital for more than 60 days, then your “normal” days would start again (deductible at the beginning of the stay, good for 60 days, etc.). I could be wrong about some of this
Part B – Out patient and PROFESSIONAL (doctors, etc.) services covered at 80% of approved amounts after the yearly deductible.
Part C – This used to be for children whose parent’s status qualified them for Medicare. For example, a retired person who has a retarded, dependent but adult child — the adult child would be the one who qualified for Medicare Part C, with the ID # being the parent’s SSN + the letter C after.
Part D – prescriptions

Medicare numbers with an A after have full inpatient and outpatient coverage; with a B means they ONLY have Part B (no hospitalization); C used to mean child, and is the equivalent of having full coverage; I’m not familiar with Part D now, though I do know that’s the prescription drug part of it.

NEW UPDATE: My friend wrote the following regarding the statistic above of men over age 65 being most likely to commit suicide.

I can’t speak for the Gen Y people – the ones your age and younger and how they will behave when they grow older, but I feel pretty comfortable talking for those who are now in their 30’s and older. Guys are “doers” and when they can’t “do” anymore then life loses the majority of its meaning. Doing can mean anything too. It is something special and unique to that person. It could be carpentry or driving or even something really esoteric like being able to multiply three numbers by three numbers in your head. Life without meaning is not life.

It does not mean much to us just to hang around and watch the grandchildren and great grandchildren if we can’t “do” something with them. Part of it is culture and upbringing and part of it, I swear, is genetic.

Also a “loss” usually means someone has to take care of the individual. Unless the individual is wealthy, that usually means the spouse. No male at 180 pounds wants to inflict looking after them over the long term on their 120 pound spouse. The nuclear family and/or extended family is no longer there. They are spread to the winds, so only rarely are you going to see brothers, sons and nephews participating. No loving husband wants to inflict this on his spouse. Also, suicide is not the “sin” it used to be. You don’t go straight to the really warm place anymore.

As to why it is predominately true for whites, I can only speculate. In the Asian culture, the male is still so predominant that it may not occur to them that the caregiving is such a sacrifice to the spouse. Also families are still more close than in the non-Asian cultures.

In African culture, I believe there is still a greater religious and cultural intolerance to suicide, at least in African Christian culture. Past that I do not know.

As to the violent means, that’s because we know what works. It may be messy but you can control where the mess is, i.e. the backyard or an interstate bridge abutment. You control the where and the when. Pills and alcohol or sticking the head in the gas oven is too easy to screw up where you either fail or screw yourself up worse to where you are still alive but now are totally incapacitated. A round through the back of the throat or aiming the pickup at a bridge abutment and going to warp works every time.

You need to read “Born Fighting – The Scots-Irish in America”; it will give you some good cultural insights.

These are just my thoughts with no scientific basis to back it up. A lot of the conclusions come from the suicide a long time ago of a great-uncle who was a M.D.

Jan 21, 2008 | Category: Occupational Therapy | Comments: none

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