Alzheimer's:She Never Said Goodbye (cont.)
Moderator: It is said that Alzheimer's can be fatal. How does it actually kill people?
Ellison: A hundred thousand people die a year from Alzheimer's. I take exception with that figure. A hundred thousand is not close to the number of people that die. The Alzheimer's people say we have four million, or over four million victims right now. They say the average life span from diagnosis to death is eight years. If you divide eight years by four million people, every year 500,000 people would die. I went to a seminar one time and I asked a neurologist that mathematical question and he said it depends on what the coroner puts on the death certificate. Many times they die of heart disease, strokes, et cetera. One of the problems with Alzheimer's that can hasten their death is they have no ability to care for themselves, or inform someone that they have a problem. They don't have that communication capability for the most part and thus medical problems may go unidentified for a length of time. Alzheimer's can hasten the death of somebody due to fact that they are incapable of conversation and self-help. It takes caregivers and doctors to observe the signs and symptoms that might lead to diagnosis of a medical problem other than Alzheimer's.
Moderator: So Alzheimer's as an actual cause of death is almost as a result of it inhibiting access to care, in a sense?
Ellison: Right. That's correct.
Moderator: Why did you place your wife in a nursing home?
Ellison: For her safety. My wife was a very active athletic woman right up to where she became ill. She used to play tennis every day. She was in great physical condition. She maintained her weight at 110 pounds. She was in excellent physical condition. She was to the point where she could outrun me. Her tendency to wander got to a point where I could no longer guarantee her safety at home. I couldn't risk losing her by having her getting away and wandering. Here in San Diego County, I've read of three cases where people wandered off, later to be found dead. I just did not want that happening to my wife. When I put her in a nursing home, I put her in a locked facility so she could not escape. That's about the only way I could see to handle the situation. Alzheimer's victims, for the most part, are taken care of at home. About 70% to 75% of Alzheimer's victims are taken care of at home. My wife was young. Had my wife been older, that may have been different. When you're young and mobile, I looked at it as a dangerous situation where she could wander off and I'd lose her.
Moderator: What is your opinion on the availability of care for Alzheimer's patients?
Ellison: In nursing homes, most of them do not take Alzheimer's victims. That's a specialized area. You can't go into any nursing home and expect to them to take care of a loved one with Alzheimer's. Right now, here in California, this past November, the California Healthcare Facilities Association, they were on the radio announcing the fact that California was facing a nursing home crisis from the standpoint of caregivers. They predicted that this year, they are going to be 30,000 people short in this industry. The nursing home industry is kind of in a crisis situation from a standpoint of qualified caregivers. In the nursing home where my wife is, the turnover in the last five years has been phenomenal. Out of 100 and some employees that were there, there is only one left. It's a very challenging profession. It's a very hard job. I certainly appreciate the care my wife has received from most people. Many of them are very dedicated people. The crisis seems to be appearing. There seems to be a coming crisis in caregiver availability. Caregivers are family for the most part. Families aren't like they used to be. My father was in a family of 12 children, mother was in family of six children. In my family, we had four children and a fifth child died. My wife and I had three. My brother had three. My sister had four. The baby boomers average just a little under two children. The number of children left behind to maybe be future caregivers has diminished over the decades so that the availability of caregivers in the future is going to be a crisis situation.
Moderator: Are the nursing home workers and care givers subject to any regulation or licensing at all?
Ellison: They have to go through training. They have to pass background checks. They can't have any prior drug involvement, any felonies, or anything like that. They have to meet certain criteria with the nursing home. I know just not anybody can be hired.
Moderator: How much does MediCal (Medicaid) pay for your wife's care?
Ellison: My wife is on MediCal and MediCal pays -- right now it pays $96.60 a day for each MediCal person. Each patient is paid differently. My wife is now at age 62. She qualified on social security based on my earnings, which only amounts to about $300 a month. All but $35 of that goes to her care. We pay about $10 a day to the nursing home, and the nursing home takes that and reduces the MediCal payment about $86.00 a day. Any money she gets from any source goes to offset her care costs in the nursing home.
Moderator: Is it true that MediCal will seek reimbursement from your estate to offset the cost of your wife's care? How does that happen, and how do you feel about it?
Ellison: Every February I get a letter from the state reminding me that if I die before my wife, then the state will come back against our estate for her care. They'll come back and take it out of our estate if there is anything there to take out. Let's say I had an estate worth $500,000 and when she died her care would cost $250,000. They would take out $250,000 and leave the other to me. If she dies before I die, then the state will allow me to stay in my home. When I die they come back against my estate for her care. If there was anything left over after that, that would go to my children.
Moderator: So under that system that state will take the balance of your estate?