Althouse: "You’re throwing me out! You’re sending me out to a doghouse! Why not put me in a manicomio?"

November 26, 2012

"You’re throwing me out! You’re sending me out to a doghouse! Why not put me in a manicomio?"

The "grannypod" (or MedCottage) — a $125,000 outbuilding, "essentially a portable hospital room."

(Manicomio means madhouse.)

47 comments:

rhhardin said...: Kliban suggested a home for unpleasant people.; 11/26/12, 7:55 AM
KCFleming said...: She won't be getting much health care with the upcoming Medicare cuts, so I suggest renting the granny pod, rather than buying.; 11/26/12, 8:09 AM
MadisonMan said...: Wouldn't you get more return on your investment if you remodeled your house to accommodate an elderly relative?; 11/26/12, 8:10 AM
Mian said...: Slippery slope to euthanasia. How European.; 11/26/12, 8:22 AM
Levi Starks said...: Dear Grandma,
Please don't die,
And please don't live with us either.
I mean what with all the other pets and stuff, we just don't have room for you in the "real" house.; 11/26/12, 8:31 AM
Eric the Fruit Bat said...: For Mischief Night, four guys should wait until Granny falls asleep. Then pick it up and put it back down facing the opposite direction.; 11/26/12, 8:36 AM
m stone said...: Our neighbors built one in the 1950s in NY for one of the elderly mothers. About the same size as the one in Fairfax. It was a novelty, but apparently served its purpose was everyone was happy. Foresight.; 11/26/12, 8:47 AM
m stone said...: MadMan: actually the separate unit promotes independence and, as anyone knows with a grandparent, that serves two purposes. Remodeling just doesn't cut it.; 11/26/12, 8:49 AM
Unknown said...: There really are not very many good answers to the problem of how to care for an elderly parent at home. I hope this will help people who need a solution. I don't think it's much different from a MIL room or guest house except it's tailored for medical care. It sure beats nursing home care, which is expensive and isolates the elderly from their family.
I suspect not very many people will be able to afford either one in the near future and granny will be in the kids old bedroom. Welcome to the good old days. Our parents did it and I guess we can too.; 11/26/12, 8:51 AM
Irene said...: This solution, like the live-at-home one, assumes that the elderly person has children or other relatives who will take the person into the house or onto the property.; 11/26/12, 8:55 AM
Wince said...: I couldn't find the creepiest of these ads, but you've probably seen them.

"A Place for Mom"; 11/26/12, 9:03 AM
Ann Althouse said...: "Slippery slope to euthanasia."

That's what's so scary about the special little box for one.; 11/26/12, 9:15 AM
Ann Althouse said...: "This solution, like the live-at-home one, assumes that the elderly person has children or other relatives who will take the person into the house or onto the property."

And that you have property that will accommodate a little house.

I'm thinking there's a whole insurance angle to this special "pod." Insurance pays for it, and when the life is over, the pod truck comes by to take it away and put it somewhere else.

Once the company is making the pods, there could be an idea like a trailer park of pods, with professional attendants.; 11/26/12, 9:18 AM
Ann Althouse said...: I also suspect this is an attempt to accommodate the health issues of the obese. Note the size of the bed (in the graphic) and the special hammock chair rigged to the ceiling for moving the person around.; 11/26/12, 9:20 AM
Ann Althouse said...: Note the double-wide door frame.; 11/26/12, 9:24 AM
Michelle Dulak Thomson said...: Ann,

And that you have property that will accommodate a little house.

There's that. It couldn't be done on this lot, for example; it's wooded and on a steep slope. If my parents ever needed to move in here, they would certainly have to be in the house proper, and it could be done; there's space enough. But if you have neither the lot nor the interior space, then what?; 11/26/12, 9:28 AM
Irene said...: "I'm thinking there's a whole insurance angle to this special 'pod.' Insurance pays for it, and when the life is over, the pod truck comes by to take it away and put it somewhere else."

I think that's exactly right. It's like what some assisted living/nursing homes do now. The resident must pay a fee (here in Madison, it can be as high as $350,000) to sign up for residency. That fee is separate from the monthly rent. When the resident moves out or dies, the family recovers 90% of the initial fee. It works like a life estate, except that the home keeps the interest it makes during the resident's life plus the 10% it keeps.; 11/26/12, 9:29 AM
Michelle Dulak Thomson said...: I wouldn't assume that the double-wide door frame is just because Grandma can't fit through anything narrower, you know. Emergency medical equipment can be pretty bulky.; 11/26/12, 9:31 AM
Robert Cook said...: "Wouldn't you get more return on your investment if you remodeled your house to accommodate an elderly relative?"

That's what my parents did, and it paid off in spades. After my grandmother--who had moved in with them, and for whom they added an attached room, (paid for by her) with its own private (handicapped-accessible) bathroom with shower, they used the large room as their new "family" room. When my father lost part of a foot and part of the other leg to diabetes, and he could not climb the stairs to the upstairs bedroom, he slept on a hospital bed in that room...and was able to bathe himself in the already equipped bathroom!

He later died, and my mother continues to use that room as her main room in the house, and it certainly added to the value of the house by far.; 11/26/12, 9:35 AM
Robert Cook said...: I should add, my mother and her mother never had a good relationship, and the four years my grandmother lived with my parents almost drove my mother mad. A separate little structure like this would not have solved that problem, but might have mitigated it a bit.; 11/26/12, 9:38 AM
KCFleming said...: "double-wide door frame "

Wheelchair, scooter.

Stretcher.; 11/26/12, 9:40 AM
edutcher said...: In the old days, a room was built onto the house.

Now, granddad doesn't even get that.; 11/26/12, 9:49 AM
Lem Vibe Bandit said...: "You’re throwing me out! You’re sending me out to a doghouse!

Its perfect for Chris Christie.; 11/26/12, 9:54 AM
Dust Bunny Queen said...: Wouldn't you get more return on your investment if you remodeled your house to accommodate an elderly relative?

Yes. That was also my first thought.

"Slippery slope to euthanasia."

Althouse said: That's what's so scary about the special little box for one.

Yes. Also my thoughts. Out of sight out of mind. Let's just put inconvenient Granny, weird ole Uncle Ed into a container in the back yard.; 11/26/12, 10:05 AM
KCFleming said...: Should make it out of a shipping container.; 11/26/12, 10:08 AM
Ignorance is Bliss said...: Ann Althouse said...

Note the double-wide door frame.

Lem said...

Its perfect for Chris Christie.; 11/26/12, 10:21 AM
Robert Cook said...: "Slippery slope to euthanasia."

This is a sure sign of stupid.; 11/26/12, 10:42 AM
Megaera said...: Anybody looked at the costs of a redo on a traditional bathroom/bedroom/kitchen to make them all handicap-accessible, with O2 hookups, fall-safe floors, light and airy PLEASANT surroundings, and then figured out how fast this can be done while doing it around the sick/elderly person plus the rest of the entire family? Look, there's no perfect solution, but this is nowhere near as strange or macabre as some of you want to make it. I do patient transfer, moving the sick from hospitals to nursing homes (and back) and to residences and I'm familiar (more than I care to be, frankly) with the shifts people are put to in order to care for a sick person at home. The cottages can be rented, they hook up to house sewer and power lines, the zoning is already taken care of, and the facilities inside are better quality than a lot of high-end rehab facilities run to. Every situation has its issues: park the patient in your dining room, well, fine, but what if the only bathroom is up a flight of stairs and she can't manage it? Any idea what one of those stair climber things costs? I know, and you don't want to. Believe me or not, these things are a lot better than an ACME-rental hospital bed in the rec-room. If you're talking about someone who needs daily nursing care, home help, that may even wind up cheaper in the long run than a nursing home -- it all just depends on the facts of the case. I'm just saying, it's easy to take cheap shots, but I'd rather be in a purpose-built room for sick care than struggling in some of the make-shifts I regularly have to deal with, and my patients are stuck in day in, day out.; 11/26/12, 10:55 AM
Megaera said...: This comment has been removed by the author.; 11/26/12, 11:01 AM
jungatheart said...: I don't think these people are getting enough credit for dealing lovingly with a difficult relative. She was apparently a heavy smoker and I would say that contributed to her already temperamental nature.; 11/26/12, 11:32 AM
Dust Bunny Queen said...: @ megaera

You have many valid points. I think the main issue that I have with this set up, besides the fact that very few people can afford to temporarily rent what amounts to another home in their back yard, is the potential lack of interaction with family and other people.

Yes....these folks seem to be paying attention to Grandma and I do know how hard it is to deal with ill and elderly with dementia. We are dealing with a good friend right now who has been moved from her beloved home [kicking and screaming the whole way] and is in a senior residence apartment complex where she is in contact with not only the caregivers but also other residents, and friends and family who routinely make the time to visit. Even so, family visits seem to be fewer and farther between. As time goes on and physical issues become more dire, she will be moved to another level of care.

Isolation is one of the worst things that can happen to anyone and especially the elderly. After a while, in a family setting that is not staffed by family who are also doctors, I can see the gradual isolation and neglect, that might not happen if the patient is in the actual home. Same issues I have with a family dog being chained up and mostly forgotten about in the back yard.

I just basically see this set up as something only the wealthy, yuppiefied types can do.; 11/26/12, 11:50 AM
Bill Harshaw said...: Affordability: as the article points out, $125K is about 3 years worth of long term assisted living. And presumably there's a pretty fair resale value to the used module.

To me there's tradeoffs on all solutions, but this seems to work for this family. For those who comment without having in-person experience with the problems of aged parents, and aging oneself: be cautious in your judgments.; 11/26/12, 12:25 PM
Peter said...: "I'm thinking there's a whole insurance angle to this special 'pod.' Insurance pays for it, and when the life is over, the pod truck comes by to take it away and put it somewhere else."

I can see a highly automated pod, one that detects when grandma didn't get out of bed, or fell and didn't get up, or just that the heating/cooling system has failed- and starts phoning from a list to get help.

Of course, it also contains medical telematics that call grandma to the console once or more daily where she takes her weight, blood pressure, perhaps inserts her glucose meter or other device. The data goes to a remote computer that algorithmically determines whether/when she needs medical care.

Unfortunately for grandma, the pod may not be her final residence as her capabilities may decline to the point where she needs a nursing home. The pod is definately something you'd rent, not buy.; 11/26/12, 12:32 PM
Unknown said...: If the Medcottage doesn't work out, there's always the Liverpool Path.; 11/26/12, 12:48 PM
kjbe said...: Obviously, there are no easy, one-size-fits-all answers to these situations.

Thanks, Magaera, for helping us see this from another perspective.; 11/26/12, 1:52 PM
Anonymous said...: A couple of weeks ago there was a discussion about nursing home placement for the elderly relative. I suggested home care was much preferable for the relative, I received a huge amount of push back because some felt it would be harmful to the nursing home industry.

If one is worried about a slippery slope to euthanasia, a nursing home would be a place in which your relative has one foot on a banana peel and one foot already in the grave. After working in nursing homes for many years I know this is true.

So if you want to enhance the last few years of your loved ones life, consider home care, even a trailer on the backyard is preferable to warehousing in nursing homes, even posh beautiful homes, which are still chronically understaffed, on purpose.; 11/26/12, 2:18 PM
Megaera said...: I'm honestly not shilling for the company -- I have no connection with it, but I've seen them and talked with renters. Peter, they are in fact set up so you can have remote monitoring of medical info (cardiac monitor, drug pump, vent, eg) reading out on a house computer screen, or video from the cottage to the house. The floors are flexible, to soften falls, and equipped with sensors that can detect them. All options that can be added or deleted, as desired. Entry is designed w/ wheelchairs & stretchers in mind, and so is access to the bed and bathroom facilities (both being major disasters in patient movement, especially bathrooms--I'll bet Shouting Thomas will back me up on that). Sure, it can be turned into a high-end holding cell, but so can the back bedroom or the dining room, and believe me, nursing homes are not full of happy people enjoying the recreational facilities. Park a family member or friend in one across town, and see how fast the visits tail off. Volunteers and staff at those places get very cynical very quickly.; 11/26/12, 2:45 PM
Anonymous said...: So right Megaera.; 11/26/12, 2:50 PM
Dust Bunny Queen said...: I must agree with Inga/Oop. It is preferable to be in your own home or in the home of a family member than to be treated by strangers in an institutional setting.

With some caveats.

A. ALL of the family members need to be willing to sacrifice much of their personal time and have a great deal of loving patience. Having taken care of my mother during an extended convalescence from a brain injury, where she was non ambulatory, incontinent and didn't know who we were, I can tell you it is incredibly hard, stressful and emotionally draining.

B. As long as the ability to provide the care is there. Sometimes the level of care is just beyond the financial means, physical means or ability of the family. Often the knowledge of when to step up to a level of medical care versus just routine maintenance is not available to even the most loving and well meaning people. Things can begin to slip and before you know it...an irreversible trend has happened.

There but for the Grace of God.; 11/26/12, 2:52 PM
Anonymous said...: DBQ, that's what visiting nurses are for.; 11/26/12, 2:55 PM
Dust Bunny Queen said...: DBQ, that's what visiting nurses are for.

Yes.

Assuming you have access to one or that there exists an agency that provides that service in your area. We have none in our area unless you are in a dire poverty stricken state. If you are working, middle class you are S.O.L.

Have insurance that will cover the costs. See linkOr can pay for it yourself.

Many people don't have the financial means or availiblity.; 11/26/12, 3:04 PM
Anonymous said...: Medicaid kicks in when the elderly relatives funds have been depleted. Same as in nursing homes, assisted livings.

As for access to visiting nurses in very remote areas, yes I can see that this might be an issue. I do know that I traveled up to 50 miles away for some cases I worked over the years.; 11/26/12, 3:16 PM
Megaera said...: DBQ -- I couldn't agree with you more. And sometimes the commitment to care can eat you alive. When I was a child, my grandmother (an iron woman in the Margaret Thatcher mould) was at one time caring for my dying grandfather in the front bedroom, my dying great-great aunt (Parkinsons)in the back bedroom, and my bedridden great grandmother in the front one, with the help of one live-in LPN. It about killed her, but when she finally had to put her mother in a nursing home the surrender to that necessity was what came closest to breaking her, because she'd given her word that she wouldn't do it. No easy answers.; 11/26/12, 3:17 PM
Anonymous said...: VNAA how is home care paid for?; 11/26/12, 3:19 PM
rcommal said...: Megaera: Second to all that you wrote. Seen a fair amount myself at first hand, for one reason and another. (Also had a grandma like yours, though she never had more than two at once.)

Caring for people who are elderly and/or sick can be hard as hell. No option is perfect. I'd be hard put to judge too easily or quickly. (Not saying most here are.) I wish good luck to anyone caring for someone requiring a lot of profound care. Surprisingly often, the support you'd think would be more r,easily available, isn't. And the painful truth is, those needing the care, even if not suffering from a dementia, sometimes do make the situation even harder, sometimes much harder, than it has to be. I say that with great compassion and empathy, but sadly, it's true.; 11/26/12, 3:57 PM
rcommal said...: Readily" not "r,easily"; 11/26/12, 3:58 PM
McTriumph said...: The Medcottage should be constructed of recycled cardboard there by saving trees. That would also lower the energy cost of cremation, rough calculations reveal a cardboard cottage providing adequate BTUs. It's a green win win.; 11/26/12, 4:55 PM