Elder Care Doesn't Have to Resemble Prison

Regulations, fear of lawsuits prevent nursing homes from allowing patients basic autonomy


You wake up in an institution and are ordered out of bed. Though you would much rather sleep in for a bit, you have no right to dictate your own schedule. You are marched to a sterile, cold room where you will be served food you don't want to eat, seated at a communal table with people who don't want to be there any more than you do. Nearly all the activities that will make up the rest of your day will proceed in similar fashion, until "lights out" is called and you are commanded to a lonely slumber. With each passing day you are plagued by loneliness, helplessness, and boredom. This is all done in the name of your safety and security, not as punishment. You are not a prisoner; you are a "resident" of a nursing home.

As the boomer generation approaches its autumn years, the issue of elder care reform has grown in prominence. Over 1.3 million Americans live in nursing homes, but thanks to byzantine regulations designed to mitigate any risk to the physical health of residents (which take little consideration of the mental health of those same residents), many nursing homes can resemble minimum security prisons.

In response, The Eden Alternative, a Rochester, New York-based non-profit, has for two decades sought to de-emphasize "top-down, bureaucratic authority, seeking instead to place the maximum possible decision-making authority into the hands of the Elders or into the hands of those closest to them."

The Eden Alternative's CEO, Christopher Perna, told me in a phone interview, "It's almost militaristic, the way many nursing homes are run, where the administration is the top dog. They make all the decisions and the staff basically do as they're told." He adds, "it's very easy to settle into a series of institutional practices that keep you within boundaries that are defined by the government. It can lead to a very sterile, very lifeless environment."

This hierarchal approach to elder care developed out of nursing home operators' fears that their businesses could be vulnerable to government sanctions for failing to comply with broadly written regulations. Everything from requirements to confine certain residents to wheelchairs in order to mitigate the risk of a fall, to strict rules on food content and preparation are covered in the Medicare and Medicaid Program Conditions of Participation, which run almost a thousand pages. But as Marshall Kapp noted in a 2012 article in The Atlantic, "sometimes…the biggest barrier to culture change in nursing homes is not the actual wording of the regulations but rather the often inconsistent, incoherent, and uninformed way that the regulations are interpreted and enforced by government employees who regularly survey facilities and cite them for perceived noncompliance."

Kapp adds, "requirements that beds must be placed only within certain spaces in a resident's room make it impossible for residents to rearrange their furniture as they wish. Regulatory prohibitions on open kitchens prevent residents from fixing snacks whenever they wish. If we are serious about making nursing homes more comfortable and homelike, a review of existing regulations and amendment or removal of those regulations that impede culture change must be put into place."

robinsan / Foter

For his part, Perna says that for the past 20 years, he has worked with nursing homes to venture as far they can into the "grey areas" of regulations. His goal is to help "reinstitute a degree of autonomy" for both their seniors and their caretakers, which he says "is just a crucial factor for quality of life." Perna adds, "if residents want to sleep in in the morning, let them sleep in. If they want to be an early riser, let them wake up early. If they go to bed early, let them go to bed early. If they like to be a night owl, let them be a night owl. And adapt the organization and staffing approaches to the needs of the elders."

How has this approach worked? According to Modern Healthcare:

Data collected in 2011 from nursing-home providers using the Eden Alternative model showed the average occupancy rate of Eden-trained nursing homes was 93%, compared with the national average of 86%. The average annual turnover rate of licensed practical nurses at Eden-model facilities was 16%, compared with the national average of 39%. Average annual turnover of nursing assistants was 26%, almost half the national average of 42%…

A 2013 study published in the journal Clinical Interventions in Aging found the Eden Alternative model was associated with "significant improvements in residents' levels of boredom and helplessness." 

Another study published in 2007 in the peer-reviewed journal Federal Practitioner found that accidental falls and assaults by patients residing in the dementia unit at the VA Pittsburgh Healthcare System fell significantly following adoption of the Eden approach.

Eden Alternative patients are safer and healthier in mind, body and spirit. They are cared for by employees less likely to leave their jobs than in conventional nursing homes. The company provides advisory services to homes all over the U.S., as well as in South Africa, Australia, New Zealand, the United Kingdom, and Canada. They expect to generate $1.5 million in revenue this year from service fees and competitive grants, and take no funding from any government source.

Perna proudly describes his organization as a group of "social entrepreneurs," but expressed disappointment that they have thus far failed to gain a foothold in a somewhat surprising place: Florida. According to Perna, "back in the 1990s you could hardly pick up the newspaper without reading about a new lawsuit being brought against a nursing home by a trial lawyer." Consequently, many nursing home providers are "shell-shocked." While "regulators would get involved," it was really trial lawyers "using regulations as a hammer" which have prevented reform in a state known for its always robust retirement-aged population.

Only true regulatory reform, with policies that allow for residents and care providers to assume a reasonable amount of risk, will prevent predatory lawsuits from holding nursing homes hostage, and facilitate a widespread cultural shift in elder care. 

You've lived a long life, you've paid your taxes. The least you deserve is the right to arrange your room the way you like it, and occasionally make a snack without official permission from an officious authority figure.

NEXT: The New Old Age: Reason's Special Issue on Aging, Pensions, and Immortality

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  1. There’s starting to be some good publication on elder care research. I recommend reading up on it.

  2. OT: CNN is on the tv with no sound. Chyron has ‘federal government warns about extremists’ & ‘300,000 civilian extremists’. Clip footage is all heavily armed police, many in paramilitary outfits and gear. Inadvertently completely matches up.

    1. Every time I have the misfortune of hearing the major networks talk about terrorism I get the feeling that they are desperate to find an American non Muslim terrorist. They so want to be able to claim Americans are the real problem and the real danger.

      1. They don’t want to be Islamophobic. Hence the discussion of the Crusades, “right-wing hate groups,” etc.

        You would think, though, that the animal-rights and environmental terrorists would get some attention from the “look at the non-Muslim terrorists” perspective. But no, it’s all neo-nazis and shit.

      2. You are correct John. What you are seeing is not only a desire to say it and an attempt to distract from the Islamic problem, but a strong desire to bring the boot down on Americans.

        Given half a chance the statists would throw away the mask and go full fascist.

      3. Every time I have the misfortune of hearing the major networks talk about terrorism I get the feeling that they are desperate to find an American non Muslim terrorist.

        One thing they do is claim a bunch of different and unrelated things are terrorism so that they can say ‘see, Islamic terrorism only accounts for a small percentage of terrorism in the West!’

        Of course, Basque seperatists blowing up a few mailboxes gets counted as five distinct terrorist attacks while the Charlie Hebdo shooting gets counted as one. That kind of skews the severity of the threats, don’t you think?

    2. 300,000? How do they define extremism?


        And it turns out the highly credible source is SPLC.

        1. Thats what I thought. Complete bullshit.

  3. Is Reason pivoting from the Millennials to the Centenarians?

    1. Libertarian shock troops!

      Oh, wait….

  4. Charter nursing homes might improve conditions, but we shouldn’t ignore the seven ton Tyrannosaurus in the middle of the room either.

    I lived in Central America for a while, and one of the questions the locals would often ask is whether it’s true that Americans send their elderly grandparents away to live with strangers.

    In the developing world, sending your elderly parents off to live with strangers is morally equivalent to abandoning your children. In fact, your obligations to your parents are probably greater–since you owe them for taking care of you as a child.

    This is the way it used to be in the U.S., as well.

    People in Central America aren’t taking care of their elderly at home because they’re wealthier than we are; rather, I think a lot of us are sending our elderly parents to live with strangers shirking our responsibilities to our elderly parents because we have Social Security and Medicare.

    Once Social Security and Medicare became available, somehow, taking care of our own elderly parents became the government’s responsibility.

    It’s called moral hazard, and Medicare and Social Security cause it.

    No really.

    And if we got rid of them both, millions of elderly Americans would have a much higher quality of life today.

    And yet it’s the people who want to scrap those programs that are being heartless!

    Live long enough, and many of us may find ourselves wishing we’d been born poor and Mayan or at least somewhere without Medicare and Social Security.

    1. Sadly though, I believe many children would abandon their parents. Can you imagine Tony inviting his elderly parents to live with him? No fucking way he’d do that unless the government ordered it. Remember that according to him, the only reason parents take care of their kids is because it’s the law.

      1. That is true. People do horrible things sometimes.

      2. Can you imagine Tony inviting his elderly parents to live with him?

        Well, I’m guessing they’d probably be more receptive to that “emotionally honest conversation” about end of life care that David Golhill was talking about.

        1. Are you kidding? They’d take matters into their own hands with a .45.

          Interpret that however you want.

      3. Also, if I may crib a line from IASIP, a lot of the time people abandon their parents or grandparents because their parents or grandparents are assholes.

        1. True, but perhaps the parents might not act like such assholes to their children if they knew they had to depend upon them later in life.

          1. I remember at one family gathering my mother was being rude to her mom, and I teasingly reminded her that she was setting an example as to how I should treat her when she’s old and suffering from dementia. Know what she did? She quit being a jerk to her mom.

            1. Personally, there’s nothing I wouldn’t do for my parents, but I perfectly understand people who wouldn’t because their parents are assholes. My maternal grandmother, for example. She’s something like 82 now. None of her kids has spoken to her for years, because she spent the last 55+ years being a miserable, caustic, emotionally abusive, lying cunt to all of them. I’m surprised nobody has killed her, let alone taking care of her in old age.

              1. If I didn’t call my father on the phone once in a while, I don’t think we’d ever speak again. I can’t remember the last time he called me. Well, yeah, actually. I can. He called me on my birthday like five years ago. I was stunned.

      4. “Sadly though, I believe many children would abandon their parents.”

        Just so you know, I’m not being Ken the Ass, here–I know this is both a funny ’cause it’s true and true even though it’s sad kind of thing.

        But since you brought it up, I think it’s also true that people would raise their children differently if they knew their future standard of living might depend on their children having a sense of responsibility.

        If Tony’s parents’ knew their standard of living when they were elderly depended on a) how well they saved for themselves, and on b) how responsible a person Tony grew up to be?

        They’d have made sure to raise him to be the kind of person that takes responsibility for himself–instead of blaming everything that happens on selfish taxpayers and government inaction.

        The moral hazard, here, works in lots of different ways.

        1. I agree.

        2. See my 1:03 comment above.

      5. There are lots of “unintended” consequences to these social programs.

        There used to be a much bigger incentive to raise your kids to be productive members of society. Now, you can raise fuck ups, hipsters, occupy wall street types, and puppeteers, and other people’s tax dollars will take care of you when you get old.

      6. Sadly though, I believe many children would abandon their parents.

        I can assure you, many people do abandon their parents.

    2. There are other factors than just shirking Ken. Smaller family size=less children to shoulder the burden, children move away and parents don’t want to move closer (and lose their friends and comfort zone), smaller homes or homes not really set up for immobile parents. Nursing home implies a required level of care beyond just assisted living.

      It’s also happening in some developing countries. China is experiencing a huge demand in elder care right now.

    3. “In the developing world, sending your elderly parents off to live with strangers is morally equivalent to abandoning your children.”

      Because it is.

        1. Really? This is abandoning your parents?


          I look forward to being so abandoned.

          1. My mother lives in one of those places. My mother-in-law lived in one of those places for about 3 years, until she died.

            Both of them were unhappy that they were not living in their own homes, or with their oldest daughter (my sister and my wife, respectively). But they could not live alone in their houses, because of (1) physical problems and (2) dementia.

            Neither of them was capable of living with their oldest daughters, and doing so would have just generated enormous amounts of hatred and discontent and fights and family discord. My mother-in-law actually wanted my wife to move in with her, while my wife was holding down a managerial job. And my sister tried it for 3 months, before I had to step in and do a “rescue”, to take her away.

            So, should I, the eldest child, take my mother into my house? She would require 24/7 supervision, because her dementia might cause her to leave a stove on, or doors open, or some other physical catastrophe in the house. She might also fall, and without someone around 24/7, she doesn’t know how to push the button to summon help.

            My mother actually says, out loud, that she does not want to burden her children with her care, even though it is clear from her face and body language that she would really love to move in with one of us. She is terribly conflicted. She wants to be taken care of, but she does not want to be a burden. How to resolve that conflict?

            1. (continued from above)
              She has enough money from the sale of her house to pay for assisted living. I could have her come live with me, and hire a caretaker. That would cause all sorts of problems with my wife.

              I think that people who talk about this “problem” have never been thru it, and think that a bit of family communitarianism would just do the trick. Unless you have actually been in this situation you have no idea of the range of conflicting human emotions that swirl around and make any decision very difficult for the various participants to accept.

              We are lucky to live in a society that is rich enough to be able to afford to take care of elders like this. I think that in the old days, the family would take care of the elders as long as they did not become too divisive or difficult to care for, and then, one night, an accident would happen, and the problem would be solved. We should be happy that we don’t live that way any more.

    4. There are a LOT of differences though with elder care now and what it was 100 years ago. The expense of longer lifespans has dramatically increased, and as people live longer, they have more years of needing more immediately available care.

      Also, I never bought the whole, “they took care of you” argument. I didn’t ask them to. They did it of their own free will, and I feel absolutely no obligation to them whatsoever about it. Hell, I wasn’t even planned; it was a byproduct of their engaging in an entirely self-pleasuring act. So no, I don’t think I “owe” them anything.

      It’s like this: if you were thinking about painting your house, and then some guy came and painted it in the middle of the night without your asking him to, would you then gladly agree that you owe that person a full salary for doing the job? How can one be obligated for something one never consciously agreed to?

      1. I think there is a difference between a legal and a moral obligation.

        If a woman’s birth control fails completely by accident, I don’t know that there is a legal obligation from a strict libertarian POV absent some sort of signed legal document, but I do think there is a moral obligation to some degree.

        1. I see your point. I suppose since I never really got on with my parents, but they didn’t treat me as badly as sarcasmic’s father seems to have, I’m sort of in the middle. I wouldn’t let them starve on the street or anything, but I’m not going to break myself to accommodate their every wish in old age, either.

          I suppose to me, taking care of parents in old age means the only experience I ever had with that (great grandmother, that my grandmother took care of): being a virtual slave to someone whose care consumes endless amounts of money and time, and you are allowed to have no life of your own, ever, for a decade until that person passes away.

          1. That’s a bit extreme. Shelter, food, and rides to the doctor. That’s where I would draw the line.

            There’s no reason to put your life on hold because somebody can’t find their favorite oatmeal spoon.

            1. Yeah and I realize it’s extreme – it’s just the only direct experience I’ve had, so I struggle to separate it from what I know the “norm” to logically be. Great-Grandma Harner was in terrible health, requiring constant attendance, for a very long time, and basically my grandmother couldn’t leave the house for more than a few hours at a stretch for an entire decade. And my grandmother went bankrupt from it. So I have a jaded view.

              1. Yeah my grandparents are well set up, living in an old folks community. They’re both in good health, although getting frailer. They have a little bungalow, and they’ll move up to the hospital at some point for assisted living. They’ve got stuff in writing and have talked to family about where the line is though. If they can have adjoining hospital beds and read and bicker with each other, I think they’d be ok with it. But I don’t think either would like to go on for long without the other.

  5. It is funny as hell watching the liberals have a meltdown over Giuliani wonder if Obama even likes America. They are living up to the maxim of “you doth protest too much”. The question they all should have to answer is if you like America so much, why are you forever apologizing for its past and trying to transform it into something else?…..nce-youth/

    1. My favorite part is that they engage in these disgusting, Kafkaesque tactics. Nothing Giuliani initially said could be construed as racist. Clearly he was talking about Obama’s upbringing, not his race.

      So what the left did is they declared Giuliani to be a racist, thus forcing him to defend himself. Giuliani then defended himself by rightfully pointing out that Obama was actually raised by white people therefore criticizing his upbringing could not be racist since you were criticizing things that he was taught by a white family.

      The left then purposefully misconstrued this comment, said that Giuliani said ‘mocking Obama can’t be racist since he was raised by a white grandmother,’ which Rudy obviously didn’t say, and then declared victory by asserting that this was proof Rudy is a racist.

      1. And of course the Left proudly hated George Bush and openly questioned his patriotism. Yet, doing that with Obama is just racist or something.

        1. Even more, candidate Obama himself said Bush was unpatriotic. Ed Henry brought this up with Josh Earnest, who didn’t exactly live up to his name.


        2. Which Bush? The one the Left incessantly called a “monkey”?

      2. I refuse to listen to anyone playing the race card anymore. It’s 98.69% smear tactics to avoid addressing the real issue.

        Fuck them all.

        1. Racist.

        2. So you don’t pay attention to Reason’s immigration coverage?

    2. I was thinking about something you wrote earlier this week about how they always refer to Martin Luther King as “Dr.” rather than “Rev.”.

      Have you noticed that they always refer to Jeremiah Wright as “Rev.” despite Jeremiah Wright holding a doctorate.

      I guess if they’re proud of you, they call you “Dr.”, and if they’re ashamed of you, they call you “Rev.”?

      1. That is a good point. I had never thought about it until I watched that film. Then I realized that growing up he was always Reverend Martin Luther King. Then at some point in the late 80s or 90s he became Dr.

        1. Maybe it’s because I’m a moron, but I figured the difference was to differentiate MLK from the Martin Luther.

      2. In all fairness, we kind of have a policy that way too. When was the last time anybody referred to Dr. Nick Gillespie?

        1. Well, I don’t call Nick ‘reverend’ either.

          1. Some would replace the “ve” with “a”. Just kidding.

        2. Dr is nearly always reserved for MDs. Other than MLK, I can’t think of a single well known PHD who is referred to in the media as “DR”.

            1. That is one. Of course she refers to herself as that. MLK didn’t call himself Doctor. He called himself Reverend.

              1. Oh, John, have you forgotten DR Jill Biden?!?!?

                1. Fucking Refresh. How does that work?!?!

                  And fuck your fast fingers, Irish!!!

            2. I thought this was about people who were both Reverends and PhDs?

              The left wants to call you “Dr.”, if they like you, as in Dr. Martin Luther King, and they want to call you “Rev.” if they’re ashamed of you.

              If Jerry Falwell had called himself “Dr.” exclusively, he’d be lucky if anyone in the media called him anything but “Baptist preacher”.

              1. Principals, not principles.

          1. I had a boss who was a psychology PhD and insisted on being called Dr. It’s a mark of insecurity, nothing more.

            1. Call me “Maestro”.

              1. Or Ishmael.

          2. Dr. Ruth (Ed D)
            Dr. Phil (PhD)
            Dr. Joyce Brothers (PhD)

            Non-medical doctorate holders are not commonly found in media.

            1. Dr. J

              Dr. Dre

              The other Dr. Dre (the fat dude that used to be with Ed Lover)

        3. When was the last time anybody referred to Dr. Nick Gillespie?

          Jerry Doyle ALWAYS introduces him that way.

          1. He has a PhD?

            Or is it his jacket which earned the PhD?

            1. Yes to both.

              Nick has the PhD, the jacket earned it.

        4. The Jacket

      3. I think part of it may be the trend of naming various public edifices after him. Rev is a religious title while Dr isn’t (other than some tv preachers who use their doctor of divinity title).

        Imagine the outrage if something was called just King [street|building|park|whatnot]? Or worse, Marty King [whatever]

      4. I’d prefer Rev., since the Rev. King *earned* that title.

        He didn’t earn his doctorate.…..-king.html

        1. “earned it”

          Was Jesus there handing out sheepskins?

          1. Rev. King was as much entitled to the title “Rev.” as any Protestant minister.

            1. So, no.

          2. No, Playa.

            It was the Pope.


  6. They took care of me for the first 18 years of my life. It’s the least I could do to take care of them for the last years of their lives.

    1. My dad kicked me out when I was 17, while later my mother let me live with her for a year while I started college. Guess which one I’d consider taking care of? Yep. It ain’t the old man.

      1. And when I say kicked me out, I mean kicked me out. He let me come over for Christmas dinner one time when I was homeless, and then dropped me off at the shelter when it was done. Asshole.

        1. And when I say kicked me out, I mean kicked me out. He let me come over for Christmas dinner one time when I was homeless, and then dropped me off at the shelter when it was done. Asshole.

          Only people who have lived in wealth and privilege their entire lives would ever dream of being libertarian.

          1. It was that stretch of homelessness that really solidified my libertarianism. That government that I had been raised all my life to believe was there to take care of me wouldn’t do shit except send out the cops to give me a hard time. And that pesky minimum wage put me in a place where I couldn’t get a job without experience and couldn’t get experience without a job. Then all the taxes that were taken out when I did get a job. For what exactly? Certainly not to help someone like me.

            1. So your dad did you a favor?
              I suppose you didn’t have anything to do with you getting kicked out? I was kicked out also. Fortunately my parents taught me unconditional love by not enabling me. I miss them both dearly.

              1. You presume much.

              2. “So your dad did you a favor?”
                I think there are ways of encouraging independence without making your kid stay at a homeless shelter. I stayed with my parents a few times off and on in my late teens, early 20s and my dad had a variety of ways to make sure I never got complacent…not letting me sleep in, keeping me accountable on job hunts, giving me lots of chores, etc.

            2. It’s amazing really, it’s almost as if welfare programs were intentionally designed to foster poverty by increasing dependency and disrupting family strictures and not as a hand up to those who have genuinely fallen on bad luck?

              Safety net my @$$

              1. It’s amazing really, it’s almost as if welfare programs were intentionally designed to foster poverty by increasing dependency and disrupting family strictures and not as a hand up to those who have genuinely fallen on bad luck?

                Before we met, my wife was having hard times and went to the welfare office to see if they could get her into affordable housing or something. Well, they told her that she made a thousand dollars a year too much, so she’d have to quit one of her jobs to be put on the waiting list. Oh, and she’d have to sell her car too. She told them to fuck off and got herself a third job.

        2. Guy sounds like he genuinely didn’t like you. My Dad doesn’t like me but at least he isn’t that big an asshole…

          1. He doesn’t like anyone. That’s why he lives way up in the Rockies off a dirt road with no neighbors. Or friends.

    2. My kids take care of me? Ha.


    British Prostitutes helping the disabled have sex. We all joke about hookers but they do serve a purpose. What if you are disabled and never married? Or if you are a widower who is too old to meet someone new? Or someone who is just too socially awkward to ever get anywhere with women? I guess those people are supposed to live without sex or risk being called predators and human traffickers for trying to have it.

    1. I NEVER joke about hookers.

      1. You are a good man.

      2. Q) What did the leper say to the prostitute?

        A) Keep the tip.

    2. Humanitarian hookers. That would be a good band name.

    3. A hooker with a heart of gold?

      I thought that was just a dream.

    4. Yeah but can they get The National Health Service to pay for it?

    5. Or someone who is just too socially awkward to ever get anywhere with women?

      EUREKA! THAT’S IT!!!!

      We all chip in and buy Bo a prostitute.

      1. We all chip in and buy Bo a prostitute.

        Why would you subject the poor girl to that?

      2. I’d chip in to buy him a revolver with one bullet in it, but that’s about it.

      3. What happens when he tries to debate her, ends up calling her a Socon, and then she walks out before the deed is done? That’ll just make the problem worse. It’s a vicious cycle.

        1. “Look Missy, I’d gladly have sex with you if you’d just assure me of your adherence to the dictates of Rothbardian non-interventionism.”

        2. I didn’t say it would be cheap.

          1. You’ll bankrupt us all. I say Reason should pay for it.

            1. There ought to be some extra cash lying around with 24/7 gone.

    6. In socialist utopia, it’s also covered but just not by choice. From each according to ability, to each according to need and all.

      …if they make it through the glorious transformation of paradise on earth.

    7. “”Sex is as essential as eating, but people look at it as a luxury for disabled people rather than a right. We pretend they don’t need sex just as much as we do. I think I thought like that myself at one point too,” says Pru, a sex worker who has specialised in working with disabled people for a number of years.”

      Well, I suppose the pre-hooker Pru has a point. Maybe sex *isn’t* like food.

      I mean, without food, you tend to die.

      But the Pope and the Dalai Lama, haven’t died. And while both Joan of Arc and Mother Teresa died, it was from incineration and old age respectively, not lack of sex.

      Even atheists can experience the joys of non-sex:…..=4&t=10993

      1. Everyone knows the Pope is fucking little altar boys in the ass.

        1. Well, *you* have a nice day, too!

        2. I had to laugh. Dalai Lama too probably.

          I read there were lots of rumors of Ghandi being gay. Apparently he had a boyfriend. I have no idea if that is true or not, but what I do know is that people who seek chastity rarely find it. Plus, they are usually weird in some fucked up kinda way.

        3. Uh, I got banned for less than that. FYI.

    8. Jim Jefferies takes his friend with muscular dystrophy to whore houses. In real life, his stand-up act, and in his TV show.

      1. How old is his friend? Because MD kills you pretty early. I had a friend with it and he didn’t make it past 26. He had his vertebrae fused back when we were 13 so he wouldn’t keel over in his wheelchair. It’s a really shitty disease; I can still remember when he was actually able to walk. That didn’t last long.

        1. I had a friend in college who had MD and he lived in the next room over for a few years. I don’t know how he’s doing now, but he was in bad shape the last time I saw him.

          One time he fell over in his chair and didn’t have the strength to push himself back up so we had to get the landlord to open the door so we could help him.

          That really is a terrible disease. Of all the things I wouldn’t want to have, any sort of muscular disorder has to be near the top.

        2. We had a family in town. The oldest son wasn’t diagnosed until they had already had 2 more boys. All 3 of them had it. All dead now, and it was awful. The McCoy brothers.

          I remember the dad saying that he wished he’d never met his wife.

        3. I’m not too sure, but I think his friend was early 20’s. And I’m pretty sure his friend died. In his TV show Legit, the MD guy was the little brother of his close friend. I think the show is a pretty honest portrayal of his actual experience. If you haven’t seen the show, it’s on Netflix and it’s fucking hilarious.

    9. Or someone who is just too socially awkward to ever get anywhere with women?

      There’s always law school and trolling message boards, John.

    10. I don’t joke about prostitutes. It’s just a job like any other job, as far as I’m concerned.

      1. Eh, I don’t think it’s immoral, but it isn’t something I’d want my daughter doing.

    11. From the article:

      And now it’s easier for people like Johhny to find these kind of services. Tuppy Owens is a campaigner for disabled people’s sexual and relationship rights, and is the driving force behind the TLC Trust, an online network that connects disabled people with appropriate sexual services.

      ‘sexual and ralationship rights’? Ugh…

    12. Parts of the U.S. suggest that consent forms be signed prior to having sex.

  8. OT: ISIS ‘special forces’ video reveals ludicrous training…..ining.html

    Seriously, how can large populations of adult men in the Middle East be LOSING to THIS?

    1. But Arabs are fucking incompetents. I hate to say it but they are. If they were not willing to blow themselves up to get at us, they would be no threat to anyone but themselves. There has not been a credible Muslim military force in nearly 500 years. You have to go back to the Ottomans and even they started losing every fight from about 1700 on.

      1. Saw something in the Daily Mail about India building a navy, and of course it had lots of pictures. Talk about some un-intimidating soldiers. A good gust of wind would blow them away.

      2. “they started losing every fight from about 1700 on”

        Unless you count Gallipoli and Ataturk’s wars vs. the Greeks

        1. Gallipoli? A single battle in that war that brought their empire to a crashing end?

        2. Unless you count Gallipoli and Ataturk’s wars vs. the Greeks

          It’s interesting that Ataturk had the only really successful Muslim war against a Western nation, and he happened to be attempting to modernize his country.

          I think the lesson here is that backwards countries have difficulty fighting wars, whereas modernizers have a legitimate chance. To this day Turkey’s more powerful than pretty much any of the more religious Muslim countries, though I don’t know how long Turkish secularism is going to persist given that they’re tending in a more Islamic direction.

        3. Unless you count Gallipoli

          Gallipoli was doomed from the beginning. Without real landing craft, good CAS and FDC coordination provided by radio, without armor, without SP artillery, there was no chance.

          1. Pretty sure they had Gurkhas. Just not enough.

            So I wouldn’t say they had no chance.

    2. Some training beats no training I guess.

      1. No, in a non-military setting, at least, I can definitely say that bad training is worse than no training.

    3. You’re assuming the large populations of adult Middle Eastern men are even putting up a fight to lose. ISIS wouldn’t be able to hold the large swaths of territory it does without a large percentage of popular support.

      Think about that.

      1. They call themselves The Islamic State for a reason. They’re displacing and replacing whatever semblance of government that was in the territory that they are occupying. That requires popular support.

        1. They call themselves The Islamic State for a reason

          Indeed. And if they want to be a “state”, then I don’t see why we have to pussyfoot around with the Paris attacks. A squad of operatives acting under the command of a state’s military attacked a member of NATO on their soil. Why aren’t 28 other states vaporizing Mosul with thermobaric weapons as we speak?

          1. The reporting on the Paris attacks that I’ve read all indicates it was an Al-Qaeda operation, not commanded by ISIS

            1. The reporting on the Paris attacks that I’ve read all indicates it was an Al-Qaeda operation, not commanded by ISIS

              Looking back, that seems correct. Problem is when one of these attacks happen, you always have a bunch of organizations throwing claims of credit around to see what sticks.

        2. They’re displacing and replacing whatever semblance of government that was in the territory that they are occupying. That requires popular support.

          So they are throwing off the government that was imposed upon them in favor of living the way they choose to live?

          I’m shocked.

          (And it sounds vaguely familiar. Some other group in history did this. Who was it?)

          1. The fact that so many are volunteering to join ISIS while nobody is volunteering to fight them says all that needs to be said.

            1. While I haven’t googled it, I have read there are people volunteering to fight ISIS. Mainly to help the Kurds.

              1. Yep, here’s one account:


                From the clip: Killing an ISIS member, to me, is doing a good deed to the world.

            2. nobody is volunteering to fight them

              You don’t know what the fuck you’re talking about.

              As if we needed another demonstration of that fact.

        3. They call themselves The Islamic State for a reason. They’re displacing and replacing whatever semblance of government that was in the territory that they are occupying. That requires popular support.

          On the other thread you guys were comparing the US govt to a mafia holding a neighborhood hostage; now you’re saying that ISIS must have the consent of the people to exist.

          1. Popular support does not mean the support of everybody, or even of the majority.

            1. So it means nothing?

      2. True. I was thinking more about this:

        “Iraqi officials told the Guardian that two divisions of Iraqi soldiers ? roughly 30,000 men ? simply turned and ran in the face of the assault by an insurgent force of just 800 fighters. Isis extremists roamed freely on Wednesday through the streets of Mosul, openly surprised at the ease with which they took Iraq’s second largest city after three days of sporadic fighting.”…..ast-states

        1. Again, as Arab Sunni men, they have nothing to lose if ISIS wins.

          1. Again, as Arab Sunni men, they have nothing to lose if ISIS wins.

            I don’t think you can say that. There are Arab Sunnis being murdered every day in ISIS controlled territory for not adhering to ISIS’ preferred ideas about Sharia law.

            1. That’s true, but they are not unequivocally marked for death or enslavement as the Yazidis, Kurds, and Assyrians are.

          2. And they sure as hell don’t want to risk being beheaded/crucified/burned alive for the sake of keeping the Iraqi Shias in charge.

            To be fair, that was 8 months ago too.

        2. Imagine that the US was broken up into eastern and western halves with parliamentary govts (like Iraq’s), and California dominated the western half by sheer population, and forced the rest of the West to abide their left wing idiocy. If you were a conservative Idahoan drafted into the western army and stationed in Salt Lake City, and there was a sudden invasion of Mormons with a reputation for beheading, crucifying, and burning POWs alive, would you stand and fight them for the sake of your Californian leftist masters, or run and go home to Idaho?

    4. “Seriously, how can large populations of adult men in the Middle East be LOSING to THIS?”

      That should tell you something about the ones losing.
      Have a gander at this and MARVEL.

      1. Oh



        That is hysterical!

      2. That is funny, but it’s probably the first time they ever did jumping jacks. Most Americans grew up knowing how to do them.

    5. Because they are fighting these guys?

      If you can’t do jumping jacks, I’m guessing those really do look like bad ass martial arts moves.

      1. Holy shit, these guys are tards.

        You and Suthenboy nailed it.

  9. “back in the 1990s you could hardly pick up the newspaper without reading about a new lawsuit being brought against a nursing home by a trial lawyer.”

    Funny how I don’t remember that, but do remember the 1970s, which were all about the crooked nursing homes stealing from their clients, their families, and Medicare.

    1. You have a convenient, (for you anyhow), selective memory.

  10. Nearly all the activities that will make up the rest of your day will proceed in similar fashion, until “lights out” is called and you are commanded to a lonely slumber.

    I really hadn’t thought nursing homes were so… regimented. How awful. My folks were independent until the end – I sure hope for the same when my time comes.

  11. In the developing world, sending your elderly parents off to live with strangers is morally equivalent to abandoning your children. In fact, your obligations to your parents are probably greater–since you owe them for taking care of you as a child.

    How many of them have parents with Alzheimers? Or twice a week trips to the hospital? Or complicated drug regimens?

    Got news for ya, in Central America, mama and papa croak from the first heart attack, stroke, or respiratory infection. Caring for corpses is a lot easier, so excuse me for not feeling guilty for paying for my parents to have professional care (while paying for several other people’s parents too via Social Security and Medicare, which I’ll never see the benefits from).

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