The Big Grey Area:
Opioid Crisis Can Leave Seniors in Pain
BY CAROL LARSON
When we think about the more than 68-thousand people who overdosed last year, we often imagine young heroin addicts found dead in their cars, or veterans over-medicated on OxyContin. We rarely think of Grandma with her bad back and doctor-prescribed pain pills.
But here’s the reality: An estimated 25 percent of Americans over the age 65—more than 10 million people—are long-term users of opioids, according to a recent National Health and Nutrition Examination survey. In fact, between 2010 and 2015 the number of seniors with opioid-related hospitalizations rose 34 percent, with emergency room visits up 74 percent, according to the Agency for Healthcare Research and Quality.
Plain and simple, seniors are the largest under-reported demographic of opioid users. For some, opioids are essential to coping with pain. For others, opioids create a confusion of symptoms and side effects that can diminish quality of life, and sometimes kill.
In this vast grey area, I’ll share two stories. First, my own.
In 2005 when I was first treated for chronic pain, I was prescribed small doses of hydrocodone because, as my doctor said, “It’s about all we’ve got to work with.” Back then no one knew opioids were not a good long-term solution.
So, that’s what I took for 14 years, until the side effects caused greater problems than the pain. For me it was sudden deafness (I stopped taking the pills and my hearing returned). But the list of other potential side effects is long: nausea, constipation, lower bone density, trouble urinating, respiratory depression, dementia, impaired sexual function, hyperalgesia (increased sensitivity to pain) and increased fall potential.
All of the above are huge problems for seniors because (more…)
Staffing Shortage Solutions
Disability Organization Innovates to Recruit and Retain Quality Employees
BY RACHEL LIEBERMAN
It’s 7:30 am, and the staff at MSS St. Paul, a Minnesota organization providing programs and support to people with intellectual and physical disabilities, is already hard at work. Direct Support Professional (DSP) Enrique Castaño is prepping for the day’s activities: computer time, visits to the YMCA and a local food hall, and exercises in financial literacy.
Many of the 130 adults served by MSS are arriving by bus, popping in and out of the kitchen, arts room, home rooms, garden, and stopping in to say good morning to Castaño or exchange a few jokes. One young woman follows Castaño as he makes his morning rounds, offering several high-fives to everyone she passes.
“I did have a little bit of a challenge at first,” Castaño explains. “It was hard for me to find a way to engage with people, but it was actually the clients who helped me to open up.”
Today is a “programming day,” a new idea implemented by MSS to allow DSPs like Castañoto break from their regular routine and join different clients in alternative activities or design their own programming for clients. Castaño, who usually spends each day in the same room, says, “It’s also an attempt by MSS to improve retention. It’s improved the morale of staff, getting a break from the same routines of performing cares (such as assistance with bathroom, food, meds) all day.”
Castaño is also a fellow at Cow Tipping Press, an organization based in the Minneapolis-St. Paul area that publishes work by authors with developmental disabilities and, by doing so, aspires to change the way society views disability. (Cow Tipping Press derived its name from a piece by one of its first authors.) Castaño says the fellowship gives him an opportunity to “model more person-centered work,” allowing him to give “more voice” to the clients he works with at MSS “so they can have input in what’s going on.” Outside of the Cow Tipping Fellows’ work, he says, “there’s not always that much progress” in that vein.
Staff retention is a huge challenge for organizations like MSS, especially in the current job market where many employers are experiencing workforce shortages. Organizations providing care and programming for adults with developmental disabilities experience high rates of staff turnover. Partly due to rising demand and stagnant wages, as well as the common perception that this kind of work is temporary, these organizations are constantly struggling to fill positions. As a result, statistics and studies show this can endanger the quality of care these organizations, and the employees who work there, are able to provide.
“Among the disability community and disability services, it’s well known that there’s a workforce shortage,” says Bryan Boyce, the Founder and Executive Director of Cow Tipping Press. “Getting people to even to apply for positions can be tough.” Yet Cow Tipping Press might have the solution, or at least part of it.
In 2018, the Minnesota State Department of Human Services Direct Care/Support Workforce Initiative created a “strategic vision for tackling the crisis in the direct care and support workforce” with seven major recommendations. These recommendations include increasing wages, expanding the work pool, improving training, building job satisfaction, raising public awareness, better utilizing technological solutions, and enhancing data collection.
Boyce, however, took a more creative approach to the solution. This last year, after talking with other organizations in the field of disability services about the challenges they face with staff retention, Boyce launched (more…)