7 ms·

"Cruises were priced similarly to assisted living centers and more efficacious"

76 points by GuiA 13y ago

BasilAwad 13y ago
This is a great idea. Instead of settling in a retirement home, which always seemed so depressing to me, abandoned seniors (I know not ALL cases are the same) can at least enjoy travel and a constant change of atmosphere if they so desire. The sad thing though is that this paper is from 2004. I wonder what action, if any, has been taken since. As a side note, I also know that some people have family members that need medical care. I just hope I'm never put in a difficult situation where I would consider putting my parents in a retirement home. But if it was a cruise! Not so bad! That's like a permanent vacation!
kashnikov 13y ago
What if serious medical care is required, i.e. surgery?
- bdcravens 13y ago
  Probably no different than if a younger traveler was injured and needing medical attention: they'd triage it onboard, and provide emergency care at the next port-of-call if needed. Worst case scenario, helicopter ride to a major hospital.
  - brotchie 13y ago
    Any idea what level of medical care they can provision on-ship? I'd presume they have morgue facilities, given the negatively skewed age distribution, but no operating theatre?
    - cdjk 13y ago
      My mom got appendicitis on a cruise ship while it was about three days from port. They have lots of antibiotics, but surgery on board was never an option, although she was immediately transferred to an ER when they got into port. In other cases passengers have been airlifted either to shore, or in one case a navy aircraft carrier, which is equipped to do surgery. That implies that reasonably advanced medical care is available ona ship, even if cruise ships are not setup to offer it. I'd link to the article, but I'm on a tablet and it's easy to find.
    - rdl 13y ago
      They're obviously focused on emergency medicine and cardiac care. Digital radiography, EKGs, external pacemakers, a lab, etc. They can do cricothyrotomy, but certainly aren't set up for major surgery. Basically anything you'd want in an ER but not OR. Although there are some ships doing cosmetic surgery at sea, and there are proposals for cruise ship medical tourism.
      - justincormack 13y ago
        And there was a ship moored off Ireland performing abortions at one point.
        Someone 13y ago
        That, in at least one case (and, AFAIK, all cases) wasn't commercial, but ideological: http://www.womenonwaves.org/en/page/769/in-collection/2582/ireland-2001 http://www.womenonwaves.org/en/page/769/in-collection/2582/i... Also, I would not call that surgery.
        rdl 13y ago
        Better example is something like the USNS Comfort and USNS Mercy (or really any big surface combatant in the USN); they can do real surgery. I'd argue that Comfort and Mercy could do more good for US national security at sea, combined with LPD/LPH for cargo transport and personnel, than any other surface ships in the US fleet -- humanitarian missions probably improve security more than anything but the submarine nuclear deterrent.
    - oostevo 13y ago
      I had a small injury -- just a broken bone in my hand -- on a cruise ship about ten years ago. There was a doctor and two nurses on duty at the time. The doctor had to be quite resourceful: he checked my vitals, took, developed, and interpreted the x-ray, and then set the broken bone. I gather the doctor(s) onboard also wind up serving as the primary care physician for all of the staff on board, too. The facilities themselves were quite sparse, and with somewhat dated but still functional equipment. The x-ray used film, after all. He also wound up using a spoon from the dining room as a splint, because the ship didn't seem to stock small splints. My understanding is that shipboard medicine has advanced considerably since then. Some cursory Googling suggested that ships are routinely equipped with satellite connections to doctors on shore, ecgs, defibrillators, and the like.
- Apreche 13y ago
  I think that's less of a concern than the constant medical care usually required of an elderly person. On top of the cost of a cruise are you going to pay to have a nurse on board with them at all times? How about if they need regular medical supplies. How would someone get say, insulin, delivered? What if they need dialysis? If there is senility involved, a boat is a bad place to be. A senior who can get by living on a cruise ship is probably also healthy enough to get by living on their own. I think it really only works in cases where the person is healthy and mentally all there, but needs someone to cook, do laundry for them, etc.
ch00 13y ago
Cruises are priced such because cruise ship workers are paid incredibly low wages: "The Cruise Lines International Association says its "crew members are provided wages that are competitive with international pay scales." But a cleaner aboard a Royal Caribbean ship, for example, will work 12 hours a day, seven days a week, for as little as $156.25 a week with no tips. U.S. labor laws are not applicable to provide protection to crew members at sea, nor is there any real oversight of the cruise lines' operations." http://www.cnn.com/2013/02/13/opinion/walker-cruise-ships http://www.cnn.com/2013/02/13/opinion/walker-cruise-ships
- coldcode 13y ago
  Unlike people who read articles I like to talk with the working folks when I am on a cruise. Yes they work long hours for often 7-9 month contracts. But the pay they get is better than anything they could ever get in their home country. A lot of them get to spend several months at home for every contract but are always eager to go out again. It's isn't an easy life but looking at it from a rich country it seems like slavery. But most of them find the work acceptable for the pay compared to their home. Some cruise lines are much nicer to their employees than others and most of them know who. I bet that nice piece of fruit you are eating was picked by someone from a poor country who is likely working illegally because the money at that farm is pretty good where they came from. Yes it might seem exploitative to us but their own country is much worse. Something we might not be willing to do for any money other people are happy to do it for any wage.
  - johnvschmitt 13y ago
    You are both true & making good points. It sounds like another "offshoring" idea then. The bigger problem from my POV is that the old folks they serve are being treated as "steady state", when in fact their conditions are often deteriorating. And, when Grandma dies, will her family have to wait 1-2 weeks for her ship to return to port for a proper family gathering & funeral? Stinky...
    - Fishkins 13y ago
rosser 13y ago
Cruise ship retirement communities were a plot element in Albert Brooks' novel, 2030, which is definitely worth the quick read.
- gregpilling 13y ago
  Also the movie Wall-E
coldcode 13y ago
I met an elderly woman that lived on a cruise ship. She need a walked but was otherwise in good health. She knew everyone on the ship, and made new friends with every cruise. To her it was an awesome life, rather than being stuck in some home. The discounts you get for multiple cruises made it quite affordable for her. Eventually she would need more healthcare but she was going to stay as long as she could. I wouldn't mind it either if the internet was better...
- hkmurakami 13y ago
  My parents went on a few nice cruises after all their children went off to college, and they had the same experience of meeting such people who were using cruises as retirement homes. When my parents shared this story with me, I had a similar reaction as you did. I imagine such a life would be much more interesting than life stuck in a single place with no new faces.
ctdonath 13y ago
Having just gotten off my first cruise, I'm amazed at how plausible this suggestion is, at least for a narrow category of folks of limited mobility but otherwise stable health. Heck, I could see a modest startup taking on handling the logistics of such an arrangement.
Eliezer 13y ago
Is this because assisted living centers have more regulatory barriers or burdens than cruise ships? Intuitively it does not seem like the costs should be the same.
andybak 13y ago
Am I the only person who initially assumed this was a Swiftian proposal intended to highlight the gross over-charging for assisted living?
- VLM 13y ago
  The purpose of assisted living is to adsorb the remaining financial resources out of the residents. Its a battle of giant corporations to prevent any inheritance from reaching the heirs. In the great feast at your financial corpse, will your wealth go to the banks, as mortgage interest, or the hospital, or the assisted living... they're all going to be pretty pissed off if the cruise ships start competing on their turf. So expect some "journalism" aka marketing news releases about horrible cruise ships. Given that multi-industry business model, how long do you think it would take until cruise ships join that business model? If the residents are not kicked out off the ship until they're utterly destitute, that cruise ship operator is leaving money on the table. Its like arguing about how a hospital room costs more than a motel 6 room. Well, duh, you're not going to squeeze blood from a rock at a motel. What sucks about this for everyone, aside from the injustice of it all, jackals at a corpse, etc, is that the new business model is completely incompatible with the old business model. When my wife and I got married, long ago, we went on a fun honeymoon cruise. This option will be removed with the new business model. Technically perhaps possible as newlyweds, but the terms will be something weird like 10% of your remaining net worth per week or whatever instead of just a fixed price "competitive with all inclusive resorts"
  - Shivetya 13y ago
    Before you demagogue the assisted care industry you might want to look at the government as well, Medicade will confiscate estates to pay for care. This was a wonderful feature of the Omnibus Budget Reconciliation Act of 1993. States are required to recover costs. My grandmother's stay at a retirement/assisted living home added years to her life. She also got to meet new people and most important, had an active life. Far better than people bound up in their home alone till they pass.
jacquesm 13y ago
Noro virus outbreaks on cruise ships would put a relatively quick end to that if it were to become popular. Of course you have those in nursing homes as well but a cruise ship is a particularly nice setting. Lots of people in close proximity, and if there is an outbreak you can't really avoid contact with infected others unless you lock yourself in your cabin.

76 points by GuiA 13y ago

This is a great idea. Instead of settling in a retirement home, which always seemed so depressing to me, abandoned seniors (I know not ALL cases are the same) can at least enjoy travel and a constant change of atmosphere if they so desire. The sad thing though is that this paper is from 2004. I wonder what action, if any, has been taken since. As a side note, I also know that some people have family members that need medical care. I just hope I'm never put in a difficult situation where I would consider putting my parents in a retirement home. But if it was a cruise! Not so bad! That's like a permanent vacation!

kashnikov 13y ago

What if serious medical care is required, i.e. surgery?

bdcravens 13y ago
Probably no different than if a younger traveler was injured and needing medical attention: they'd triage it onboard, and provide emergency care at the next port-of-call if needed. Worst case scenario, helicopter ride to a major hospital.
- brotchie 13y ago
  Any idea what level of medical care they can provision on-ship? I'd presume they have morgue facilities, given the negatively skewed age distribution, but no operating theatre?
  - cdjk 13y ago
    My mom got appendicitis on a cruise ship while it was about three days from port. They have lots of antibiotics, but surgery on board was never an option, although she was immediately transferred to an ER when they got into port. In other cases passengers have been airlifted either to shore, or in one case a navy aircraft carrier, which is equipped to do surgery. That implies that reasonably advanced medical care is available ona ship, even if cruise ships are not setup to offer it. I'd link to the article, but I'm on a tablet and it's easy to find.
  - rdl 13y ago
    They're obviously focused on emergency medicine and cardiac care. Digital radiography, EKGs, external pacemakers, a lab, etc. They can do cricothyrotomy, but certainly aren't set up for major surgery. Basically anything you'd want in an ER but not OR. Although there are some ships doing cosmetic surgery at sea, and there are proposals for cruise ship medical tourism.
    - justincormack 13y ago
      And there was a ship moored off Ireland performing abortions at one point.
      - Someone 13y ago
        That, in at least one case (and, AFAIK, all cases) wasn't commercial, but ideological: http://www.womenonwaves.org/en/page/769/in-collection/2582/ireland-2001 http://www.womenonwaves.org/en/page/769/in-collection/2582/i... Also, I would not call that surgery.
        rdl 13y ago
        Better example is something like the USNS Comfort and USNS Mercy (or really any big surface combatant in the USN); they can do real surgery. I'd argue that Comfort and Mercy could do more good for US national security at sea, combined with LPD/LPH for cargo transport and personnel, than any other surface ships in the US fleet -- humanitarian missions probably improve security more than anything but the submarine nuclear deterrent.
  - oostevo 13y ago
    I had a small injury -- just a broken bone in my hand -- on a cruise ship about ten years ago. There was a doctor and two nurses on duty at the time. The doctor had to be quite resourceful: he checked my vitals, took, developed, and interpreted the x-ray, and then set the broken bone. I gather the doctor(s) onboard also wind up serving as the primary care physician for all of the staff on board, too. The facilities themselves were quite sparse, and with somewhat dated but still functional equipment. The x-ray used film, after all. He also wound up using a spoon from the dining room as a splint, because the ship didn't seem to stock small splints. My understanding is that shipboard medicine has advanced considerably since then. Some cursory Googling suggested that ships are routinely equipped with satellite connections to doctors on shore, ecgs, defibrillators, and the like.
Apreche 13y ago
I think that's less of a concern than the constant medical care usually required of an elderly person. On top of the cost of a cruise are you going to pay to have a nurse on board with them at all times? How about if they need regular medical supplies. How would someone get say, insulin, delivered? What if they need dialysis? If there is senility involved, a boat is a bad place to be. A senior who can get by living on a cruise ship is probably also healthy enough to get by living on their own. I think it really only works in cases where the person is healthy and mentally all there, but needs someone to cook, do laundry for them, etc.

ch00 13y ago

Cruises are priced such because cruise ship workers are paid incredibly low wages: "The Cruise Lines International Association says its "crew members are provided wages that are competitive with international pay scales." But a cleaner aboard a Royal Caribbean ship, for example, will work 12 hours a day, seven days a week, for as little as $156.25 a week with no tips. U.S. labor laws are not applicable to provide protection to crew members at sea, nor is there any real oversight of the cruise lines' operations." http://www.cnn.com/2013/02/13/opinion/walker-cruise-ships http://www.cnn.com/2013/02/13/opinion/walker-cruise-ships

coldcode 13y ago
Unlike people who read articles I like to talk with the working folks when I am on a cruise. Yes they work long hours for often 7-9 month contracts. But the pay they get is better than anything they could ever get in their home country. A lot of them get to spend several months at home for every contract but are always eager to go out again. It's isn't an easy life but looking at it from a rich country it seems like slavery. But most of them find the work acceptable for the pay compared to their home. Some cruise lines are much nicer to their employees than others and most of them know who. I bet that nice piece of fruit you are eating was picked by someone from a poor country who is likely working illegally because the money at that farm is pretty good where they came from. Yes it might seem exploitative to us but their own country is much worse. Something we might not be willing to do for any money other people are happy to do it for any wage.
- johnvschmitt 13y ago
  You are both true & making good points. It sounds like another "offshoring" idea then. The bigger problem from my POV is that the old folks they serve are being treated as "steady state", when in fact their conditions are often deteriorating. And, when Grandma dies, will her family have to wait 1-2 weeks for her ship to return to port for a proper family gathering & funeral? Stinky...
  - Fishkins 13y ago

rosser 13y ago

Cruise ship retirement communities were a plot element in Albert Brooks' novel, 2030, which is definitely worth the quick read.

gregpilling 13y ago
Also the movie Wall-E

coldcode 13y ago

I met an elderly woman that lived on a cruise ship. She need a walked but was otherwise in good health. She knew everyone on the ship, and made new friends with every cruise. To her it was an awesome life, rather than being stuck in some home. The discounts you get for multiple cruises made it quite affordable for her. Eventually she would need more healthcare but she was going to stay as long as she could. I wouldn't mind it either if the internet was better...

hkmurakami 13y ago
My parents went on a few nice cruises after all their children went off to college, and they had the same experience of meeting such people who were using cruises as retirement homes. When my parents shared this story with me, I had a similar reaction as you did. I imagine such a life would be much more interesting than life stuck in a single place with no new faces.

ctdonath 13y ago

Having just gotten off my first cruise, I'm amazed at how plausible this suggestion is, at least for a narrow category of folks of limited mobility but otherwise stable health. Heck, I could see a modest startup taking on handling the logistics of such an arrangement.

Eliezer 13y ago

Is this because assisted living centers have more regulatory barriers or burdens than cruise ships? Intuitively it does not seem like the costs should be the same.

andybak 13y ago

Am I the only person who initially assumed this was a Swiftian proposal intended to highlight the gross over-charging for assisted living?

VLM 13y ago
The purpose of assisted living is to adsorb the remaining financial resources out of the residents. Its a battle of giant corporations to prevent any inheritance from reaching the heirs. In the great feast at your financial corpse, will your wealth go to the banks, as mortgage interest, or the hospital, or the assisted living... they're all going to be pretty pissed off if the cruise ships start competing on their turf. So expect some "journalism" aka marketing news releases about horrible cruise ships. Given that multi-industry business model, how long do you think it would take until cruise ships join that business model? If the residents are not kicked out off the ship until they're utterly destitute, that cruise ship operator is leaving money on the table. Its like arguing about how a hospital room costs more than a motel 6 room. Well, duh, you're not going to squeeze blood from a rock at a motel. What sucks about this for everyone, aside from the injustice of it all, jackals at a corpse, etc, is that the new business model is completely incompatible with the old business model. When my wife and I got married, long ago, we went on a fun honeymoon cruise. This option will be removed with the new business model. Technically perhaps possible as newlyweds, but the terms will be something weird like 10% of your remaining net worth per week or whatever instead of just a fixed price "competitive with all inclusive resorts"
- Shivetya 13y ago
  Before you demagogue the assisted care industry you might want to look at the government as well, Medicade will confiscate estates to pay for care. This was a wonderful feature of the Omnibus Budget Reconciliation Act of 1993. States are required to recover costs. My grandmother's stay at a retirement/assisted living home added years to her life. She also got to meet new people and most important, had an active life. Far better than people bound up in their home alone till they pass.

jacquesm 13y ago

Noro virus outbreaks on cruise ships would put a relatively quick end to that if it were to become popular. Of course you have those in nursing homes as well but a cruise ship is a particularly nice setting. Lots of people in close proximity, and if there is an outbreak you can't really avoid contact with infected others unless you lock yourself in your cabin.