Monday, November 4, 2013

Warehousing Our Elderly


It is a national shame that in our culture we stick our elderly in warehouses called nursing homes, or assisted living or rehabilitation facilities. About twenty years big corporation recognized the huge money profits by exploiting end of life care. Many churches had not-for-profit homes to care for older people who could no longer live independently. But one by one they were bought up by for profit corporations.

In the United States older persons are invisible, not valued or respected in general. We put those who have outlived their usefulness in institutions. Out of sight ---out of mind. Some fortunate older people have family members who live close and can act as advocates when they can't act on their own behalf. But more and more families are spread out in different states, even different countries, and the elderly person is alone

If the person has a stroke, ALS, terminal cancer or other life threatening illness and cannot speak for himself or herself, they are often neglected, dehydrated even abused.

I recently spent five days in a nursing home tagged as a rehabilitation facility. It was an eye opener. The nursing home collected big bucks from my health care provider and was determined to keep me there as long as my insurance company paid. They got more for rehabilitation patients than regular "residents."

The care was abominable. My bed sheets weren't changed for the entire time; I didn't receive a bath or even given a basin of warm water to sponge bath myself. I had ankle reconstruction and was in a cast and in severe pain. Medication was withheld or errors were made. The staff was overworked and underpaid. When I was assertive in requesting necessary care some staff embers were passive aggressive and I was either neglected or punished in some way like leaving me on a bedpan for over two hours, or spilling urine as the bedpan was removed then leaving me in a urine soaked bed and refusing to change my bed. One staff member refused closing the door at night to shut out the noise in the hall or loud conversations of the night staff. Turning overhead bright lights on in the room at 3:00 AM to take my blood pressure because the nursing assistant forgot to take it at bedtime wakened me. These are just a few of the infractions I received.

Physical therapy was ordered but I didn't receive any, yet my insurance company was charged for this service. I requested a bedside commode and never got one. The staff said none were available.

I was fortunate because I wasn't there permanently but my roommate was, and she was reduced to a passive compliant wimp. Prior to her stroke she was a Unitarian Minister a successful assertive woman. On one occasion after she had been given a suppository and was having severe abdominal cramps and she needed a bedpan during the night a nursing assistant threatened her if she turned on her call light again and refused to give her a bedpan. She cried in pain.

Greedy corporate elderly care owners cut back on quality care by hiring staff with little or no training, pay minimum wages, cut back of food, have insufficient equipment available. They do little or no staff in-service training or offer staff incentives to reduce the difficult and depressing job. These administrators are so far removed from the recipients of their services they have no idea nor do they care about quality of life issues, including attractive and tasteful healthy food, well trained staff, hydration, cleanliness, comfort, recreation therapy as appropriate, regular medical visits and supervision, not to mention respect and kindness.

Care of the elderly is at the bottom of the priority list in the delivery of health care services, is poorly monitored or regulated and it is a national shame.

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