Just Work: The Golden Years?

People say that you should judge a society by how it cares for its young and old. These days, this country isn't doing very well at either.

The substandard care available to our aging parents and grandparents is particularly shameful. The golden years have become bleak years for too many older adults who spend their last days in poorly managed nursing homes. In the worst cases--like my Mom's--the wrong nursing home can even be deadly.

In September of 1999, my four sisters and I checked my mother into a nursing home for what was supposed to be a temporary stay. When we said goodbye, we had no idea that she would never get out again.

My mom had five daughters. All five of us pitched in, alternating who would help Mom out at home. When situations arose and it turned out all five of us were going to be out of town for about 10 days, we researched our options and decided on a nursing home that would be the most comfortable option for Mom. The nursing home had a pretty good reputation. It had 24 hour care and a range of support for various levels of sickness. At 66, Mom suffered from diabetes and heart disease, but she was energetic, fully mobile, and doing well. When we left Mom, she was in a nicely decorated single room on a floor that was full of smiling residents.

Ten days later, it was as if we had returned to a different Mom in a foreign nursing home. Mom was in complete kidney failure. She had a large infected wound on her leg. She was too weak to get up on her own to go the bathroom. She had dropped weight, and she had bruises all over her arms. She had been moved to a double occupancy room on a dismal floor where the patients' vacant stares replaced the smiles we had left behind only days before. Mom had aged ten years in ten days and her health was rapidly spiraling downwards.

The culprit? We soon realized that it was simple, ugly neglect.

One morning, when we were still trying to make heads of her sudden deterioration, one of my sisters found Mom covered in her own vomit. She had gotten sick in the middle of the night but no one had come to clean her up or change her dirty sheets. Turns out they were down to just one nurse on an 80 bed floor at nighttime. We also learned that Mom's bruises were from falling in the middle of the night while trying to get up to go to the bathroom or get a glass of water. She would remain on the floor for hours until a staff member appeared to help her back into bed.

We spoke multiple times with management at the home to plead our case and ask why Mom was crying for water in the middle of the night and frequently left unattended. But they just told us that she no longer required the same amount of care that she has needed when she first came to the home. Of course, the opposite was true. We knew that the neglect had more to do with the fact that her private health insurance maxed out after only two weeks.

When I look back, it's hard to understand how everything went downhill so quickly. I wish we had figured out a way to get her out of there--but at the time we felt completely stuck. Mom was too sick to take back home and not sick enough to be checked into the hospital. We didn't have the financial resources to provide her with private 24 hour care. On top of everything, Mom's health insurance was running out and the nursing home was warning us that she would have to go on Medicaid. This meant that Mom would have to move to a four bed occupancy suite in the basement on the psychiatric ward.

In the end, Mom never had to make that dismal move. At 11:59 p.m. the night before Mom was supposed to become a Medicaid patient, she died. She had been at the nursing home from September 1 to October 10.

I don't think nursing homes are bad places. I know from my research and from conversations with other people that there are homes all over this country that are dedicated to patient care where the residents are thriving. I don't blame the nursing staff that tried to care for Mom. They were always trying to do their best, but there simply weren't enough of them to provide for the patient's needs.

I do blame the race for higher profits that has reached the very homes that we entrust with our loved ones when they are in greatest need. Tragically for my mom and too many other seniors, this greed at the top has created squalor and tragedy at the bottom.

Today, in yet another massive business deal, the Carlyle Group is set to gobble up Manor Care, the largest nursing home chain in the country. I'd like to think that Carlyle will improve on some of the problems with Manor Care's nursing homes, but I'm afraid it may lead to even shoddier care. Since these buyouts are set up to build profits for the wealthy investors, it's hard to see how patient care will be their priority. From what I can tell, the new finance savvy owners are just focused on paying off the debt and avoiding taxes. The business of serving elderly clients is an afterthought. I recently found out that one of the Manor Care directors is expected to make as much as $186 million from the deal! It makes me sick to know that none of those profits will go towards preventing deaths like my Mom's.

It's wrong to build fortunes on the backs of our elderly. As a society, we cannot allow this greed to go unchecked. It's time to put care before profits and restore honor for our elderly so that they can face their golden years with dignity.

-- Robin Bawkey

Robin Bawkey is a homecare worker and a member SEIU (Service Employees International Union) Healthcare Michigan in Kalamazoo, MI. Robin recently joined fellow senior advocates and nursing home staff on a weeklong caravan from Toledo, Ohio to Washington DC to raise concerns over The Carlyle Group's $6.3 billion takeover of HCR Manor Care. The trip culminated in lobby visits on Capitol Hill Oct. 23, where U.S. Reps. John Dingell and Barney Frank announced new committee investigations and the first Congressional hearings on private equity ownership of nursing homes. For more information on Manor Care, go to www.carlylefixmanorcarenow.org. For more background on how private equity buyouts can hurt average workers, go to www.beyondthebuyouts.org.

Just Work is a series presented by the Service Employees International Union (SEIU) to give a voice to working people to discuss their daily struggles to balance work, afford life and participate in a more just society. SEIU welcomes submissions to Just Work! Please send your story (800 words or less) to [e-mail].

About SEIU The 1.9 million-member SEIU is the fastest-growing union in North America. SEIU members are winning better wages, health care, and more secure jobs for our communities, while uniting their strength with their counterparts around the world to help ensure that workers, not just corporations and CEOs, benefit from today's global economy.

Comments

[Silverstar]

I worked for Manor Care for six months. It was the worst six months of my life. Because of their constant understaffing, an illness I had was exacerbated to life-threatening proportions. Since that time I have been disabled. The care is not only bad for the residents, but for the staff.
This was the point at which I began to see that health care should not be a for-profit business. Another nursing home chain I worked for kept buying up smaller chains, and went bankrupt. Meanwhile they cut back the staff's hours to where we couldn't live, but couldn't get unemployment, or another job either.
I can't believe they told the author her mother wasn't sick enough for the hospital. A massively infected wound should have gotten her there. On the other hand, I'm not surprised. I have seen too many doctors and hospitals send residents back too soon, or even admit straight to a nursing home someone who to me obviously belonged in a hospital. Makes me glad I'm too disabled to work there now.

[praxis00]

I love this idea, dadw5boys! What I don't love it that one person can walk away with $186 million in profit from a deal when there are nursing shortages and gross underpayment of nurses' aides.

Long ago, I worked in a nursing home for a little more than minimum wage. I wanted to be a doctor, so I thought it was a good job to support me in my college years. What I found were horrendous working conditions, a beaten down workforce, and employers who looked for opportunities to scrimp and save at the expense of the residents. The managers operated under the premise that if you could get 10 people up, dressed and fed by 8:30 am, you could handle 12. And putting 15 people to bed at night was no problem if you started at 6 pm. So what if the residents weren't tired. As each aide's patient load got bigger, the "little" things went out the window: brushing teeth, applying deodorant, making conversation, changing diapers at 2p. Anything that might slow you down.

The result, as you might imagine, was despair. Despair from the residents, who felt dehumanized; despair from the staff, who felt inhumane; despair from the families, who felt guilty.

After about a year, I caught on to my role in the cycle. I made a pledge that I would emulate a fellow aide who hadn't given in, who maintained a standard of care that far exceeded what the parameters allowed for. Did her patients sometimes eat breakfast in bed? Sure. Did she work much later into the 3-11 shift than others? Yup. Did she run afoul of management? Of course. But were her patients the cleanest, healthiest, happiest people on the floor? Without a doubt.

My last three years were better, and my patients were among the best cared for in the place. But it wasn't easy and it wasn't supported by policies or resources.

I'm sorry for your loss, Ms. Bawkey. I am sure your mother is proud of your efforts to raise awareness about this problem.

[babyboomerorig]

I can't imagine the kind of care your mother received. It's beyond shameful.

The Carlyle Group has GHW Bush among it's members and money is the only reason they would buy up nursing homes. It would be nice to think that they would take some of GHW's concerns for the Aids patients in Africa and use that for the care of our elderly.

[dadw5boys]

WE NEED SENIOR CARE CENTERS AND DAYCARE CENTER BUILT SIDE BY SIDE IN THIS COUNTRY.

Seniors could not only aguement thier income by working at child care centers but make their lives fuller by not being isolated in a room with a T.V. waiting to die. I have yet to see a grandparent turn down a hug from a child.
Children would be safe and the always have someone there to watch over them and teach them.