As parents, we worry about our children's future. We believe that giving them a good start is the best bet we have for a positive outcome, so we work each day toward that end. We envision them happily married with beautiful children who we'll adore, and we imagine our job will be done. If only it were that simple.
What if, after all that planning, your adult child, your old adult child, ends up in a nursing home? What if that home is just like many of our nursing homes today? Statistically, 70 percent of people over age 65 will need long-term care in their lifetimes, leaving us with the reality that our children might well be tomorrow's nursing-home residents.
Here's more reality. You will be powerless to stop a nursing assistant from slapping them because their limb contractures leave them difficult to dress. You won't be there to stop that assistant from shoving a dirty glove into their mouths to muffle the repeated pleas to go back to bed. Who will feed them from that food tray that sits out of their reach? It will return to the kitchen untouched because the nursing home is too short-staffed to help with "feeders" or give them a sip of water.
You won't be there to change their soiled sheets or gently soak the dried fecal matter from their infected bedsores. Your old and frail children will be in the hands of overworked and underpaid caregivers who've been known to relieve their own despair by withholding your children's pain medication and taking it themselves.
Many of today's nursing homes are controlled by thoughtless and greedy business executives whose main objective is pleasing their investors. They are rewarded with generous salaries and bonuses for staff slashing and other cost-cutting prowess. Profits are invested in powerful lobbying groups that enjoy robust influence over legislators and regulators. These corporations respond to wrongful death lawsuits, not with lessons learned and corporate mandates to improve care, but with tort reform, introduced and passed into law by unscrupulous and recompensed lawmakers.
Eighty percent of the industry's payments come from public funds, Medicare and Medicaid, and we are not getting our money's worth.
Health and Human Services reported that Medicare paid $5.1 billion for substandard nursing home care in 2009. Benign consequences of substandard care have taught this industry that it's more profitable to provide shoddy care and pay an occasional fine than it is to hire and train staff to provide good care. Sequestration cuts are further weakening the bite of regulatory agencies that view themselves as in "partnership" with the very industry they're charged with watching. Fines are measly, inconsistently collected and do not act as deterrents.
Silence and inaction are daily reminders that our public doesn't want to think about old people suffering neglect and abuse in nursing homes. Even associations with "aging" and "health care" in their titles don't want to cross the nursing-home threshold. The realities of life and death in nursing homes are too dark, and our human nature surrenders to more pleasant matters.
Accounts of abuse are as neglected as the victims themselves and reform advocates are repeatedly reminded they can't force people to care. There are no children or puppies or kittens to rescue in these stories. They are old people who can no longer protect and defend themselves.
Advocates are nothing more than average citizens who have come to understand that the way we treat our institutionalized elderly is nothing short of a crime against humanity.
Sadly, the number of people willing to push back against this powerful profit-motivated industry remains consistently low. This is why true reform and good care remain out of our grasp. We simply need more people to care and to be counted. If you believe that nursing homes are not good enough for a child of yours, we need your help. You simply need to commit to act and be counted, because the consequences of inaction are the unthinkable.
Jan Scherrer, of Versailles, is a speech pathologist with experience in geriatric and nursing home care. She is a board member of Kentuckians for Nursing Home Reform.