Gillian Jones: We must do better by seniors and senior citizens to come
WILLIAMSTOWN — I remember telling a representative with a home health care company that I would put a hospital bed in my living room to take care of my mother before ever putting her in a nursing home. When she got bilateral hip replacement surgeries in 2009, she came straight home from the hospital. My brother and I took turns taking care of her, in her own home.
While she has lived with me for the last several months, she is presently recovering from two surgeries, doing rehabilitation and receiving excellent care in a skilled nursing facility in North Berkshire County. She has had multiple short stays in area nursing homes for respite care, while living with me, and for nearly a year, she resided in a nursing home following a stroke that resulted in severe cognitive impairment.
I have visited nursing homes over the years as part of my job. Whether it was for a picnic, special event or school children singing holiday songs to residents, I've been inside skilled nursing facilities more times than I can count.
So it is sad, but not surprising, to hear the claims of abuse and neglect of nursing home residents at Sweet Brook in Williamstown, outlined in a story by Eagle reporter Haven Orecchio-Egresitz on Sunday, Jan. 6.
According to an article in SeniorAdvisor.com on the history of nursing homes, "seniors today have it better than they have at any other point in history. Medical advances mean that most people can count on living longer and more comfortably than in the past. And the senior living options available to people of every class are far superior to what they've traditionally been."
Since the birth of our country, up to the early 20th century, poorhouses or almshouses were places designated for some elderly to reside, and many of them had deplorable conditions as they housed the "undeserved poor." Poor elderly people often lived alongside the insane, inebriated or homeless.
When Social Security was established in the 1930's many seniors moved into board-and-care homes where they could rent a room, receive a basic level of care, and expect a couple of meals each day.
In the 1950s skilled nursing facilities or nursing homes were established to give seniors a facility to rehabilitate in, avoiding long stays in a hospital. From then until the 1970s such mandated facilities grew, but abuses occurred. Laws like the 1965 Moss Amendments and 1987 Nursing Home Reform Act were passed to protect residents. From safety codes to comply with, keeping registered nurses on staff, providing transparency to make fraud easier to spot, and a residents' Bill of Rights, residents could expect a certain level of care and safety.
Once Medicare and Medicaid were introduced in 1965, the federal funding of nursing homes was expanded greatly.
But then in the 1970s, investigators learned that many facilities were providing substandard care to residents. Amendments to the Older American Acts in 1973 and 1987 provided and strengthened nursing home ombudsman programs. Now nursing homes residents and their families had a secure way of voicing any complaints.
Still even today, the mere notion of residing in, or even visiting a nursing home carries dread with it.
All one needs to do is hear the cacophony of call bells and various alarms to know that residents' needs are outpacing the staff. I've been hit with the smell of feces and urine permeating the hallways and witnessed tired, cranky staff trying to do their jobs under the worst of conditions: understaffing. It is hard to stomach the stress on the staff and the confusion of the residents. I suppose if a resident has dementia, they won't remember anyway. Fortunately, when my mother returns home, she never remembers her stay.
I have spoken to others who have family in nursing homes and heard the sad stories of their loved ones not being well cared for. Everyone seems to know the facility is understaffed and staff turnover is high. What is worse is that many seem to have accepted that this low level of care is well, just the way it is. Have we as a society marginalized our elderly and their care in the twilight of their lives?
A report to Congress prepared by the Center for Medicare and Medicaid Services estimates that over 91 percent of nursing homes are staffed below the level that is minimally necessary to provide all needed care.
According to an article on increasing the Medicare and Medicaid reimbursement rate to increase staffing, by the Center for Medicare Advocacy, increased reimbursement has led to little change in staffing, or the improvement of wages in those workers involved in direct care. Apparently explicit staffing ratios are required to improve staffing ratios. Sound familiar? Massachusetts voters had a ballot initiative on that issue this past November. It did not pass. Every day Baby Boomers are getting older. A continued strain on our nursing homes seems inevitable. What is the future of our children when they become senior citizens?
Gillian Jones is an Eagle photographer who is writing an ongoing series of opinion page pieces on caregiving. Her email is email@example.com.
Gillian L. Jones
Digital Visual Journalist
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