With the future of American health care hanging on an upcoming Senate vote on the Better Care Reconciliation Act of 2017, a recent New York Times piece revisits the grim reality of nursing homes in the 1970s. In that decade, 12 states were swept up in an epidemic of elder abuse happening in long term care facilities and nursing homes. Illinois, Wisconsin and Michigan were 3 of the 12 states that had facilities who frequently left patients in soiled undergarments and bedding, riddled with bedsores, malnourished, dehydrated, and otherwise neglected and abused. In New York, another hard hit state, hospital staff would hear of a transfer from a nursing home and knew to expect a patient with limited mental faculties who was suffering from one of many ‘common’ conditions plaguing abused and neglected nursing home residents. Those sadly common conditions were urinary tract infections, pneumonia, and bedsores, among many other ailments.
The author notes that the economic and societal conditions of the 1970s created a prime environment for elder abuse and given the trajectory we are on now with our potential healthcare plan, we’re at risk of repeating history.
In the 70s, industrial production was rapidly declining and revenue from taxation was also down, leading to less funding for things such as Medicare and Medicaid. Cutting Medicare and Medicaid has traditionally always led to slashing care and services for the elderly. Such was the case in the 70s and cuts resulted in too many residents and too few staff. Underpaid, overworked nursing home employees were forced to neglect patients, with many also turning to verbal, physical and emotional abuse.
According to the author, because 65% of a nursing home’s costs come from paying wages and benefits, a cut to Medicaid means a cut to the amount states can pay their staff members. Too often nursing homes take the route of eliminating staff in order to save money, and the expectation is that they will do exactly that in the face of reduced reimbursements. However, the demand for nursing home care is expected to rise, likely causing a repeat of the crisis we faced in the 70s.
The author closes with a powerful quote from a Pennsylvania nursing home resident who was victimized by a certified nursing assistant (CNA) and was finally able to face her abuser: “I curse you, I curse you — that you will live to feel 90 years old in your bones and will know what you’ve done to me.”