Nursing home placement – another form of elder abuse?

Edward Munch Self Portrait

Elder abuse takes many forms. Nursing home placement may be a humane solution, but to many elders it feels like involuntary confinement. I was moved by Jean Henry Mead’s comment on my last post, about the 98-year-old woman who jumped to her death from a nursing home window. My own father experienced a similar sense of abandonment when my stepmother abruptly placed him in a nursing home without consulting the rest of the family.

I was in New York City in my ninth month of pregnancy when I got his furious call from Michigan. She’d betrayed him, he said, and he wanted a divorce. Although he’d suffered from mild dementia, the outrage triggered total lucidity. I’m also convinced it killed him, because a cardiac event – what doctors sometimes call a sympathetic storm – caused his death early the next morning, before my husband and I could help make alternate arrangements.

That wrongful death preyed on my mind for years, and ultimately swayed my decision to choose eldercare as a profession. The same is true of Claire Lindstrom, the protagonist of Eldercide, my novel of medical suspense, as you’ll see if you read to the end:

              The trilling of the cell phone was so subtle that the sound carried barely twenty feet from shore, harmonizing with the chirping of the sparrows and the soft cooing of the mourning doves. If not for her dog Freia, Claire Lindstrom would have missed it entirely, but the big blond Labradoodle was dancing on the dock, wagging happily as she bounced around the little black instrument of torture.

            “Good girl!” Claire murmured as she steered the kayak in for a landing. She’d taught the dog this silent pantomime in deference to the neighbors, most of whom didn’t appreciate being stirred from sleep by a salvo of barks, no matter how magnificent the sunrise.

            Setting down the paddle, Claire grabbed the cell phone and peered at the caller ID. The number was Harriet Gardener’s. 

            A shiver swept over her, despite the rising heat of the early September day. As nursing supervisor for a couple of dozen home care clients, Claire was accustomed to getting calls at all hours of the day and night. Call her compulsive, call her a workaholic, but she’d made it clear to everyone on staff that she wanted to be brought up to speed on anything out of the ordinary, no matter what the hour. Most of the clients at Compassionate Care were elderly, and many were gravely ill. The aides knew better than to leave Claire out of the loop when it came to making judgment calls about the people in their charge.

            But Harriet Gardener was in excellent health, physically at least. She suffered from mid-stage Alzheimer’s and needed supervision to prevent her wandering away or burning down the house with her absent-minded attempts at cooking. But she was strong, and she rarely came down with so much as a sniffle. For the time being, thanks in large part to her live-in aide Dahlia Douglas, her quality of life was excellent. But inevitably that would change. Although they tried not to show it, the fact that she was fated to endure many years of painfully slow decline, culminating in the eventual loss of all her mental and physical functions, distressed her overwrought family no end. . . .

 Halfway across the lawn, she had the cell phone out of the bag, her finger poised over the callback button. She jabbed the button as she set foot on the first step, and the phone was ringing by the time she reached the deck.

Dahlia answered on the third ring, her voice weak and shaky. “Harriet’s gone,” she stammered. “It must have happened sometime in the night.”

Claire’s heart sank. “But Dahlia, how could she get out without your knowing? Everything’s locked up tight. You sleep right across the hall from her, and I know you’re a light sleeper.”

“Not that kind of gone.” Dahlia’s careful diction had yielded to the earthy dialect she usually reserved for the other Jamaican aides, and the melodic lilt of her voice was incongruously at odds with her message. “She’s gone. I mean she passed. I don’t understand. She was fine when I tucked her in bed last night. She had such a strong heart, and you know how the family used to kid around with me. We thought Harriet would outlive us all.”

Just like my father. Claire shivered. She took Dahlia’s report, somehow got through the formalities, hung up. Then, suddenly wobbly, she sank onto a chaise. Nine years ago, on a flawless September morning much like this one, she’d gotten a call from the nursing home where he’d been admitted the day before, suffering from mild dementia. He had gone to bed ostensibly healthy, died sometime in the night. A previously undiagnosed cardiac problem, they said. Or, as Claire always thought of it, a broken heart. He’d been furious when her mother shunted him off to a nursing home against his wishes, vowed to get out if it was the last thing he did. He had fulfilled his vow, although not the way he planned.

He shouldn’t have died that way, abandoned and alone in an institutional bed. His death shocked Claire into abandoning graduate school and entering nursing. She found her way into home care, where she could help keep people away from those warehouses for the dying. All these years spent making amends, and now it had happened again.

 Read the entire first chapter of Eldercide here on my blog. You can order the novel from Amazon or directly from me – see the page on how to order my books for contact information. I did the cover illustration for Eldercide – perhaps you can see that Munch is one of my inspirations.

13 thoughts on “Nursing home placement – another form of elder abuse?

    • Thanks, Diane. What was wrong was the suddenness with which the decision was made without any input from my father or the rest of the family – and the lack of advance planning. My father and stepmother married when both were in their mid-seventies. After the funeral, when I asked her if they’d ever discussed their wishes in regard to planning for this type of eventuality, she said it didn’t seem necessary – “Your father seemed so healthy.”

  1. I have to say that not all nursing homes are the same. My uncle was placed in our home town nursing home and the people were very caring there – he liked to flirt with the women employees and was so easy to deal with, he was a favorite. He was fortunate in that my sister visited him twice a day – her home is just around the corner -and took him out for rides very often. I noted that his sign-out sheet was covered with dates while other’s sheets were blank. Of course, it is a small town where everyone knows everyone else, so good care is practically assured, otherwise the whole town would knowabout it. Marilyn Rothstein

    • Marilyn, I agree that nursing home placement can be the best solution, and many are fine establishments. When I was running my agency, ElderSource, I encountered many situations where nursing home placement would have been preferable, but family had made promises to keep their elders at home come what may – not always the right decision, and the stress can be unbearable for all concerned – hence the plot of Eldercide!

  2. It’s a horrible dilemma for some families, especially when the spouse or “kids” are not so young and healthy, thus are unable to adequately care for the elder. I think with most nursing homes, the secret to competent care is frequent and unscheduled visits from the elder’s family members. Staying involved is critical, even if the elder is difficult, cantankerous, or suffering from dementia.

    • Good points, Patricia. Those with the most family involvement often get the best care. Ombudsman programs help too – I became certified as an Ombudsman when I was starting up my agency, and the training is very worthwhile, usually free of charge from not-for-profit agencies. They visit assigned nursing homes and act as advocates for the residents.

  3. Pingback: Tweets that mention Nursing home placement – another form of elder abuse? « Julie Lomoe's Musings Mysterioso --

  4. I’m so sorry about your dad, Julie. It’s difficult to lose a parent under normal circumstances. Devoting your life to elder care I’m sure has made him very proud.

    The above passage is beautifully written and makes me want to read the book.

    • Thanks, Jean, and thanks for the wonderful feedback about my writing – it means a lot to me! I wish I knew how to get my books out to more readers.

  5. I read what you’ve written, and it breaks my heart, not because of the thousands of elders who face such a situation, but for my mother. I have good reason to believe she is being financially abused. I have called and reported the situation. And I have been told that unless I am prepared to have her declared incompetent (something that would be a hard sell, because she is in good health and apparently capable of making decisions) there is nothing I can do. And so I am watching a young man my age, in good health, live with her, drain her retirement funds, and destroy her property value by filling her house, shop, property, and even the neighbor’s property, with junk.

    I’ve checked with numerous people, and received the same information–without a declaration of incompetency, there is nothing I can do to save my mother from the results of her foolish decisions. “There’s no law against making stupid choices,” was how one investigator put it.

    There are five of us. All of us have tried to persuade mom to do something to preserve her finances and assets (her accountant says she has about one more year of resources, at her current rate). Her friends (those she has not stopped seeing because they are “jealous” of the young man living with her are concerned about her. She is lying to the people at her church about her situation and her finances.

    When I last tried to talk to her about it she told me the “Lord would take care of her,” and hung up on me when I suggested that perhaps the Lord had, and she had some part in taking care of herself.

    It’s an impossible situation. And there’s nothing I can do. If you know of something, anything, please tell me, because I don’t want to see my mom eating cat food, and with the economy the way it is none of us have the resources to repair the income she is squandering.

    • What a devastating situation. Unfortunately, the people you’ve consulted are probably right in that she would need to be declared incompetent, and that’s very difficult to do, especially since, as you say, she appears to be in good health and capable of making her own decisions, no matter how ill-considered.

      Unfortunately, these types of scenarios are all too common – we saw examples when I was running my own home care agency, ElderSource.

      I’m assuming you’ve consulted with Adult Protective Services and with elder law attorneys. It sounds like a heart-breaking situation, and my heart goes out to all of your family, including your mother. Thanks so much for sharing.

  6. I took Eldercide with me on vacation and read and enjoyed it while we were away. Bill has started reading it. The mistreatment and even unnecessary deaths of seniors in nursing homes or even in home care situations is, indeed, disturbing. Thanks for writing this informative book, Julie.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s