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The Elderly as a Source of Profit
One of the purposes that this blog has come to serve over time is to show how acute problems that individuals face are often not theirs alone, but are the result of larger social and economic structures that work against them. Sometimes the damage done to individuals is an accidental byproduct of poorly thought out products or policies. Other times, it looks to be a disturbingly central element of the business model.
We’ve been alerted to an issue that no doubt many readers have had the misfortune to encounter, but our sense is that has yet to be recognized as a broader societal issue, namely, how the medical-industrial complex takes advantage of the elderly. As Lambert put it:
Eldercare is really the limit case of health care for profit. Stick a tube in the helpless body, extract rent. It’s brilliant in its simplicity!
We don’t want to pre-empt the excellent Maggie Mahar, author of the widely acclaimed book Money Driven Medicine, who is about to launch a series of posts on how longevity will become the major medical crisis of the 21st century, with Alzheimer’s and other types of dementia a particularly acute problem. She is starting this coverage with a discussion of Katy Butler’s book: Knocking at Heaven’s Gate. It chronicles what took place after a doctor insisted on outfitting her father, who was cognitively impaired after a catastrophic stroke, with a pace maker. It’s a troubling account of how families are effectively shoved aside in making decisions on behalf of loved ones, even when a medical power of attorney is in place. I strongly suggest you sign up for her e-mail alerts from her Health Beat blog
We had a reader, Mark L, tell us over the last two weeks of his worry and frustration about how his elderly father seemed to be held hostage in a rehabilitation facility. His father had previously been cared for at home by his wife with the assistance of a aide who visited four to five days a week. Mark L admitted he could not be fully certain of all the details, since he was working in Eastern Europe and was getting updates from his increasingly distraught mother. However, Maggie Mahar described an even more clear cut instances of medical “caregiver” overreaching in her correspondence with me, so directionally, Mark L and his mother’s fears seem well warranted. Key sections from one of his e-mails:
My father is 89 years old and was admitted to a hospital a little over a month ago because his care-giver said he was sleeping too much (both at night and during the day) and that was “not normal”. The care-giver contacted a nurse and doctor who thought it would be good to take him to the hospital.
The doctors could find nothing wrong with him. However, they guessed that this might be the effect of medicine he’d been taking for many years. Possibly the cumulative effect was to decrease the activity of his kidneys. This was speculative and it lead only to a brief period when the medicines were not administered.
In the end, the only problem was that he’d lost strength from being in the hospital bed, and sleeping so much without being on his feet. So, he was admitted to a “rehabilitation center” – presumably one owned by the same for-profit entity that owns the hospital.
My mother was told that he would be there for two weeks, to get his strength back. (During the time, he was to be given physical therapy, and regularly walk with the assistance of staff.)
Now that two weeks are almost up, my mother has just met with a Social Worker and an Unidentified Hospital Employee — someone who had no name badge, and who did not even have the courtesy to introduce himself.
My mother was informed that Medicare would pay for so many days, and that their Private Insurance would pay for so many days, and that after that, she would have to pay. But the message was that my father will not be going home.
No explanation has been given as to why he must stay longer than two weeks, and the orginal reason for admitting him to this facility has not been referred to again.
Evidently the goal of this is to obtain the maximum amount of money, and indirectly to bankrupt the family.
Note well: The entity where my father is being held is under-staffed. My father has been found wandering around because no one is keeping an eye on him. And, that on several occasions.
Moreover, due to Skype, I was able to hear a conversation between my mother and the care-giver in which she described the situation in the facility. She did not use the word “understaffed” but between her sympathy for those who work there and the words she actually used, it is clear that the problem is an insufficient number of staff. The care-giver was trying to help out in sympathy with those who worked there because she’s worked in such facilities before. She identified with the situation of the employees there, saying words to the effect that you go to one room, check that someone is OK, and then rush to the next room or to a room where there is a problem. In other words, there is not time to give proper attention to any one individual. This is not what my father deserves, nor should it be legal. It is not acceptable. It is plainly a case of housing people in an under-staffed facility.
Most recently, when my mother’s care-giver visited the hospital to spend time with him, she did not find him in his room. Instead, she found him unattended with an oxygen cord dangerously wrapped around his neck in a room down the hall from his room. He was unharmed, but he was in the wrong room, and confused.
This looks to me like a scam – BAIT and SWITCH — aimed at extracting the maximum amount of money for the for-profit entity. Bait: Only two weeks to get his strength back. Switch: Now, that we’ve got him, we won’t let him go; and you will have to pay!
I must emphasize: in this facility, my father is not receiving the care he needs, and he is not happy. He frequently complains that he wants to go home, and he asks for my mother at night. (To deal with his “anxiety” they give him a pill. But if anything, his desire to leave the place is evidence that he remains rational. No sane and healthy person wants to be in such a sterile, lifeless environment, without a familiar face, and only the professional affection of nurses, if one happens to be present.)
When my father was hospitalized in the past, my mother stayed in the hospital with him. Now, they do not allow her to stay at this under-staffed facility. Moreover, my parents have been married for sixty-three years, and this separation, is, in and of itself cruel.
All for the sake of profit. And not because the care-givers or nurses are receiving high salaries or generous pensions.
The doctors could find nothing wrong with him. However, they guessed that this might be the effect of medicine he’d been taking for many years. Possibly the cumulative effect was to decrease the activity of his kidneys. This was speculative and it lead only to a brief period when the medicines were not administered.
In the end, the only problem was that he’d lost strength from being in the hospital bed, and sleeping so much without being on his feet. So, he was admitted to a “rehabilitation center” – presumably one owned by the same for-profit entity that owns the hospital.
My mother was told that he would be there for two weeks, to get his strength back. (During the time, he was to be given physical therapy, and regularly walk with the assistance of staff.)
Now that two weeks are almost up, my mother has just met with a Social Worker and an Unidentified Hospital Employee — someone who had no name badge, and who did not even have the courtesy to introduce himself.
My mother was informed that Medicare would pay for so many days, and that their Private Insurance would pay for so many days, and that after that, she would have to pay. But the message was that my father will not be going home.
No explanation has been given as to why he must stay longer than two weeks, and the orginal reason for admitting him to this facility has not been referred to again.
Evidently the goal of this is to obtain the maximum amount of money, and indirectly to bankrupt the family.
Note well: The entity where my father is being held is under-staffed. My father has been found wandering around because no one is keeping an eye on him. And, that on several occasions.
Moreover, due to Skype, I was able to hear a conversation between my mother and the care-giver in which she described the situation in the facility. She did not use the word “understaffed” but between her sympathy for those who work there and the words she actually used, it is clear that the problem is an insufficient number of staff. The care-giver was trying to help out in sympathy with those who worked there because she’s worked in such facilities before. She identified with the situation of the employees there, saying words to the effect that you go to one room, check that someone is OK, and then rush to the next room or to a room where there is a problem. In other words, there is not time to give proper attention to any one individual. This is not what my father deserves, nor should it be legal. It is not acceptable. It is plainly a case of housing people in an under-staffed facility.
Most recently, when my mother’s care-giver visited the hospital to spend time with him, she did not find him in his room. Instead, she found him unattended with an oxygen cord dangerously wrapped around his neck in a room down the hall from his room. He was unharmed, but he was in the wrong room, and confused.
This looks to me like a scam – BAIT and SWITCH — aimed at extracting the maximum amount of money for the for-profit entity. Bait: Only two weeks to get his strength back. Switch: Now, that we’ve got him, we won’t let him go; and you will have to pay!
I must emphasize: in this facility, my father is not receiving the care he needs, and he is not happy. He frequently complains that he wants to go home, and he asks for my mother at night. (To deal with his “anxiety” they give him a pill. But if anything, his desire to leave the place is evidence that he remains rational. No sane and healthy person wants to be in such a sterile, lifeless environment, without a familiar face, and only the professional affection of nurses, if one happens to be present.)
When my father was hospitalized in the past, my mother stayed in the hospital with him. Now, they do not allow her to stay at this under-staffed facility. Moreover, my parents have been married for sixty-three years, and this separation, is, in and of itself cruel.
All for the sake of profit. And not because the care-givers or nurses are receiving high salaries or generous pensions.
More at http://www.nakedcapitalism.com/2014/05/elderly-source-profit.html .
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