CNN had an article titled “The darker side of living to 100” which examined the costs associated with extreme ageing. The morbidities and infirmities that the extremely aged suffer are not so much ignored as abandoned to the efforts of medical services and social care.
“In Denmark, one of the few national surveys of nonagenerians was conducted around the turn of this century. The researchers found that the majority contacted had some disability and that women were more often affected than men. The same researchers also observed that “about 10% of the octogenarians and more than 55% of the centenarians live in nursing homes, while dependency rises from approximately 30% to 70%, and the prevalence of dementia rises from approximately 7% to 50%”.
Estimates suggest that chronic pain “in people aged 85 years or older is common”, affecting the majority of people from this age group.
In 2017, an 85 year-old woman was assaulted by a staff member at The Poplars nursing home in North Epping, Sydney. All if this was captured in a video which shows the 59 year-old Dana Maree Gray pulling off the woman robe, hitting her with her hand repeatedly and then taking a full garbage bag and attacking her with that.The assault continued with Gray pulling the elderly woman’s hair and dragging her body back and forth, and when she finally left the room, Gray left the bed in such a position that she was unable to properly sit or lie down. The video of the attack was shown to the court and it was found to be so disturbing that the magistrate would not release it to the public.
It should be noted that the elderly woman also had dementia, and though it was clearly evidenced through the video how horribly she was treated, she could not tell the story herself on account of being unable to remember.
Gray and her lawyers asked that her case be heard under the Mental Health Act in Australia, which could have helped make allowances for her behavior by siting a mental health problem as the cause of the even. But the magistrate refused to use the Mental Health Act, saying that would turn the attention away from the defendant’s gross conduct and allow the blame to be set away from her actions.
These cases don’t just happen in South Carolina, and they don’t just happen in the U.S. Across the world, the elderly are vulnerable to abuse and neglect at the hands of malicious workers who choose to hurt them instead of help in addition to corporations and systems which allow this kind of behavior or endorse neglect through understaffing and underfunding their own facilities.
A few weeks ago, a disruption was reported late in the morning in Fountain Hills, Arizona, where police soon found a 72 year-old man shot twice in his home. Earlier that morning his mother, who had been up for days upset about a dispute they’d been having, walked into the room where her son and his girlfriend slept, and killed them. What was the object of this dispute? Fear of being neglected at a nursing home.
Before the incident, Anna Mae Blessing had been living with her son and his girlfriend for about six months. The two didn’t get along very well and on multiple occasions each one had called the police, both separately suspecting the other of potential violent behavior. Within the house, there were 13 guns, 11 which belonged to the unidentified son and 2 which belonged to Blessing.
In the days leading up to the murder, Blessing’s son informed her that she had become too difficult to live with and he was going to place her in the care of a nursing home. This made Blessing extraordinarily angry, knowing that oftentimes those who live in nursing homes are unhappy or not taken care of as well as they’d like to be. So in response, after days of thinking and growing in her anger, Anna Mae Blessing took her two pistols, hid them as she walked into her son’s bedroom, and shot him twice before his girlfriend intervened and prevented any more use of the weapons before she herself fled the scene. Reportedly, Blessing went back to her bedroom and waited in her chair until the police arrived, where she said “You took my life, so I’m taking yours,” as they took her away. Later, however, she also said she wanted to kill herself after committing those crimes.
The fear of being sent to a nursing home certainly wasn’t the only cause for this crime, but it remains a significant factor. Anna Mae Blessing had trouble living with her son, but she truly believed that leaving him for an assisted living facility would take away her life completely. She knew how people are often treated at nursing homes, with poor living conditions and bad food sometimes being just the tip of the iceberg. There were always stories of abuse and neglect and people developing illnesses and injuries they never should have had. It’s unacceptable that Blessing felt she had reason to kill her son when around the corner lay a nursing home where her life would be taken away.
A while ago a report went out that three South Carolina residents had been charged with 38 counts of serious crimes including healthcare fraud, money laundering, identity theft, and wire fraud. As a part of the schemes, Cameron Banks and his partners Angela and Solomon Pyatt applied for loans in the names of patients at the dentistry practice where Banks worked, converted funds for personal use, and falsified many other forms of documentation and applications in order to illegally obtain money. Each crime separately is worth 10 or more years in prison and at least $250,000 in fines. In the past Banks, who’s been known to go by the alias Reggie Staggers, had also been charged for federal tax crimes, as well as arson in relation to a church at which he was pastor.
Cases like this of healthcare fraud and identity theft are more common than one might think. While it sounds like something for which you’d have to go to great lengths and pains, maneuvering and jumping through government hoops to trick a whole system into giving you money, the reality of healthcare fraud is still this: people like Cameron Banks, in addition to real doctors and nurses, are able to mischarge for procedures they may never have performed, pretend to be patients in order to make claims on their behalf and receive that money, and find many other creative ways to siphon funds.
The world of nursing homes and elder care isn’t excluded from this crime either. In fact, because the elderly often lack the ability to vouch or stand up for themselves the same way a normal patient would, it becomes even easier for healthcare workers to engage in fraud and more difficult for the government to catch them. The most popular form of this comes from home healthcare services where the physicians and other healthcare workers will have patients sign documents stating they were attended to at home or helped in ways in which they weren’t. The workers will then receive payment for services which were never provided and slowly build up their personal funds.
When someone has trouble breathing in an emergency situation, doctors often employ intubation, a method of helping patients to breathe by inserting a tube down their throat and connecting them to a ventilator to help or replace the process of breathing. Because of its function, many people think of intubation as a miracle procedure — or at least one that works well. It’s supposed to help keep people in serious, painful conditions alive. But, especially for elderly and geriatric patients, that might not be the case.
For an elderly patient, whose condition would be easily weakened or changed, the process of intubation can be particularly invasive. Aside from removing the patient’s ability to speak and sedating them, the process also shows the potential of causing damage and danger to the lungs, throat, and other vital bodily functions.
The New York Times published an article about the unknown dangers of intubating elderly patients at hospitals. It shows, through evaluation of different scientific studies, that elderly patients rarely benefit from intubation. Instead, they are at risk for many more complications as well as pain, injury, and even death as a result of those complications.
In realizing the danger intubation poses toward older patients, doctors have looked to methods of “noninvasive ventilation” as alternatives to intubation, which would cause less physical distress to the body. For example, BiPap devices fall under this category, using a mask over the face instead of a tube down the throat to facilitate healthy breathing. It also gives patients better options in terms of communicating and controlling their own faculties, in addition to running a much lower risk of death or extensive treatment after it’s employed.
When it comes to elderly patients, it’s easy to think of them as an exception. If they don’t naturally react well to a process like intubation, any outsider could think their fragility or susceptibility to pain would be unavoidable due to their age or preexisting conditions. On the other side, family members of elderly patients who have to choose whether to allow intubation are likely to believe their loved one will be an exception to the risks involved in the procedure and follow the more dangerous path.
But these patients don’t necessarily have to live with those risks and pains, and their family doesn’t necessarily have to make such a heavily weighted decision. If innovations in noninvasive ventilation continue to come through, many elderly patients and their families will be saved serious heartache.