Recent events leading to the slow death of nursing home care are a betrayal of America's frail elderly. Congress is slashing the budget for long-term care by $65 billion over the next 10 years on top of the draconian 11 percent Medicare cuts that went into effect last October.
These cuts are so deep, so great and go on for so long they are tantamount to barbarism of our frail elderly populations and nothing less than a betrayal of American social ideals as espoused by President Lyndon B. Johnson who said, "Older citizens will no longer have to fear that illness will wipe out their savings, eat up their income, and destroy lifelong hope of dignity and independence. For every family with older members it will mean relief from the often–crushing responsibilities of care. For the Nation it will bring the necessary satisfaction of having fulfilled the obligations of justice to those who have given a lifetime of service and labor to their country."
The sad reality is those who have the most to suffer have the least power to do anything about it — those patients who cannot get out of their wheelchairs or out of bed or who have dementia. Those who have no family or friends in a position to step in should the need arise. They lack the strength to write a letter much less go to the polls. Often the only representation of this voiceless constituency is their caregivers. Under the banner of fiscal responsibility, the government would turn these helpless aged out. Perhaps if caregivers lined up the hundreds of thousands of these patients in need in front of the capitol in their hospital beds their voices would be heard.
Yet, this moral argument need not stand alone. It can stand shoulder to shoulder with an economic one. For a certain demographic of patients, institutional nursing care is the least expensive responsible option. What are the alternatives for a frail, chronically ill patient too weak to get out of bed, who may be suffering from cognitive disease? If this person lives at home he (or she) will need a nurse 24 hours a day along with specialty medical equipment. The home health care cost of a 24-hour-a-day nurse with necessary medical equipment far exceeds that of nursing home care. On the other side of the coin the cost of long-term hospital care is so much more expensive than nursing home care the comparison is absurd.
The modern institution of nursing home care established in the United States in 1965 is being pushed beyond the brink of operational viability, and the frail elderly populations it supports are (unknowingly, in most cases) facing a barbaric and primitive borderline geronticide. Without diversification in their portfolio, they would be staring down chapter 11. The skilled nursing divisions of these large companies and others are, presently, known as "loss leaders"— and a lot more cuts are coming. Are we facing a return to primitive societies and their practice of senicide? It has been said the measure of greatness of a society lies in how it treats its most vulnerable.
Further, nursing home care is one of the nation's largest employers. The disappearance of this industry would leave a large void of hundreds and thousands of health care workers and administrative teams without jobs.
The nursing home business is not glamorous; it is a mature, low margin industry. Despite how it might appear given the current health care crisis, many in the industry are there, not for money, but because they care. "(The elderly) have been caring for younger people all their life, and here we can 'do' for them." — nursing home volunteer. Are we really asking ourselves, as a nation, whether or not we are willing and capable to care for those, who due to advanced age and poverty, cannot take care of themselves?
Roland Kirton is a business analyst with Avalon Health Care Group Inc.