The Careless in Elder Care

Those who are reared by parents that understand and impart the basics of human civility, like ethics, social skills, caring for others — in other words, by parents who act adult — are fortunate, indeed. For in this era of rampant selfishness, aloofness, and apathy, the fortunate are fewer and fewer.

It is old news to note the decline of things like neighborliness, good customer service, and loyalty in business: good old-fashioned qualities that went out with the ‘80s. Yet to well-adjusted adults who mourn these losses, what is not old is our utter inability to rationalize them. We wonder: Why now are so many people indolent, angry, indifferent? In all their wisdom, my best teachers impressed in me how much easier it is to live by acceptance than by animosity, and given how significantly different these opposites make not just the recipient feel, but also the giver, they were right of course. Then why, given the choice between accommodating and alienating, do so many these days choose the latter?

Particularly confounding is why so many who make their living providing care to senior citizens actually care very little. (Although precise data about how many older Americans are being neglected, exploited or abused are currently not available, according to the National Center on Elder Abuse, “Evidence accumulated to date suggests that many thousands have been harmed.”1 According to best estimates, as many as two million Americans aged 65 years and older have been mistreated by someone on whom they depend for care.2)

I know a wonderful brood, three sisters and a brother, who recently had to help their aging parents make the physical, and emotional, adjustment from real home to nursing home: in the lingo of health care, to an assisted-living facility. In assisted living, apartments are made available for elderly persons who are still capable of living independently, yet who need (as one senior-living website notes) “a little extra help to maintain their independence.” In other words (for thousands of dollars a month), assisted-living residents are provided 24/7 access to a full breadth of health-care services and licensed health-care professionals, from care companions to nurses and physicians.

In concept, splendid.

However, in the case of my friends’ parents (and too many others in their position) in the brief time since they arrived at their elderly-care home they have been beset by grievances, because too many of their caregivers continuously demonstrate that they don’t care. Among many cases in point:

1. Due to chronic arthritis, Mom has limited mobility; consequently she sometimes gets crotchety. Rather than accommodate her mood swings, or, at the least, brush them off (each response should be routine for health-care professionals; after all, grouchiness is common among the aged), several on staff regularly patronize her; some outright ignore her.

2. Mom and Dad have a beloved cat (who also happens to be elderly). Recently the litter box began to stink — this, because Mom had to temporarily move to the rehabilitation center for physical therapy, and Dad, who has middle-stage Alzheimer’s, sometimes forgets. On the day of Mom’s departure, a member of the housekeeping staff — who was aware of Mom’s and Dad’s situation — made an effort during her regular visit to help Dad clean the box. This assistance continued another day. However, on the third day a supervisor told the housekeeper to stop: Cleaning cat litter boxes is not in her job description. Later, as the supervisor was informing the siblings of this facility “policy,” she made an offer. The housekeeper would resume litter-box cleaning (a) for a monthly fee of $87.00 (this on top of the hundreds of dollars Mom and Dad had to pay, prior to moving in, for the “privilege” of keeping their cat); (b) however, the housekeeper would not be able to provide this assistance on weekends. When, naturally, the siblings queried the supervisor, she blamed the cat. “It should be gotten rid of,” she said.

Elderly-care homes are regulated at the federal level by the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services. One wonders how diligently these agencies watchdog their fair-practice standards.

At the senior-living community where Mom and Dad reside, its website boasts telling quotations: “It’s the most wonderful job in the world” (employee) and “Everyone is so friendly here” (resident). Of course, one would hope that these sentiments are real, given not only that they exude care at an enterprise at which care is paramount, but also given that more and more senior citizens are moving to elderly-care homes, including the Baby Boomers (5% of Americans aged 65 years and older currently live in elderly-care homes; by 2020 this number will have more than doubled3). Yet one wonders whether these appraisals are authentic or rather products of some ad agency’s creative brainstorm. (A third quotation — “Seriously. Fun. Living.” — is also attributed to a resident. Seriously, who talks like this?)

For a senior citizen who no longer possesses the strength or mental facility to maintain his/her own home, transitioning to an elderly-care home presents a major emotional challenge that should not be exacerbated by careless caregivers. Yet sadly — especially to dreamers as I, who keep wishing for a more perfect society — for too many elderly-care givers, “care” is a state of the mind and heart of which they are ignorant, or about which they couldn’t care less.

Someday many of these caregivers may feel differently when it comes their time to seek elderly care.

To those fortunate for whom caring comes naturally and from good upbringing, this irony is palpable.

  1. National Center on Elder Abuse.
  2. Elder Mistreatment: Abuse, Neglect and Exploitation in an Aging America. 2003. Washington, DC: National Research Council Panel to Review Risk and Prevalence of Elder Abuse and Neglect.
  3. U.S. Bureau of the Census.