The Last Days Of Their Lives


An eight-year investigation of nursing homes by the Department of Health and Human Services has come up with conclusions that are not surprising to many people. The care of frail, elderly people in many nursing homes is dangerously inadequate.

Sen. Charles E. Grassley, R.-Iowa, chairman of the Special Committee on Aging, said understaffing "means that residents don't get fed enough...don't get turned to prevent bedsores...end up in the hospital much more often than they should." (Maybe it'll be a hospital where there will be someone to feed them and turn them and change their diapers, and maybe not. But that's for another investigation.)

The 200,000-word report by the federal health officials sets minimum standards. Staffing should be adequate to provide each patient two hours of care by an aide each day and 12 minutes of care by a registered nurse. In more than 50 percent of the nursing homes surveyed, this level of care is not being provided. This is scandalous.

A frail, elderly person who is bedridden needs to be bathed in bed each day. He or she very likely must be fed each spoonful, maybe given liquids slowly with an eyedropper. Such a patient ought also to have simple range-of-motion exercises once a day. And be turned in bed every two hours. Then there is the sanitary care of the old person who can't get to the bathroom. Those are the essentials. An added comfort would be the occasional opportunity to be lifted into a chair for a while.

On some days all of this might take more time than on others. But two hours would never cover the needs.

There's a lot of bottom-line talk about the problem. The nursing home conglomerates say they are hurting from inadequate Medicare reimbursements. Health care aides are underpaid because of this. So it's difficult to fill the jobs, especially in this period of low unemployment. All of this is reportedly being looked into because of the findings of the report. And it certainly must be. In this land of prosperity, such neglect of the elderly is a disgrace.

However, there is a much deeper level of concern to be addressed. Helpless elderly people need the same kind of care that babies need. Only they're not tiny and cute, and they're not always sweet. No matter how much you paid some health care aides, they wouldn't get the concern they need.

In a glitzy nursing home with crystal chandeliers and a lake view where I used to visit a relative whose Down syndrome had progressed to Alzheimer's disease, I saw the neglect described in the new federal report. Wondering if maybe somebody could hold his hand for a little while to diminish his loneliness was a ridiculous idea.

Even if a person's physical needs were taken care of, there would remain the loneliness, the longing for tender concern. The frail elderly have virtually nothing left. They don't see or hear well, or at all. They have no freedom. They may not even have memories any more. Imagine the feeling of abandonment.

We know there are institutions which are based in Catholic teaching, in Christian concern for those who are helpless. They are struggling with Medicare cuts, too. But tender, loving care remains part of their mission.

Then there are the volunteers, who take seriously the Lord's call to visit the sick. What a wonderful thing to do. There are many of you, members of parish groups and other apostolates who visit the patients in nursing homes. You are people of love who go to places where love is most needed. To people who deserve to be cared for and loved during these last days of their lives. How can any society fail to realize that?