Is there purpose in the foregoing question? One might answer “It is both!”

I have written on the issue in the past and it came to the foreground the night before last as I was reading Just a Word by Rose Lamatt.

The story is about Lamatt, the caregiver, caring for her partner Carol who was diagnosed with Alzheimer’s Disease (AD) and lived another ten or so years. I have not finished the book so cannot be precise. In the later stage Rose placed Carol in a nursing home when Rose could no longer physically handle Carol.

The first nursing home was a disaster. Although well rated in the state a friend who worked at another nursing home said this was the worst of the worst. Based on the lack of care, gross in their omission of providing basic hygienic care, Rose transferred Carol to the nursing home of her friend. In each nursing home Rose provided and paid for private care to supplement that provided by the home.

In the first Rose found Carol in the bathroom pounding her frustrations out with the nursing home attendant and the private duty attendant one sitting in a chair the other lying on the bed outside the bathroom, well within hearing, watching TV. She found Carol, incontinent, not changed when needed, found a dirty diaper lying in the hall for two days outside of the door.

In the second home service was a little better but there were still dramatic oversights. One such was coming in to find Carol in the bathroom pounding on and breaking the mirror.

After listing much of this Rose made the following comment on pp. 1277-79 (Kindle Edition)

I understand things are tough, but what’s happened to, respect for your elders and the ill? Doesn’t it mean anything anymore? I’ve come to believe Health Care is an Industry not a service. … but it needs fixing, not with a bandaid, but an overhauling from top to the bottom. Too many generals and not enough soldiers. Too many suits and ties, and nice dresses, while hands on people are underpaid and overworked. When will it change? Order Just a Word at Amazon.com Book information:

Paperback: 180 pages
Publisher: CreateSpace (February 9, 2009)
Language: English
ISBN-10: 1440475172
ISBN-13: 978-1440475177

I asked at the start of this essay “Is there purpose in the foregoing question?” namely “is health care a service or an industry?” This question in its asking so succinctly describes what I have lamented in earlier essays I have written.

I have posted part of an essay I posted on an Alz.Org Message Forum this past April following my experience of ½ a month in a transitional care unit. Transitional Care is a euphemism that falls between and extended care ward of a hospital and a nursing home. It is in all ways a nursing home.

My Essay WHAT’S WRONG WITH THIS PICTURE? Is posted at MY ALZHEIMER’S ARCHIVE OF ARTICLES AND MEMORANDA

I was in the best of the best of the nursing homes in my area. I was appalled at the service wondering what it must be for some of the less costly ones. In the essay I illustrate my treatment, or lack of it. I also question the system.

My questions of the system was where does the money go? It goes to the Heads, the Supervisors, the Consultants, the variety of programs that support the infrastructure. When all of that is paid there is nothing left with which to pay staff.

Therefore professional service providers receive minimal pay and aids receive minimum wage. In my experience in a “good home” at best no more than half the aids could communicate with the patients because of inadequate language skills.

In my home County years ago the County Supervisors built a new Court House. When they did they forgot to put in Court Rooms. They remembered good offices and great meeting rooms, but Courtrooms? Oooops, they built an annex.

We have some great well run nursing home but poor and cheap service.

Industrialization has diminished service; Rose Lamatt said it so well!

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