A Tale of Two Elders

Concern for elderly relatives and friends has been heightened during the coronavirus pandemic.   In the last month, I have visited two nonagenarians:  one was in the assisted living portion of a large multi-level care facility; the other, in her own home.  In both, frequent hand washing or sanitizing by visitors was done.  The assisted living facility visit required a mask and at least six feet of distance between us at all times.  The second nonagenarian refused to wear a mask, and we ate several meals together, maintaining some interpersonal distance.  Both visits were incredibly special, and I am grateful that we all continue to be well.

Thanks to Andrew Cockburn’s “Elder Abuse” article in Harper’s Magazine, I have formulated some important questions to ask about the care facilities for elderly that abound in our nation.  These should be helpful for relatives and friends who are either in long-term care facilities, or contemplating moving into one:

  1. Are you/will you be close to concerned relatives or friends, or far from any potential visitors?
  2. How often are visitors allowed?  What are the rules, including during a pandemic?
  3. Who owns the facility?  Have there been any fines levied for substandard care/other problems?
  4. Is the facility in a state that has legislation holding harmless the facility during this pandemic?
  5. Does the state where the facility is located have an ombudsman for senior care?  Is that office functioning now?
  6. Is there a local newspaper/reporter who publishes on senior issues?  Read their articles, and consider sending an email to interact with the writer of any article on elder concerns.  Building bridges in the community is important.
  7. Not to put too fine a point on it, but who will be paying for the care?  The “Elder Abuse” article points out that nursing homes strive to obtain the “right mix” of Medicaid and Medicare patients.  A COVID-19 diagnosis can benefit facilities monetarily; but then, so can discharging Medicaid patients in an effort to open beds for patients with higher-paying Medicare benefits.

Using data from the World Health Organization, Cockburn reports the differences between, inter alia, the United States and Greece, in terms of elderly casualties from COVID-19.   The United States has 515 nursing home beds per 100,000 population; Greece, 15.  The United States has 39 COVID-19 deaths per 100,000; Greece, with the “largest proportion of elderly people in Europe,” has two deaths per 100,000.  The author suggests, “One might almost conclude that the death toll that has so traumatized and destabilized much of Western society in 2020 was not wrought principally by the coronavirus, but by nursing homes.”

The nonagenarians I recently visited are both Americans.  The masked 93-year-old in an assisted care facility has been restricted from speaking with other residents he meets in the hallway or when he walks outside on the well-manicured grounds.  He has spent months having meals delivered to his room where he eats alone.  He spends thousands of his retirement dollars per month, but cannot be said to be happy with his purchase.  The other nonagenarian I visited lives alone.  She has not seen the inside of a store since March, because other people shop for her, using lists she has provided.  Her budget is significantly smaller than her counterpart described above, but she is rich in relationships.  For her birthday this summer, she received 123 cards. 

The Greek model of elder care seems clearly a better choice. Americans could do this — without importation tariffs.