Sheila Fox, Contributing Editor
The World Health Organization defines Ageism as “the stereotyping, prejudice and discrimination towards people on the basis of age.” 1
I am a 72-year-old, white, Jewish, retired Clinical Social Worker, living in Delaware County, Pennsylvania. When my father was dying in the hospital in 1995, the medical staff told us, his family, that he must be discharged to a nursing home. My sister and I went on a frantic search and did find a good nursing home. He died two days after admission.
We visited several nursing homes, drab, bleak, hospital like settings. Their images stay with me until this day. The residents in these nursing homes are our parents, grandparents, partners, people we love.
According to the A.A.R.P. (American Association of Retired People), December 2020 Bulletin, fewer than one percent of Americans live in long-term care facilities, but 40 percent of Covid 19 deaths have occurred there. As of December, 2020, 100,000 residents and workers in these long-term care facilities will have died of Covid 19. 2 As of May, 2020, 68 percent of the total Covid 19 deaths in Pennsylvania have occurred in nursing homes and long-term care facilities. 3
These are stark, bleak statistics. How did this happen? What can we do about it?
How much do our own attitudes towards aging play a part in this social policy?
In 1965, Medicare, the federal health insurance plan for those over 65 and Medicaid, health insurance for the poor, became the major payors for long-term nursing home care. 70 percent of all 15,650 nursing homes in the U.S. are for profit. In 2017, 166 billion dollars in income was received by nursing homes in the United States. Medicare pays approximately 350 dollars per day for up to 100 days of skilled nursing home care. Medicaid pays approximately 200 dollars per day for long-term skilled nursing home care. 3/5 of the long-term fees are paid for by Medicaid. Medicare and Medicaid do not pay for long-term in-home nursing care. 4
Most nursing home aides are paid approximately 13 dollars per hour with no benefits. This leads to high staff turnover and constant staff shortages. There was widespread failure to provide early and adequate testing for Covid 19 in nursing homes. This led to the high number of deaths. 5
Most elderly people would prefer to remain in their own homes. The main obstacle is lack of government funds to pay for in-home skilled nursing care. Also, there is no government paid leave for family members to care for the frail elderly. This must change. 6
The A.A.R.P. advocates for a five-point plan for care homes during the pandemic:
- Regular testing and reporting.
- Adequate safety equipment and staffing.
- Transparency in government Covid 19 spending.
- Virtual visitation for families.
- No blanket legal immunity for long-term care facilities. 7
What can we as individuals do?
- If possible, volunteer to take a shift for a frail elderly person at home. You can do this for a friend or family member. You can also volunteer at local agencies. There is a list of local resources at the end of this article.
- Carefully investigate any nursing home before you place a frail elderly person there: ratio of staff to residents, meals, recreation, socialization, physical therapy.
- Add elder care to your list of priorities as you vote, petition, advocate for change. Form an elder care committee in the organization that you belong to.
- Carefully examine and reflect on your own ageist attitudes. As modern medicine increases our life expectancy, what kind of quality of life are we entitled to as we age, become ill and may need long-term care?
- PA. Dept. of Health. Covid 19, nursing homes. 1-877-712-3250.
- LeadingAgePA. Non-profit, advocacy for continuing, evolving service for the aging. 1-800-545-2270.
- C.A.R.I.E. Center for the Rights and Interests of the Elderly. Non-profit. Many programs, volunteer opportunities, direct assistance. 1-800-356-3606.
- A.A.R.P. American Association for Retired People. Nationwide membership organization. Advocacy, research, benefits for aging empowerment. 1-888-687-2777.
- P.C.A. Philadelphia Corporation for Aging. Non-profit, advocacy, liaison for many direct services and assistance for the elderly. 215-935-6321.
- Phila.gov.stayinyourhome/ Division of Housing and Community Development.
- Alana Officer, Vania La Fuentes Nunez, “A Global Campaign to Combat Ageism.” Bulletin of the World Health Organization, Vol. 96(4), pp. 295-296.
- The Editors, “Covid 19 and Nursing Homes: An American Tragedy.”A.A.R.P.org., December 2020, Vol. 61, No. 11, p. 7.
- The Editors, p. 7.
- Joe Eaton, “Who is to Blame?”A.A.R/P. Bulletin, December 20, 2020, p. 21.
- Joe Eaton, p. 22.
- Joe Eaton, p. 25.
- Jo Ann Jenkins, CEO, “Turning the Pandemic Tide.”, A.A.R.P.org. Builletin, March 2021, Vol. 62. No. 4., p. 42.