Guest commentary: Nursing home lobby stifles change

Senior citizens have a vision for the future: Virtually every long-living adult wishes to live in their own home, and many say they would rather die than go to a nursing home. The wait list for in-home support is at 40,000 and growing; the nursing home vacancy rate is at 25 percent and growing. Ignoring the clear choice of seniors, the Department of Health and Hospitals continues to spend twice as much on nursing homes as on in-home support for seniors.

This injustice goes way beyond what statistics can capture. Two recent reports, one by the legislative auditor and one by AARP, detail a nightmare for the 25,000 seniors in nursing homes. The legislative auditor’s investigation disclosed life-threatening and spirit-crushing conditions in numerous Louisiana nursing homes: pressure sores, physical restraints, psycho-active medication used as restraint, understaffing and pervasive clinical depression.

Please take a moment and imagine being in such a “home.” Pressure bed sores are caused by prolonged neglect. Physical and chemical restraint, the restraining “geri-chair,” tying people to beds and drugging people, are all ways that the industry substitutes social control for staff support. Ever since Robert Butler, the first director of the National Institute on Aging, published his nursing home investigation in 1968, titled “Houses of Death are a Lively Business,” nursing homes have been infamous for substituting physical and chemical control for staff support. Quite simply, it’s where the money is.

One does not have to wonder why people in nursing homes withdraw and are deeply depressed. What would you and I do?

In the past three weeks, I have called DHH, members of the House and Senate Health and Welfare committees, the chairs of both Health and Welfare committees and many other representatives and senators. In my calls and emails, I requested that the Joint Health and Welfare Committee hold hearings on the reports to investigate the life-threatening conditions affecting 25,000 Louisiana seniors. I also requested that DHH specifically respond with a follow-up investigation and reform plan.

The response has been silence.

Even the free market, so often extolled by DHH officials and Louisiana legislators, is, on its own, clearly moving to phase out nursing institutions. Market demand has been continually declining for nursing homes as reflected in a 25 percent vacancy rate; market demand for in-home support is at an all-time high, with 40,000 people willing to wait as long as 10 years for in-home support.

But this is no free market. The nursing institution industry contributes more money to legislators and the governor than the oil and gas industry. Nursing home special interests have bought “protection” on a massive scale: Nursing home rates have enjoyed a 38 percent increase in the past four years, while in-home support rates have been cut by 23 percent during the same period. Nursing homes are even paid for empty beds. With legislative support and DHH acquiescence, nursing homes are close to passing a constitutional amendment, which will make nursing home budget cuts illegal.

The Legislature does not uphold the sacred free market when political contributions cascade like a waterfall. And DHH remains on bended knee before nursing home political power.

The legislative auditor and AARP have exposed the pretense of Louisiana nursing homes as a source of quality medical and social support and revealed the true nature of what the political class is protecting — greed-motivated practices that inflict suffering and despair on thousands.

In the face of these alarming revelations, DHH and the Legislature have chosen silence — in effect, collaboration with a life-threatening industry.

Clearly then, it is up to us to protect seniors and advocate for deep reform. Pressure your legislators and DHH to shift resources from nursing institutions to what our citizens want and what best practice prescribes: a system of quality, person-centered in-home support.

The life you support may be your own.

Bruce C. Blaney coordinates the LA Supported Living Network, an association of in-home support agencies. His wife oversees an in-home support agency.