31 July 2010

Elder Abuse

Grandma dies on her 81st birthday, with sores large enough to see the tendons through. She had been sitting in her own filth and allowed to sit in a recliner all the time. Charges are forthcoming against the family members she lived with.

Wow.

You know, I used to be a really judgmental person on stuff like this. How could you NOT NOTICE sores in which you can see the muscles and stuff beneath? Wouldn't it stink? Wouldn't you notice that Grandma's toenails are all curled up into her skin and that she's uncomfortable?

Well, I'll say this. I'm not sure if charges are warranted or not. I'm not the cops or the hospital room attendant. I'm pretty sure the jails are crowded enough that they don't just go looking to toss people into the slammer at taxpayer expense. But I'm also pretty sure that mistakes can be made, too.

The story tells us that among other outrages, Mary Araujo had "1-inch facial hair around her mouth." Now think about this. Is this even something to get worked up about? I'm looking at it from the older person's perspective. Everything takes up all your energy. You want to stay home and not be bothered with extra stuff like eyebrow plucking and facial waxing. That doesn't mean you want your name plastered on the internet after you're dead with a description like, "one-inch long facial hair" (the CORRECT way to write that, AOL News. You never type numbers under ten. But 11 and up you write like this. Though I just looked in the *new* AP Stylebook and saw that they have deemed that to be correct. The losers. Good grammar compromised to save space. But back to the story.)

You're incontinent every five minutes. Are you really "sitting in your own filth" because it's someone else's fault, or are you just leaky all the time? I'm picking the latter. It would have to be really, really awful for me to think about pressing charges if I were a prosecutor. Even with a diligent family, you're NOT going to be able to prevent someone from "sitting in her own filth" from time to time. The situation just causes filth too frequently.

And the sores? Where were they located? The story doesn't tell us. If I were old, and pooping and peeing and not able to bathe thoroughly, and my clothes even when they were washed still had that urine-y smell, do you think my caregivers would smell "bedsore" over the ickiness? Probably not. And I can't imagine it would be "appropriate" for a daughter to ask her mom to show her butt off every day so that she can check for sores.

And do you know what my reaction to you is going to be if you suggest that I should let you shave my facial hair? Guess.

Even in a good nursing home, if you push the call button, sometimes they take 45 minutes to respond. I do know a person who died in a nursing home with sores and problems as described in this story. Sometimes people refuse care. Sometimes folks do all they can, and it isn't enough.

Does that mean I think these caregivers are totally innocent? No. I think the position of caregiving is one in which you will NEVER be innocent. No matter what you do, it is never enough. Someone will always, always be able to ask, "Why didn't you do this?" Or that... or consult this specialist... and why aren't her toenails done nicely? (Have you ever seen how difficult it can be to care for an older person's foot? Especially if complications like diabetes come up.)

I'll leave the judgment of this situation to the judge or jury of this case, but I wanted to put out there that while there IS elder abuse out there, not all of it is intentional. Not all of it is vicious. Sometimes the patient's rights should be respected, even if the patient doesn't quite have all her marbles. And I'm quite certain that there are many people in situations like this asking for help and not receiving any.

7 comments:

  1. Mrs. C,

    I simply cnanot agree with you on the substance of this post. When I was a child my elderly dying uncle lived in our house. My parents bathed him every day, fed him, changed his clothes.

    Right now, I have another aunt who is caring for my elderly grandmother. She takes good care of her. Helps her in and out of the tub, administers her medication, combs her hair.


    If a sick, elderly person needs care, it is impossible to give it properly and not see deep bedsores, smell rotting flesh, or the stink of urine.

    If we are talking about someone who can provide a bit of self-care, then that's different. In that case I could see where you're coming from. That's not what I get here.

    Bottom line: we have grown too comfortable with the idea that we are not responsible for caring for our elders. The analogy that caring for a very old person is much like caring for a toddler is true in many instances. It takes work, time and attention to the details.

    May God give me the strength and grace to rise to the occasion and do a good job if such a responsibility falls to me.

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  2. If I might add one more point: I know that the family memebers said this woman rejected offers to help her bathe. They should not have taken 'NO' for an answer.

    Yes, I am saying they should have picked her up and given her a bath. The simple reality is that a declining elderly person with limited mobility who is unwilling to bathe (mentally deficient?) needs her children to take charge of the situation.

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  3. I agree with Terry. When I was a teenager we cared for my grandmother and her sister in our home. I spent many a Saturday helping my mother bathe them both--an event neither of the elderly sisters liked. We kept their hair clean and combed, their clothes clean, their room clean and kept them fed. I rubbed feet, clipped toe nails and finger nails, styled hair, and even changed colosomy bags. It was often a struggle, but it was the right thing to do. They deserved the best we could give them, even if we had to argue with them or carry them into the shower. It is often like caring for a toddler who has her own will, but not enough mental capacity or physical ability to care for herself. The parent of a child found in her own filfth would be found guilty of negligence, even if the child "refused to bathe." I think the same should be true for carers of eldery people.

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  4. I'm not sure that I see older folks' care being like that of a toddler, but then I have never personally cared for an older person day-to-day and seen that played out. But since I would want MY rights respected, I would probably go overboard respecting those of others who aren't completely "there."

    But no car keys. Hey, live on Milky Way bars and cigarettes like our neighbour did until her kids put her in the nursing home. But no car keys. I'm telling ya, she scared me to death on that road!! She would tell me to keep my kids indoors when she was backing out because she couldn't see well... and she kept cracking her car up... GAH! If I were her kid and heard something like that I would take the keys and call a lawyer!

    One thing I'm not clear on from the story is whether they were living in her house and whether they had taken on that "caretaking" role. I guess I wouldn't want to be prosecuted because an older relative is dotty and I didn't "step in." HOW do you know when to step in? We all know that there are extremes... but I'm thinking there is a vast middle ground there. I don't know about this case (as I've said before) but let's just say I think my folks would rather die than have me intervene w/o their permission. I wouldn't want someone looking over my shoulder thinking that every surgery, every pain or forgetful symptom would mean that this is "it."

    But like I said, I have not dealt with this up close. :)

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  5. I must speak up for wife on this one as her position was for the judge and jury to decide.

    It was my grandmother who she was speaking about ... and when I spend the last hours of her life with her, I was the one helping to clean her dead body. I saw the incredible number of bedsores on her. I questioned this to my sister and the careworker.

    My rage calmed down to just tears as I heard the story. If you saw her, you would be outraged ... but listen to the story and here.

    My grandmother was always very proud ... She had her own dignity to go the bathroom. Even when she was dying she made sure to hold it in as best as she could. Please remember that word ... dignity. Forcing a woman (who is still in her right mind) to do something she feels will take that dignity away ... should be closely considered .. not just pick her up and through her in a bath.

    I want you to imagine that someone comes into your home ... could be a stranger or a relative ... and then tell you ... sorry ... your not washing properly ... Take off your clothes and get in a bath ... or I will do it for you! I think you would be shocked ... and you would lose some dignity.

    Now back to my grandmother. The other situation are this ... Any movement of her body caused so much pain and agony that she would scream out in pain. This was so much pain that even the high dosage of pain medicine she was on would still not be enough.

    She also had to take medicine that would try to kill the cancer ... that was causing her pain ... would prevent the bedsores from healing.

    The workers would try to turn her over ... even though she screamed ... to help the bedsores heal ... but they would not.

    So you many have taken care of a relative ... but every one is different. There is a big difference between a relative who has their right mind and is relatively healthy but cannot take care of all of their needs and perhaps one that is suffering internally that causes a caregiving to carefully consider whether the movement that causes pain ... is worth the pain of bedsores.

    My heart breaks everytime I remember my grandmother and what she had to suffer during that time.

    So my conclusion is this: I have no idea ... don't jump to conclusions. How do you know if that family overcame huge odds.

    Like my grandmother, the place she stayed is not unlike many other places that like. They were always understaffed ... but we had family who made sure things were done properly. This family could have made the sacrifice to take care of their loved ones ... and went through all this (which is not easy) ... only to have it in the papers as somehow abusing.

    Do not try them without knowing everything ... let the judge and jury decide!

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  6. Hi, D!

    I was thinking of your grandmother's troubles when I wrote, but hadn't specifically brought her situation into it. Even with the very best of care round the clock, and your mother's watchful eye, she did die a very painful death covered in these sores. When you get to be this age with this many medical problems toward the end, you have to decide between helping one problem and hurting another in medicines and general care. I know your mom had to make some truly hard decisions.

    I have no idea about the people in the story, either. :(

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  7. I'm a cert. nusre aide. I've seen all kinds of nursing home some very bad. The numbers of resident to one nusre aide is unacceptable. I've reported them to the dept. of health in our state. Nothing was done! I had to quit. I now work for a nursing home that does an amazing job. I love to work there because I can give the best care possible to the residents. The problem lays with who has money and those who don't. The care changes big time. Where I work caters to those who have more money. As far as home care, it is hard. we cared for my grandmother. We couldn't get her to shower so we gave her sponge baths. better than nothing. We did have to turn her and we had to deal with her screams because turning her prevented bed sores and infection which only cause more pain. I hope the family gets a fair shake but if they are at fault there need to consquences.

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