April 19, 2018
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Restore dignity to Maine’s elderly by properly funding nursing homes

By Patrick Eisenhart, Special to the BDN

How sad it is to read about Gov. Paul LePage’s enthusiasm to build a new prison, while nursing homes continue to suffer chronic underfunding. There does not appear to be any kind of understanding of the need to care for the growing population of elderly in Maine.

To get an idea of what it is like to live in an underfunded nursing home, I would share my grandfather’s experience in a beautifully constructed but underfunded Minnesota nursing home a few years back.

For my 88-year-old grandfather, it meant bowel and bladder incontinence due to poor menus, which left him lying in his own excrement for hours, while staff, stretched thin, had to help other patients. It meant he got no solid food because that would have required more staff to put his dentures in and take them out to be cleaned. Instead of solid food, he got lots of baby food, tapioca and rice.

Worse, it meant the proud, fiercely self-reliant man who served for years as a hunting guide and Alaskan bridge foreman had to wear diapers, which were changed by staff lifting his legs over his head like a baby whose bottom had become soiled. Oftentimes the changing occurred in full view of people walking by in the corridors.

It meant he got no exercise to regain the strength in his legs after fracturing his left femur. That meant he lost circulation in both legs and gangrene set into the middle toe on his left foot. It meant they gave him heart medication, which was not prescribed. It also meant nobody bothered to check into the festering, cancerous sore he had on his right wrist.

He hated television, but there was one on all day and night, placed at the foot of his bed in the middle of the room facing the corridor, so staff could catch portions of whatever they were watching as they traversed from room to room. Needless to say, the programming was not for my grandfather’s other three roommates — all stroke victims who neither spoke, opened their eyes or moved during the entire five-day period I was there.

Instead of referring to him as Mr. Lewis, he became just Bob, and people spoke to him like he was hard of hearing and a child.

He hated the nursing home and begged us to take him back to Maine. The nursing home staff warned that the trip could kill him. Grandfather didn’t care. He said he would rather die trying for better life than die alone in his own excrement.

My grandfather was one of the few lucky ones with family willing and able to provide family and home health care.

Within a year of leaving the nursing home, and, after a combination of family and home health care, grandfather regained control of his bowel and bladder and underwent surgery to restore circulation and to remove blockage in his urinary tract. He had his gangrenous toe amputated. With regular exercise, he became ambulatory with the help of a cane and subsequently attended Little League games. He even went to sea on a whale watch.

Bottom line: He enjoyed a happy, healthy and rich additional three years at home due mostly to my wife’s loving care.

In addition to gaining a personal insight into the results of nursing home underfunding, Gov. Paul LePage and legislators must wake up to the reality that the problem is going to get worse before it gets better. There are now more Americans age 65 and older than at any other time in U.S. history, according to the 2010 U.S Census. The 65-and-older population jumped 15.1 percent between 2000 and 2010, compared with a 9.7 percent increase for the total U.S. population.

The governor and Legislature need to take immediate action to appropriate emergency funds for underfunded nursing homes and then develop a plan for dealing with this crisis.

The cost of funding for the immediate needs of nursing home care could be offset by the implementation of long-term comprehensive planning, which would create jobs for new construction of assisted-living and semiprivate nursing home care facilities as well as funding for in-home care training and services.

Private and public investment in home health services have proven
themselves through the years to be money-savers
. In-home health care prevents malnutrition, pneumonia, under or over medicating, falls, flus, insulin shock and a host of other avoidable events resulting in expensive hospital or nursing home care.

A 2012 Genworth “Cost of Care” Research survey of more than 25,000 providers, nursing homes, assisted living facilities and home care providers in all 50 states and the District of Columbia concluded that the national average daily rate for eight hours of in-home care was $112; nursing home (semiprivate), $181; nursing home, $205; and assisted living, $90.

It is time for the governor and the state Legislature to realize it is morally reprehensible and pound foolish to underfund health care services for the elderly and not to have an immediate and long-term, comprehensive plan to deal with this crisis.

Anybody without a brain can wield an axe.

Patrick Eisenhart, of Augusta, is retired from the U.S. Coast Guard, where he served as a commander.

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