Monday, October 22, 2001

Disrespecting Our Elders

Disrespecting Our Elders
Pamela Appea
Originally published October 22, 2001

Senora Russell never thought her father would be neglected or treated badly at the Bethany Nursing Home in Nashville, Tennessee. But Willie Russell, 83, who had lost his power of speech after a stroke, became increasingly withdrawn after moving into the assisted living facility in January 1999.

The Russell family began to see small, disturbing signs that Willie Russell was not receiving proper care. Senora arrived once at the home late in the day and it seemed as if her father had not been washed, toileted or recently fed. When she asked a caregiver for an explanation, the nursing home employee said, “I didn’t know we could get him up.”

Russell, herself a teacher and a caretaker for children and the Tennessee School for the Blind, vowed to visit her family more often so that she could take care of his daily needs herself. But during another visit, Senora Russell’s daughter found her grandfather had soiled his bed with feces, and that no one had come to help, or even to wash his hands. Her father was visibly distraught, Russell said.

Situations like these are becoming more and more common as the US population ages. While it’s difficult to determine how many seniors—and African American seniors—are the victims of abuse and neglect, the numbers have increased. Between 1986 and 1996, Adult Protective Services agencies nationwide found elder abuse and neglect claims increased by 150 percent. And a National Elder Abuse Incidence Study estimated that for each reported case of elder abuse, about five go unreported. A 1996 study found that 551,000 people aged 60 and over had experienced abuse and neglect, while advocacy groups like the American Association of Retired Persons report that as many as 25 percent of senior citizens may experience some form of abuse or neglect.

Carol Downs of the National Center on Elder Abuse in Washington, DC says African Americans are more likely than whites to live in extended family households than include multiple generations and both kin and non-kin. But while this fact may lead many to assume that in the African American community elder abuse and neglect is lower than the national average, experts warn this may not be the case.

“Studies have shown that African American parents over age 50 are most at risk to be victimized by their children, and are also more likely to be victimized by a partner,” Downs said. “Multigenerational families may live together due to stressful life circumstances such as divorce and drug problems, which have been shown to be risk factors for elder abuse.” And these socioeconomic and other factors may predispose African American seniors to elder abuse and neglect, which, besides physical mistreatment, can also involve financial and emotional exploitation.

Other groups like the St. Paul, Minnesota-based Institute on Domestic Violence in the African American Community, headed by Oliver Williams, have begun to delve into research on elder abuse and maltreatment. But the issue is shrouded in secrecy. No one—especially in the African American community, which is often purported to place exceptional value on the status of elders—is going to admit they exploit an older relative, spouse or other person they care for on a regular basis.

While most research groups and advocacy organizations for senior citizens do not address ethnic-specific concerns, in one rare instance, the Journal of the American Medical Association published a 1998 Brown University study charging nursing homes with neglecting African Americans and other minorities with terminal illnesses such as cancer. The study found African Americans were 50 percent less likely than whites to receive analgesics, like aspirin, to help relieve pain. But while some state justice programs are equipped to shut down an extremely negligent home when multiple cases of severe neglect are found, it is still hard for African American seniors to receive a high standard of care in both nursing homes and private homes.

Downs said it’s important to get awareness out through informal means, from beauty shops to cafeterias to churches. She acknowledges some in the African American community may distrust outreach programs because they “reinforce stereotypes” but says the effort must be made in a sensitive and culture-specific way. It all comes down to educating the public about what can happen behind closed doors, Downs said.

In Willie Russell’s case, things went from bad to worse at the Tennessee nursing home. Senora Russell said the staff began to put bandages on her father for what they explained to the family was a sensitive skin problem. After a downturn in Willie Russell’s health, Senora insisted on taking her father to the hospital—and the nursing home resisted, suggesting he should be left to die peacefully at the nursing home.

Once father and daughter did finally make it to the Nashville hospital, the nurses and doctors were horrified at Willie Russell’s condition, Senora recalled. His body was covered with infected sores, including his back, his genital area and his chest. “At the hospital, they said he would be treated like a burn patient,” Senora said. The infected sores smelled so bad that a nurse became physically ill.

Sores can originate from a myriad of factors, including unclean sheets, poor personal hygiene, poor diet and if the senior is not moved from the bed. Left untreated, the sores become infected, as they did in Willie Russell’s case. His foot was gangrenous and was amputated at the hospital, Senora said. He died a few days later at the hospital.

“I think it is terrible that people have to die like a dog,” Senora Russell said, noting that since her father’s death she has come into contact with others who have had similar experiences with their loved ones.

Russell has attended frequent conferences across the country to speak about her experiences, and says if she could do it all over again, she would have taken care of her father in her home. She chose Bethany Nursing Home because she believed it was a skilled facility that could give him the care he needed.

Russell filed a state complaint against the home, but it did not get far. And while local lawyers were sympathetic in listening to her case, she said they wanted “up front” money to begin an sort of lawsuit.

Russell said she never heard anything form Bethany Nursing Home, not even a formal apology. “I took them at their word,” she said of the nursing home, which is still operating. “I thought this was the best place for him.”

Her father’s only daughter, Russell, 57, said she was always close to her father, who worked for decades as a Coca-Cola Bottling Co. stocker and later as a truck driver to support a family of five children.

“If you had known my father … he was so strong, he helped people,” Russell said, remembering that even at age 80, before his decline, Willie Russell had driven his friends to the laundromat and grocery store because they could not.

It’s difficult for Senora Russell to accept that her father’s death may have resulted from the tragic negligence of people she was paying to take care if him.

“It’s just murder in another tone,” she said.