Thursday, September 14, 2017

After the Storms

Hurricanes kill, of course, but it's what comes after them that kills absolutely.

Nowhere is this more evident than in Hollywood, Florida, where at least eight elderly nursing home residents - inmates, actually - have died in temperatures nearing 100 degrees Fahrenheit. Whether heatstroke, tainted food, preexisting conditions or dehydration were contributing factors or direct causes is moot at this point. Because the real cause is criminal human neglect and policies decided at the very highest levels of our corporacracy.

There was no flooding to prevent the evacuation of these trapped patients, as was the tragic case at New Orleans' charity hospital during Hurricane Katrina. The Florida "rehabilitation facility" is located right across the street from the nice, clean, modern, air-conditioned hospital with which it is affiliated. 

The nursing home administrator, Jorge Carballo, as well as relatives of patients complained to the media that Florida Power and Light was unresponsive to their incessant pleas to repair the broken fuse which allegedly caused the air conditioning to fail. They called and they called and they called, but nobody ever came. "It was life-threatening," said one patient's daughter, who understandably wished to remain anonymous.

So they set up fans to circulate the humid 100-degree air, and they made their patients as comfortable as is humanly possible in an inhumane situation.

The utility company itself said the nursing home was not on its list of critical infrastructure priorities. It is not surprising that old, sick, poor people are not top priorities in a state which depends so heavily on the luxury tourism industry for its revenue. What, you thought this nursing home was Disneyland or something?

Why nobody seems to have done the logical thing and called 9-1-1 immediately is still a mystery. As evidenced by the professed myriad calls to a utility company, the phone system, at least, was operative.

But here's the dirty little secret about nursing homes. They are really loath to discharge their patients, let alone lose their entire population in one fell swoop, along with all those Medicare and Medicaid dollars. As with everything else, eldercare is increasingly privatized and profit-motivated.

And another dirty little secret is that the inmates of these facilities can get so desperate and so confused and so scared that even on a good day they pick up the phone and call 9-1-1 themselves. Over and over and over again. And once the cops arrive, because they are required by law to do so,, the nurse or administrator tiredly explains that it was just Mr. Jones, the Alzheimer's patient, at it again.

Also, nursing homes and 9-1-1 dispatchers have a fraught relationship. Overworked staff requesting an ambulance must go through a whole checklist before help is dispatched. For legal reasons, the emergency dispatchers have to ascertain, among other things, whether the nurse making the call is even medically trained enough to observe and measure symptoms.

And, according to a government-commissioned study by Health Services Research, "hospitalizations of nursing home residents are costly and expose residents to iatrogenic disease and social and psychological harm. Economic constraints imposed by payers of care, predominantly Medicaid policies, are hypothesized to impact hospitalizations."

So we don't know yet whether the Florida facility called for help in a timely manner. But testimony about the measures taken or not taken should be enlightening, to say the least. In the end, it will probably all boil down to a cost/benefit analysis gone horribly, horribly wrong. Mistakes were made. No one person can ever be held criminally or civilly accountable. It's the bureaucracy, you see. 

It's hard to successfully sue nursing homes, because oftentimes their ownership is sliced and diced into so many hidden little pieces it becomes a losing battle from the very beginning. Unaccountability is built right in to the system. And under the Trump administration, it's getting even harder to hold them liable  for even the most flagrant neglect and abuse. They're doing away with a belated Obama rule which at least prohibited a facility from immediately foisting a "non-arbitration" agreement on new patients who are already confused enough by their change in surroundings. The oligarchic United States Chamber of Commerce was instrumental in ensuring that any patient who refuses to sign arbitration papers can be denied admission. The chances of collecting damages have gone from slim to none.

But back to getting outside help when confined in a facility. When I myself was a patient/inmate at one of these public/private "subacute care" homes for three months after a severe injury about a decade ago, patients taking it upon themselves to call 9-1-1 was a regular occurrence. One gentleman with dementia, who used to wheel himself into my room to chat and confabulate, would invariably beg me to call 9-1-1 for him because the Mob was out to get him. (I was lucky enough to have my own phone.) And truth to be told, I was often tempted to call for outside help on my own behalf. But that's a long story, or really a book, for another day. The facility ended up closing when a purchase deal went sour. Now it's being profitably used as a movie set.

Unfortunately, the tragedy in Hollywood, Florida is probably just the tip of a rapidly melting iceberg. This state is Retiree Central, and electrical service to millions of customers is expected to be off for weeks, if not months.

So where are our vaunted military troops with their ships and their planes conducting the mandatory evacuations of the poorest and most vulnerable people to cooler climes? Those searches and rescues which are currently underway are in ever-increasing danger of becoming the most massive corpse salvage operation in history.

The humanitarian crisis in Florida, Texas and the Caribbean no longer even leads the front pages of our establishment newspapers. Over at the New York Times, Trump's bipartisan dinner with Chuck Schumer and Nancy Pelosi was the lead article today. Even the "Pharma Bro Felon's" arrest on charges of threatening Hillary Clinton's hair follicles is placed above the now day-old story of the nursing home catastrophe. 

And when I turned on CNN yesterday afternoon, there was the same old RussiaGate panel at it again, mewling over Michael Flynn's son's collusion with the latest colluders. There was Hillary Clinton again, talking about the only humanitarian crisis that really matters: her political defeat. To give CNN credit, however, these tawdry stories are at least regularly interspersed with post-storm coverage by some actual reporters we never see unless there's a terror attack or a weather catastrophe. I especially appreciated foreign correspondent Clarissa Ward's description of the Caribbean chaos as a Lord of the Flies scenario.

Meanwhile, Bernie Sanders has finally introduced his Medicare For All legislation. It could not have come at a better, more pressing time. Millions of people are going to need some pretty intensive physical and mental health therapy in the arch-conservative states of Florida and Texas, whose receding flood waters contain a fair portion of unregulated toxic chemicals and antibiotic-resistant microbes. What more urgent time than right now to make sure that they get help that doesn't come with a premium or deductible?  If a devastated Great Britain could establish its own National Health Service in the rubble of the Nazi blitz, certainly we can do the same to stave off the continuing assault on life that is man-made climate change.

There is a full-blown third world humanitarian crisis going on right now in the richest country on earth. It's a do or die moment. Call the New Deal ambulance, pronto.

7 comments:

Kat said...

"No one person can ever be held criminally or civilly accountable. It's the bureaucracy, you see."
Oh, who said that? Where did you read it?

Karen Garcia said...

I added another paragraph and link to explain "who said that and where I read that."

I also read an excellent book called "Unaccountable" by Janine Wedel which explains in detail how lawsuit and culpability avoidance are integral parts of the corporatocracy.

Probably the worst that will happen in this case is that an administrator or two will get fired. If this ends up in criminal court I'll eat my hat.

annenigma said...

@Kat

God Mammon said it. It's right there in the Capitalist Bible, edited by Martin Shkreli. It's being sold on Amazon for a gazillion dollars each, with 1% of the proceeds are being charitably donated to the Wall Street Relief Fund.


Great post, Karen, as usual. I've seen enough of the whole nursing home nightmare that it makes my skin crawl, and this tragedy and your writing about it brings it home.

I have advance directives that specify that if I somehow ever end up in a nursing home due to being incapacitated and unable to refuse, then to let me die with the first infection, no oxygen, no feeding tubes or other artificial measures to prolong my life, and I cap it off with a standing Do Not Resuscitate order.

Talk about Hell on earth. Those poor folks.

Unknown said...

These last two columns ascertain your place as one of the most astute social and political observers writing today. I hope you will continue to challenge yourself to research, define and expose the power structure, so to champion the voiceless. Thank you, Karen.

Kat said...

Karen,
That book looks interesting. I read some reviews online and this one caught my eye:
“Slow but steady cultural shifts often go unremarked until we suddenly realize that we are in a place we really do not want to be. This book draws attention to one such shift. Wedel documents an alarming increase in the number of individuals and associations who, while purportedly acting in the public’s interest, seem actually to be pursuing their own objectives.”
Did you read that "rock star" teacher article in the NYT? I was remarking to my husband about the slow drip drip drip of ideas and one day you're reading about a third grader talking about their "digital footprint" and how they must be careful about what they leave as the wrong words (or images) could hurt their employment chances. I do think people "pursuing their own objectives" often convince themselves that they are doing good while doing well for themselves.
I think as far as the criminal charges go it could go either way. I'm not sure they are in the too big to jail category like say, the C class at Equifax.

Pearl said...

One can only hope that Florida governor Rick Scott will be implicated in the lack of rules and proper response to evacuation plans for the elderly in line with his disgraceful history of becoming a billionaire by stealing funds from the medical system. He is a favorite of Trump to try and replace Bill Nelson as State Senator for Florida who is fighting for his political life against the money interests and oil companies waiting to pounce nearby and ruin safety regulations regarding ocean encroachment on state land.

Great column Karen which I found hard to read remembering the happy winters we spent in Florida when retired.

voice-in-wilderness said...

On NPR I heard an interview with a woman whose mother was a nonagenarian patient in that nursing home (she survived). The daughter said that both she and the nursing home were calling the power company and 911, to no effective result. She said when they called 911 they were given bland words about being in a queue.