Saturday Evening Outpost
NOT DEAD YET: PART V —Made of Titanium
Daisies might seem like a simple flower, but not only do they close at night and open with the morning light, they follow the sun as it moves through the sky. They are remarkably resilient, thriving in many conditions, and often have a very long flowering season. They have even been known to bloom during the winter.
We arrived that next morning to find Grammy awake and sitting up in bed! She was struggling to drink from a heavy mug of coffee and Mom immediately started helping her. Grammy smiled and pointed to Mom but didn’t speak, had a few sips of coffee and a couple of bites of toast, and then fell back asleep. “I swear to God, she’s made of titanium,” my mom said with a smile on her face. I laughed, shaking my head. When the nurse popped in to take her tray she remarked that Grammy’s vitals were remarkably good given her diagnosis — better than most people half her age, she laughed. She also remarked that it was a great sign that the antibiotic seemed to be doing its job already.
By lunchtime, Grammy was awake, sitting up and ravenous. She ate her pizza, her cookies, and her ice cream. She drank her lemonade, a bottle of water, and managed to ask for some coffee…and it was a joy to behold. We tried to talk to her but she was still having a difficult time verbalizing. We were just happy that she recognized us and was in such good spirits. Things were looking up and it felt good…until my aunt called Mom to tell her the police had paid her a visit because she was listed as power of attorney for Grammy (Mom was as well but unfortunately they didn’t realize that the day before when they visited the hospital.) It was about allegations of sexual abuse.
Apparently, a nurse's aide overheard Grammy’s roommate saying she thought Grammy’s condition (her urinary tract infection) was because of sex, and that an aide might be involved. Any allegations of sexual abuse must be reported to the police, which was why they were investigating. I tried not to let the horrific thoughts of it all overwhelm me. It seemed so unreal. Mom cautioned that we shouldn’t jump to conclusions. Neither she nor her sister could imagine something like that had happened. I was sick to my stomach about it, but the most pressing thing at the moment was getting Grammy better and finding her a new place to live. While she was improving much more quickly than expected, they’d need to keep her a few more days to make sure her kidneys were functioning properly. Our hope was to get Grammy into a facility that could give her the compassion, care, and rehabilitation she needed before we were forced to remove her from the system.
We decided to tell the clinical resource manager everything Grammy had gone through up until this point and she was very moved by our case. She promised she’d do everything she could to help find Grammy a new home. Later that evening she rushed in, out of breath. She had found a facility with great reviews and an excellent reputation and they had a bed available. If we wanted it for Grammy it was ours! Mom and I both started welling up with tears and then she did too. All I could do was offer her a big hug, which she accepted with wishes for a better life for Grammy.
After a short three-day stay in the hospital, Grammy's vitals were so much better that she was released to her new facility to begin light rehab and start anew. The months following, we worked with the statewide ombudsman for aging who directed us to a non-profit agency on aging and eldercare. They tried to help us navigate how we could get some answers and eventually justice. We learned that if we wanted anything to happen, we needed to have sufficient grounds for an elder abuse/neglect lawsuit. The non-profit, unable to help us, suggested we speak with their list of lawyers who specialized in this type of civil suit. My mom and aunt were adamant that this wasn’t about monetary damages, we just wanted accountability for those who had knowingly endangered Grammy’s life, misled us, and lied to us. We wanted to make sure that this didn’t happen to other residents.
In all of our conversations, the lawyers were compassionate but apologetic…unfortunately, because of Grammy’s age, there really was no winnable case. We were confused. At what age is someone considered not worthy of having their rights defended? Shouldn’t justice be served regardless of age? Apparently not. The standard of guilt for negligence in this instance is to prove long-term suffering/damage caused by the accused. As we were gently told by the firms we contacted, it wasn’t possible to establish that because at 103 years old, she probably didn’t have long to live! When we asked if there were other firms we could reach out to, one lawyer very kindly told us we’d most likely get the same response. Our best bet would be to file a complaint with the state’s Attorney General via the state website. If they pursued the complaint and found neglect we might have a case.
We spent nearly $800 purchasing her records from the nursing home, charged as a per-page fee from the time she first arrived. Several thousand pages, given to us on a compact disc. We were advised that we shouldn’t inform the facility that we were filing a complaint and we should request the records before submitting our complaint to the state. We spent weeks compiling detailed notes complete with witnesses, names, and phone numbers. We detailed circumstances not only leading up to the day we removed her from the facility, but all the times we had found her in a neglected state. Since there was no place to submit photos on the online form, we noted we could provide some should they be needed for reference.
A month later we received a letter from the Ohio Department of Health. “After a thorough investigation, our surveyors were unable to find evidence that substantiates the issue or issues you raised, and we have determined that (the Care Facility) was in compliance with regulatory requirements at the time of this investigation.”
That was it. No phone calls to speak to us about the long list of neglect and abuse we had outlined in our complaint. No picture requests to corroborate our story. Not a single reference to abuse or neglect. Not a single question asked of us. Nothing. Just a pathetic response in what appeared to be a form letter. For a state that claims to be committed to protecting and improving the health of its residents, as well as protecting older residents who are being exploited or harmed, this was a far cry from that mantra. To us, those were empty words.
We learned a lot during this time. Revenue from the nursing care facility industry is north of $125 billion dollars a year. Over 65% of nursing homes are for-profit. In an analysis done in 2011 (sourced from medicareadvocacy.org), the top ten for-profit chains had the “lowest staffing levels, the highest number of deficiencies identified by public regulatory agencies, and the highest number of deficiencies causing harm or jeopardy to residents.” Why is that acceptable? On the website of the for-profit that owns Grammy’s previous facility, it states that the CEO is focused on building stakeholder value. That’s OK, it’s a for-profit company. But, it’s what it doesn’t say. It doesn’t say, “focused on providing excellent care to our aging population WHILE building stakeholder value.” Maybe because there’s a real conflict there?
How is value built when the bulk of revenue (largely from Medicaid and/or Medicare) in a nursing facility comes from the number of beds they fill? Half of a shared room (about a 7' x 10' area) at Grammy’s old nursing facility costs over $6300 a month. The facility has about 90 beds which means they could rake in over half a million dollars a month. It seems reasonable to consider that hiring less staff, hiring fewer registered nurses, and paying lower wages will cut costs and raise stakeholder value. And it’s reasonable to suggest that if stakeholder value rises from that, value for the residents and their families decreases.
The real question is, why should there be a profit motive in caring for our aging and elderly? Why do we allow anyone to profit off taxpayer dollars if cutting care in the very system designed to protect our most vulnerable is how those profits are made? And, don’t forget about the extra taxpayer dollars states need to regulate the industry. Obviously, with all that cash going into the system, surely the residents who are living in those facilities are receiving the best care money (taxpayer money) can buy, right!? That was not our experience.
In the end, it didn’t matter how angry we were at this flawed system or how sickened we were by the people who failed miserably at a job where they were supposed to be compassionate caregivers. It didn’t matter what had happened to Grammy or how it had happened. We would never know if something unmentionable had happened to her because dementia made it impossible to get any solid information. There would be no reckoning for those who failed to care for her or the system that was supposed to protect her. There would be no justice for Grammy.
We were heartbroken and numb…and resentful. But, we felt we had nowhere left to go, so we decided to focus our time and energy on what mattered. Grammy.
Vivian Ruth Haynes turned 105 on October 26th, 2020. As I write this, she continues to live at the facility she was relocated to, where they treat her with the care and compassion that every person deserves. We have not been able to have physical contact with her since the beginning of the COVID pandemic. The separation has been extremely difficult for our family. Mom and my aunt continue to be dedicated to caring for their mother any way they can. They visit by standing outside and looking through a window and taking her vanilla shakes and chicken McNuggets, which they pass inside to staff to give to her. The facility, like many, has had cases of the virus among both residents and staff. Grammy, who also made it through the Spanish Flu, has not contracted Covid-19.
Many years ago, on one of our visits home, she had taken a pretty bad fall in the kitchen. Our big dog had gotten behind her and when she backed up she fell and whacked her head. Once back in her chair and mom had checked her vitals I kneeled down next to her and she smiled at me.
“I’m so sorry, he’s just bigger than he thinks!” I knew he followed her in there because she couldn’t resist giving him a piece of whatever she was eating. “I should have kept him out of the kitchen.”
“Oh come on,” she playfully scolded, “it wasn’t his fault, he’s a good boy, he was just looking out for me!”
I put both hands up gently holding her face. “Are you sure you‘re OK, Grammy?” As I looked into her eyes, a delicate waft of rose perfume once again found my childhood memories.
Her cool, soft hands with their brilliant-red painted nails found my face giving it a light squeeze. “Well…” a wry smile came across her face, “I’m not dead yet!”
No, she wasn’t. And no, she isn’t…________________________________________________________________
Author’s Note: On March 30th, 2021 our sweet Grammy left the planet. She died of natural causes. To read her Eulogy please follow this link: https://saturdayeveningoutpost.medium.com/eulogy-for-grammy-2b1884a066db
Additional Note: While this story was told from my perspective, it must be noted that all of my siblings, their spouses, and children had their own wonderful and unique relationship with Grammy. They are all part of a powerful support system that we are so lucky to call our family… I am forever grateful to my mom, aunt, and all of them.
