We are in a full-blown systemic crisis that has been causing insufferable consequences for our mostvulnerable. In particular, our elderly. For decades. And yet, most people have no idea. Thosewho do, either refuse to believe it or, tragically, just don’t care.I only learned about this crisis while attempting to acquire adequate care for my 89-year-oldmother, Norma, who was enduring a list of egregious repercussions of the system while the nursinghome manipulated the system to avoid accountability.
The documentary manifests like a classicHero’s Journey where I find myself battling in a world that is completely foreign to me (thehealthcare system) while facing one of my darkest fears – my mother’s death, whena mentorappears in the form of a guest on my podcast, Love Conquers Alz.RickMountcastle. A former, badass US Attorney and award-winning federal prosecutor who took down Purdue Pharma for fraudulently marketing OxyContin and wasportrayed by actor, Peter Sarsgaard, in the Emmy-nominated Hulu series, DOPESICK. Rick also prosecuted nursing homes for fraud and abuse for 20 years – butnever saw any significant change. Having recently retired and basking in his 15 minutes of fame, hesigned on as a producer. Together, wedecided it was time to wake up the collective conscience by producing NO COUNTRY FOR OLDPEOPLE, a documentary that would provide the public with critical information about the nursing home industryand embolden them to demand policymakers change our system into one that prioritizes taking care of people. Nottheir pockets.
I chronicled the last six months of my mother’s life beginning January 17th,2022, and poetically ending July 17th, 2022. Using video I shot and over 70 interviews from caregivers, residents, Nurses, CNA’s, Doctors, and Specialists, as well as experts on Medicare, Hospice, Federal Policy, andElder Abuse Law, we share the battle I forged against a culture wrought with denial, ageism, andableismand the broken nursing home system propagated by private sector companies who value profit over people.
My story began when my mother, who was living in a 5-Star Nursing Facility in Los Angeles, wasrushed to the ER and admitted into the hospital for sepsis, pneumonia, dehydration, 10% kidneyfunction, and a UTI, that were all the result of a stage IV bedsore. The hallmark of neglect and abuse.A “never event” is defined by the Centers for Medicare and Medicaid (CMS) as a non-reimbursableserious facility-acquired condition.
For six months, I felt as if I was playing whack-a-mole. My mother was being shuttled between
hospitals, the nursing home, acute skilled nursing, and hospice. She was intubated three times, despitea “do not intubate” directive, denied treatment for her worsening pressure bed sore, remainedunnecessarily on an enteral feeding tube and internal catheter, was denied food, liquids, and evenshort visits outdoors. Instead, she was given too many psychotropic drugs and kept in bed inside asmall, often hot, room. In a 5-star Facility. In Los Angeles.
I fought on thefront lines of this systemic catastrophe daily, but despite my relentless advocating, my mothersuffered and died from what was inarguably egregious nursing home neglect and abuse. It’s horrifying to think about what happens to residentswithout advocates.
In a case of every cloud having a silver lining, we have COVID-19 to thank for pulling the curtain
back on what is a national American crisis. After the pandemic’s 200,000 nursing home deaths – let that sink in -over 200,000 deaths… the nursinghome industry blamed most of their difficulties on COVID-19. But the truth is, the same issues havebeen going on for decades. Why? Greed and lack of transparency.
Elder care hasturned into a cutthroat world of private equity and real estate investment trust-backed nursing homes.A system that was designed to protect our aging population has been flouted by greedy corporationswho have lowered the standard of care to increase the profit. Our imprisoned are treated with more dignity and humanity, while mymother’s only crime was being old.
There are currently 14 million peoplereceiving some form of long-term care and that number will double by 2050. About 70% of people overage 65 will need some form of long-term care before they die and 70% of the nation’s 15,400 nursinghomes are for-profit.
Capitalization is largely extractive in the form of realestate and sale lease-back transactions.For-profithomes underpay, under-train, and reduce direct carestaff tomaximize profit.Regulators are not enforcing evenminimal staffing requirements and as a result,vulnerable nursing home residents are suffering fromabuse and neglect. Additionally, America is facing asevere caregiver shortage thathasdirectly led to 400,000 nursing home and assistedliving staff to quit, citing exhaustion as well as low payand lack of advancement.
Ageism and ableism are a lethal combination and play a huge part in our broken nursing home system. Deeply rooted inour Western individualistic culture, they encompass negativeperceptions, preconceived notions, and attitudes that contribute tothe marginalization and social exclusion of older and disabled people.
There is a Ghanaian proverb that says, “The hands of a child cannot reach the shelf, nor can the handsof elders get through the neck of the gourd on the shelf,” meaning that life is a matter of mutualassistance and benefit. Both the old and young are needed in society to support one another.While I couldn’t agree more, I havediscovered that far too many couldn’t agree less. Most of thepublic remains safe and sound in denial where people don’t age and are never dependent on others. Acatastrophic mistake.To quote anti-ageism activist, Ashton Applewhite, “Ageism is a prejudice against our future self.”
A total oxymoron. They are nothing like a home. But most of us don’t know that. We don’t know what really goes on inside of these places. We don’t want to know. We avoidthem at all costs. Why? Because they depress us. Because they smell like urine and the lighting isharsh and, like the residents, the food is gray. Because we wouldn’t want to live like that. So, we lookaway.As long as we can.
Sooner or later, someone we love or ourselves require long-term care, and we come face to face with the machine that prioritizes profit over people. Where human rights and dignity are grosslyviolated. But still, no one wants to talk about nursing homes. It’snot sexy. It’s scary.
Almost 2 million people in America reside in nursing homes/long-term care.As many as260,000 residents in nursing homes report abuse orneglect every year, yet for every one instanceof abuse, 44 instances go unreported. Bringingthe number of incidents to over 6 million.So, how are we going to convince the public that the prevalence of ageism has allowed a deadlyhealthcare crisis to grow into an unwieldy beast right under our very distracted, age-denying noses?Bypresenting our case to the public like a consummate litigator armed with the truth:Engage the public. Get them angry. Make them care.
Traditional advocacy has been going on for over 5 decades. It’s just not working. Legislation andregulations are performative at best. Regulators are not enforcing requirements and as a result, vulnerable nursing home residents are suffering from abuse andneglect in the form of more pressure ulcers, more antipsychotic medication, lack of mobility, morepain, and more deaths. And when there are penalties – they are simply the cost ofdoing business.Why?Because the nursing home lobby is incredibly strong and has a lot of money to donate to politicians andto put people on the floors of congress to ensure everything remains status quo.
Until the public at large knows what is really going on, the system will remain the same. NCFOP will educate the public about how thenursing home systemcurrently operates, how it often fails to deliver the care that is required under current federal andstate laws and regulations, why there is a failure of care, and the consequences of those failures onthe people who are dependent on that care. It will also reveal the impact on the healthcare workersstriving to deliver that care.The film is poised to grab the public by the heart and invoke a revolutionfor change via a grassrootsPeople Over Profit Movement that will shame politicians into doing the right thing and motivate a cultural shift in howour society cares (or doesn’t) for our most vulnerable. Care that is promised by long-term care facilities.Care that taxpayers pay for. Care that most of us will inevitably need.
Because although this is my mother’s story…it’s really everyone’s.
