Over the eight years before her death my mother survived a stroke which caused major brain damage and loss of right side mobility; a broken hip; a broken shoulder; several serious gastric bleeds, and more drugs than my system would be able to tolerate.
She lived with me after her stroke but her - largely iatrogenic - medical needs became more complex and we moved her into a rest home, a studio where she lived for three years until she fell and broke her arm and ended up in hospital level care - where she rapidly declined.
In the months before her death she suffered from episodes of extreme confusion and anxiety. She repeated over and over that she was 'terribly, terribly frightened' - or various garbled versions of that. It was distressing for her and for those of us who visited her, as nothing calmed her - except the chemical cudgel wielded by the medical staff - with the very best of intentions of course.
Whilst I respect the front line workers who keep elder care facilities functioning, I cannot say the same for the industry as a whole. It sucks vast sums of money out of the public purse and makes huge profits for owners and shareholders while paying its front line staff low wages and often feeding its residents a diet that is low in essential nutrients, and treating them like children.
It pays lip service to patients' rights and it purports to care deeply about their welfare - but strip away the patina of political correctness and there is the cold, hard commercial reality of the making of big profits - mostly, these days, for a large corporate entity.
It is almost impossible to find an aged care facility that doesn't charge a premium per a week in addition to the c$900 a week government set maximum charge - which is the state subsidy payable for people with less than $220k in assets.
This 'premium’ is charged for an en suite, or shared shower room, a room with a view, one that is larger than average or one that is sunny - or any other attribute the owners can dream up to justify whacking on an extra charge. Hospital level care is further subsidised by the government.
An en suite is more of a convenience and time saver for staff than a benefit for residents who are immobile but the industry still charges a hefty premium for them. A room of a good size, one that gets some sun, that is pleasantly decorated - these should be standard for all rooms.
In rest homes, the rooms typically are very small as residents are expected to spend time in the communal lounges. Rooms tend to be larger in the hospital facilities, not as a benefit to the residents, but because the staff have to be able to use hoists to manoeuvre fully or partially immobile people in and out of bed.
The institutionalised care of old, frail, disabled, sick people is big business. It is why sporting icons like the All Blacks are advised to invest in it. The returns are very high and there's a huge and growing demand in an ageing population in a society that no longer cares for its old within the family - or cares very much at all.
I hate it. And all the more because it operates behind a facade of 'caring' while it exploits - mainly women – workers, and perpetuates a model of elder care that can turn end of life into a kind of nightmare.
I want to be able to end my life on my terms, to my time frame, with those I care about around me - I do not ever want to end my life like that. It's cruel and it's based on a massive hypocrisy that is a combination of religious dogma and corporate greed.
Only god can take a life say the fundamentalists but it's ok for us to go to extraordinary lengths to prolong a life of fear, misery and hopelessness, or to hide behind the administration of drugs given purportedly to ensure quality of life but which effectively shorten it.
Hospital level care homes may leave a person in a bed 20 hours out of 24 - mostly for their convenience. When not in a bed, the person is in an armchair on wheels - parked in a group of other helpless old people in front of a TV or radio invariably spouting utter garbage. If the person is disruptive, they are put back in their room - on their own - possibly with their TV tuned into some other utter garbage - or they are put back to bed.
They are turned regularly to avoid pressure sores - and their incontinence pads are changed regularly to avoid skin damage and infection - because these may all be interpreted as signs of 'neglect' if they occur.
If the person makes too much noise or gets distressed in the morning by being moved, washed and dressed - which is highly likely because of muscle stiffness and joint pain - they are drugged.
The worst is fentanyl - used because the slow release skin patches are convenient and the drug is so terrifyingly powerful that tiny amounts give the same narcotic effects as other opioids thus reducing the adverse side effects. The amount may be tiny but when so is the person's body and the brain and / or liver are damaged, the effects will be more powerful and unpredictable.
But these businesses don't employ enough staff to allow time to be taken with individuals - and the patients are triaged and some are deemed to no longer benefit from physio. So they are shunted from bed to chair to bed and some, like my mother - spend most of their last days in a haze of pain and fear.
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