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Olson: “Dehumanizing” elder care will only get worse

After researching issues related to aging for the past three decades, Laura Katz Olson, a professor of political science at Lehigh and department chair, sees a future where millions of senior citizens and their stressed caregivers face few, if any, viable options that would allow elders to live out their last years with any semblance of comfort and dignity.

In her fifth book on aging, The Not-So-Golden Years: Caregiving, the Frail Elderly, and the Long-Term Care Establishment (Rowan & Littlefield Publishers, Inc., 2003), Olson argues that the aging of our population is placing overwhelming burdens of care on wives, daughters, and minimum-wage, overworked aides—mainly Blacks, Latinos, and immigrants—and places the blame on misguided government policies.

“Policymakers have allowed the profit motive and greed to eclipse social responsibility and public accountability,” Olson says. “Nursing home owners reap billions from our tax money. Yet the vast majority of elderly Americans living in these institutions are subjected to dehumanizing treatment that spans the spectrum from mere neglect to outright abuse.”

”A system run amok”

In fact, Olson says, the chances of an elderly person being mistreated in a nursing home are so great that “quality care should be considered the exception rather than the norm.

“I would venture to say that it is a system that has run amok. It is bankrupting older people and their families and depleting national and state government treasuries while nursing homes, home care agencies, and other long-term care business establishments cash in on the social programs,” she says.

Olson points out that the new Medicare drug benefit is “just another opportunity for the health care industry to financially exploit the system and its aged beneficiaries.”

“The problems related to elder care have reached crisis proportions,” Olson says. “The media periodically spotlights horror stories of the more flagrant nursing home abuses and the government regularly generates reports documenting the substandard care experienced by a significant number of residents. Policymakers even pass new regulations periodically. But, the dehumanizing conditions persist because the underlying reasons for the problems are largely overlooked. And, it’s only going to get worse.”

Facing the problem

Olson argues in her book that political leaders have to take off their blinders and face the realities of our costly but vastly ineffectual approach to long-term care in this country, which includes:

• a swelling, chronically ill older population
• overworked and underpaid nursing aides increasingly recruited from abroad
• persistent shortages and understaffing in nursing homes
• the growth of nursing home chains that are accountable mainly to their stockholders
• self-serving providers, each with their own consolidated turf, feeding from the public trough
• mounting financial fraud and unscrupulous practices among elder care providers
• frail older people and their families, who are held hostage to the current system, including fear of retribution if abuse is reported
• few prosecutions or severe penalties in cases of nursing home patient mistreatment and abuse
• escalating costs of long-term care that are not meeting the needs of elders or their families
• growing impoverishment of chronically ill elders
• financial pressures on state budgets

“The problems are dire and only getting worse,” Olson says. “And they affect not only the elderly, but have the potential to affect the vast majority of Americans in one way or another, whether as caregivers or taxpayers.”

Sounding the alarm

Olson is adamant that the country needs to view our vulnerable elders as a collective responsibility and make a national commitment to their care.

“There is no Band-Aid approach, nor are there personal or individual remedies,” she says. “One person or one family cannot solve this problem alone. Care of our dependent elders is a social problem that must be met head-on by all of us.”

Foremost, Olson says, there should be a recognition by the American public about the gravity of the problem and some of the underlying causes. For instance, she says, if we want to change the nursing home environment by creating the kind of place where you can expect a level of respect befitting human beings, we must move beyond the “business ethic” of care.

“That means focusing on people and their needs instead of focusing on industry and its needs,” she says.

The kind of national commitment Olson envisions would be an investment in the future of middle-aged adults as well. “Not only would we be enhancing the well-being of today’s frail elders, but we would assure a safer, more caring environment for ourselves in our old age.”

Olson asserts that American politicians, including the current crop of presidential candidates, are largely ignoring the issues for fear of turning off the public.

“They don’t want to make the public confront such unpleasant realities as elder abuse perpetrated with our tax money, or with massive fraud within the Medicare and Medicaid systems,” she says. “My goal is to sound the alarm, to get people to understand the crisis we are facing both financially and morally. Let’s hope people listen.”

Olson came to Lehigh in 1974, and this is the fifth book he has published on the topic of aging. Her previous books were: The Political Economy of Aging: The State, Private Power and Social Welfare ; Aging and Public Policy: The Politics of Growing Old in America ; The Graying of the World: Who Will Take Care of the Frail Elderly? ; and Age Through Ethnic Lenses: Caring for the Elderly in a Multicultural Society .

She has published widely in the field of aging and women’s studies on such topics as pensions, Social Security, problems of older women, and long-term care. She has been a scholar at the Social Security Administration, a Gerontological Fellow, and a Fulbright Scholar. She also has lectured extensively through the Pennsylvania Humanities Council on Social Security, Medicare, and long-term elder care policies.

--Linda Harbrecht

Posted on Friday, January 23, 2004

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