This letter addresses one written by Gilda Johnstone, Nevada State Long Term Care Ombudsman, and published on May 23. I take issue with assertions made by Ms. Johnstone regarding the comparative quality of facilities available in this region of Nevada and what is a reasonable definition of elderly abuse.
I believe I am qualified to disagree with these assertions by virtue of my mother's final years after breaking her hip in March 1997. Following hip surgery, my brother and I brought her to a convalescent center in Carson City for rehabilitation therapy. Having had no prior experience with this kind of thing we were shocked during or daily visits by the repulsive environment and the perfunctory daily care. The proof of this came when my mother became severely dehydrated. When we told the doctor at the center that we wanted her to go to her own doctor, he insisted that wasn't necessary. Despite this, we took her to her doctor who immediately had her admitted to the hospital where she was put on emergency care for hydration and other related complications.
Foolishly, we returned her to the center. Her doctor wrote orders to the personnel at the center that it was imperative she have water at all times. Yet, day after day, her water container was bone dry. A short time later we took her home for two months of the most arduous times of our lives trying to please her and protecting her from injuring herself. After another visit to the hospital when the first hip operation failed, we placed her at Nevada Cares in September 1997.
For the first time we felt a sense of relief and confidence for her well-being and her safety. Being an energetic type, despite her infirmities, we were in constant fear she would fall unless some kind of restraint was employed. We were informed that state regulations would not allow this, that this would be abuse. She fell and broke her other hip in June 1998.
A second lengthy stay ensued at Nevada Cares during which time we employed the services of Home Care Plus to care for her special needs. In January 1999 her health declined. After yet another stay at the hospital we were advised to take her to a convalescent home where she would receive the needed "skilled nursing" for her problems.
We placed her in a second convalescent center in Gardnerville (now defunct). While the smell there wasn't as bad as at the first, the level of care was just as bizarre. Patients were routinely warehoused by day in wheel chairs, stacked in the halls or in front of a television no one watched. Again, the issue of our mother's safety was glossed-over, citing the state's restraint edicts and abuse definitions.
She fell from her wheelchair twice. On the first occasion, we were notified by phone message that she had fallen and sent to emergency having sustained a laceration to her forehead. Remarkably, no one at the center could tell us where she had been sent and we had to call the emergency facility ourselves to locate her. Further, no one had informed the doctor that she had sustained multiple hip fractures in the past.
We returned her to Nevada Cares, where we again supplemented her medical needs with Home Care Plus and eventually Hospice Services. Once me, we felt more at ease that we had in months. Fearing further falls, we also gave Nevada Cares a written agreement to allow our mother to wear a posey, a small apron that fits over the chest and back that can be tied loosely to a chair or bed. Anonymously, the relative of another patient felt the need to report this fact to the state. An agent was sent to investigate.
On Sept. 8, 1999, at Nevada Cares, the Hospice nurse told us that our mother's pulse was 85 over zero. At that very moment, the state's agent was also there in the same building poring over our mother's medical records! She died the next morning.
What we faced will be encountered at some time by over 50 percent of those who read this. Our experiences with Nevada Cares were the only bright spots interspersed between a series of nightmares. Unless judicious decisions are made toward nurturing rather than what is tantamount to attacking these facilities, they will disappear when we most need them.
DORIS J. KERKLA
Carson City
