Sunday, December 11, 2011

Truth Falls Victim in Nursing Home Tragedy

By Nicholas Stix
February 16, 2004
A Different Drummer and ‘round the Web

“Granny taken up to roof?” “Insider Says Understaffing Killed Grandmother.”

So blared the newspaper headlines in the Daily News and The Wave, respectively, in reporting on the tragic death of nursing home patient Lillie Gardner in Queens, New York.

Lillie Gardner was born in Richmond, Virginia, and came north to New York as a teenager, where she married Lloyd Gardner. While living in Corona, Queens, the devout Christian gave birth to and raised five sons and one daughter, worked 20 years as a teacher’s aide, caring for other people’s children, and had 14 or 15 grandchildren, depending on who is reporting. She led a quiet, private life. In death, however, she has achieved fame, based on her usefulness for the living.

Nine months ago, Gardner’s children placed her in the Bishop Charles Waldo MacLean Nursing Home in Far Rockaway, Queens. She was suffering from the early stages of Alzheimer’s Disease, and walked with a cane.

Lillie Gardner died at 1 a.m., on Wednesday, February 4. After her Tuesday dinner, Mrs. Gardner either wandered up the stairs, or in a defective elevator, to the building’s roof where, disoriented, she succumbed over the course of six hours to the cold, the wind, and deep puddles of freezing water. She wasn’t found until 12:30 A.M., at which point, she was beyond saving.

Negligence may have been a factor in Gardner’s death, since an alarm apparently sounded at 6:30 p.m., when she opened the door to the roof. A staffer went upstairs to see whether anyone was up there, saw no one, called out and got no answer, and not wanting to get wet feet in the deep, frigid puddles, went back downstairs.

Normally, my heart would go out to the victim’s grieving family. Only in this case, it seems that the moment Gardner’s 50-year-old son Sidney, bishop of the House of Israel Worship Temple, discovered she’d died, he strategized with his lawyer, Kenneth Mollins. The day of his mother’s death, rather than pulling the family together and mourning and praying, Bishop Gardner joined hands with attorney Mollins, in unleashing a scorched-earth media campaign, in which the two were interviewed by every major TV and print media outlet in New York. Gardner is suing the nursing home for wrongful death.

Bishop Sidney Gardner insisted that his mother could not have walked the 12 steps from her floor to the roof, and must have been forced to go to the roof. "My mother did not go on the roof on her own strength. I question whether she went up on her own will."

On Wednesday, February 4, lawyer Mollins also contended to the New York Times, that “the family” said that Lillie Gardner had bruises on her arm and wrist, a contention which police denied.

There is no evidence that anyone forced Lillie Gardner to go to the roof, or in any way harmed or abused her.

Meanwhile, Mrs. Gardner’s eldest child, 52-year-old Arthur, insisted to the Daily News that he and his siblings had only placed their mother in a nursing home, while they arranged for a home health aide to care for her. "It was supposed to be a temporary thing. My mother wasn't supposed to die like that." Meanwhile, Arthur told the New York Post that he and his siblings had placed their mother in the nursing home because she had a problem with “wandering,” thus contradicting both his story to the Daily News, and his brother’s story.

The contention by an anonymous worker at Bishop MacLean’s, which credulous reporter Brian Magoolaghan repeated in the Rockaway newspaper, The Wave, that “understaffing” was at fault, is also nonsense. Three Certified Nurse Aides (CNAs) were on duty at the time, for 45 patients. Considering that the Rockaway peninsula, where Far Rockaway is located, is the world’s nursing home capital, Magoolaghan should have known that a 3:45 CNA-to-patient ratio is perfectly adequate. (The “Rock” has at least 17 nursing homes and over 2,000 patients, out of 100,000 area residents. Some news reports, which claimed that the area has 25 nursing homes caring for 3,200 patients, may have included adult care facilities, which cater exclusively to former mental patients who lead independent, if limited lives.)

Prior to Lillie Gardner’s death, Bishop MacLean’s had a clean record, free of sanctions for abuse or neglect. Although a patient there died, following a fall, in 1996, and the patient’s family cashed in, the home was apparently not cited for negligence in the case. Since Gardner’s death, New York State officials have cited the home for inadequate security for wandering patients. (Most nursing homes keep their hallway doors locked; workers know the code required to open them. If a door on a floor is opened improperly, it sets off an alarm. Some homes also use “wanderguards,” bracelets that patients wear which go off, it their wearer seeks to enter an unauthorized area, or to leave the premises.) Note, however, that nursing homes are not permitted to act as patients’ jailers, and that in recent years many methods traditionally used to protect vulnerable patients have been forbidden by authorities, as improper constraints.

Since it takes less than a month to arrange for a home health aide, in truth, Lillie Gardner’s children had permanently placed her in the nursing home. Had they bothered arranging for a home health aide, their mother would likely be alive today.

My attitude toward Mrs. Gardner’s sons Sidney and Arthur may come across as heartless. But consider that when a family suffers the tragic death of a member, the survivors typically are too broken up initially to talk to any journalists. By contrast, Bishop Sidney Gardner couldn’t shut up.

One thing you can infer from Lillie Gardner’s life is that she raised her children such that they knew that it was wrong for them to have dumped her in a nursing home. And so, they fibbed about the matter. And now her sons seek to exorcise, transfer, or project their own guilt onto the nursing home.

And the media will get its payoff, too. As occurs every couple of years, city and national editors will now dispatch reporters to dig up dirt on nursing homes. The usual boilerplate tells of CNAs from Hell who abuse and assault patients, as opposed to the reality – which my wife and I know from having worked as nursing home CNAs in Far Rockaway and elsewhere on the peninsula -- in which it is the patients who typically abuse, harass, and assault the CNAs. And this tendency is bound to rise, as nursing home operators increasingly fill beds with ever more and younger psychiatric patients, drug addicts, and violent criminals who played the system.

There is nothing romantic or idealistic about nursing home operators, who are barefisted businessmen, who even in union shops, often cheat workers on their pay. And yet, conditions today in American nursing homes, particularly in New York, can hardly be compared to the bad old days of the 1950s through the early 1970s when, most notoriously, Bernard Bergman owned dozens of New York nursing homes in which patients lived in horrific conditions. After Bergman was convicted, among other things, of Medicaid fraud, various states empaneled commissions to investigate and draft reforms for the industry: E.g., the Moreland Act Commission in New York, the “Little Hoover Commission” in California, and the Ohio legislature’s Nursing Home Commission.

Today, the problems with nursing homes tend to be the lack of a stimulating environment for patients, of workers falsely reporting that they have given patients physical or occupational therapy or range-of-motion exercises, and the curious tendency of the condition of patients admitted to a nursing facility for short-term therapy to deteriorate, and the patients ultimately to live out the rest of their days there. Once a nursing home operator has filled a bed with a patient, he does not want that patient, and the latter’s payment, ever to leave. Those are all bad things, but they don’t generate the sort of sensational stories that news editors seek.

At the same time, nursing home owners – not to mention staffers – have to contend with patients who, though they are not paying for their own care, constantly call authorities with false accusations of abuse or negligent care, and who constantly initiate frivolous lawsuits against the facilities, in order to shake them down for lucrative settlements.

And I’m not even talking about the Gardners. According to the letter of the law, they have a legitimate cause for action. And yet, in the face of human fallibility, no nursing home operator could ever satisfy the letter of the law and the demand by family members for a level of care that cannot be provided at current payment levels and under current law (and that family members are unwilling or unable to provide themselves), and perhaps could not be provided at any payment level, and the demand for steep monetary penalties for any and every mishap.

If all the Arthur and Sidney Gardners of the world were successful in their lawsuits against nursing homes, the homes would all be forced to close, and the Gardners and their ilk would have to rely on the tender mercies of their own children, once they became aged and infirm. That would be poetic justice.

Caring for a debilitated family member requires a Herculean effort. For several years, my Toogood Reports editor/publisher, A.J. Toogood, has singlehandedly cared for his wife, Betty. Betty developed a case of early, rapidly deteriorating Alzheimer’s Disease, like that which killed Rita Hayworth. Based on his understanding of what it means to be a Christian, A.J. would never consider dropping off his wife at a nursing home. Eventually, the strain of taking care of Betty and running a full-service web site caused A.J., who was retired and in his mid-60s, to develop pneumonia; he almost died. And so, as he has written, he was forced last month to shut down Toogood Reports.

Time was, folks would routinely sacrifice themselves to care for an invalid family member, whether they liked it or not. Back then, “reactionary” notions such as family, duty, and honor held sway. But why bother with the expense, the exhaustion, and the frustration of caring for a helpless, needful relative, when you can just shuffle your loved one off to strangers at a “free” institution at taxpayer expense, pose as a devoted family member without any of the work or the responsibility, and then get rich suing the strangers, when their care proves less than perfect?

In life, Lillie Gardner deserved better; in death, she still deserves better.

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