Nader v. Nursing Homes

You can dress like a gorilla,

You can frighten her and kill her,

But never put your mother in a home.

The unseen father of the film Where's Poppa? must have read Ralph Nader's latest report before he made his sons promise him on his deathbed that they would never put their mother in an old folks' home. For, as Nader made clear last week in a report to the Senate Special Committee on Aging, Momma may be far better off sharing an apartment with a homicidal son than in many of the nation's 24,000 nursing homes.

Researched by a team of six student volunteers and a teacher who observed Washington, D.C., nursing homes and studied masses of state and federal documents, Nader's report is a passionate indictment of the industry that provides care to at least one million of the 20 million Americans over age 65. Among its findings:

> Nursing homes are often unsafe. Investigation of a fire that killed 32 people in a nursing home in Marietta, Ohio, disclosed that the building failed to meet some safety standards, and that personnel had received no training in emergency procedures. The report goes on to note that though the Federal Government dispenses vast funds, inspection of the homes is left to the states, which are often less than diligent.

> Nursing-home care is poor. The report cites case after case in which homes were short-staffed--to a point where one home had only three people to cover an intensive-care floor of more than 50 patients. Those who are employed are often poorly trained for their jobs. As a result, many patients have waited hours for medical care. Cruelty to patients is also common, report Nader's Raiders, whose personal journals record instances in which elderly people have been abused by nursing personnel.

> Medical procedures in nursing homes are slipshod. In many cases, the doctors supposedly responsible for individual patients are unavailable when needed. Doctors who actually visit the homes often exercise insufficient caution and supervision over drug prescriptions. In one example cited by Nader, a doctor who had been administering an experimental drug justified his action by producing a release signed with an "X"; the patient had been judged senile three years before.

> Governmental regulation of nursing homes is inadequate. According to Nader, there have been "neither the full-fledged congressional hearings, nor the enforcement of adequate federal and state standards, nor the administrative inquiries and disclosures that are needed to reduce the institutional violence and cruelty that are rampant."

To remedy the situation, Nader recommends for nursing homes receiving federal funds: rigorous enforcement of existing standards, stricter medical review and licensing procedures, as well as the development of such alternatives as subsidized private housing and in-home care for the elderly.

Nader's report has already come under attack from at least one industry spokesman. L. Malcolm Rodman, executive director of the Maryland Health Facilities Association, called the study "clandestine, superficial and haphazard." But the committee, which began its current investigations in January, seemed generally impressed by the testimony of Nader's young investigators. Senator Frank Moss, a Utah Democrat, is looking toward establishment of a corps of federal inspectors to see that the homes come up to standard. Moss also hopes to change the system of federal payments to reward those homes that provide high quality care and discourage those that do not.

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