Friday, May 20, 2011

Visiting Nursing Homes With Chiquita Smith

Last week I visited two nursing homes in Brooklyn and Queens with Chiquita Smith. Previous interns have been on similar visits before me, but they went to different places. Chiquita Smith is quite an interesting person. She devotes a lot of time to defend the rights of nursing home residents. To find out about residents’ living conditions, she travels to different nursing homes every couple of months. She brings interns from Global Action on Aging to see how poor elders live in such nursing homes. Chiquita lost her vision a number of years ago due to diabetes.

Our first stop was at Cobble Hill Health Center. This nursing home is located in downtown Brooklyn, a big building in the middle of an urban jungle. It is a non-profit nursing home and has a total of 570 beds available. When I first walked in, I could not decide if it felt like I walked into a school or a hospital. The big dining room and the wall decorations reminded me of my old elementary school back in Sweden. Soon enough I realized I was not in a school but in a nursing home.

When we arrived, it was time for the residents to have coffee in the 'common room'. Quiet music was playing in the background. Slowly, one resident after the other joined us. We sat down with Chiquita’s good friend to talk. Chiquita told me she has two main concerns when it comes to nursing homes: whether the residents get a chance to go outside when the weather is nice, and if they get help to vote during elections. We were told that the Cobble Hill seniors used to go out. But no longer, unless they are capable of going outside by themselves. During elections there is some assistance available. I looked at their weekly entertainment schedules which suggested that indoor activities had been planned for them every day of the week. This is good, since social interaction is important at any age. However, three things bothered me. The first one was how residents and employees interacted. I felt that a lot of the caregivers were talking 'over the head' of the residents or as if they were not there. In the middle of coffee time the fire alarm went off. It took a very long time until it was turned off. The sound was very loud. As this was going on, an employee of the nursing home said to me:

- ”Thank God for the paycheck.”

At first I was not sure I heard her right. I thought that this comment was highly inappropriate. Not only is it troubling hearing this ironic remark from a person who is working with human beings that are depending on them, but it also confirmed my observation about poor communication and apparent disrespect toward the residents. We read about understaffed nursing homes all the time. We know that understaffed nursing homes can lead easily to abuse and neglect of the elderly. Almost 50 percent of all nursing homes in the United States are short-staffed; this situation leads to employee burnout and stress. Why is nothing done? Is the answer as simple as money? Unfortunately, most nursing homes are for-profit businesses; one of the easiest ways to increase profits is to reduce staffing costs.

The second nursing home we visited is located by the ocean, in Far Rockaway, Queens. The Bezalel Nursing Home is rather new and has 120 beds, smaller than the average in New York City. The ride to get there took about 1 hour. The closer we got, the lower the landscape became. After a while, you could even smell the salty fresh air from the sea. We arrived around lunchtime which made it seem a bit chaotic. The dining room was on the main floor. All the seniors were on their way back to their rooms. This made the line to the elevator very long.

Meanwhile, waiting for Chiquita's friend to finish his lunch, I took a look around and discovered a nice outdoor area where some seniors were sitting. Even though we arrived during a busy hour, the dynamic between the residents and the care givers seemed good. We also got the chance to see the room of Chiquita’s friend, Frank, which he shared with one other person. Chiquita wanted to know how Frank liked living at Bezalel Nursing Home. He told us that the staff is friendly and he gets to go outside. The only thing he complained about was that he did not get any help during election campaigns in order to exercise his right to vote. Except for the last detail, I got a pleasant and warm feeling about the atmosphere in Bezalel Nursing Home.

After visiting these two nursing homes, I think I got a good introduction to how elder-care can look in the United States. I can only compare it with my experience in Sweden; and it looks very similar. The biggest difference is that you do not share your room with anybody and when you move into a room in a Nursing Home, you bring your own furniture. The exception is the bed since the nursing home wants a special hospital bed.

The two nursing homes were lacking one thing each: Cobble Hill did not offer opportunities to go outside, while Bezalel Nursing home failed to assist during elections. Perhaps the location had something to do with this situation. Helping seniors to vote is easier when you are in the city, but all the traffic and the lack of space might make it hard to find nice outdoor areas. Going to a nice area requires more time. And while a nursing home located close to the beach might make it easier to help seniors to go outside, the distance to the city might make it harder to assist them during an election. I don’t think the main responsibility lies on the nursing homes, but that does not mean they shouldn’t make the effort to ensure their residents human rights. This should not be an issue since there are laws that handle this. The Voting Accessibility for the Elderly and Handicapped Act of 1984 generally requires polling places across the United States to be physically accessible to people with disabilities for federal elections. Where no accessible location is available to serve as a polling place, a political subdivision must provide an alternate means of casting a ballot on the day of election. This law also requires states to make available registration and voting aids for disabled and elderly voters.

Sanna Klemetti


  1. Good article. ALL residents of LTC should be able to go outside and enjoy the fresh air and birds. It is the duty of the Activity Director to plan outside activities weather permitting. Even residents confined to G chairs should be able to come out and listen to the activity. Residents must be treated as you would wish to be treated. If able also have a small garden (ground/raised). The staff must help the Activity Director transport the residents. You are there for them, not a pay check.

    As far as elections. The election board should come to the LTC with a representative from all parties. NO staff, family, or election board should control the votes. It is the job of the LTC to watch this. Families and the election board will try and control the votes. The election board decides whether a resident is capable of voting. I feel this should be a join decision of the election board and the LTC staff that know if the resident is alert and oriented. The election board or anyone should not tell the resident this is the way you always vote. If the resident says NO to voting that is his or her right. Do not pressure. The Activity Director, Social Service, or DON should watch closely the voting. If a resident wishes to vote at an election site then the LTC should make arrangements to transport resident if physical able. It is the right of ALL US citizens to vote.

  2. Last month I went to a care home and I noticed that many people don't have visitors which is very bad. We should respect our elders.

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