18. GHETTOIZING THE ELDERLY

"Age" is a dirty word in America. Calvin Klein image-molders cater to a nation of dieters and Joggers who would perennially pour themselves into jeans designed for the teenager. To age is to pass from the limelight reserved for beautiful people into a wasteland of neglect, despair, and poverty.

In America, your probable reward for 50 years of service to family and society, as well as lifelong payments of social security, federal and state taxes, will be confinement to a nursing home at age 65, where one-third of the residents die within the first year. As Medicare insurance makes no provision for extensive nursing home coverage, you will have to exhaust your savings and sell your property to pay for "care" from an institution where the administrators often earn $35,000 to $50,000 per year, and whose shareholders often earn a 40 percent return on their investments. When your funds run dry, you will be eligible for Medicaid, and will be quickly shuffled out of the "for-profit" nursing home into a substandard home plagued by fire code violations and staffed primarily by underpaid and undertrained women.

If you are fortunate enough to remain outside the walls of the nursing home at age 65, you will nevertheless be hit with skyrocketing medical costs. The cost of medical care in the U.S. has grown at a faster rate for the aged than for everyone else, now consuming about 30 percent of the national medical bill.

Medicare and Medicaid legislation, passed in 1965, brought a phenomenal boost to profits of both the medical and nursing home industries. In 1962, the total national expenditure for long-term care of older people totaled only $500 million. Formerly charitable institutions or "mom-and-pop" operations, nursing homes today have become large chains, selling stock on the open market. The industry's revenues since 1962 have increased twenty-fold -- to $12.6 billion. More than half the revenues are paid by Medicare and Medicaid.

In contrast to the growth of profits in the aging industries, the elderly themselves are being plunged into poverty. Nearly 15 percent of the elderly today live in "official" poverty; half are getting by on $75 a week. Blacks are especially hard hit and die more than four years sooner on the average.

When will we begin to look at creative alternatives? In other countries the elderly are not coldly institutionalized, but are afforded care that fosters more independence and self-respect. In England the government pays home nursing and house-keeping services, and hot meals are available at community centers. In Sweden apartments have been built around a central unit providing medical care, therapy, hot meals, and social activities.

If the media spotlight were more frequently turned from the derriere of Brook Shields to the human tragedy of 1.3 million Americans ghettoized in nursing homes, needed reforms could be sooner forthcoming. Or must we consign the elderly to silent decay until the post-war baby bulge becomes a senior citizen lobbying power in the year 2000?

The failure of the media to put the plight of the elderly on the national agenda qualifies this story for nomination as one of the "best censored" stories of 1980.

SOURCES:

The Progressive, February 1980, "Nursing Home Watchdogs," by Karen Hering; Mother Jones, May, 1980, "Growing Old Absurd," by Hugh Drummond, M.D.