I've been following Danny Hakim's series of articles on the terrible state of homes for the developmentally disabled in New York State. He has a new article.
Hakim explains that these disabled children and adults are abused and even killed by poorly trained, over worked, and under educated staff workers. There's no question that these staff workers have a tough job. The patients are often violent, schizophrenic, and erratic. They work long shifts. But we cannot have this vulnerable population abused in state-run facilities.
In the past year, I've visited some state-run homes for the elderly. My mom's friends are growing old and I sometimes drive my mom to these homes for visits. Old people can be annoying, too. Crotchety, delusional, and in pain. I've seen rows of over-medicated people propped up in wheel chairs in the hallway of these elder homes.
There has to be more oversight of these institutions. Staff members should not be allowed to take on double shifts. No one with a criminal record should be allowed to work in these institutions. Residents should not be over medicated, though I have no clue how that would be determined. Staff members should rotate their responsibilities between patient care and non-patient care to prevent burn out. Cameras could be installed for off-site monitoring.
Megan picks up this post and adds her own thoughts. She writes that improving the quality of care at these facilities is easier said than done.
Read the resumes of the people in the stories: most of them are dropouts, many of them have criminal records. The people who are taking these jobs are the people who have no other options. I doubt the state agency in charge of these homes wants to hire people who have criminal records and a history of being fired from other places. Maybe it's sheer malfeasance, but the more parsimonious explanation is that they can't find anyone else willing to do this work. Working with the developmentally disabled is emotionally and physically difficult, and not that many people feel called to do it. It's hard to attract people who have other choices. Monitoring won't help if there's no one to replace an abusive attendant on night call.
They could, of course, pay them much more. But at a guess, labor is the largest cost of these facilities–it certainly is for nursing homes, where my understanding is that it accounts for 60-70% of total costs. Doubling or tripling wages, which might well be required to attract a sufficiently large pool of better applicants, would substantially raise the cost of caring for these vulnerable populations. Where is that money coming from? Budgets at this point are zero sum, so whose jobs or benefits will you cut to double spending on the elderly and the developmentally disabled?
Caring for the sick, old, and disabled is hard work. My mom and I were just discussing this article and mom made the same point. It's a career path that few willingly follow.
Yet, caring for people isn't all that bad. What are you doing right now? It can't be THAT interesting if you are reading a blog post that doesn't have any double entendres. Wouldn't you much rather take a group of kids bowling? I have a friend who works in a psychiatric hospital in the city. She spends her afternoons coloring with the patients. Not bad. If you work for the state, you probably get great benefits. You can schedule your hours, so you're home with your kids.
Money alone won't change the treatment of the sick, disabled, and elderly in these state-run homes. We need to create a culture of care. We have to learn to be around the disabled and the elderly and find them amusing and interesting. We have to recognize that they are human beings. That's the only way that we're going to get good people working in these institutions. I suppose that's a much bigger challenge.