In the old days, Young Readers, before the goal of eldercare was merely profit, nursing homes used to have things called “missions.” Missions focused on the well-being of the elders they cared for — not only their physical well-being but also their emotional and spiritual health.
Back then, facilities often catered to a specific clientele, such as those of a particular religious or ethnic group, because they sought to fill the needs of their local community. Sometimes homes adopted a philosophy of caregiving that was thought to best serve their residents.
Missions were wonderful things. They were guideposts that all workers could use to steer their actions, to decide whether they were consonant with the goals of the organization.
Over the years I worked in places that offered specialized care to Catholics or Jews or Episcopalians, or those that had large groups of Chinese or Caribbean residents, or younger residents, or people with multiple sclerosis. Others used an Eden Alternative philosophy or had specialized dementia units.
All were proud of their missions and strove to provide excellent care for their residents and heartfelt jobs for their employees. The benchmark of decision-making was whether it was in accordance with the mission and good for the residents.
Nowadays, as you’ve no doubt seen, Young Reader, the goal is profit and choices are consonant with that goal. Nursing homes are owned by corporations because it’s virtually impossible — margins being what they are — to run an independent facility.
Decisions are made by corporate.
What kind of decisions, you might be wondering? Back in the day, for instance, if someone received a medical treatment, you could be
99%, 95%, sure it was because it was something they needed and not because it was a high-reimbursement procedure being provided by an affiliated company.
I know that this is common now, but back then, this was considered shocking, immoral and illegal. Actually, it’s still immoral and illegal but no longer shocking as it seems to have become the standard of care.
I’m not saying things were perfect back then, or that only saints were running the homes, no.