What’s Behind the Nursing Home Horror

After decades of mistreatment, older Americans are bearing the worst of the pandemic.

By Charles C. Camosy
Dr. Camosy teaches bioethics and moral theology at Fordham University.

Emergency medical technicians transporting a patient from a nursing home to an emergency room bed at St. Joseph's Hospital in Yonkers, N.Y., on April 20th.Credit...John Minchillo/Associated Press

We knew it from the beginning. A nursing home in Washington State was the center of the first known coronavirus outbreak in the United States. We knew that institutions caring for the elderly and disabled in close quarters would be particularly vulnerable during the pandemic.

But we did not act. Personal protective equipment, special training and extra staff went almost exclusively to our critical care facilities. Nursing homes got virtually nothing. Well, that’s not entirely true. In New York and other places we gave them patients, and even nurses, infected with the virus.

The result has been a raging wildfire of infection and death. We don’t have full reporting of anywhere close to all the deaths at this point, but the best estimates right now are that about half of those who have died from Covid-19 have been nursing home residents. In some places, it’s much more: Connecticut reported that nearly 90 percent of its Covid-related deaths between April 22 and April 29 occurred in nursing homes.

We tend to see this as a public health failure, but it is also a moral failure. That fact hit me recently, after I went on Fox News’s “Tucker Carlson Tonight” to talk about the plight of nursing homes.

Even before the pandemic, these were places where what I call “throwaway culture” was thriving. The staff aren’t paid a living wage, often have poor training and are hopelessly overworked. The residents face elder abuse, and large percentages of them are desperately lonely. A good number get no visitors at all, which pushes rates of dementia among residents to unbelievable levels.

I suggested to Mr. Carlson’s audience that it was no surprise that throwaway culture kicked into hyperdrive in nursing homes during our current moment. I was excited to be able to make my case to a national audience; afterward, I was exhausted. All I wanted to do was help my wife get our 2-year-old to bed and go to sleep myself.

But that’s when the messages started coming in. Email. Facebook messenger. LinkedIn. Twitter. One after the other after the other. And they were horrifying.

It is one thing for a professor of bioethics to cite abstract numbers and trends and offer a theoretical explanation for them. It is another thing to get message after message detailing the human toll of what you had just discussed.

One of the most moving — and frightening — was from a nursing home staffer. She said she was given inadequate P.P.E. and training, and had likely been exposed to the virus. Her communications with management were ignored. Staff members at her facility were not being tested. She decided to quit her job rather than risk infecting her residents. “I don’t know if you can help me,” she said. “I feel that what you said is true; the elderly need a voice by someone that cares.”

Another correspondent, who had worked in health care administration, said that she was “not surprised in the least that the hospitals were trying to discharge their Covid-19 infected patients” back to long-term-care facilities because, in her experience, this has “been happening for quite some time.” It got worse: Agreeing with me about the radical understaffing of nursing homes, she said that it is “increasingly common is to discharge high cost and difficult patients to homeless shelters … Yep, you heard me right … HOMELESS SHELTERS.”

Not every story was coronavirus-specific. One man told me the story of the fatal neglect of his father — after which the nursing home falsified his father’s records and hid behind state laws that nursing home lobbyists had written.

A former director of nursing at a long-term-care facility said that given her terrible professional experiences, she had refused to put her 78-year-old husband, who was suffering from dementia, anywhere outside her own home. Another clearly frightened woman explained that she had just had a horrible experience with her mother in a nursing home; she even gave me, a complete stranger, her phone number, in the desperate hope that I could raise the alarm about how bad things were.

We need to listen to people like this and act on what they are saying. The pandemic doesn’t have many silver linings, but as the number of nursing-home deaths piles up, the news media is being forced to cover a world many of us would prefer to ignore.

It is understandable that we would. Part of the price we pay for living in a death-denying, consumerist, throwaway culture is that we must push these kinds of grim realities to unseen places that afford us plausible deniability. The pandemic forces us to look. If we want to understand the current phase of the coronavirus pandemic, we can no longer look away.

After receiving this waterfall of messages, I expected to fall into despair. But while I do have my bad days, I also have hope. Times like this have produced major cultural changes in our past. If we do take a hard look, we may change more than just the way we treat older Americans. We may, along the way, find a way to push against throwaway culture in all its forms.

Instead of denying the reality of cognitive impairment, aging and death, could our culture begin to embrace it forthrightly in ways which lead us to honor the final years we have with the family members and friends who go before us? To honor the moral and social equality of every human being, regardless of their mental or physical status?

Why not? Many of us are staying home and practicing physical distancing, not primarily for ourselves but for the benefit of our elders and others who find themselves at risk. Let us build on that good and decent impulse by challenging a throwaway culture that, right up until this very moment, has marginalized these populations and made the nursing-home crisis a tragic inevitability.

Charles C. Camosy (@ccamosy) is an associate professor of theological and social ethics at Fordham University. His most recent book is “Resisting Throwaway Culture.”

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What’s Behind the Nursing Home Horror

Fordham professor laments physician-assisted suicide, says it hurts vulnerable people the most

Nine states have already legalized physician-assisted suicide,(PAS) and New York may be next in line, Fordham University professor of theological bioethics Charles Camosy told Fox News' "Tucker Carlson Tonight" Tuesday.

Camosy told host Tucker Carlson that the most common reason patients in Oregon, where assisted suicide has been legal since 1997, request access to PAS is not due to "physical pain and suffering," -- as is often assumed -- but rather a fear of "being a burden on others," and fear of "losing one's autonomy."

NEW JERSEY ASSISTED SUICIDE LAW BLOCKED BY TEMPORARY RESTRAINING ORDER

"I'm a college professor so I'm around progressives a lot," Camosy said. "It's an absolutely bizarre reaction ... to say 'Well, there are these people who fear these things because of our socially unjust world, [so] let's make it easier for them to kill themselves.' That can't possibly be the correct response from somebody that cares about social justice."

Carlson suggested to Camosy that it would only be a matter of time before companies "figure out that it's a lot cheaper if you are dead than if you are, say, being treated for diabetes."



Camosy agreed, noting that what he called the more "vulnerable" populations that seem the most skeptical of PAS.

"They get it," he said. "They know that when you say things like, 'Who is a burden?' It's them. Who has lost their autonomy? It's them. There is a whole elitist substructure which says 'We're going to benefit from that now.' It's not explicit but they do in fact benefit from that.'"

MAINE IS 8TH STATE TO LEGALIZE ASSISTED SUICIDE

Camosy said his book "Resisting the Throwaway Culture" emphasizes the importance of speaking up on the issue, "at least if we do care about vulnerable populations."

Camosy also noted that Latinos and African-Americans specifically are "on the front lines of this" and have spoken out against PAS "very disproportionately especially compared to privileged whites."



"We hear about racial justice all the time ... how about being consistent and saying 'Let's listen to these voices of color here, not just on the set of issues that we happen to care about Monday through Friday," Camosy said.

Camosy predicted that New York state was likely to legalize PAS in the near future, but urged viewers to "pay attention to those vulnerable voices."

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"I think if we can pay attention to those vulnerable voices, those who don't get heard, the forgotten people and really pay attention to them and not just give them lip service, we will be deeply skeptical of this," he concluded.

California, Colorado, Hawaii, Oregon, Vermont, Washington, Maine, New Jersey and Washington, D.C., all have legislation permitting medically assisted suicide, according to the Death With Dignity National Center and the Death With Dignity Political Fund.

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Fordham professor laments physician-assisted suicide, says it hurts vulnerable people the most