You who were so important to changes in society’s values during the ’60s and ’70s need to take on one more issue, treatment of older Americans.
Why? It started with a letter instructing a man to take a driving test with no reason given. Then a Hennepin County social worker came for an uninvited “visit” with him and his wife. Though the house and yard were pristine under the care of this couple, both of whom had advanced degrees, this visit resulted in the threat to their son, “You take care of them or we will put them in assisted care and we will take the house to pay for it.” Next arrived a company representative who told them they were “homebound” and proceeded to take over the household. The couple told them to leave, but eventually yielded to pressure from the county and hired their own private help several hours a week.
My mother received the same experience from Goodhue County workers, who told her she was “homebound.” She didn’t think she could even leave the house for a lunch date!
Another woman reported to me that she called the Minnesota Department of Human Services for advice on some handrails for her aunt. The next thing she knew, the aunt was in assisted care and her house was sold.
Hospitalized elders who are placed in a nursing home for rehab or any reason are routinely given a “cognitive test,” which Medicare requires, though a person can refuse it. I was at a diagnostic meeting where a woman was told to take the driver’s test. She responded, “I just took it two months ago.” The occupational therapist told her to take it again.
I was visiting a neighbor in a rehabilitation nursing home after she was hospitalized for pneumonia. The woman’s “dementia” was discussed by her physician in front of her, as if she were not present. Now she was not so demented as to not know what he was saying. She keeps house for herself and a son and keeps up with news and her neighborhood. Maybe she didn’t say the four numbers backward or something in the cognitive test, but so what?
What does it have to do with one’s daily tasks?
The relationship between one’s daily activities, including driving, to these mental tests is called validity. That is, does the test measure what it is supposed to measure?
Is it possible that a person may forget the three words when asked for them later and still be able to drive to the hardware or grocery stores in one’s neighborhood?
People are having their lives curtailed based on these very gross and simple measures. A good start would be to develop more tests of functional capacity for different activities.
And what is the relationship of these private home-care companies and the counties that they can come uninvited into a home on the word of a social worker?
How should healthcare workers be trained to deal with the elderly? People should be in as familiar and normal a place as possible. This helps keep people “normal.” Instead, we move them to unfamiliar places and are surprised that they seem confused. Of course, the confusion validates society’s opinion.
Baby boomers, expect to be on the receiving end of the above experiences. We have work to do.
—Grace Dyrud, Ph.D., licensed psychologist, Lauderdale
