Across the country, including here in Ohio, the nursing home industry is flailing against proposed state cuts in Medicaid funding, which it insists will hurt the patients they serve.
Meanwhile, in Washington, D.C., this same industry is arguing that it should be exempt from providing the health care of hourly wage earners who take care of the patients they claim to be fighting for in the states.
As The New York Times’ Robert Pear reported earlier this week, among those workers who deliver hands-on, often backbreaking care at nursing homes, one in four is uninsured. Most nursing home health care plans that do exist probably wouldn’t meet the standard of coverage set by health care reform required in 2014.
In the past couple of weeks, I’ve talked to dozens of nursing home aides. Most of these women reached out, via email and voice mail, because of previous pieces I’d written about hourly wage earners. Not because they want to make more money, even though they average $9 an hour. They’re worried about what the cuts in Medicaid will mean to the patients they tend.
Only a few of the women I spoke to even knew about the recent debate over their health care. When you work as a nurse’s aide, you’re used to low wages for the hard work that keeps people alive. I’m not suggesting all nursing home aides are saints. But there are a lot of good women and men out there taking care of aging people for paltry wages.
One of them is Janet, who is 60 and works in a nursing home in the Cleveland area. She was full of stories about the patients she has grown to love, and said I could share the details as long as I didn’t use her last name or identify her employer.
Understand, she was never critical of the nursing home. She just knows she was hired for her manual labor, not her opinions, and that it’s too easy for a worker like her to be fired.
Janet talked at length about the job she loves. She’s responsible for as many as 15 patients in an eight-hour shift, all of them elderly.
Her days begin by clocking in to work, and then getting updates on each patient from the aide on the previous shift. “It’s important that we know what they’re eating, who is weight-bearing and can stand on one foot, two feet or not at all, and what new problems might have surfaced overnight. One day they can be docile and content, the next day very needy and anxious.”
Janet makes an effort to say hello to each patient and asks how he or she is doing. She’s big on the little things that allow patients their dignity.
“They don’t want to be talked down to,” she said. “I let them comb their own hair, brush their own teeth if they can, instead of doing it myself to get it over with. They’re not children.”
Baths can be quite the ordeal. It takes an hour and lots of muscle, for example, to bathe an elderly man who is paralyzed on one side and rarely speaks. Janet uses a hydraulic lift to move him from his bed to a chair and into the shower. Then she slowly, and carefully, lathers him up, dries him off, then uses the lift again to tuck him into a clean bed.
“Feel better?” she asked him recently.
To her delight, he answered with a roar: “Yeaaaaah!”
Sometimes, her day is too busy and short of help to give him that shower. That bothers her a lot.
“Staff turnover is huge,” she said. “And people call in sick a lot. I don’t blame them. I’m twice the age of most of the aides who work here. When I was young, I wouldn’t have had the ability to focus on the patients as individuals and their needs. Most of the women I work with are struggling and don’t have time to think about other people’s struggles.”
Janet said she’s one of the lucky ones.
“I’m so blessed to have a husband’s salary to fall back on. This is not a living wage. Most of the aides have children they can’t support, or they’re taking care of grandchildren. They’re trying to spread their wages like the loaves and fishes, and it’s not working.”
She chuckled, and let out a big sigh.
“What are we going to do when they cut Medicaid?” she said. “All these politicians talking about how they respect life. I don’t know whose lives they’re respecting.”
Connie Schultz is a syndicated columnist for The Plain Dealer in Cleveland and an essayist for Parade magazine.