OLD AGE: The Last Segregation by Claire Townsend

OLD AGE: The Last Segregation

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The Ralph Nader Study Group Report on Nursing Homes is evidence that youth and inexperience, even looks and money (viz. the seniors from Miss Porter's School who chiefly prepared it) are not barriers to a creditable piece of work; concomitantly, it demonstrates that expert guidance and entree to officialdom are not decisive assets: Garvin and Burger's 1968 Where They Go to Die is at least as thorough an exposure and as penetrating an indictment. The lead-in here is weak -- an anonymous if apparently authentic letter chronicling a case of massive malfeasance, one girl's recap of a frustrating, frightening trek with an elderly patient that asks many questions but doesn't answer some obvious ones. But with the data on ""Government and Nursing Homes"" come substance: the history of national health insurance documents a general need (throughout the focus broadens and narrows) and the discussion of Medicare and Medicaid apropos of nursing homes is strong and clear on the futility of having three different sets of standards for each situation, the specific weaknesses of inspection programs, and the disinclination to enforce standards altogether. ""Inside the Nursing Home"" we have discontinuous excerpts from the girls' journals (based on brief undercover experience as aides) plus long accounts of the Marietta, Ohio, fire and the case of salmonella poisoning in Baltimore, the latter bringing up the absence of medical supervision and of qualifications for administrators. Re ownership, the important point is made -- but not weighed -- that 90% is private, i.e. profit-making; much that follows on the ""irrevocable"" contract abuse, the shortage and incompetence of personnel, and the maladministration of drugs is worthwhile but not new or definitive. Most sensitive (in ""The Incentive to Live"") are the remarks of Washington psychologist and gerontologist Dr. Robert N. Butler: ""There is no such thing as senility,"" he claims, explaining its supposed signs as natural to aging. The book draws heavily from published reports of all kinds and, to its credit, sources are cited scrupulously; one can assess its strengths and recognize its limitations thereby.

Pub Date: July 1st, 1971
Publisher: Grossman