KosAbility is a community diary series posted at 5 PM ET every Sunday and Wednesday by volunteer diarists. This is a gathering place for people who are living with disabilities, who love someone with a disability, or who want to know more about the issues surrounding this topic. There are two parts to each diary. First, a volunteer diarist will offer their specific knowledge and insight about a topic they know intimately. Then, readers are invited to comment on what they've read and or ask general questions about disabilities, share something they've learned, tell bad jokes, post photos, or rage about the unfairness of their situation. Our only rule is to be kind; trolls will be spayed or neutered.
This diary is the second part of a two-part series on the epidemic of abuse affecting millions of disabled children and adults in the United States. In this diary, I will explore one of the reasons why I believe this kind of morally reprehensible behavior is allowed to continue…
Years ago, I took a job at a facility that provided care for mentally disabled adults. At first, I loved it—I enjoyed interacting with the residents, and tried to do my best to provide them with excellent care. Then, about a month after I started, I witnessed something that shattered my youthful naivety—while I was doing my rounds, I witnessed another employee slapping a resident.
Shocked and horrified, I went down the hall, straight to the charge nurse, and told her what I had seen. She told me she would look into it. Shaken, I finished the shift, went home, and slept very little that night.
The next morning, I was called into the office as soon as I got there. Several of the higher ups, and a man I realized was a lawyer were sitting there. They spent about 15 minutes questioning me about what I had seen. When I asked them what was going to happen, I was told, “Probably nothing—you were the only witness.” I was too afraid to suggest that they might take a look at the scratches and bruises on the resident in question, or perhaps ask if anyone else, including some of the folks living there who were verbal, if they had seen or heard anything.
The next day, I was assigned to work on the same hall as the asshole who hit that poor resident. Being a much meeker, gentler, and younger Tonyahky, I simply worked my shift, seething with anger at her, as she went about her day complaining to the other workers about her husband, the fine he got for a DUI, and on and on for the rest of the shift. Nobody would talk to me—later, I realized, I had already been branded a traitor.
The next day, I had a chance to speak with the charge nurse to whom I had already reported the abuse to. I asked her why The Abusive Bitch hadn’t been at least suspended. She looked at me, a little exasperated, and said, “Because if the facility admits that these kinds of things go on, we can be sued—then everybody, including you, will be out of a job.”
I hung in there a few weeks more, while I lined up another job I could do while I was going to college—then I quit. During that time I had to endure being seen as a “narc” and a “do-gooder” who thought “her shit didn’t stink.”
At an early age, I learned something about the way the people who run many health care facilities think—that avoiding liability is more important than doing what’s right—and the bottom line is more important than anything else.
Since the late 80’s, when I had that job, the profit motive has become the dominant force in determining what course of treatment should be given to a particular patient—not the patient’s actual needs. This is mainly due to the fact that much of the care provided to mentally disabled patients has largely been privatized. Lax oversight by state agencies charged with protecting the elderly and mentally disabled has led to flagrant abuses like those that occurred at The Pines, a facility for troubled adolescents in Virginia—in which patients were assaulted and given the wrong medications…and the state allowed these kinds of things to go on for three years before finally intervening.
In Texas, elderly and disabled patients were being placed in homes where they were being forced to sleep eight to a room, having their social security checks taken by their “landlords,” and were often subjected to severe abuse before a bill was finally passed regulating these kinds of homes. Obviously, some folks are so hard-hearted, they can treat other human beings worse than they would treat a dog if it will line their pocket with a nickel.
And it’s not just individual facilities and care providers who are in on the act—in Pennsylvania a few years ago, Allen Jones, an investigator with the Pennsylvania Office of Inspector General found that drug company money was being used to influence state officials—and some of them were paid as much as $2,000 for speaking engagements. As a result of the pharmaceutical company’s lobby, many patients are overmedicated—there have been many deaths as a result. A psychiatrist, Dr Stefan Kruszewski, who was hired by the Pennsylvania Bureau of Program Integrity in the Department of Public Welfare to oversee the mental health and substance abuse programs was fired after he revealed that many children in the state’s care were being sexually abused and subjected to dangerous drug therapies.
But what can be done to prevent these kinds of abuses? After spending many years as both a health care worker—and as a parent to a severely disabled child, I believe the following needs to be done:
Develop a nationwide abuse registry to prevent workers with a history of abuse from skipping the state and getting a new job somewhere else.
Independent review of facilities charged with caring for the mentally disabled—as well as third party case mangers who have no financial ties to the agencies providing the patient’s care.
Enact stronger legislation protecting patient's rights.
And most of all…get rid of the profit motive in health care---we need single payer!
