Time - Man of the Year/Time_Man_of_the_Year_Compact_Publishing_3YX-Disc-1_Compact_Publishing_1993.iso/moy/040692/0406104.000

Text File | 1992-08-28 | 6KB | 128 lines

                                                                                NATION, Page 24

FAMILIES

When Love Is Exhausted


The abandonment of an elderly Alzheimer's patient highlights the
pressures on those who care the most

By J. MADELEINE NASH/CHICAGO -- With reporting by Elizabeth
Rudulph/New York and Lynn Steinberg/Seattle


    It was just another Saturday night at the Coeur d'Alene
Greyhound Park in Post Falls, Idaho. The dogs had returned to
their kennels. The boisterous stands had nearly emptied.
Custodian Lou Tonani was making his usual rounds when he
happened upon an old man in a wheelchair, a bag of diapers
dangling by his side. He wore a brand-new sweatsuit, blue
bedroom slippers and a baseball cap emblazoned with the words
PROUD TO BE AMERICAN. Twin typewritten notes, carefully taped
to opposite sides of the wheelchair, identified him as "John
King," a retired farmer suffering from Alzheimer's disease and
requiring round-the-clock nursing care. All labels had been cut
from his clothing and identifying marks scoured from his
wheelchair. Who on earth, Tonani wondered, had left the man
there, and why?

    From the start, it seemed like a classic case of "grandpa
dumping." Some stressed-out family member, experts conjectured,
had suddenly broken under the pressure of caring for a confused
and ailing spouse or parent. "It's shocking and terrible," says
University of Chicago geriatrician Dr. Christine Cassel, "but
it doesn't surprise me at all. The families of Alzheimer's
patients sometimes just give up in despair." Such families have
been known to drop their elderly charges off at hospital
emergency rooms and then disappear. "It happens here probably
once a month," says University of Chicago emergency-room
physician Dr. Cai Glushak. "Before you can turn around, the
person who registered the patient has gone. They've left no
phone number, no address."

    Some abandoned patients are merely frail and suffer from
the complications of chronic diseases such as diabetes. But
more are clearly demented. They show up in emergency rooms with
acute problems like dehydration. Elderly people who live alone
are sometimes so desperate for help that they in effect abandon
themselves. Others are dumped not by relatives but by landlords
and even household employees. In Greenville, N.C., a
65-year-old alcoholic woman materialized on the doorstep of the
Pitt County Memorial Hospital after she was shoved out of a car
by a fed-up and weary maid.

    How widespread is the phenomenon of abandoned elders? The
evidence is mostly anecdotal, and reliable statistics are
elusive. Dr. Robert Anzinger, a past president of the American
College of Emergency Physicians, estimates that between 100,000
and 200,000 such individuals show up in hospital emergency rooms
every year. "These are desperate acts," says Dr. Ellen
Taliaferro, an emergency-room physician at San Francisco General
Hospital, "committed by desperate people."

    Social workers understand that caring for an aging, infirm
relative day in and day out drains families, not just
financially but physically and emotionally as well. The wonder
is that so many people willingly shoulder the burden with
fortitude and grace. Noreen Maluchnik, head of the English
department at Chicago's Resurrection High School, gets into the
shower with her 77-year-old father in order to bathe him. Daily
she helps her mother change his diapers, cut up his food and
clean the bed linens, carpets and floors whenever there is an
"accident." At times she wonders how to hold on to sanity.
"Although I could never abandon my dad at a hospital or a
racetrack," she says, "I can certainly understand the pressures
that would lead another person to do something like this."
Rather than renounce responsibility, caregivers often neglect
their own health and risk ending up in hospital emergency rooms
themselves.

    John King turned out to be a retired autoworker named John
Kingery, 82, who in early March was placed in the care of
Regency Park Living Center in Portland, Ore. For a year and a
half he had lived at the Laurelhurst Care Center, another
Portland nursing home. His daughter, a suburban Portland
resident, removed him from Laurelhurst over the protests of the
staff, then reportedly checked him out of Regency Park the
morning of March 21. Half a day later, he turned up more than
300 miles away at the Idaho dog track; authorities are still
trying to learn exactly how he got there.

    "To me, it's a sin and a crime," says Post Falls police
detective Harlan Fritzsche, "but I'm left in a quandary." There
is no law in Idaho against abandoning the elderly. But Oregon's
Medicaid-fraud unit and the Washington County sheriff's
department have launched investigations that may result in
criminal charges. Among the questions under examination is why
Laurelhurst did not receive Kingery's pension checks -- which
partly covered the cost of his care -- for five months before
his departure.

    Kingery's tale is drawing the attention of policymakers to
the plight of people with devastating long-term illnesses and
the limited options available to their families. Medicare, for
instance, will pay hospital costs for acute illnesses but not
for maintaining an Alzheimer's patient in a nursing home. Many
nursing homes have neither the staff nor the inclination to
provide advanced Alzheimer's patients with the exhaustive
services they require. For families struggling to care for their
own disabled, as an impressive four out of five now do, adult
day-care centers can provide well-earned relief, but there are
far too few of these (2,100 nationwide) to meet the need.

    Helping families care for ailing elders will not be cheap:
a respite-care bill sponsored by U.S. Senator Bill Bradley
carries an estimated price tag of up to $2 billion a year. But
it is probably the most humane and cost-effective remedy for a
growing problem. Today 4 million people in the U.S. have
Alzheimer's disease. In the year 2050, there will be an
estimated 14 million cases. By illuminating this frightening
black hole in the nation's health-care system, John Kingery
serves as a beacon in helping young and old alike search for a
solution.