The Nursing Home Gambit


In the ongoing daily struggle against health-care incompetence, the major event of the week was The Nursing Home Gambit. It began when the chief of medical staff came in to say that Blue Cross was refusing to cover any further treatment at the pretend hospital. He announced this development as he loomed over Max’s bed. Is this correct protocol? Oh well.

Two days later, I called the “hospital” case manager about getting a bed near a window, and she revealed that Max needed to be discharged to a facility with a lower level of care. I laughed and repeated the words “lower level of care” thinking, Is that even possible? I warned her that we would not agree to any discharge until I had visited the new facility.

She gave me the addresses of two facilities that Blue Cross was willing to pay for. My friend Mark drove me to the first one, a convalescent home called something like “Windsor Palace” and located in the hood.

We tried parking in the tiny garage under the building but the stench was intolerable. Mark dropped me off at the entrance, where two old codgers were hanging out in wheelchairs. The codgers seemed pleasant, and one of them helped me when I felt dizzy and nearly fainted.

Inside, the scene was surreal. A “receptionist” sat at a small card table. Next to her, a white-haired old lady sat in a wheelchair, wearing a pink house-coat and a long rosary, wailing mournfully in a high-pitched tone at the top of her lungs. I said in a cheerful voice that I’d come to look around on behalf of my son.

A nice young Hispanic guy appeared and said he had just reviewed Max’s records. His supervisor had decided that they were not able to offer   Max the care he needed. I exclaimed, “Oh thank god!” and he walked me to the door. Outside, waiting for Mark to pick me up, I chatted with the two codgers. They confirmed that no one ever visited any of the residents, although “the CNA will sometimes spend some time with you if she likes you.”

Back at the “hospital,” I called Blue Cross. The guy I talked to said that they hadn’t denied any authorization for care from the “hospital.” Haha, false alarm! Or, more sinister, perhaps the “hospital” just wants to get rid of Max because he requires more care than a helpless old octogenarian with a tracheotomy.

Here is the thing to keep in mind: If you are considering a nursing home for one of your loved ones, it may be more merciful to simply kill them, if Windsor Palace is the norm, and I believe it is. I personally would much prefer to end it all with a quick blunt object to the back of my head than to spend my last months or years in a stinking hellhole where nobody reacts to my screaming and the CNA might spend time with me if she likes me.

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24 Responses to The Nursing Home Gambit

  1. Alicia says:

    Sadly, they are like that. It’s horrid in nursing homes. A small part of me was happy my sweet granny went on before she was released to one of those places.


  2. andrea says:

    Oh, such is the way of our world when we are at the mercy of private insurance companies. Their job is to deny care. But I don’t want to turn this into a political rant. I remember when my father was in an acute care hospital and he was getting kicked out because he was no longer “acute”. He was in NY and I was in Baltimore at the time. We knew that he could no longer go back to his own home, and I started making plans to have him transferred to a nursing home near me. I went to visit one that came “highly recommended”. I can still smell the stench of urine that permeated the air throughout the halls. I was sickeningly “glad” when he was found to be bleeding from an unknown cause, miraculously making him “acute” again so he could remain in the hospital. He actually never came out of the hospital, having died there a few months later. I still miss him terribly, he was such a sweet and loving man. But I was actually relieved that he did not have to go to a nursing home and I was spared the emotional pain of seeing him have to put up with living in that hellhole. Is there any way Max can come home to your house with a visiting nurse checking on him, a physical therapist, and a home health aide to help him with his needs until he is independent again? It’s not ideal, it will not be easy, but you and he will feel so much better. That’s what I had decided to do with my dad before he died.

    I hope you are feeling OK and taking care of yourself. I am having my surgery on Monday, so say a little prayer for me! I’m a little nervous because I know all too much what can go wrong. Wish me luck!

  3. Andra says:

    I simply cannot believe this kind of stuff goes on in your country.
    We think things are totally stuffed in the health system in Australia but, Jesus, it is nothing like this crap and EVERYBODY can go to hospitals and doctors on the national health system.
    I have been to my local hospital several times in the past few years and the staff and treatment have been wonderful.
    I am so sorry for you.
    Is it too late to move to Australia?

  4. Aja says:

    This makes me very sad. My Uncle who passed away earlier this year was discharged to one of these so-called homes after having open heart surgery. They released him early and he got sick again and this time, his body couldn’t take it. I miss his phone calls and it makes me weep to think his last days were spent somewhere miserable. Keep your chin up, Max will get the care he needs and deserves.

  5. Even the worst hospital in the UK is like a 5 star number compared to the ones the lovely Blue Cross ( are they blue because they depress everyone) sends patients to. I’m not saying we are perfect but I do think morally the National Health Service is the right system for a society.

    I’ll keep praying and hoping – and andrea’s suggestion sounds interesting to explore.

  6. Stephanie says:

    God, your stories kill me – I’m not saying I don’t want to hear them, but I just wish they weren’t reality. I’m getting a Masters of Public Health and hate to hear that this is how our healthcare system is operating.

  7. Sarah.P says:

    I agree with MDS – I just didn’t appreciate our NHS until I started reading thsi stuff. I am genuinely dumbfounded.

    Also, I’m aware I just keep logging on saying, “God this is awful,” and “I think of you often” and “Lots of love to you both” and it must get really boring, but I do mean it every time.


  8. Mrs. Shreck says:

    Nursing homes are horrible places. They are severely understaffed and usually everyone who works there would take another job in a heartbeat! No one wants to be there…not the nurses, the auxiliary staff, or the residents. I can’t even begin to tell you the things I have seen.

  9. I’ve already informed my kids that I would much prefer a blunt object to the back of the head than to end up in a nursing home.

  10. deja pseu says:

    I spent a few years of my childhood visiting my great-grandmother in “nice” nursing homes (she had dementia) and my very worst fear remains that I’ll end up in one. We really are a third world country when it comes to health care.

  11. Suebob says:

    Yes. This is why I am going to drive off a bridge when I turn 70. I am not even joking.

  12. Sil says:

    I am really surprised to hear what you have to deal with. If Australia is too far to move, move to Spain ASAP. I promise I will never complain about our sistem any more…

  13. Deja Pseu is right on, our health care system is Third World. And to get into a good home, patients with big bank accounts get priority, of course.

  14. Ann says:

    After my dad had mostly recovered from his horrible car accident in June 2000, the doctors advised he needed to stay in a rehabilitation facility for a month for physical and occupational therapy. They gave us a list of facilities that Blue Cross would cover. Many of these “rehabilitation facilities” were nursing homes. I asked my dad’s doctor, a lovely 28 year old man-child, where he would put his father if he were in my shoes. He kindly told me to fight as hard as necessary to keep him in the hospital’s rehabilitation center and not send him to one of the nursing homes. I was shocked at his candor and asked why he felt so strongly about it. He told me that most of the nursing homes listed were dumps, and a place where people go to die, not to be rehabilitated, and he was concerned my father would fall into a depressive state if he had to spend a month in such a location. He had me apply for my dad’s residency to be at the hospital, which I did, but I still needed to find a backup location in case the hospital denied him.

    I visited what the doctor reluctantly deemed to be “the best” of the nursing homes on the list. It’s in West Palm Beach, FL, called Darcy Hall of Life Care. I took one step in the place and could not believe what I heard, saw and smelled. Incoherent patients screaming at walls, groaning from their beds, meandering unattended and in disoriented states down hallways in wheelchairs and walkers (no offense, Sister), and the unmistakable smell of urine and fecal matter. I turned and walked right out, crying as I left.

    We were lucky and my dad was able to stay at the hospital for his rehabilitation. 9+ years later and he is healthy as can be. Reading your story brought back the most awful memories and I would sooner die than send anyone I even remotely care about to a nursing home in this country. My love and blessings to you and your family, and my staunch promise to wield that blunt object to the back of your head before I let anyone take you to any such place.

  15. annemarie says:

    I plan on dying like an animal. Alone, under a bush. With dignity.

  16. Leslie says:

    When (if) I have children, I will write them out of my will if they send me to a nursing home. At least let me die the way I want.

  17. hammie says:

    I hate my parents. Send me the link. xx

  18. OMGGMAB says:

    Can Max possibly come home with home nursing care???!!! Fight for it. Bring him to an environment where at least his family gives a shit what happens to him if he happens to vomit on himself.

    I hate insurance companies. They are like the Catholic church. If it is about money and power, they are all about it. If it is about the poor, sick, or dying, dig yourself a hole a jump in. Let’s sell the Vatican to pay for U.S. healthcare!

  19. OMGGMAB says:


    YES! I intend to jump into the Grand Canyon. Thelma and Louise style. I hope I maintain the mental where-with-all to make that happen!

    Can you here me children?

  20. OMGGMAB says:

    hear, I meant

  21. OMGGMAB says:

    UGH, hear, not here!

  22. Juri says:

    Sue those fuckers! Give that case manager a good tongue-lashing and let her know that if she ever comes to Denmark I’ll be happy to give her another one.

    I don’t even dare to imagine how the nursing homes will be like 20-30 years from now when it’s time for me to sign in. We’ll probably read about Victorian workhouses and sigh “what a fucking luxury That Oliver Twist lived in!”

  23. Dianna says:

    I work in a nursing home. I have spent the last 23 years working in nursing homes. I went to school, got my degree in social work, because I love working with the elderly. So to those who responded- “Nobody ever wants to work in a nursing home”, or “kill yourself before you go to a nursing home” needs to re-think the statement. I work in a facility that is kind, caring and loving to our seniors. I work in a facility that is staffed appropiately, so our residents needs are met (call lights answered, residents turned and repositioned etc),and I work in a facility that is 5 stars out of 5 stars on HealthGrades. If you are considering nursing home placement for a family member, you can check out facility scores on and compare survey scores of individual facilities in your area. There are good teachers, good cops, good physicians, and good nursing homes. There are also poor teacher, bad cops, poor physicians, and very bad nursing homes. To lump all of us together is unfair and wrong. Good luck in the future.

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