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Oklahoma Still Has A Nursing Home Problem

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A new report shows the overall quality of Oklahoma’s nursing homes is among the worst in the nation and, unfortunately, that’s an old story dating back at least three decades.

I know the timeline well because, as a former journalist, I wrote a series of articles in 1982 along with another reporter outlining the overall poor quality of the state’s nursing homes and the political forces that helped make it so.

I visited several nursing homes in 1982 as part of my research for the series and while I found there were some outstanding homes there were simply far too many with problems, including substandard care.

The new report, issued by Families For Better Care, ranks the quality of Oklahoma’s nursing homes as 49th in the nation, only behind Texas and Louisiana. A major part of the problem then and now is the lack of professional staffing. The report notes, for example, that “. . . more than 80 percent of nursing homes had middling to below average professional nursing levels.”

This is from the 1982 series about the specific staffing problem:

The reason for the shortage and high turnover stems from the nature of the job. It's an unglamorous task. Nursing aides are responsible for bathing residents, cleaning up messes, helping residents use the bathroom or, in some cases, changing diapers. Aides also must help lift heavy bodies and empty portable toilets.

The new report also notes that Oklahoma nursing homes “with severe deficiencies remained inordinately high when compared to other states . . .”.

As I noted earlier, I visited some wonderful nursing homes in the state in 1982, and there are surely some great nursing homes here now, but overall Oklahoma’s homes have consistently been ranked below the national average.

It’s a complex problem that gets intertwined with the drawn-out process of dying of old age in this country, a process that many medical experts believe needs reconsideration. Some experts believe too many unnecessary procedures are performed to sustain the lives of bedridden dementia patients, who require around-the-clock care.

According to one prominent member of a panel formed by the Institute of Medicine to study the issue, end-of-life care is “poorly designed.” This is from a recent article in The New York Times:

“The bottom line is the health care system is poorly designed to meet the needs of patients near the end of life,” said David M. Walker, a Republican and a former United States comptroller general, who was a chairman of the panel. “The current system is geared towards doing more, more, more, and that system by definition is not necessarily consistent with what patients want, and is also more costly.”

Of course, that statement is a red flag for right-to-life groups, which make the slippery-slope argument that such thinking could lead to premature or even government-ordered deaths among the elderly.

None of this solves Oklahoma’s nursing home problem, which seems chronic and everlasting at this point. Obviously, someone with enough money can find a decent facility in which to die, but many nursing home residents rely solely on Medicaid dollars. It’s a tragic situation.

This is from one of the 1982 articles:

Nursing homes scare people.

They frighten people because they offer a glimpse into almost everyone's future: wrinkles, gray hair, loss of mobility and, possibly, senility.

It’s no different 30 years later. Everyone ages. All of us could theoretically end up as nursing home patients as we near death. As a culture, we need to drastically improve our end-of-life protocols and processes. Improving nursing homes here and elsewhere should be a central component of any reform.

McCaskill Criticizes Stoops On DGB Decision

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It’s probably time to pay attention when a United States senator goes out of her way to castigate a prominent university football coach while urging real leaders in “big-time sports” to “do a soul search on character.”

That coach is Bob Stoops, head of the University of Oklahoma Sooners, and the senator is Missouri’s Claire McCaskill, a Democrat and a former sex crimes prosecutor, who wrote recently about how surprised she was that Stoops had been selected by some Division I coaches as someone they would want their “sons” to play for.

The reason she was stunned, according to her widely circulated article in USA Today, was because Stoops had welcomed to his football program University of Missouri transfer Dorial Green-Beckham, nicknamed DGB. DGB was kicked off the Missouri Tigers football team after he allegedly pushed a woman down some stairs, McCaskill points out. No charges were filed in the case because the woman, according to McCaskill’s article, didn’t cooperate with police or prosecutors.

OU petitioned the NCAA to rule DGB eligible this year on grounds that seem to intentionally ignore the gory details of the case, but it was denied, and it’s unclear whether he will ever play for the Sooners or any college football program again.

In her article, McCaskill asks rhetorically, “But for Stoops to get the most votes from his fellow coaches as the coach they wanted to influence their sons?” She goes on to argue:

Unfortunately, that says it all. It is time for real leaders in the world of big-time sports to do a soul search on character. Every decision they make reflects on them in ways that a won/loss record never will.

McCaskill didn’t but could have also mentioned how Stoops has handled the case of 18-year-old Joe Mixon, an OU player who was caught on videotape July 25 hitting a woman in the face and fracturing her jaw. Mixon was charged with the misdemeanor crime of “an act resulting in a gross injury” and the university, with Stoops’ apparent agreement, suspended him for only one year from the team. Mixon has since been seen hanging out with the team. Remember, Mixon’s violence was caught on a tape that was viewed by media members, and he and his attorney have not disputed the video evidence.

All this comes at a time when NFL players like Ray Rice and Adrian Peterson have been kicked off their teams for violent actions. Rice was kicked off the Baltimore Ravens after a new tape surfaced showing him knocking out his fiancé with a violent fist jab. Peterson, a former OU player coached by none other than Bob Stoops, was kicked off the Minnesota Vikings after it was learned he whipped his 4-year-old son with a tree switch, leaving behind cuts and bruising.

“Got him in the nuts once I noticed,” Peterson apparently texted the boy’s mother, according to one article. Isn’t that sexual abuse as well? What if Peterson had struck a 4-year-old girl on her genitalia? Wouldn’t he be charged with a sex crime? Nonetheless, Peterson has been charged with “reckless or negligent injury to a child” in Texas where the beating occurred.

Those people who try to defend people like Stoops, Mixon and Peterson forget that coaches and star athletes on major college and professional teams serve as role models, a standard trope that is promoted through, among other things, jersey sales, television appearances and commercial endorsements. The media is culpable as well by creating a worship culture around star athletes. They make their money, too. Everyone gets their cut, except the victims of violence.

McCaskill does us all a great service for bringing out into the open and arguing against the violent behavior permeating what she calls big-time sports. It’s a sick culture—and that includes many sports fans—that tolerates this violence or dismisses it with a shrug or doesn’t remove the offenders from their pedestals.

Teddy's Progressive Politics

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Ken Burns’ new PBS documentary The Roosevelts, among many things, should remind us just how radical and extremist the Republican Party has become since the turn of the century.

It’s not difficult to imagine how the progressive politics of Theodore Roosevelt, a Republican president from 1901 to 1909, would be greeted today by conservative politicians, who advance the cause of states’ rights and corporate greed over the welfare of their country.

Roosevelt eventually wanted his “Square Deal” for people, arguing, “The effective fight against adequate government control and supervision of individual, and especially of corporate, wealth engaged in interstate business is chiefly done under cover; and especially under cover of an appeal to States' rights . . . “ That’s simply the antithesis of the Republican Party today.

Burns’ documentary is a fascinating study of Theodore, Eleanor and Franklin Roosevelt. Republicans must hate it because it exposes the contemporary paltry platform of this country’s right-wing reactionaries, who in their paranoia always see sinister motives in their country’s government. Theodore Roosevelt’s political philosophy was much larger than that.

Oklahoma’s Republicans, who dominate state government right now, are especially anti-federal government as evidenced by Attorney General Scott Pruitt’s legal actions against the Affordable Care Act and any number of recent legislative actions based on supposed intrusion.

The war here on the federal government always has its negative consequences. When the legislature and Gov. Mary Fallin recently scrapped some Common Core standards for schools because of supposed intrusion, for example, the federal government announced the state would lose its “No Child Left Behind Waiver” and may have to reassign some $29 million federal funding.

The most recent mess to come to light because of paranoia over the federal government involves state driver's licenses. In 2007, lawmakers passed a law banning the state from participating in a federal program called the REAL ID Act, which was implemented as an anti-terrorism measure. Now, we’re finding out that Oklahomans starting in 2015 won’t be able to use their state licenses to get through a federal government security checkpoint. Starting in 2016, Oklahomans also won’t be able to board an airplane by showing their state license. Instead, a federally approved document, such as a passport, will have to be used.

Obviously, the paranoia and resulting hassle and contradiction are not limited to Oklahoma. An article this week in The New York Times points out that despite the success of the Affordable Care Act in Kentucky, some residents there—even those who have benefited from so-called Obamacare—are supporting Republican politicians who want to do away with the new health care law.

It’s tempting to file all this anti-federal government sentiment here and elsewhere under “stupidity” or just argue that it’s Republican and corporate manipulation of low-information voters, but Burns' documentary reminds me that something more fundamental has changed among a major segment of the electorate.

More than ever, it seems impossible to me that we can bridge through words or arguments the great partisan divide or educate voters in some meaningful and large-scale sense. Perhaps, only incremental demographical developments—an increase in minority voters, for example, who reject racist politics—will make a difference and advance progressivism in the twenty-first century.

Theodore Roosevelt’s Republican politics at the turn of the twentieth century started this country on an enlightened course and his cousin, Franklin Roosevelt, a Democrat, showed us how government can be a humane force in our lives. They were two significant politicians from the country’s two largest political parties in agreement with the pressing issues of their time. They were united under the philosophical idea of progressivism.

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