RIPPING OFF THE ELDERLY - INSIDE THE NURSING HOME (FROM CRIME AT THE TOP - DEVIANCE IN BUSINESS AND THE PROFESSIONS, 1978 BY JOHN M JOHNSON AND JACK D DOUGLAS SEE NCJ-47130)

• NCJ Number: 47133
• Author(s): A FONTANA
• Date Published: 1978
• Length: 8 pages
• Corporate Author: J B Lippincott
• Publication Format: Document
• Language: English
• Country: United States of America

Annotation

THE REPORTED FINDINGS WERE UNCOVERED DURING FIELD WORK BY A RESEARCHER SERVING AS A JANITOR IN A CONVALESCENT CENTER IN SOUTHERN CALIFORNIA.

Abstract

GENERALLY THE QUALITY OF CONVALESCENT CENTERS VARIES INVERSELY WITH THEIR PROXIMITY TO A LARGE CITY; THE GREATER THE DISTANCE FROM GOVERNMENTAL INSPECTORS, THE LESS LIKELY AN EXEMPLARY CONVALESCENT CENTER. THE CENTER UNDER STUDY WAS A LOCKED-DOOR FACILITY IN WHICH A NUMBER OF PATIENTS WERE OFFICIALLY DEFINED AS SUFFERING FROM MENTAL ILLESS; THE OTHERS WERE OLD, FRAIL, AND UNLOVED BY RELATIVES. INAPPROPRIATE OR ILLEGAL ACTIONS BY STAFF OR MANAGEMENT WENT BEYOND FINANCIAL MISAPPROPRIATIONS. THE CENTER EXHIBITED MANY FORMS OF DEVIANCE WHICH WERE NORMALIZED AND DONE FOR THE SAKE OF ORGANIZATION. THE GOAL OF THE CENTER WAS A SMOOTHLY OPERATING WORK FLOW, THUS MINIMIZING DISTURBANCES. MANY DEVIANT ACTS PERPETRATED BY PATIENTS ON OTHER PATIENTS OR BY THE STAFF MEMBERS ON PATIENTS WERE HANDLED IN WAYS THAT MINIMIZED THEIR DISRUPTION OF ROUTINE, OR WERE EVEN NORMALIZED. RULE-KEEPING WAS A FORMAL RATIONALE, BUT ALL COULD BE INFORMALLY BROKEN TO MAINTAIN ORDER. DRUGS WERE THE MAIN TOOLS FOR ENFORCING CONTROL; MEDICATIONS WERE PRESCRIBED ON AN 'AS NEEDED' BASIS WHICH LEFT THEIR ADMINISTRATION TO THE NURSES WHO IN TURN RELIED ON AIDES' SUGGESTIONS ABOUT PATIENTS' BEHAVIOR. SEXUAL AND VIOLENT MISBEHAVIOR WAS EITHER IGNORED OR NORMALIZED IN SUCH WAYS THAT INTERFERENCE WITH ROUTINE WAS AVOIDED. TO MAINTAIN ORDER, THE STAFF ALLOWED PATIENTS TO BE TEASED BY OTHER PATIENTS AND CONDONED BEHAVIOR WHICH BRUTALIZED THE WEAK. THE PATIENTS, WHO ARE THE VICTIMS OF THIS SYSTEM, ARE CONSIDERED DEVIANTS: THEY ARE DEVIANTS IF THEY ARE SENILE (A DEFINITION THAT ALLOWS THE HOME TO OBTAIN EXTRA MONEY FROM MEDICAID); DEVIANT IF THEY ARE RESTLESS (AGITATED BEHAVIOR); DEVIANT IF THEY ARE MOODY (MANIC-DEPRESSIVE BEHAVIOR); AND DEVIANT IF THEY ARE ANGRY (HOSTILE BEHAVIOR). IRONICALLY, THE PATIENTS COME TO BELIEVE THE STAFFS' VIEW, AND SEE OTHER PATIENTS AS DEVIANTS, A CONDITION WHICH ENFORCES ISOLATION FROM OTHER PATIENTS AND FROM A STAFF THAT HAS NO TIME FOR THEM. REFERENCES ARE PROVIDED. (KBL)