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Truth falls victim in nursing home tragedy

By Nicholas Stix
web posted February 16, 2004

"Granny taken up to roof?" "Insider Says Understaffing Killed Grandmother." So blare the headlines in the newspapers the Daily News and The Wave, respectively.

Lillie Gardner led a quiet life, devoted to her own and other people's kids, and to church. In death, however, she has achieved fame, based on her usefulness for the living.

Mrs. Gardner was born in Richmond, Virginia, and came north to New York as a teenager, where she married. While living in Corona, Queens, the devout Christian gave birth to and raised five sons and one daughter, worked 20 years as a teacher's aide, caring for other people's children, and had 14 or 15 grandchildren, depending on who is reporting.

And yet, she was "useless." Nine months ago, Gardner's children placed her in the Bishop Charles Waldo MacLean Nursing Home in Far Rockaway, Queens. She was suffering from the early stages of Alzheimer's Disease, and walked with a cane.

Some time after Lillie Gardner's 4 p.m. dinner on Tuesday, February 3 -- probably about 6:30, since an alarm was then heard that the roof door had been opened -- she made her way to the facility's roof, where dazed and confused, she succumbed to the cold and wind and wetness of a roof whose drains were blocked with snow and ice, causing the water in some spots to be several inches deep. Taylor was discovered missing during a 9:30 p.m. check of her room, and wasn't found until 12:30 Wednesday morning. Found lying in a puddle of frigid water, she was taken to the attached facility, St. John's Episcopal Hospital, where she could not be revived, and was pronounced dead at 1 a.m.

Gardner's 50-year-old son, Sidney, the eloquent bishop of the House of Israel Worship Temple, insisted that his mother must have been forced to go to the roof. ""My mother did not go on the roof on her own strength. I question whether she went up on her own will."

Bishop Gardner maintained that his mother could not have walked the 12 steps from her floor to the roof. Meanwhile, Mrs. Gardner's oldest child, 52-year-old Arthur, insisted that he and his siblings had only briefly placed their mother in a nursing home as a temporary measure, while they arranged for a home health aide to care for her. "It was supposed to be a temporary thing. My mother wasn't supposed to die like that," said Arthur, as reported by Tony Sclafani, Tamer El-Ghobashy, and Richard Weir, in the February 6 Daily News.

Lawyer Mollins also contended to the New York Times on Wednesday, February 4, that "the family" (which most likely means Sidney) said that Lillie Gardner had bruises on her arm and wrist, a contention which police denied.

There is no evidence that anyone forced Lillie Gardner to go to the roof, or in any way harmed her. I would believe that she walked up the 12 steps, before I would believe her sons, who have a credibility problem.

Lillie Gardner had already been in Bishop MacLean's for nine months. It takes less than a month to arrange for a home health aide; Lillie Gardner's children had permanently placed her in the nursing home.

According to Newsday reporter, Lindsay Faber, "Her son, Sidney Gardner, 50, of Staten Island, arrived at St. John's Episcopal Hospital, South Shore, he and his lawyer said, thinking his mother would be fine.

"'He was expecting to see his mother, and then he heard she was gone, and he was shocked,' Melville attorney Kenneth Mollins said. ‘They led him to believe she was fine. This is a very suspicious situation, and it seems clear it was negligence.'"

Now, no sane or honest person, upon hearing that his 79-year-old mother is in the hospital, expects her to be "fine." If she were "fine," she wouldn't be in the hospital. Heck, no 79-year-old is ever fine. Circa 1985, I looked up a then 80-year-old great uncle. "How are you?, I asked. "I'm 80 years old," came his gruff reply.

My attitude to Mrs. Gardner's sons Sidney and Arthur may come across as heartless. But consider that in New York, when a family suffers the tragic death of a member, the survivors typically are too broken up initially to talk to any journalists. By contrast, it appears that the first thing Bishop Sidney Gardner did upon learning of his mother's tragic death, was to call his lawyer, Kenneth Mollins, and formulate legal and media strategies. (The family is suing the nursing home for wrongful death, but for appearances' sake, waited a few days to announce the suit.) The bishop and the lawyer then spent all of Wednesday – the day of Lillie Gardner's death – on a scorched earth campaign, giving interviews to every TV and print media outlet in town. Thus did Bishop Gardner and lawyer Mollins' remarks make it into Thursday's papers.

Note that in nine months' time, Lillie Gardner's sons could not be bothered to engage a home health aide for her – in which case she would likely be alive today.

One thing you can infer from Lillie Gardner's life, is that she raised her children such that they knew that it was wrong for them to have dumped her in a nursing home. And so, they fibbed about the matter. Lying about the circumstances of Mrs. Gardner's incarceration, er, I mean, treatment, is also bound to make a more favorable impression on the jury at the civil trial. And now her sons will seek to exorcise or transfer or project their own guilt onto the nursing home, in the form of a multimillion-dollar lawsuit.

And the media will get its payoff, too. Already, I'm sure, as occurs every couple of years, city and national editors have dispatched reporters to dig up dirt on nursing homes. Already reporter Brian Magoolaghan, of the local newspaper, The Wave, produced some yellow journalism for the weekly's February 6 issue. "An insider at the nursing home where an elderly woman died of hypothermia Tuesday night said the staff made a series of blunders that led to the woman's death – because they were shorthanded."

The employee also claimed that administrators were negligent, in having Mrs. Gardner in a room near a stairwell: "You're not supposed to have wandering patients near doors.'"

At the time of Mrs. Gardner's disappearance, three certified nurse aides (CNAs) were on duty, responsible for 45 patients. That was entirely sufficient staffing. A 4:45 CNA-to-patient ratio would have been even nicer, but was not necessary, and besides, who is going to pay for such luxurious staffing?

My basis for the above judgment, is that I am a CNA, and worked in three different Rockaway nursing homes for a staffing agency in 1998. (I was moonlighting, at my wife's insistence, while I was off for the summer from teaching college.) My wife, who is a nursing home nurse, sees things the same way. While working for five years as a nursing home CNA, at times she had to care, all alone, for anywhere from 22 to 45 patients. Now, that's understaffing! (Such cases were always due to one or more CNAs having called in sick for an 11 p.m.-7 a.m. graveyard shift, and no one being found to cover for the absentees.)

The worker's claim that the home was negligent, in placing Mrs. Gardner near a stairwell, is also nonsense. You cannot keep shuffling patients' rooms (which would result in lawsuits) to keep "wanderers" away from all stairwells, and there are too many ambulatory but confused patients for such a strategy to work, even if it were permissible. All of the nursing homes my wife and I are familiar with, keep their stairwell doors locked; employees punch in a code, to open the door. Should the door somehow be improperly opened, an alarm sounds. Some nursing homes also use electronic bracelets called "wanderguards," which are activated, if the patient enters an unauthorized area, or seeks to leave the premises.

Besides, if Bishop Sidney Gardner is to be believed, his mother was no threat to climb the stairs.

(However, according to WNBC-TV news, "Arthur Gardner … told the New York Post that the family had placed her at the nursing home because of her wandering. ‘They knew what her predicament was.'"

Apparently, Sidney and Arthur forgot to get their stories straight, and Arthur's story to the Post contradicted the story he told the Daily News. Arthur should have left the PR campaign to his younger brother.)

The anonymous worker also insisted, "The staff is not happy, and if the staff is not happy, the work can't be done."

The one believable statement the worker made, was in noting that as the roof was mired in several inches of cold water, the staffer who first went to check out the alarm at 6:30 p.m. likely called out from the stairwell door, without venturing further. Mrs. Gardner was found at a spot not visible from the door. (My wife's theory is that the victim may have taken the elevator to the roof. She recounted incidents where elevator repairmen disabled the lock preventing the elevator from going to the roof, and then forgot to re-set the lock when they were done.)

I have never heard of a happy nursing home staff; such staffs are typically miserable. A CNA's job involves changing gigantic diapers that are soaked in urine, feces, or both, and worn by people who in many cases are helpless, and in other cases choose to live like infants. In patients with severe dementia or brain injuries, the body's muscles contracture through disuse, so as to resemble rigor mortis. Thus does lifting a tiny, 134-pound patient, feel like lifting a 234-pound body. Imagine trying to manipulate and force open the contractured legs of a bed-ridden patient, in order to change her diaper. (Or lifting her, without help, from a geriatric "geri chair" onto a hydraulic scale, in order to weigh her!) And to be sufficiently restrained to ensure that the patient is not harmed, in spite of all the necessary force and manipulation used, requires additional strength.

But not all patients are demented or helpless. Some are just vicious, violent, or both. It is a sad testament to the low status of CNAs, that newspaper "exposes" tell only of abusive, violent CNAs, but never of abusive, violent patients. In my experience, it is common for patients to abuse or assault CNAs, while the converse is rare. This situation has gotten increasingly worse in recent years, as nursing home administrators have found that they can fill beds with violent, physically able psychiatric patients who are anywhere from 20 to 50 years of age.

CNAs have one of the toughest and most despised jobs I know of, which is probably why their rights are routinely violated. If a CNA defends herself against a violent patient, she will almost certainly be fired, lose her license, and be prosecuted. Yet I have never heard of a patient being prosecuted for attacking a CNA. And so, CNAs have developed illegal methods for dealing with vicious patients behind closed doors. Humanitarians would decry such methods as inhumane, but that is because they believe that some classes of people have the right to harm certain other classes of people with impunity, and deny that every human being has the right to defend himself.

And then there are the non-violent crazies who constantly ring the staff's bell at all hours of the day and night, curse the staff, engage their relatives to harass staffers, and though they pay not one cent for their care, initiate frivolous lawsuits against the institutions caring for them. (Almost all patients' care is paid for by the taxpayers.)

Note too that nursing home administrators and supervisors love destroying CNAs' careers, by making them take the rap for higher-ups' incompetence, and have been known to cheat CNAs on their pay, even in union shops.

The Wave, which serves the Rockaway peninsula (Far Rockaway, Arverne, Rockaway Beach, Rockaway Park, Belle Harbor, Neponsit, Breezy Point, Roxbury and Broad Channel) is a better-than-average community newspaper with excellent coverage of school issues, due to its editor, Howard Schwach, a recently retired public school teacher who served for 30 years in local schools. Brian Magoolaghan only recently joined the paper. His previous reporting in The Wave showed no glaring errors, but consider that the Rockways are the world's nursing home capital. In an area with 100,000 residents, at least 17 nursing homes serve a minimum of 2,000 patients. Nowhere else does one see such a concentration of women (mostly black West Indians and Haitians) wearing starched, white pants and white shoes on the street and on buses. Such ignorance about what is possibly the largest legal enterprise in one's reporting area is inexcusable.

If all the Arthur and Sidney Gardners of the world were successful in their lawsuits against nursing homes, the homes would all be bankrupted and forced to close, and the Gardners and their ilk would have to rely on the tender mercies of their own children, once they became aged and infirm. That would be poetic justice.

Caring for a debilitated family member requires a Herculean effort. For several years, my Toogood Reports editor/Publisher, A.J. Toogood, has singlehandedly cared for his wife, Betty. Betty developed a case of early, rapidly deteriorating Alzheimer's Disease, like that which killed Rita Hayworth. Eventually, the strain of taking care of Betty and running a full-service web site caused A.J. to develop pneumonia; he almost died. And so, he was forced last month to shut down Toogood Reports.

Of course, time was, it was understood that a family member would sacrifice herself to take care of an invalid relative. But that was before the age of nursing homes, taxpayer-paid health care, and civil attorneys for whom every person or business with deep pockets is a potential defendant, culpability be damned.

Why bother with the expense, the exhaustion, and the frustration of caring for a helpless, demented family member, when you can just shuffle your loved one off to strangers at a "free" institution, come up with a cover story to make you sound like a devoted family member without any of the work or the responsibility, and then get rich suing the strangers, when their care proves less than perfect?

In life, Lillie Gardner deserved better. In death, she still deserves better.

Nicholas Stix can be reached at Add1dda@aol.com.

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