Silent Scream

Mute and immobile, Alice Joy Taylor couldn't cry out when fire ants attacked her in her nursing-home bed, but would anyone have heard her if she did?

The family made her room at Cross Timbers homey, decorating it with posters of Texas Rangers baseball players (Taylor became an avid fan in her 70s) and other personal touches. Taylor's room was so comfortable-looking that the nursing home staff would show it to prospective tenants as an example of how cozy a nursing home room can be. Without fail, Osborn visited every day--sometimes twice a day. She paid for a bedside telephone that allowed her mother to call anytime. The grandchildren also regularly visited, and--unlike some of the elderly, who are essentially warehoused in nursing homes--Joy Taylor was taken out frequently. Sometimes family members would collect her and take her to Osborn's home for a special dinner or holiday. Sometimes, she'd stay at her daughter's house overnight.

"I could take her to the mall. I could take her to Ranger games. We could bring her to the house. That was the best part," Osborn says.

As she always had, Taylor worried about her appearance. She frequently prodded her daughters for reassurance that they would take care of her looks if, for some reason, she became unable to do it herself.

Joy Taylor in a photograph taken at Flower Mound's Cross Timber's Care Center.  Taylor spent one of her last days alive in the nursing home where fire ants were allowed to invade and feast on whatever they could find--even people.
Peter Calvin
Joy Taylor in a photograph taken at Flower Mound's Cross Timber's Care Center. Taylor spent one of her last days alive in the nursing home where fire ants were allowed to invade and feast on whatever they could find--even people.
Cross Timbers Care Center in Flower Mound, just a few miles from Carolyn Osborn's house, at first seemed like the perfect place for her mother.
Peter Calvin
Cross Timbers Care Center in Flower Mound, just a few miles from Carolyn Osborn's house, at first seemed like the perfect place for her mother.

"Even if she went to a Ranger game, it was important to her that she look good," Osborn says. "She always wore makeup. She never quit wearing makeup. I would put lipstick on her when she was a resident out there."

Osborn's frequent and unannounced visits began to irritate staff members, Osborn says. She began taking care of things for her mother that seemed like the responsibility of the home. She'd fetch ice for her mother's roommate or sweep the floor. Initially, it did not bother her, helping out like that, but to Osborn the home seemed to be getting more short-staffed all the time.

"For the most part, in the beginning, it was things that I could stay on top of," she says. "It wasn't life-threatening. It wasn't something like, I felt like I've got to get her out of there."

Her mother's deteriorating condition seemed to parallel that of the home. The little things seemed to get bigger. The home changed owners in late 1997, and the staff was a stream of new faces and never enough of them.

"I spent all the time that I would have liked to have spent visiting with my mother...doing things that they hadn't done all day," she says. "I can't even begin to tell you the things I witnessed out there, from neglect to just, you know, people putting on their call lights and nurses going up there and not doing anything and not answering."

Taylor began suffering "mini" strokes that left her unable to move and largely mute. She was put on a feeding tube that went directly into her stomach. Her blood sugar needed monitoring, and she needed to be moved regularly to prevent her lungs from filling with fluid.

"The doctor recommended that she not lay in bed, that she be gotten up every couple of hours in the morning and a couple of hours in the afternoon to prevent pneumonia," Osborn says.

Osborn badgered the staff to move her mother at proper intervals, but it appeared to her that wasn't being done.

"I think family may have to step in and do a lot of things...[But] if they don't change their diaper or you find them soaked through and there is a pad under their chair and it is soaked through...that is nothing but not being turned." Osborn says. In addition, her mother's feeding tube was not being cleaned like it was supposed to be. Her mother wasn't getting regular snacks to maintain her blood-sugar level, and she wasn't even getting fresh water when she needed it, Osborn says. Once, Osborn discovered that before going off-shift, a nurse recorded her mother's blood-sugar level 12 hours into the future--for the next morning.

By early 1998, Osborn could barely keep up with the new staff members. She reported problems to the nurses' aides, the director of nursing, and the administrator and met with the family council. She says that she didn't go to state authorities because she wanted to go through the proper channels.

"I told my sister, 'we are going to have to move her. I don't know what we are going to do but we are going to have to move her,'" Osborn says. "But you can't just check out. You can't move someone in her situation just overnight."

Already worried about what was happening to her mother in her absence, Osborn appeared at the nursing home one Monday in June 1998 and found that nursing home staffers had apparently injured her mother's foot while moving her from her bed to a chair, Osborn says. Toenails were ripped and bloodied, and her entire foot was black and blue for weeks. Osborn contacted the state and told them about what happened. The state took no action. She put her mother's name on the waiting lists at other nursing homes. Before the incident with her foot, nothing at the home seemed to be threatening to her mother's life, but her feelings changed after the injury. "I was concerned for her safety and for her life," Osborn says.

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