A Michigan Nursing Facility or SuperMax ICE Detention? I Know What I'd Choose.

There are numerous conversations to be had post-COVID. I hope one of them is about this country’s continued ageism and the nursing facilities that have proliferated and profited from it.

In 2016, I toured a SuperMax ICE Detention Facility in McHenry County, Illinois for a series on LGBTQ detainees.

In 2018, my team and I toured 40 various types of nursing facilities in Oakland County, Michigan.

America has a penchant for mass-warehousing people it no longer wants. So when I fall into that category, if I’m given a choice between a nursing facility and Super Max ICE Detention?

I’ll take SuperMax ICE Detention.

Examining both prison systems was heartbreaking. The majority of both are corporate owned. Both have aggressive lobbyists. One just has curtains.

But the biggest difference is that the prisoners at the ICE facility were treated more as human beings than the prisoners inside the nursing facilities.

At the ICE facility, prisoners were given three meals-per-day, healthcare, recreation and classes.

At the nursing facilities, residents were left for days without food, confined to beds 24/7 where they rotted surrounded by their own and other’s stench of urine, disease, feces and decay.

At the ICE facility, there were cameras covering every corner.

At nursing facilities, lobbyist attorneys are arguing that cameras are not strictly legal.

In 2017, the Prison Rape Elimination Act (PREA) was extended to cover ICE facilities.

Nursing facility lobbyists The National Healthcare Association and LeadingAge have successfully used COVID to make it damn near impossible for a prisoner to sue even in cases of your more typical nursing facility abuse.

The prisoners at the ICE facility had more rights than the prisoners at nursing facilities who were under Oakland County guardianship.

Both systems had issues with COVID breakouts, but only one had the governors of New York and Michigan deliberately make the situation worse by moving COVID-infected patients into nursing facilities in order to keep their beds filled. Both governors have refused to report how many people died in these facilities as a result.

Both facilities isolate, or administratively segregate, their prisoners as a dehumanizing form of correction. The lockdown wards at nursing facilities add the kind of torture that even CIA Black Sites would decry as “excessive.”

Three weeks ago, one of my dearest friends in Virginia was diagnosed with stage four bone cancer. She had me down as a patient advocate. After ten days in the hospital, the doctors wanted to discharge her to a rehab (nursing) facility. I responded “Over my dead body and hers because that is an immediate death sentence.”

I put my foot down and we were able to get her home, where she now has her own hospital bed, visiting help 16-hours-per-day as well as visiting Physical Therapists and pays less out of pocket than she would have in a nursing facility. But this is not widely known. 

The mass proliferation of American nursing facilities was an after-birth of Medicaid. Like the ageism that this country still refuses to acknowledge (you’re not going to get cancelled for making an ageist joke), they became woven into American culture. It was expected that when Mom and Dad got old, a nursing facility lay in their future.

The word “Care” was completely bastardized. Individual facilities and the industry itself added it to the tail-end of names as a selling point; “nursing care”, “hospice care” etc.

But if COVID has laid bare any lesson that one hopes might stick in the country’s collectively short memories, it’s that to add “care” as a descriptor to a nursing facility should either be dropped or changed to “care less.”

The facility lobbyists were worried about it for a New York minute, crying to congress in the fall of last year that the entire industry was on the verge of collapse.

Of course, this was in order to ensure a bail out. But for one shining moment, they were right. Americans were pulling their parents and grandparents out of these facilities and in-home care had become all the rage.

But now, facilities are recovering and organizations like the aptly and coldly named “A Place for Mom” are back with their insidious commercials.

On Friday night, comedian Bill Maher made the typically spot-on aside “This country is shitty to its old people.” Later in the show, he included a joke about Japan’s oldest person being asked to carry the Olympic flame.

Maher is at least a step-up from someone like Seth Meyers whose old people jokes are a stock-in-trade.

Face it. We are an ageist country but we aren’t prepared to do anything about it.

Case in point, New York Governor Andrew Cuomo. When his murder of his state’s old people and the sibsequent cover up broke, it caused momentary cable news outrage but it looked like he was going to weather that storm. Now that he’s been accused of sexually harassing 20-somethings? Justifiably, he’s as good as resigned.

In Michigan, Governor Gretchen Whitmer pulled exactly the same shit with her state’s nursing facilities but the only ones trying to hold her to account are journalist Charlie LeDuff and a GOP county prosecutor.  

None of this is surprising.

Every time I have criticized the use of nursing facilities, I’ve had a slew of defensive comments declaring “You don’t know what it’s like to care for Mom and Dad.”

I don’t?

When my son was born in 1994, it was an exciting moment. Had Instagram existed then, he would have been the focal point for endless pictures. But despite his inability to communicate except through screaming, the constant diaper changes, the dribbling, vomiting and exhaustion at having to ensure 24/7 that he didn’t wander out of the house or stick his fingers in an electrical socket, I never thought that he’d be better off in a facility. Who does?

“But Gretchen, that’s different! He was smaller!”

Oh? In a race between a toddler and an 80-year-old man as to who can get out of the house fastest, throw the meanest punch or could deck the other with the most powerful body-slam, my money’s on the toddler.

Ageism has led us to become prisoners to the “we make life easier” sales pitch of nursing facility lobbyists. I’d argue that, as a result, they’ve done better at ensuring their beds are filled than jails that face justifiably well-motivated activist groups who have successfully pushed for prison reform and a reduction in their populations.

The only activist group that has shown any visible media traction in this country in terms of the human rights that should be afforded to its seniors and developmentally disabled populations is the #FreeBritney movement.

The problem is that the ageism that empowers these facilities rather than the victims and allows literally medieval guardianship laws that leave innocent Americans with less rights than imprisoned felons unreformed is incredibly short-sighted.

Sure, in the 1980s when my biggest concern was Aqua Net, I didn’t see it. But as a Gen Xer I am more than aware that nursing facilities and their lobbyists already have me in their sights. Unless I can get the hell out of this country before it’s too late, I’m right behind the Boomers for a slow execution in a jail with curtains.

Millennials may not want to believe they’ll ever face it, Gen Zs even less so but blink and you’ll be there. And if you want to know what to expect? The man pictured above is telling you. His name is Thomas Howard. He was stripped of all of his rights, his home and his savings under and Oakland County guardianship and this photo was taken shortly before he died at a nursing facility where he suffered multiple abuses.

Granted, provided there’s still a world for you to live in, you really don’t want to be dragged out of your home and end up, like Thomas, looking down the face of nursing “care” any more than you want to end up in ICE detention.

The future to stop both is in your hands.

Frustrated with the number of American publishers turning down the book my co-auther and  I wrote about  the case of Rudy and Rennie North because there’s “no market for a book about old people”, I asked an editor friend of mine how I could avoid that road block in future proposals.

Julie and I even floated the idea of making her parents in their mid-20s and Julie, who rescued them from professional guardian April Parks, a kind of “Kindergarten Katniss” armed to the teeth and, alongside those other "kids" who helped, with amazingly young prowess.

The editor replied “Yeah, either that or change this country’s culture.”

Obviously, at this point,  the former would be much more realistic.