Currently, since beginning of summer 2019, a huge movement of strike is hitting the Health care industry in France, and especially the Nursing homes for elderly (EHPAD in French) and the Hospitals’ Emergency unit.

This movement fights for dignity for workers and for hospital patients.

What is new is that this movement emerged from the workers themselves, inspired by the dynamic of the Yellow Vests, outside from the trade-unions (even if unions are running after the movement to try to catch it and canalize it)

To understand what is at stake, we republish below an article we issued 10 years ago exactly … when we supported struggles and strikes of staff from different retirement homes. But at that time those strikes ran only localy, in isolated movements, so it didn’t last enough for a global change.

While the overall situation has not changed from what we described in our article (apart the name of the Ministers that has changed, but policy stays as ever .. ), maybe the generalized awareness of the workers in this industry will lead to a general strike (and not isolated struggles) that would achieve a balance of power sufficient ?

RETIREMENT HOMES and ELDERLY NURSING HOMES (EHPAD) : WHEN ABUSE IS INSTITUTIONAL

Up-dated version of an article written in February 2009

A permanent scandal

In 1998 over 20 years in 2019, … The well-known magazine of Consummer’s rights « 60 million of consumers » published a report on retirement homes. His title? « The scandal ». A word that has not finished coming back every time it is about the subject. And which is not there by chance!

Faced with the public’s emotion in front of this « hermetic world, where too often the only objective is the lure of gain », we have been promised, then, so many things! Not on the overall substance of retirement homes – because the leaders of our society, based on segregation, do not envisage any other way of life, more human, for the elderly. But, on their form: « We will reform and clean up retirement homes’ organization » became the public authorities’ leitmotif.

Twenty years after, all is continuing, even worst sometimes ! Meanwhile a lot of reports or books have been published, many TV shows broadcasted, a lot of trainings and round tables organized … It didn’t lack anything to denounce the situation … but with no change.

Let’s take a few examples from people who have little suspicion of anarchosyndicalist sympathies. After the huge heat wave in 2003, whose lamentable management constitutes a state crime, “Le Figaro”, a highly conservative newspaper wrote under the title « Retirement homes: the scandal continues »: « More than 4,600 of the 15,000 victims of last summer have died in these institutions that are supposed to protect them.  » As « protection », indeed, we do better … Guilty of having let die of dehydration 15 000 old people, the government renews its promises, this time with the key, a « bright » idea: the creation of a new tax for the workers, the so-called solidarity day (during this day, the workers are not paid, all their wage is going to the State to abund a special fund for elderly people), which – the government promised, swore – should definitely improved the lot of the elderly. Result: workers gave away their Pay Day, but the elderly didn’t see any result in the retirement homes …

And everything went on as before. Another example among a thousand: in 2007, the investigation broadcast “Forbidden Zone (M6)”issued a documentary: « Diverted heritage, unscrupulous retirement homes: the scandal of elderly people abused ». Summary of the this program: « Evil testimonials: Vexations, deprivations, malice … reasons of absues : the working conditions: insufficient resources, lack of control, lack of qualified personnel … in this hidden universe where the law of silence prevails … » In 2008, other TV shows with a strong audience made the same observation (« retirement homes, from scandal to hope », knowing that « the hope » appeared far away …). Those who want, in 20[1]9, to show new images are sure to matter!

The more it is changing, the more it is the same

Indeed, if the living conditions are variable from one Nursing home to another, if you « scratch » a little bit the surface, you would reveal same shameful details! It is enough to ask the families … at a distance, because of the law of silence: some homes threaten to send back any resident whose family would be too loquacious …

This is not enough to silence the witnesses, even if they are forced to witness anonymously. Here, « the cleaning of the morning do not finish until around 11 o’clock then, so we are force to have the breakfast around 11:30!!! ». There, « little things alerted me, when I came and I fed my mother she devoured as if she had eaten nothing for 15 days, then a young intern with whom I had sympathized told me, « Your mother has been sitting for a whole afternoon tied in her chair with her glass of water in front of her on the table, but as she can not drink on her own she kicked in the table to make it fall. So I gave it to her myself. « Elsewhere » My 92-year-old mother, who lives in a nine-square-meter room, never leaves her floor. She didn’t get outside since months because the lift is too small for her wheelchair. » Or also this assessment from a Physician : “drug prescriptions are far too numerous, with many sedatives and psychotropes”. A nice euphemism to say that they are stupefied with sedatives. And not to mention the soiled patients who wait for hours to be cleaned, all on the background of emotional and psychological misery.

The reason behind the abuse: greed …

The reason for this institutional abuse and mistreatment is obvious and well known, « … the only goal is the lure of profit » already said « 60 Million consumers » 20 years ago.

Hence the exorbitant price for elderly Nursing Homes. It’s easy to understand : politicians’ lack of attention to the aging of the population (a highly predictable phenomenon) has created a shortage. As a result, the occupancy rate of retirement homes has reached 98% and there are waiting lists! Hence also the reduction of « production costs » and above all, the compression of labor’s costs, and therefore a constant under-staffing and under-qualification. Not to mention the small profits that are made on absolutely everything by lowering the quality of meals, of heating, of bedding … As for outings and distractions, and even the real day-to-day functional rehabilitation, they melt like snow in the sun.

Jean Charles Escribano, author of « We finish off well our elderly » and renowed expert of the question, gave very interesting figures in an interview at « Monthly University ». He compares with the datas from the Association of Belgian nursing homes: in this country, there is on average one professional per elderly person – against one for two elderly people in France. And yet, the basic rate is for families of about 1,300 euros per month in Belgium, against more than 2,300 euros in France (sums to which should be added, in both cases, public funding to the Nursing Homes, which are equivalent in both countries). As the cost of living in Belgium and France is the same, the difference of price for Nursing homes should not be lost for everyone …

The organization of abuse

Indeed, the standard for dealing with a population of elderly people with a high proportion is bedridden should be an employee for one person (to cover the needs, day and night, year-round). By keeping their staffs half-staffed, retirement homes organize institutional abuse: the staff, despite all their goodwill, have no choice but to work quickly, very quickly. One would like to push them to make mistakes, that one would not do otherwise.

Here too, the situations are variable from one Nursing home to another, but the testimonials (often from professionals who have left the circuit, the law of silence requires) abound: Marie-Claude, nurse: « At XXX, there is only one woman to perform 15 resident’s cleaning, clean 25 rooms and serve 25 breakfasts in three and a half hours « . Mathilde, former cleaning lady: « At our Home, for the night shift, there are only two of us for 96 elderly people, many of whom are heavily dependent, sometimes in palliative care, and of course, there is not a single skilled nurse the night shift. We have to “handle things” by ourselves. When a patient dies during the night, we are forbidden to wake up the Director, as it could disturb her husband… We must do the mortuary toilet. Morally, it is hard , especially when they are people to whom we are attached. We are dying from this situation. « Jeannine: » Our job is like slaughterhouse, like in a factory. We work with a tight flow. Due to lack of time and staff, some elderly people do not have more than one shower per month. « All this leads to tragic situations such as in this retirement home in Saint-Germain-en-Laye where, under a heap of mattress and a pile of boxes was discovered the corpse of a resident … missing for a year. A house yet certified, like all the others, by the Regional Health Agency (DDPP). This does not surprise the professionals: Management always knows well in advance the dates when DDPP will perform checks, so they can « do the right thing » to clean up the mess before the inspection.

Institutional abuse: employees ARE suffeRING too

In a situation of constant understaffing, the staff are deeply mistreated and abused.

Not all though. There is a notable exception: the Nursing Home’s Directors. In our country where even dog-poo on the sidewalks are regulated, there is something that is escaping yet to any regulation : being a retirement home manager. It shows how the State is concerned by the security of the elderly … To date, in practice, anyone can run a retirement home.

In February 2007, a decree was nevertheless taken to impose a minimum of competence on the Directors, but it leaves them a period of … almost 10 years to comply with!

But such leniency does not apply to basic employees. For them (they are essentially women), working conditions are extremely hard: they have to work every day, day or night work, holidays also, … at the whim of the employer who has every facility to change the schedules. Premises are often unsuitable (hence work overload); beds and equipment just as unsuitable (hence musculotendinous diseases, sciatic …), confrontation with aging and death without support (hence depression, anxiety) … and pressure for them to make technical acts that they do not have the right to do (such as distributing drugs for service personnel), all for lousy wages : minimum hourly wage (SMIC) or barely more (often, to avoid seniority bonuses, these shock bosses manage to sack the oldest employees). Moreover these real industries with high profitability rates often impose their employees part-time, condemning them to precariousness.

There are plenty other abusive practices: unexpeted changes of schedules (which is a way used by managers to push the employees to resignation. Case of Latifa for example : ten years of seniority without any reproach, for which the schedules had suddenly become incompatible with the placing of her children in day nursery ) ; bonuses different from one employee to another with no real reason, just to apply the famous principle « Divide and control the staff » … A lot of Nursing homes seek to put the burden of institutional abuse on their employees. This guilt, with the threat of dismissal and even prosecution, is a constant sword of Damocles on their heads. Not to mention the Managements that make excessive use of « layoff » … So many ways to harass employees.

The government’s response: repression and “hot air”

The government also brandishes another sword of Damocles with cynicism : the professional malpractice. In Nice, an overworked emergency doctor works quickly (but well), has been put in custody! In Paris, a nurse who runs everywhere for lack of a sufficient number of colleagues, is mistaken about the bottle has been also kept in custody, and put on trial ! The Emergency Dispatchor In essones District didn’t find, despite 27 calls, any single room for a dying personn, the Minister of health express publicly its surprise and suggests that he is incompetent! Meanwhile, the real responsible for this worsen situation still do not feel guilty. Between overseas tanings sessions or few evenings between « famous peopoles » dining with fine food and wines, they play naive, “we didn’t know”, and continue the same policy. And hospitals or retirement homes, it’s the same. Far from recognizing its immense responsibilities, the Power wields the stick (threats and custody) and the carrot in the form of the « famous-training -which-will-finally-teach-us-soon-how to work well ». All on the background of the famous verse « We will reform and clean-up Nursing retirement homes. » But still, the Power pretends to forget the essential : it must start by doubling the number of basic staff!

Finally some fresh air : employees and families are determined to not let themselves crushed

There are still new things. The first is that everyone now knows that institutional abuse is organized to increase profitability and it is a reality. In particular, families understand that what happens to them is not an isolated case, a local malfunction, due to a « bad employee » but the consequence of a system that takes full advantage of its rapacity. The second is that the workers themselves are beginning to understand that elder abuse and staff harassment are never more than two sides of the same coin!

This is not the first time that at CNT-AIT union we are dealing with retirement homes. Each time, and this is the case this time again, it is in support of employee actions. Defending workers dismissed under the most misleading pretexts, we note that these mini-actions leave a mark. Understanding of the stakes and fighting spirit are manifested, sometimes where it was least expected. Just as it becomes clear to a growing number of employees that these “Top Managers” are ultimately only idols with feet of clay, and that it would not take too much to stop their scandalous practices: a little “hyphen” between all the concerned, workers, residents and families. A links between families and employees, carefully avoiding all « mediators » whose role is to make sure nothing will never change (« representatives » of workers, collaborative trade-unions, …). Spread the word. If we are more numerous to understand it, to say it, to do it, some managers, those for example who will feel targeted by reading the testimonies, could be forced to change practices …

 »Gérontologix »

Original article in French : MAISONS DE RETRAITE et EHPAD : QUAND LA MALTRAITANCE EST INSTITUTIONNELLE

In English : RETIREMENT HOMES and ELDERLY NURSING HOMES (EHPAD) : WHEN ABUSE IS INSTITUTIONAL

Italiano : CASE PER ANZIANI, RESIDENZE SANITARIE ASSISTENZIALI (Rsa), OSPEDALE : QUANDO IL MALTRATTAMENTO È ISTITUZIONALE

In Portuguese : CASAS DE APOSENTADORIA, CASAS DE ENFERMAGEM IDOSAS (EHPAD) E HOSPITAL : QUANDO MALTRAITÂNCIA É INSTITUCIONAL